Prevention Science最新文献

Understanding causal mechanisms for implementation strategies is a priority for implementation and health promotion research. Logic models are helpful for understanding and illustrating mechanisms through which implementation strategies operate. Little guidance exists for developing logic models for existing implementation strategies. We demonstrate how to use Implementation Mapping (IM) in a retrospective manner to develop an IMap Logic Model for a social-emotional learning program implemented at Boys & Girls Clubs of Greater Houston (BGCGH). To inform logic model development, we used qualitative interview data (from implementers) and conversations with program organizers. To develop the logic model, we specified the most accessible information, beginning with the program and health-related outcomes. We then specified the implementation strategies and implementation outcomes, followed by change methods (i.e., theoretical techniques that influence positive change in determinants), practical applications (i.e., specific techniques for operationalizing change methods), and determinants (factors that influence implementation) and other contextual factors. The effectiveness outcomes for the program were to improve emotion regulation and social skills among youth. Clinician implementers delivered the program and BGCGH club directors and staff supported delivery. The implementation strategies were (1) group leader trainings; (2) implementation guide; (3) BGCGH staff training; (4) needs assessments (via site visits); (5) follow-up meetings; and (6) pilot program check-in meetings. Collectively, the strategies used various practical applications (e.g., scenario discussions, reviewing procedures) to operationalize change methods (e.g., active learning, participatory problem solving) to address determinants (e.g., knowledge, interorganizational relationships). The strategy set out to improve implementation behaviors (e.g., delivering program components as prescribed) and implementation outcomes (e.g., fidelity). The developed IMap Logic Model can be used to inform implementation evaluation efforts by helping identify outcomes, mediators, and moderators. The logic model can also be used to identify gaps that, if addressed, can help ongoing implementation and scale-up efforts.

Decades of research have demonstrated that parenting programs are effective at changing parent behaviors and subsequently preventing myriad child outcomes including anxiety, depression, substance use, and HIV infection. However, most research into preventive parenting interventions in the United States has been conducted with English-speaking populations only. There is a clear mismatch between the linguistic diversity of the United States and the available evidence for preventive parenting programs. The current systematic review aimed to summarize the evidence on preventive parenting interventions in the United States delivered in a language other than English (LOTE). Forty-four peer-reviewed articles and three dissertations met eligibility criteria and represented evidence across thirty-five distinct studies. Most studies described how linguistic and cultural adaptations were made to deliver the program to parents who speak a LOTE. Synthesis across studies revealed that parenting interventions in a LOTE can be effective in promoting effective parenting behaviors and subsequently preventing child problem outcomes, with the caveat that almost 90% of randomized controlled trials in this area were delivered in Spanish. Recommendations are made to increase testing of preventive parenting programs in a LOTE with control samples to strengthen the current evidence base.

This commentary explores challenges and innovations in prevention science that arose during the COVID-19 pandemic, with a focus on measurement issues and the contextual influences on data collection and intervention delivery. The pandemic necessitated a rapid shift to remote data collection and virtual interventions, many of which proved effective and scalable, as demonstrated by studies in this special issue. Innovations such as remote observational assessments improved reliability, reduced costs, and increased accessibility. However, the pandemic also revealed how contextual factors influence measurement properties for key constructs, with examples from this issue showing shifts in scale dimensionality and item functioning over time. These findings underscore the importance of considering context when designing and interpreting quantitative measures. I argue that by embracing heterogeneity in exposures and outcomes, prevention researchers can improve the precision and relevance of their work.

Qualitative content analysis of an HIV testing and communication skill-building session explored the development of sexual agreements and HIV risk prevention strategies among emerging adult (18 to 24 years old) sexual minority men (SMM) to inform HIV testing services for younger SMM in relationships. In total, 29 intervention sessions were transcribed and coded for analysis. Most youth identified as cisgender male (86.2%), gay (72.4%), and as Latino/x (41.4%) or non-Hispanic White (37.9%). Results revealed that the process of forming a sexual agreement with one's main partner, as well as the composition of sexual agreements, was generally similar to those found in studies of adult SMM. HIV transmission risk reduction was not a central goal for establishing a sexual agreement for SMM emerging adults in this study; however, behavioral strategies for managing HIV risk did vary across casual partner types. SMM frequently used condoms with anonymous or new non-primary partners but relied on other HIV prevention strategies (e.g., sexual history, disclosing HIV status, pre-exposure prophylaxis) with regular non-primary partners. Sexual health service providers should assess for risk separately across non-primary partner types and collaborate with clients to discuss appropriate preventative strategies.

