Prevention Science最新文献

Partisan affiliations and other demographic characteristics inadequately explain support for gun policy and provide vague public health messaging guidance. Gun-related beliefs may be more malleable and meaningful determinants of policy support for gun violence prevention. Using a nationally representative, community-engaged, mixed methods design, we examined predictive associations between gun-related beliefs and public support for six gun policies (i.e., universal background checks, waiting periods, minimum purchasing age, violent offender prohibitions, concealed carry permits, and extreme risk protection orders (ERPOs)). Gun-related beliefs were more strongly associated with policy support than political affiliation. Strength of agreement with "no one should own AR-15 style semiautomatic rifles" was positively associated with support for all six policies. Beliefs about gun policies as violence prevention were also highly salient, predicting support for five policies, with disagreement or agreement both predicting higher probability of support for universal background checks, violent offender prohibitions, and ERPOs than neutral beliefs. Beliefs that "guns are tools" were generally unassociated with policy views. Findings suggest potential for gun violence prevention messages that combine values-based language with salient themes to build support for preventive policies across political and demographic lines.

Vaccination played a critical role in controlling the 2022 mpox outbreak in the United States, yet only a quarter of eligible individuals are estimated to be fully vaccinated. Using mixed methods, we analyzed cross-sectional data collected from 60 sexual and gender minority people with and without HIV (PWH and PWOH) in August 2022. We investigated willingness to receive an mpox vaccine and to participate in mpox vaccine research, as well as actual vaccine uptake and experiences, and compared results by HIV status. Two-thirds of participants (66.7%) had received at least one dose of the mpox vaccine, including 61.5% of PWH and 70.6% of PWOH. PWH and PWOH had similarly high levels of willingness to receive an mpox vaccine. In open-ended responses, participants described personal and societal benefits of vaccination and had positive attitudes towards vaccines. Despite high vaccine acceptance and uptake, satisfaction with the vaccine rollout was low. A majority of unvaccinated participants who had tried to get the vaccine reported that they were unable to access it. Willingness to participate in mpox vaccine research was lower than willingness to receive a vaccine, though still moderately high. Some participants expressed uncertainty about research participation, concerns about safety, and negative attitudes toward research in general. PWH were more willing to participate in an mpox vaccine trial than were PWOH; however, this difference was not statistically significant. These results can inform future mpox research, vaccine rollout, and community engagement for vaccine trial recruitment.

It has been demonstrated in multiple randomized trials that the PAX Good Behavior Game is an effective school-based program for reducing the severity and progression of childhood emotional and behavioral problems that are prognostic of mental disorders, personality disorders, and self-harm behavior in adolescence and early adulthood. Embedding effective programs into routine practices of frontline settings is a global priority for mental health prevention, however, little is known about what strategies effectively support program implementation in schools. The purpose of this study was to test the effect of a multicomponent implementation strategy on the adoption and efficacy of the PAX Good Behavior Game, using a cluster randomized controlled trial with a type-3 implementation-effectiveness design. The trial was conducted in 25 primary schools across New South Wales, Australia. Schools were randomly assigned to receive the PAX Good Behavior Game plus an implementation toolkit to support adoption (intervention group) or the PAX Good Behavior Game only (control group). The primary outcome was change in rate of program adoption, measured as current use or support of the PAX Good Behavior Game, first measured at 6 weeks post-registration (T0). The secondary effectiveness measure was change in students' emotional and behavioral problems, using the teacher-reported Strengths and Difficulties Questionnaire (SDQ). The first measure of the SDQ occurred at trial registration, prior to program implementation (T0). Both adoption and effectiveness were re-measured at 6 months post-registration (T1). All data were analyzed using intention-to-treat methods. Early program adoption was higher in the intervention group compared to control group (93.6% vs 45.2%: OR = 21.20, 95% CI [3.50, 128.45], z = 3.32, p < 0.001), with no differential effects at 6 months (96.8% vs 95.7%: OR = 1.21, 95% CI [0.16, 9.04], z = 0.18, p = 0.855). Emotional and behavioral problems reduced in both groups from baseline to 6 months (p < 0.001, d = - 0.25), with no differential effects observed at T1 (p = 0.474, d = - 0.08). There was a positive linear relationship between adoption and the perceived acceptability, appropriateness, and feasibility of the program for the pooled sample. It seems that providing implementation support early in the process of establishing new innovations in schools may help accelerate early adoption by increasing perceived appropriateness and acceptability, but uncertainty remains as to what support is needed to optimize implementation and effectiveness longer term. The protocol was retrospectively registered with the Australian New Zealand Clinical Trials Registry, ACTRN12621001125819.

