Prevention Science最新文献

Early identification and intervention support for children with disabilities improve their cognitive, educational, and social outcomes. Studies show that disability identification varies by child race and ethnicity, with children from historically marginalized populations being less likely to be identified during early childhood, where identification tends to happen in the community. One major factor that varies across communities is their resources, broadly defined as the environmental, social, and economic factors within a geographically defined area. While extensive evidence exists noting inequitable distribution of community resources by race and ethnicity, little research has examined whether community resources are associated with differential early disability identification rates. This study explored the association between the availability of community resources and early disability identification and whether it varied by child race or ethnicity. Leveraging 2019 statewide data collected through the Virginia Department of Education (VDOE), we combined information about 91,210 incoming kindergarteners with the Child Opportunity Index 2.0 (COI), a measure of community resources known to be associated with child development. After controlling for multiple covariates, children entering kindergarten at schools in higher-resourced communities were more likely to be identified with a disability prior to kindergarten. Although access to community resources and early disability identification rates varied by child race and/or ethnicity, the interaction effect was not significant. This study has implications for viewing community resources as potential malleable factors to address children's varying needs prior to the start of formal schooling.

The objective of this study is to examine cross-over effects of the Raising Healthy Children universal childhood preventive intervention on adult suicide behaviors and related mental health. A nonrandomized controlled trial was conducted in elementary schools serving higher-risk areas in Seattle, Washington (during ages 6-13, grades 1-6) and followed up at ages 21-39. The panel originated in Seattle but was followed in and out of state. This study examines participants who had been in the intervention (n = 156) vs. control (n = 220) conditions in grades 1-6. The intervention provided teachers with methods of classroom management, parents with family management skills, and children with social-emotional skills training. Outcomes examined were ever suicide ideation, attempt, or completion, and DSM-IV-based criterion counts for depression, generalized anxiety disorder, PTSD, and social phobia across 6 waves, ages 21-39. At follow-up, the intervention group showed significantly lower suicide ideation and behavior, depression, generalized anxiety disorder, PTSD, and social phobia than the control group. Universal childhood preventive intervention can reduce suicide ideation and behaviors and related mental health problems in adulthood. Clinical Trials.gov ID: NCT04075019.

Program adaptations or modifications are often necessary to suit local contexts, populations, and resources available. Despite the frequency with which program modifications are made in practice, they are rarely systematically recorded and reported comprehensively, particularly in the context of scale-up delivery led by implementers and in low- and middle-income countries. We use the FRAME framework to document the modifications of a parenting program called Parenting for Lifelong Health for Parents and Adolescents, locally known as Furaha Teens, which was delivered to over 30,000 families in Tanzania in 2020-2021. We draw on thematic analysis of 12 focus groups and 67 semi-structured interviews with program facilitators, coaches, coordinators, and managers (164 participants). Both proactive and reactive modifications were made to the program context and content. Proactive modifications included delivering the program as part of a wider package of services for families with adolescent girls, focused on HIV prevention, and adding HIV-related content. Both proactive and reactive modifications were made to make the material more acceptable to participants, such as by translating into local languages. Modifications to condense the number and frequency of sessions were reactively made by implementers to meet delivery timelines, particularly due to COVID-related closures. Study findings suggest that a range of program modifications may be required to scale programs to large cohorts as well as new contexts. To ensure successful delivery at scale, funders can support implementers in learning from the modifications and encouraging reflection on whether and how modifications affect program fidelity.

Mediating variables serve a primary role in devising intervention theories and applying them to practice. Prevention scientists have repeatedly called for understanding how and why an independent variable (X; e.g., intervention) is related to a dependent variable (Y; e.g., drug use). Quantitative mediation is used to describe mediating variables that intervene in the causal path from X to Y. Most methodological development for mediation analysis has focused on statistical methods and the assumptions necessary for valid application of these statistical methods. The current paper describes how qualitative methods extend into mediation research and the unique strength of qualitative mediation in identifying potential mediators and mechanisms of change not previously hypothesized. Taking examples from prevention research, we outline how qualitative mediation generates unique and complementary information about mediating mechanisms that may only be available through interviews, focus groups, observation, archival analysis, and other qualitative methodology. We briefly describe cautions when using qualitative mediation including reliance of retrospective reports, potential to influence interviewees, and selective sampling. We underline how qualitative mediation analysis is particularly well suited for exploratory studies and extracting mechanisms of action for new or adapted interventions in prevention science.