Youth involved in the criminal legal system (YILS) are more likely to experience significant disruptions in social determinants of health. This contributes to, and is reciprocally affected by, ongoing contact with the legal system. Using multiple methods, the current study examined the feasibility and impact of a prevention cascade model designed to universally identify and address early signals of social determinants of health needs including housing and family cohesion using a cash-plus, navigator model. The analysis included 147 youth referred to the Housing Stability for Youth in Courts (HSYNC) program from four juvenile courts in one northwestern state from 2019 through 2022. Analyses revealed youth and families receiving cash-plus were five times more likely to engage in recommended services. Engagement in services across all types of need severity (prevention and crisis) exceeded published benchmarks for other prevention and intervention engagement models. These findings suggest non-coercive services using cash-plus is a highly promising model for connecting YILS and their families to services designed to strengthen social determinants of health.

Children who engage in aggressive behaviors are at heightened risk of being involved in the justice system, committing serious offenses, and becoming chronic offenders. The Stop Now And Plan (SNAP) program was designed as an early intervention to address several mechanisms underlying the development of conduct problems, including emotion regulation, prosocial behaviors, and parent-child relationships. The purpose of this study was to systematically review and synthesize current research on the SNAP program and conduct a meta-analysis. Following PRISMA guidelines, PubMed and PyscINFO were searched, and the developers of SNAP were contacted to ensure no articles were missed. Twenty-two peer-reviewed articles were ultimately included following a two-stage screening process. The meta-analysis revealed a moderate effect size change (SMD =  - 0.54, 95% CI [- .42, - .65], p < .001) in externalizing problems from pre- to post-SNAP Group. The narrative review found evidence for decreases in symptoms (e.g., conduct problems, aggression, delinquency, internalizing problems) across SNAP programming. There was also preliminary evidence for changes in proposed mechanisms across the groups (e.g., emotion regulation, parent behaviors, child-parent relationship). Two randomized controlled trials (RCT) supported the efficacy of the SNAP Boys Group over another active treatment. One waitlist control found similar results for the SNAP Girls Group. There is growing evidence for SNAP, attributable to the effective clinical research partnerships established by the developers. More rigorous methods and RCTs will help solidify SNAP as a top evidence-based intervention.

Many randomized controlled trials have investigated the role of school-based prevention interventions to reduce symptoms of anxiety and depression in young people. Systematic reviews have subsequently demonstrated a small, beneficial effect of these interventions when compared to a combined control group including usual care, no intervention, or waiting list controls. However, evidence from behavioral science and clinical psychology suggests control group choice may influence the relative effectiveness of non-pharmacological interventions. Here we explored whether separating this combined control group into distinct categories might influence the apparent effectiveness of preventive interventions. After updating an earlier review and network meta-analysis of preventive interventions for anxiety and depression in young people, we considered the impact of alternative control groups on estimates of effectiveness. This analysis was restricted to comparisons with cognitive-behavioral interventions only-the most common intervention used in the included studies. In targeted populations, for both anxiety and depression outcomes, the effect of a cognitive-behavioral intervention was larger when compared to waiting list controls than to usual curriculum, no intervention, or attention controls. For anxiety, the effect of no intervention was also considerably larger than waiting list control (standardized mean difference -0.37 [95% credible interval - 0.66, - 0.11], favoring no intervention). These results suggest that the beneficial effect of preventive school-based interventions previously observed in standard meta-analyses may be an artifact of combining control groups. Although exploratory, these findings indicate the impact of different control groups may vary considerably and should be taken into account when interpreting the effectiveness of interventions.

