1. Prevention & Promotion
What does this mean?
“An ounce of prevention is worth a pound of cure.”
Chapter 9
Fall 2010

2. Prevention: It’s Everywhere
Fluoride in Water
Seat Belts
Condoms
Hand Washing
Self-exams (breast & testicular cancer)
Fall 2010

3. Key Concepts Prevention – Promotion – Fall 2010
- Distinction in field of preventing something negative vs. promoting something positive
PREVENTION IS A COMMON SENSE CONCEPT THAT DERIVES FROM THE LATIN WORDS MEANING "TO ANTICIPATE" OR "BEFORE SOMETHING TO COME". THE LANGUAGE OF PREVENTION IS PERVASIVE IN THE CULTURE--PARENTS TRYING TO PREVENT CHILDREN FROM GETTING IN TROUBLE, POLICE PREVENTING CRIMES, LEGISLATION PREVENTING VIOLATION OF RIGHTS.
PREVENTION IN COMMUNITY PSYCHOLOGY FOCUSES ON TWO MAIN AGENDA: PREVENTING SOMETHING BAD FROM HAPPENING (DEVELOPING A PSYCHIATRIC CONDITION SUCH AS DEPRESSION, SCHOOL PHOBIA, OR ANTISOCIAL PERSONALITY. PROMOTING SOMETHING GOOD WHICH WILL SERVE AS A PROTECTIVE FACTOR AGAINST DEVELOPING SOMETHING BAD OR SOMETHING VALUABLE BECAUSE OF ITS GENERALLY POSITIVE IMPORTANCE FOR THE INDIVIDUAL: SOCIAL SKILLS, FOR EXAMPLE, DO NOT PREVENT SOMETHING SPECIFIC BUT MAY COME IN HANDY IN A VARIETY OF POTENTIALLY STRESSFUL SITUATIONS, SUCH AS DEALING WITH INTERPERSONAL CONFLICT, DISCUSSING PARENTAL DEMANDS WHICH DIFFER FROM YOUR HOPES, AND NEGOTIATING SAFE SEX WITH A PARTNER.
Fall 2010

4. Practice Problem: Smoking Develop an example of prevention program
Develop an example of promotion program
Fall 2010

5. 3 Models of Prevention/Promotion
Bower’s Model of Competence Development
Kiss
Aid
Ice
Kaplan’s Prevention Model
Primary
Secondary
Tertiary
Institute of Medicine Methods of Prevention
Universal
Selective
Indicative
Fall 2010

6. Model for Competence Development (Eli Bower)
3 types of settings where all societies prepare young for adult life:
Key-Integrated Social Systems (KISS)
Ailing-in-difficulty institutions (AID)
Illness correctional endeavors (ICE)
Fall 2010

7. (1) KISS: Key Integrated Social Systems
Formal & informal settings where individual interacts from conception through childhood
Primary KISS Systems: Health care, family, school, peers, & religion are key systems
Secondary KISS Systems: workplace, leisure/recreational systems, community organizations, internet
Fall 2010

8. (2) AID: Ailing-in-Difficulty Institutions
Institutions that come into play if KISS is not loving enough
Mental health clinics
Local police
Hospital emergency rooms
These institutions are 1st responders
Fall 2010

9. (3) ICE: Illness Correctional Endeavors
Facilities where people go when AID is not enough
Fall 2010

10. Bower’s Quote
“With a good loving KISS early in life, people will need less AID & fewer will have to be treated with ICE.”
Fall 2010

11. Bower’s Approach: Summary
An ecological perspective on prevention
How institutions can play a role in furthering individual development (from socialization to rehabilitation)
Provides framework for prevention interventions by specifying different key arenas
Fall 2010

12. 3 Models of Prevention/Promotion
Bower’s Model of Competence Development
Kiss
Aid
Ice
Kaplan’s Prevention Model
Primary
Secondary
Tertiary
Institute of Medicine Methods of Prevention
Universal
Selective
Indicative
Fall 2010

13. (2) Caplan’s Prevention Model
Three Levels of Prevention
Primary
Secondary
Tertiary
Fall 2010

14. (1) Primary Prevention
An intervention given to an entire population when they are not in a condition of known need or distress
Goal is to lower new occurrences of a disorder
DARE
Baby Inoculations
Fall 2010

15. (2) Secondary Prevention
Early Intervention – Programs targeted to individuals considered “at risk” for development of bad outcomes
Head Start
Risk Factor Assessment
Fall 2010

16. (3) Tertiary Prevention
Intervention given to people who already have a disorder with intention of limiting the disability caused by disorder
Reducing its intensity & duration, thereby preventing future re-occurrence
E.g., Neighborhood attitudes toward mentally ill
Fall 2010

17. 3 Models of Prevention/Promotion
Bower’s Model of Competence Development
Kiss
Aid
Ice
Kaplan’s Prevention Model
Primary
Secondary
Tertiary
Institute of Medicine Methods of Prevention
Universal
Selective
Indicative
Fall 2010

18. (3) IOM Methods of Prevention
Emphasis on prevention of illness, not promotion of health
Universal (primary)
Selective (people with above average risk for disorder)
Indicated (people with high risk for disorder)
Fall 2010

19. Best Practice Principles of Effective Prevention/ Promotion Programs for Children & Youth
Address risk & protective processes identified in research
Involve families, peers, schools, & communities to address multiple, related goals
Are sensitive to cultural traditions
Strengthen social-emotional skills & ethical values & foster applications to everyday life
Fall 2010

20. Best Practice Principles of Effective Prevention/ Promotion Programs for Children & Youth
Use teaching-learning approaches that involve participants actively at multiple points in their development
Focus on second-order change
Involve skills training & support for staff to foster high-quality implementation of programs
Monitor local needs & program quality to promote continuous improvement
Fall 2010

21. Prevention & Promotion: Implementing Programs
Chapter 11
Fall 2010

22. Implementation: The Efficacy Effectiveness Dilemma
What happens to programs conducted under optimal conditions
High resources
Highly selected & trained personnel
Conducted in non-random settings
High control over what happens
Incentives for participants
What happens when these programs confront the real world?
What happens when these programs conf
Fall 2010

23. Have prevention/promotion programs been widely adopted?No
School Intervention Implementation Study (SSIS; Maurice Elias)
550 school districts in New Jersey mandated to develop prevention programming related to substance abuse & social competence promotion
65% response rate
Fall 2010

24. SSIS Results Most schools were doing “something”
Implementation was sporadic
Programs used not necessarily those supported by empirical evidence
1/3 of the districts had no programming at all in at least 4 grades
Even well-resourced districts had as many schools that failed to successfully implement
Fall 2010

25. Why? Bad Directions? Didn’t think it would work?
Tired of being told to do new programs each year?
Too expensive/complicated to do it?
Inadequate training?
Lots of possibilities for things to go wrong
Fall 2010

26. Sustainability
Capacity of project to continue to deliver its intended benefits over time
Program continuity
Program effects
Sustaining Skills
Sustaining Effects
Fall 2010

27. Program-School Fit/Match Factors
Factors for initial engagement
Relevance to local needs: If a program offers solutions to meet a school’s specific needs, it is likely to be perceived as attractive and likely to be engaged for a try out at least (foot in door)
Fit with school practices: If a program embodies principles and approaches already extant in a school, the school will find the program attractive, as it is likely to be compatible with current thinking and initiatives.
Fall 2010