Prevention Science最新文献

Evidence reveals that minoritized groups face disparities, underscoring the need for interventions to address behavioral health inequities. This review examined which minoritized populations are represented in evidence-based preventive interventions (EBPIs) and whether they equitably benefit from these programs. Using the Blueprints for Healthy Youth Development online clearinghouse, we synthesized findings from 240 high-quality experimental evaluations of EBPIs conducted in the U.S. between 2010 and 2023 and performed a descriptive analysis based on consensus coding to assess (1) the prevalence of culturally tailored EBPIs; (2) how frequently tests for subgroup effects were conducted; and (3) whether subgroup tests indicated differential benefits for minoritized groups. We found few culturally tailored interventions (31%), with 4% evaluating EBPIs developed for African American or Black populations and 1% for Hispanic or Latino youth. Additionally, only 25% and 15% tested for subgroup effects by race and ethnicity, respectively. For other subgroups, few (28%) evaluations included effects by economic disadvantage while 47% examined outcomes by binary gender categories. Essentially no reports tested for subgroup effects by sexual identity, location, or nativity status. Encouraging findings were that EBPIs more often benefited racial and ethnic minoritized groups, and there was an upward trend in reporting subgroup tests across time. EBPIs should test for subgroup effects to answer the questions of "what works for whom?" and "in which settings?" and to better understand the generalizability of findings. Investments are needed in culturally grounded programs developed for historically marginalized populations and trials of EBPIs that investigate mitigating health disparities.

Developing accurate and equitable screening protocols can lead to more targeted, efficient, and effective, teen dating violence (TDV) prevention programming. Current TDV screening protocols perform poorly and are rarely implemented, but recent research and policy emphasizes the importance of leveraging more trauma-focused screening measures for improved prevention outcomes. In response, the present study examined which adversities (i.e., indices of family violence), trauma-focused risk factors (i.e., threat and reward biases) and strengths (i.e., social support and racial/ethnic identity) best classified concurrent and prospective risk for physical and psychological forms of TDV-perpetration. Participants included 584 adolescents aged 12-18 years (M_Age = 14.43; SD = 1.22), evenly distributed across gender (48.9% female), race (35% African American; 38.5% White) and ethnicity (40% Hispanic). Surveys completed at baseline and 1-year follow-up were analyzed using an evidence-based medicine (EBM) analytic protocol (i.e., logistic regression, area-under-the-curve; (AUC), diagnostic likelihood ratios (DLR), calibration curves) and compared to machine learning models. Results revealed hostility best classified risk for concurrent and prospective physical TDV-perpetration (AUCs > 0.70; DLRs > 2.0). Additionally, domestic violence (DV) exposure best forecasted prospective psychological TDV-perpetration (AUC > 0.70; DLR > 3.0). Both indices were well-calibrated (i.e., non-significant Spiegelhalter's Z statistics) and statistically fair. Machine learning models added minimal incremental validity. Results demonstrate the importance of prioritizing hostility and DV-exposure for accurate, equitable, and feasible screening for physical and psychological forms of TDV-perpetration, respectively. Integrating these findings into existing prevention protocols can lead to a more targeted approach to reducing TDV-perpetration.

The need for well-implemented evidence-based interventions (EBIs) for the prevention of behavioral issues among children and adolescents is substantial. In rural areas, the need often matches or surpasses that of urban areas. Schools have a wide reach for prevention-focused EBIs. However, implementation in rural schools is often hindered by limited resources and capacity. Rural School Support Strategies (RS3) are a bundle of implementation supports that address implementation challenges in rural settings. They include providing additional leadership and coaching training, individualized technical assistance (mostly virtual), and monthly meetings of a virtual learning collaborative. A cluster-randomized Hybrid Type 3 implementation-effectiveness trial tested RS3 for implementing school-wide positive behavioral interventions and supports (PBIS), a universal prevention approach to improving student behavior, academic outcomes, and school climate. Forty rural schools received a multi-day training on PBIS each summer for 3 years. Half were randomized to also receive RS3 support. Linear and logistic regression models examined the effect of treatment condition and dosage of support on implementation fidelity for Tier 1 (universal) PBIS. Condition and dosage (number of hours) of support increased the odds of schools achieving the 70% threshold for adequate implementation fidelity. In the first year, the higher dosage of technical assistance events increased the likelihood of schools reaching fidelity, whereas later in the trial, the higher dosage of attendance at the virtual learning collaborative sessions yielded significant improvements in fidelity. Implications for accelerating the implementation of universal prevention initiatives in schools-particularly in rural settings-are discussed. This study was prospectively registered on ClinicalTrials.gov (NCT03736395), on November 9, 2018.