Youth mentoring programs are an increasingly popular intervention and prevention strategy to promote positive youth development and to address a range of youth needs. Past research shows positive, albeit moderate, effects of mentoring across multiple domains, but there is evidence that suggests heterogeneity in treatment outcomes. Several studies have examined the role of risk factors in mentoring outcomes, but less is known about the role of protective factors. This study examines the extent to which ecological factors outside of the mentoring relationship, specifically, youth risk factors and existing social support, play a role in the effectiveness of mentoring in promoting adaptive coping outcomes, as measured by academic achievement, self-efficacy, and expectations. Using a person-centered approach, we examined (1) whether there were distinct profiles of youth participating in mentoring using mentee risk factors and existing social support as indicators; (2) associations between profiles and youth race/ethnicity and gender; and (3) whether profiles differed in post-program adaptive coping outcomes. Two classes of youth were identified. One class reported higher risk factor presence and higher social support and was more likely to be youth of color. The second class reported lower risk factor presence and lower social support. Classes did not differ in their adaptive coping outcomes. The implications of these findings for mentoring programs and further research are discussed.

Early childhood services can lay a critical foundation for refugee and immigrant children as they develop in new cultural contexts; however, these populations are underrepresented in a variety of early childhood programs such as early care and education, home visiting, and early intervention. This scoping review examines the strategies being implemented to increase newcomer families' participation in services and parent preferences for early childhood services. A systematic search yielded 38 studies, 22 of which included strategies to increase access for newcomer families and 20 of which explored parent preferences around early childhood education. Identified strategies to promote access were categorized as program responsiveness (67%), outreach (57%), workforce responsiveness (57%), service delivery (52%), added supports (52%), social networks (43%), partnerships (43%), program policies (43%), or state and national policies (29%). Parents' preferences for care were related to child academic and social-emotional development (80%), perceived quality (65%), type of care (65%), cultural responsivity and match (60%), and language (50%). Most studies focused on access or preferences related to early childhood programs or child care and early education broadly (89%), while fewer focused on strategies to increase access to home visiting or early intervention (11%). Additional research is needed to identify the strategies being utilized to promote access to home visiting and early intervention and to empirically test the relationship between identified strategies and improved access to these services.

Studies of program components (i.e., the ingredients that make up programs) have risen from obscurity to join mainstream program evaluation approaches over the last two decades. Researchers and policymakers are interested in leveraging information about the effectiveness of program components to better address the needs of programs' intended populations and reduce disparities in outcomes. Identifying which components are responsible for improving outcomes can inform evaluation design, measurement, and the state of the evidence as well as program development, adaptation, fidelity, and scale-up. This paper summarizes strategies for conducting components research, and anchors those emerging best practices in a components case study of a teen pregnancy prevention program. It offers applied guidance on ways to define and operationalize components, and best practices in measurement and analysis that have emerged from this work. This paper will help guide the prevention field toward conducting more and better research that yields consensus about which components are most important for program effectiveness.

Black young people are at high risk for firearm homicide in the USA. A promising intervention for mitigating firearm-related injuries and deaths is mentoring provided by individuals with specific lived experiences with firearm violence and trauma (e.g., credible messengers, violence interrupters) in community violence intervention (CVI) programs. The purpose of this study was to identify the factors through which mentoring interventions in CVI programs could cultivate protective factors (e.g., social support) that prevent interpersonal firearm violence. Semi-structured interviews were conducted with 20 mentors and program administrators in CVI programs in Washington State to examine their insights on the components of mentoring interventions that could work towards preventing firearm violence. A framework was developed through the use of a constructivist grounded theory methodology to capture the components within mentoring interventions in CVI programs aiming to prevent firearm violence among marginalized young people in communities disproportionately impacted by community firearm violence. Implications for both mentoring and CVI research are outlined in the manuscript.

