The Journal of Primary Prevention最新文献

In recent decades, prevention policies--i.e., insurance policies constructed to give incentives to investments in prevention and thereby reduce reliance on insurance--have been much discussed both with regard to different kinds of market insurance and, albeit primarily within a European context and in relation to an ongoing discussion about the need for a shift towards an "active" welfare state, with regard to social insurance. The present contribution identifies normative issues that deserve attention in relation to a general introduction of prevention policies in market insurance and social insurance. It is argued that the importance of these normative issues suggests that arguments and distinctions drawn from moral and political philosophy should play a more prominent role both in the debate on the shift towards an active welfare state and the use of prevention policies in market insurance.

OptimaHl 60plus was a prevention study that included the participatory development and evaluation of an interdisciplinary counseling aid and aimed to improve the nutrition and physical activity behavior of people 60 years and older. The direct involvement of this vulnerable group in prevention programs might contribute to a reduction of inequities in health. This article describes the recruitment of the elderly, especially those with low socioeconomic or migration status, to the OptimaH1 60plus study. It presents successful strategies to reach and recruit the elderly. Community partner involvement, focus groups, translated intervention material, and involving the media all facilitated recruitment. The article gives recommendations for research, practice, and policy implications.

This paper describes and compares a selection of available modeling techniques for identifying homogeneous population subgroups in the interest of informing targeted substance use intervention. We present a nontechnical review of the common and unique features of three methods: (a) trajectory analysis, (b) functional hierarchical linear modeling (FHLM), and (c) decision tree methods. Differences among the techniques are described, including required data features, strengths and limitations in terms of the flexibility with which outcomes and predictors can be modeled, and the potential of each technique for helping to inform the selection of targets and timing of substance intervention programs.

The purpose of this study was to determine whether children who participated in a booster program 3 years after completing an emotion regulation program show a greater increase between pretest and post-test in the development of emotion regulation skills than children in a comparison group. A booster program was implemented as a pilot project with seven children ages 12-14. The contrast group consisted of eight children ages 10-14. Results of the study showed that the booster group had significant increases on 4 of 10 outcome measures: emotional awareness, emotional expressiveness, number of identified body cues, and number of identified calming activities. The contrast group showed no significant pretest post-test changes on the outcomes measured. EDITORS' STRATEGIC IMPLICATIONS: Replication will be required with a larger sample size, but the emotion regulation results presented are encouraging. Program developers and evaluators will benefit from the authors' discussion of the importance and role of booster programs.

It is becoming increasingly common for community teams or coalitions to implement programming for children and families designed to promote positive youth development and prevent adolescent problem behaviors. However, there has been only limited rigorous study of the effectiveness of community teams' programming efforts to produce positive outcomes. This study employed a community-level randomized control design to examine protective parent and youth skills outcomes of evidence-based preventive interventions selected from a menu and delivered by community teams supported by a community-university partnership model called PROSPER. Twenty-eight rural communities in two states were randomized across intervention and control conditions. Data were collected through written questionnaires that were completed by approximately 12,000 middle school students in the fall of the 6th grade, prior to intervention delivery, and again in the spring of the 7th, 8th, and 9th grades. Positive intervention effects were found for youth, parent, and family outcomes (e.g., association with antisocial peers, child management, parent-child affective quality) at each post-intervention assessment point. Improvements in these family and youth skill outcomes are expected to support long-term reductions of adolescent problem behaviors, such as substance abuse. EDITORS' STRATEGIC IMPLICATIONS: In this important and well controlled trial, the authors demonstrate that university partnership-supported community teams, especially when supported with ongoing technical assistance, can continue to produce positive outcomes even after much of the control over delivery of programs is turned over to representatives of the communities in which they are implemented.

Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16 years old who were living in affordable housing communities participated in this randomized wait-list control study. Results showed considerable improvements in computer self-efficacy, decreases in internalizing behavior problems, and excellent attendance and consumer satisfaction. Self-esteem and school motivation results were mixed. Computer self-efficacy mediated the relationship between improved computer skills and self-esteem. Younger adolescents showed greater improvement than did older adolescents. EDITORS' STRATEGIC IMPLICATIONS: Although there are limitations to this study's sample size and scope, Computeen appears promising as a developmentally appropriate, strengths-based prevention program.

The purpose of this study was to evaluate a questionnaire assessment of the perceived stigma of problem drinking that was designed for use in workplace substance abuse prevention research. Municipal employees from a mid-sized city (n = 315) and a large-sized city (n = 535) completed questionnaire measures of perceived coworker stigmatization of problem drinking, drinking levels, substance-use policy attitudes, workgroup stress and interdependence, alcohol-tolerance norms, and demographic variables. Inter-item correlation coefficients showed that the measure of the stigma of problem drinking had good internal consistency reliability (.76) in both samples. Hierarchical regression analyses showed that higher education, abstinence from alcohol, stress, and perceived temperance norms were all uniquely correlated with perceived stigma. Women and men perceived the same level of stigma from coworkers. Editors' Strategic Implications: This brief, validated measure provides organizations with a way to assess the level of stigma attached to alcohol abuse in their workplace culture, thereby enabling the organization to target and promote effective strategies to decrease the stigma attached to seeking help with the goal of reducing alcohol abuse.

The authors evaluate the effectiveness of the small media campaign in raising community awareness about the importance of going for a health check up. Data were collected over time from 535 respondents ages 15-30 years using cross-sectional surveys in two low-income, predominantly African-American communities in New York city. Regression analyses indicated campaign material recognition at 15 months was significantly higher in the intervention community relative to the comparison community. There were no significant changes in social norms, attitudes, or beliefs. Media campaigns aimed at adolescents and young adults on a community-wide level are an effective means of gaining material recognition. Editors' Strategic Implications: This research illustrates the effect of a public health media campaign on awareness, but it also serves as a reminder to public health officials that awareness is not necessarily sufficient to promote attitudinal or behavioral health changes.

It is well known that the current combination of aging populations and advances in health technology is resulting in burgeoning health costs in developed countries. Prevention is a potentially important way of containing health costs. In an environment of intense cost pressures, coupled with developments in disease prevention and health promotion, it is increasingly important for decision-makers to have a systematic, coordinated approach to the targeting and prioritization of preventive strategies. However, such a systematic approach is made difficult by the fact that preventive strategies need to be compared over the long term, in a variety of populations, and in real life settings not found in most trials. Information from epidemiological models can provide the required evidence base. In this review, we outline the role of epidemiological modeling in this context and detail its application using examples. Editors' Strategic Implications: Policymakers and researchers will benefit from this description of the utility of epidemiological modeling as a means of generating translational evidence that helps to prioritize data-based prevention approaches and bridge the gap between clinical research and public health practice.