Universal and selective preventive interventions targeting youth behavioral problems have shown crossover effects on suicide risk, the second leading cause of death among youth. However, the mechanisms that explain this long-term unanticipated benefit are understudied and unclear. The current study examines the crossover effects of PROSPER, a community-university partnership model for delivering interventions for the prevention of adolescent substance misuse. We examine whether intervention effects on developmental trajectories of parent-child relationship quality and school belongingness explain the putative crossover effects. The analytical sample was 1,974 youth who participated in a randomized controlled trial of PROSPER in the 6th grade and completed an age 19 follow-up assessment. Participants completed annual assessments of parent-child relationship quality and school belongingness from the 6th to 12th grades, and reported on suicidal thoughts during the young adulthood assessment. Our developmental cascade model showed that PROSPER reduced the magnitude of declines in youths' reports of school belongingness from the 6th to 12th grade. In turn, youth who reported less decline in school belongingness reported fewer depression symptoms and suicidal thoughts during young adulthood. Study findings highlight the role of decline in school belongingness as a factor that contributes to the effects of universal prevention programs on youth suicide risk.

Recent work indicates clinically meaningful differences in domains of psychopathic personality - such as grandiose-manipulative (GM), callous-unemotional (CU), and daring-impulsive (DI) traits - and parenting factors. Yet, different domains of parenting and reports from multiple informants may vary in their associations to psychopathic traits. This study examined psychopathic traits and their links with parental monitoring behaviors, parental knowledge, and adolescent disclosure. Further, we evaluated whether adolescents' self-reported resting arousal moderated these associations. A mixed clinic-referred/community sample of 134 adolescent-parent dyads (M_age = 14.49; SD = 0.50; 66.4% female) completed multi-dimensional measures of psychopathy, parental monitoring behaviors, parental knowledge, and adolescent disclosure; adolescents also self-reported on their resting arousal. Results indicated links between: (a) increased parent-reported GM traits and decreased parent-reported parental knowledge, and (b) increased parent-reported DI traits and lower parent-reported monitoring behaviors, which were attenuated at high levels of adolescent-reported resting arousal. Associations between elevated dimensions of psychopathic traits and lower levels of parental monitoring behaviors, parental knowledge, and adolescent disclosure were most consistent within-informants, with some cross-informant associations identified for links between elevated GM and DI and lower levels of parental monitoring behaviors and parental knowledge. These findings have important implications for our understanding of how to assess and prevent psychopathy and associated externalizing problems, and suggest that targeting modifiable environmental and psychophysiological factors may be particularly important.

This commentary responds to the paper recently published in Prevention Science, entitled "The Promise and Challenges of Integrating Biological and Prevention Sciences: A Community-Engaged Model for the Next Generation of Translational Research" by Leve and colleagues (2024). A framework is advanced to provide a rationale for and facilitate the difficult and oft-avoided task of integrating concepts, techniques, methods, and datasets from diverse disciplines. The unfortunate reality is that disciplines germane to prevention continue to be highly siloed. The field of prevention science stands to benefit from knowledge that leads to greater precision-based-and thereby more effective-approaches to intervention. What is particularly underappreciated is the potential for this information to also guide policymaking based on what we could learn about the social-ecological conditions that impact child and youth brain and behavioral development and are alterable in response to evidence-informed public health policies. In this commentary, we offer some context for and appraisal of the paper and provide additional rationale for a precision-based approach with appropriate precautions for the research and utility of findings. Discussion ensues on the economic pros and cons and the policy implications of this integrative "neuroprevention" strategy should the field of prevention science accept the challenge.

Behavioral interventions delivered in preschools can help young children who need support for their behavior. However, preschool teachers face barriers to implementing behavioral interventions, leading to a research-to-practice gap. To better understand how to support preschool teachers, we conducted a scoping review of determinants (i.e., barriers and facilitators) and strategies used to support the implementation of behavioral interventions in preschool settings. A systematic search identified peer-reviewed manuscripts describing the implementation of teacher-delivered behavioral interventions in preschools. Each included manuscript was evaluated to answer the following questions: (1) what determinants to teacher implementation of behavioral interventions have been explored and (2) what strategies have been identified as promising in addressing determinants (i.e., implementation strategies)? Twenty-two manuscripts met inclusion criteria. Data extraction and synthesis were used to summarize key findings. Results indicate that few studies have explored determinants of implementation, and while these determinants span numerous implementation domains, there was little consensus on common determinants. In contrast, all the included studies deployed an implementation strategy, and there were two clear foci of the strategies: training and quality monitoring. Implications and recommendations are discussed for both the preschool context and the implementation science field.

Beginning with the successful sequencing of the human genome two decades ago, the possibility of developing personalized health interventions based on one's biology has captured the imagination of researchers, medical providers, and individuals seeking health care services. However, the application of a personalized medicine approach to emotional and behavioral health has lagged behind the development of personalized approaches for physical health conditions. There is potential value in developing improved methods for integrating biological science with prevention science to identify risk and protective mechanisms that have biological underpinnings, and then applying that knowledge to inform prevention and intervention services for emotional and behavioral health. This report represents the work of a task force appointed by the Board of the Society for Prevention Research to explore challenges and recommendations for the integration of biological and prevention sciences. We present the state of the science and barriers to progress in integrating the two approaches, followed by recommended strategies that would promote the responsible integration of biological and prevention sciences. Recommendations are grounded in Community-Based Participatory Research approaches, with the goal of centering equity in future research aimed at integrating the two disciplines to ultimately improve the well-being of those who have disproportionately experienced or are at risk for experiencing emotional and behavioral problems.