PREVENTION RESEARCH 2001

PREVENTION RESEARCH BRANCH The Staff: Liz Robertson, Ph.D., Chief Liz Robertson, Ph.D., Chief Susan David, M.P.H., Deputy Chief Susan David, M.P.H., Deputy Chief Kathy Etz, Ph.D. Kathy Etz, Ph.D. Eve Reider, Ph.D. Eve Reider, Ph.D. Larry Seitz, Ph.D. Larry Seitz, Ph.D. Liz Cooper, Branch Secretary Liz Cooper, Branch Secretary

RESEARCH OBJECTIVES  Prevent initiation of drug use;  Prevent the progression of drug use among those who use;  Prevent drug-related HIV infection.

 Support Extramural Research  Efficacy Studies  Effectiveness Trials  Services Research  Methodology Studies

PREVENTION SCIENCE  Epidemiology  Origins and pathways to drug abuse  Theories  Research evidence that prevention programs do work

WHERE WE ARE  20 years of research found:  Modifiable risk & protective factors  Points of vulnerability  Some basic prevention principles

RESEARCH EXPANSION 1996 to 2000 GRANTS BY COMPONENTS Components % Change to Multi-component180% Family200% School100% Work100% Clinic600% Media1000%

GRANTS BY TYPE Components % Change to Centers-50% Training200% Methodology-33% Services160% Etiology-300% Epidemiology-100% RESEARCH EXPANSION 1996 to 2000

LEVELS OF RISK  Universal – all persons in a particular group  Selective – groups at high risk  Indicated – individuals at high risk

RESEARCH EXPANSION 1996 to 2001 GRANTS BY Level of Risk Components Change from Universal113% Selective375% Indicated225% Tiered100% Special populations 58% Gender specific 200%

RESEARCH EXPANSION 1996 to 2000 SBIR PROGRAM FYGRANTSCONTRACTSTOTAL

THUS, CURRENT FOCI…..  Broadening the components of intervention  More multi-component programs  More selective and indicated level programs

THUS, CURRENT FOCI…..  Early childhood through adulthood  More independent replications  More meta-analyses

THE BOTTOM LINE…  In five years, a 100% increase in grants

SNAPSHOTS OF SELECTED FINDINGS

FINDINGS ON PROGRAM COMPONENTS  Parents who smoke can lower the risk of smoking among their children by engaging in anti- smoking socialization (Jackson, et al., 1997).

FINDINGS ON PROGRAM COMPONENTS  Intervening as early as grade one to decrease aggression and increase academic success substantially reduces subsequent substance abuse, depression and anti-social behavior (Ialongo, et al., 1999).

FINDINGS ON AUDIENCE  Gender significantly affects drug offers and types of offers (Moon, et al., 2000).

FINDINGS ON AUDIENCE  Programs adapted to address the needs of specific ethnic audiences have greater effects in reducing substance use than universal non- adapted programs (Botvin, et al.,1997).

FINDINGS ON PROGRAM IMPLEMENTATION  Providing accommodations to families helps to attract and retain them in preventive interventions (Spoth, et al., 1999).

FINDINGS ON PROGRAM IMPLEMENTATION  Grouping anti-social youth in interventions can lead to unintended negative effects such as increases in substance use and violence (Dishion et al., 1999).

ROLE OF MODIFIERS MODERATORS MODIFIABLE RISKS INTERVENTION

EARLY CHILDHOOD MODIFIABLE RISKS INTERVENTION Inability to share Inappropriate parental expectations Inconsistent discipline Child social practice Early education Parent skill training

ELEMENTARY SCHOOL AGE MODIFIABLE RISKS INTERVENTION School transition Teacher rules & expectations Lack of parental involvement Organized classroom Consistently applied rules Parent/teacher communication

MIDDLE SCHOOL AGE MODIFIABLE RISKS INTERVENTION Shy/aggressive behavior Schoolfailure Problem behavior Poor parental monitoring Social competence Academic skills Prosocial opportunities Parent skills

ADOLESCENCE MODIFIABLE RISKS INTERVENTION Anti-social peer Lack of school commitment Family conflict Social & academic skills Refusal skills Parent training Family therapy

NEW DIRECTIONS CROSSING THE GREAT DIVIDE

SELECTIVE AND INDICATED POPULATIONS  Clinical populations  Externalizing disorders  Internalizing disorders  Multi-risk children and families

HIV PREVENTION  Primary prevention  Selective populations  Indicated populations

BASIC PREVENTION  Next generation of research:  What works  For whom and  Under what conditions

PREVENTION SERVICES  Existing systems for prevention  Funding sources  Program selection  Cost-benefits/effectiveness  Service availability, access, and delivery

Prevention! Go Prevention! GO PREVENTION! Go Go Prevention! Go Prevention Go Prevention! Go Prevention Go Prevention!