[Early preventive services in Germany-perspectives for future development].

Abstract

The future development of early preventive services and intervention depends on structural anchoring, the resources of the professionals working in the field, and utilization and acceptance by the target population. In order to understand the dynamics of the development, this discussion contribution first presents the contemporary historical origins of early intervention in Germany since the beginning of the 20th century. Further sections bring together the bodies of knowledge from various relevant sciences, in particular neuroscientific findings on the early childhood development of the brain, attachment theory, results of family and prevention research, trauma studies, and health economic models on the benefits of social interventions. From this, requirements for the further growth of the early intervention system are derived. These can be conceptually classified as a "Health in all Policies" strategy (with a particular focus on combating child poverty) combined with interprofessional learning and collaboration, inclusive access for all children, and diversity-friendliness as characteristics of good process quality. To further develop and expand early interventions, proof of benefits must be carefully planned and implemented through long-term, interdisciplinary research programs in the aforementioned fields of knowledge through independent research funding. The complex methods for evaluating complex interventions at the individual level, subgroups, and the entire population, including health economic effects and participatory and qualitative empirical research, are partly available and should be further developed.