Artificial intelligence and machine learning (AI/ML) in prevention science may improve or perpetuate health inequities. Community engagement is one proposed strategy thought to empirically mitigate bias in AI/ML tools. We outline how to incorporate community engagement at every stage of the model development and implementation. Borrowing from a framework for phases of prevention research, we describe the value and application of engaging communities to help shape more rigorous and relevant applications of AI/ML for prevention science. We provide concrete examples from real-world applications, including efforts in suicide prevention with Indigenous communities, on chronic disease prevention for Hispanic and Latino populations, and a community-driven effort to leverage AI/ML to improve allocation of resources focused on social determinants of health for Native Hawaiians. This work aims to provide applied examples of how community-engagement has been incorporated into AI/ML development and implementation, with the goal of encouraging those in the prevention science field to consider the voices of the community as the use of such tools grows. Engaging with the community around AI/ML is critical to ensure these tools reach populations in need and advance health equity for all.

Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention tool for HIV yet remains underutilized among key populations, particularly among young sexual and gender minorities (SGM). Recognizing the popularity of specific dating and social media apps among SGM young adults, we leveraged user data from these platforms to build a machine learning (ML) model that could inform targeted, data-driven interventions aimed at improving PrEP uptake and adherence. We adapted eWellness, an Android mobile app, to passively collect data from research participants capturing mobile app usage, keystroke patterns and logs, and GPS location data between 2021 and 2024. These data were used to train a ML model to predict self-reported PrEP use. Model accuracy was evaluated through F1 scores across different data types and feature combinations. Study protocols were developed in collaboration with community partners and adhered to strict ethical and privacy standards. A total of 82 SGM young adults participated, with 46 (56%) reporting PrEP use at baseline. Our machine learning model demonstrated good predictive accuracy for predicting PrEP use and non-use, achieving an F1 score of 0.84 (PrEP use) and 0.82 (non-use) outcomes when incorporating data from all mobile apps, including messaging, dating, and social media mobile apps. By contrast, predictions based solely on social media mobile app usage, language associated with sexual behavior and substance use risk, or location monitoring demonstrated worse accuracy (F1 scores of 0.79/0.75, 0.70/0.57, and 0.70/0.52, respectively). Additional feature extraction methods, as well as various combinations of these features, were also tested. However, none achieved predictive accuracy as well as the model incorporating all mobile app usage data combined. This study demonstrates the potential of machine learning to accurately predict PrEP use status among SGM young adults. The findings offer a foundation for developing more personalized PrEP promotion strategies, particularly among SGM young adults who use social media and dating apps. Future research should assess the model's adaptability across diverse SGM subgroups to further inform intervention development. Registry: ClinicalTrials.gov, ID: NCT04710901, November 9, 2020.

Pediatric firearm injuries represent a leading cause of morbidity and mortality in the USA, yet clinical care models for youth with firearm injuries remain fragmented and unstandardized. Unlike other serious pediatric conditions such as asthma and cancer, which benefit from established interdisciplinary care pathways, firearm injuries are often treated as isolated events without structured follow-up or coordinated support systems. This absence of standardized clinical guidelines reflects broader systemic biases in how these injuries are perceived and managed within health care. Drawing on the Injury Equity Framework and established chronic disease management models, we propose comprehensive, trauma-informed clinical guidelines for pediatric firearm injury care spanning primary, secondary, and tertiary prevention. These guidelines emphasize universal firearm safety screening integrated into routine pediatric visits, standardized protocols for acute trauma care with automatic interdisciplinary team activation, and structured longitudinal follow-up addressing medical, behavioral health, and social needs. By comparing current fragmented approaches to evidence-based care pathways used in asthma and cancer management, we identify critical gaps in continuity and comprehensiveness of firearm injury care and offer specific, actionable recommendations to close these gaps.