Mental health and alcohol problems are significant public health concerns amid the COVID-19 pandemic. Housing instability and symptoms of fatigue are understudied aspects of the pandemic. This study examined history of Alcohol Use Disorder (AUD), history of COVID-19 infection, and housing instability as correlates of fatigue, anxiety, and depression symptoms. Data were drawn from 250 adults enrolled in an online survey within the NIAAA COVID-19 Pandemic Impact on Alcohol Study in between April 6 and June 2 of 2022. Participants completed self-report measures of housing stability, fatigue, and mental health symptoms. Multivariable analyses controlling for age, sex, race, ethnicity, and household income were conducted. Individuals with a history of AUD reported higher mental fatigue, anxiety symptoms, and depressive symptoms when compared to those with no history of AUD. Individuals with "other" housing arrangements (not renting or owning) reported higher mental fatigue, pandemic fatigue, anxiety symptoms, and depressive symptoms relative to homeowners. Individuals who worried about not having a place to live in the past 6 months reported higher physical fatigue, mental fatigue, anxiety symptoms, and depressive symptoms when compared to individuals without housing worry. History of COVID-19 infection was neither associated with mental health nor fatigue symptoms. Housing instability, as captured by housing worry and having "other" housing arrangements, was associated with greater fatigue and mental health problems, even after controlling for household income. Housing instability uniquely contributed to mental health symptoms, warranting further research and targeted prevention and intervention efforts.

Rates of suicidal thoughts and behaviors (STB, i.e., suicidal thoughts, plans, and attempts), substance use, and bullying victimization are higher among lesbian, gay, bisexual, transgender, and/or queer (LGBTQ +) youth compared to their heterosexual peers. However, research examining the interactive and potentially compounding associations of concurrent bullying and substance use (alcohol, cannabis, hallucinogens, and opioids) with STB is sparse, especially among LGBTQ + youth. Thus, the current study aims to understand how these substances moderate the association between bullying victimization and STB by utilizing data (N = 96,482) from the combined 2003-2019 Youth Risk Behavior Survey (YRBS). Using a cross-sectional design and hierarchical logistic regression, we found that, on average, LGBTQ + youth who were bullied were more likely to report planning to attempt suicide (O.R. = 2.71, p < .01). Similarly, youth who reported using opioids/prescription drugs (O.R. = 4.60, p < .05) or hallucinogens (O.R. = 8.89, p < .01) were more likely to attempt suicide. No significant associations between alcohol use and STB were found. Lastly, cannabis emerged as a significant moderator of the associations between bullying victimization and suicidal ideation and plans, such that adolescents who were bullied and used cannabis were less likely to report suicidal ideation and planning compared to those who were bullied but did not use cannabis. These findings highlight that different substances are distinctively associated with STB among LGBTQ + youth, providing a better understanding of how individuals who are being bullied may cope and to develop prevention programs to combat suicidal thoughts, planning, and attempts.

Drug use trends change rapidly among youth, leaving educators and researchers struggling to respond promptly. Widely adopted universal evidence-based interventions (EBIs), such as the Michigan Model for Health™ (MMH), and their delivery systems offer an opportunity to reach large youth populations and reduce the onset and escalation of emerging drug use trends. Tier 1 EBIs do not always reflect the most current needs of the context and population. Implementation strategies are needed to optimize EBIs and system responsiveness to emerging drugs. This study employs after action review (AAR) to examine past responses to emerging drugs and design implementation strategies for rapid responses. AAR centers on four key questions: (1) What was expected to happen? (2) What happened? (3) What went well? and (4) What can be improved? We collected qualitative data from 35 participants, including state education partners, school administrators, counselors, teachers, prevention specialists, and the state's health coordinator network. We used rapid qualitative and iterative inductive-deductive thematic analytic approaches. Data analysis revealed three central tenets for rapid responses: collaboration, readiness, and planning. We then identified implementation strategy core functions aligned with the central tenets and strategy form options (e.g., build/leverage a coalition) for each function to accommodate school-level heterogeneity. We created a systematic process to develop and deploy an implementation blueprint for building prevention infrastructure to enhance rapid responses for emerging drugs leveraging an existing intervention (MMH) and delivery system. AAR is a promising approach to identifying gaps and best practices in school-based responses to urgent drug crises. Our results indicate that while the core implementation strategy functions are constant, health coordinators benefit from strategy options tailored to their context. Trial registration: NCT05806840, https://classic.clinicaltrials.gov/ct2/show/NCT05806840 .