Schools' readiness appears an important factor influencing their implementation of violence prevention programs. This review was undertaken to identify, describe, and compare existing theoretical readiness models and their strengths and limitations, and to select an appropriate theoretical model to underpin the study of schools' readiness for child sexual abuse (CSA) prevention education. This, in turn, would guide development of a new instrument to assess schools' readiness for CSA prevention. Searches were conducted from September to December 2022 in ERIC, PsychINFO, PubMed, Science Direct, Sociological Abstracts, Web of Science, and Google Scholar, and handsearches were made in academic journals. We included peer-reviewed papers published in English that reported the development, testing, or use of a theoretical readiness model at an organizational level. We identified three candidate groups of theoretical models from 85 papers: the community readiness model, the multidimensional child maltreatment prevention readiness model, and organizational readiness for change theories. These models were appraised using four criteria for selecting implementation science theories and frameworks (Birken et al. 2017). We propose Weiner's (2009) organizational readiness for change as the most plausible theoretical model with both descriptive and analytical potential for assessing schools' readiness for child sexual abuse prevention education, and discuss the conceptual and empirical strengths and weaknesses of the identified models. The review has demonstrated the utility of applying criteria (Birken et al. 2017) to appraise and select theoretical readiness models in CSA prevention education and other implementation research areas.

Evidence-based program repositories have been designed to help practitioners in their decision-making. Most repositories supplement summaries of effectiveness evidence with information intended to assist with implementation of each included program (e.g., training costs). It is less common for guidance to be included to support translation of findings for a broader range of purposes, such as enhancing related programs already in place. To help address this gap within the area of youth mentoring, the National Mentoring Resource Center has appended "Insights for Mentoring Practitioners" to profiles of 47 mentoring programs included in the CrimeSolutions.gov repository of the National Institute of Justice. We qualitatively analyzed these commentaries to elucidate themes across them that can inform the development and improvement of mentoring programs. Themes included (1) ensuring alignment across program goals, design, implementation, and evaluation; (2) connecting the intervention to mentees' home, parents, and larger environment; (3) tailoring mentor engagement and support to effectively serve youth; and (4) optimizing the role of mentoring within multi-component programs. Discussion focuses on how findings inform the improvement of mentoring programs, and how content geared toward the translation of evidence to practice could enhance and improve evidence repositories.

Preschool children in the United States are expelled at a rate of about 250 per day with a disproportionate number being Black children. There is a need to better understand how to prevent preschool expulsion. Using a random-assignment experiment, preschool teachers (N = 95; 92% female; 61% White) were assigned to one of eight conditions: child race (Black vs. White) $\times$ child gender (boy vs. girl) $\times$ parental cooperativity (cooperative vs. uncooperative). Teachers read two controlled vignettes: one about a child and one about that child's parents. The child vignette described the child's challenging classroom behavior (identical behavior for all children); the parent vignette described a subsequent meeting with the child's parents (half of the parents were described as uncooperative with the teacher and half as cooperative). After each vignette, teachers were asked to complete sections of the Preschool Expulsion Risk Measure (PERM) to assess two known risk factors for preschool expulsion: (a) teachers' perception of the disruptiveness of the child's classroom behavior and (b) teachers' feelings of hopelessness about changing the child's behavior. Even though the child's challenging behavior was controlled (by experimental design), teachers' construal of the child's behavior and teachers' feelings of hopelessness towards the child were significantly influenced by the descriptions of parental cooperation. Variations in results by child race and child gender are also reported. Findings indicate that teachers' perceptions of parents may be a particularly important factor to prevent children from preschool expulsion.

Two strategies used by teachers in targeted antibullying interventions, condemning of the bullying behavior and empathy-raising, have been shown to positively predict bullies' intention to stop bullying. However, the mechanism through which they work remains unknown. We tested whether moral emotions (guilt and shame), and empathic emotion (sadness) mediated the effects of students' perceptions of teachers' condemning and empathy-raising messages on their intention to stop bullying. A normative sample of 277 seventh-grade students (M_age = 12.93, SD = 0.49; 47% female) was asked to imagine having bullied a peer and being invited to a discussion with a teacher. They saw a video vignette with one of three messages: condemning, empathy-raising or a combination of both. Analyses revealed that the effects of perceived condemning of the bullying behavior on intention to stop were primarily mediated by feelings of guilt, while the effects of perceived empathy-raising were mediated by both sadness and guilt. Shame was not associated with intention to stop bullying and did not mediate the effects of the perceptions. These findings suggest that targeted anti-bullying interventions should aim to evoke guilt and sadness (or empathic concern) rather than shame.

Hospitalization and death following COVID-19 infection continue to pose a major public health concern and place strain on health system resources. Outpatient antiviral medication can reduce the risk of COVID-19 hospitalization and death for those at risk of poor outcomes, but identifying high-risk populations who may benefit most from treatment is challenging. The objective of this study was to develop and validate a prediction model for the composite outcome of hospitalization or death in the 14 days following COVID-19 infection. Our sample included 67,530 COVID-19 infections documented in outpatient care and occurring between April 1, 2020, and November 1, 2022, for 64,529 Kaiser Permanente Washington patients who did not receive outpatient antiviral treatment; 1378 (2.0%) of these infections resulted in hospitalization or death. Our prediction model, estimated using logistic regression with LASSO variable selection and ridge penalization, included 19 risk factors and showed high performance, including an area under the curve of 0.825 (95% confidence interval 0.813-0.836). Among the 10% of infections with the highest risk predictions, the true positive rate was 48% (46-51%) and the positive predictive value was 9.9% (9.2-10.6%). Supplemental analyses confirmed strong model performance across racial and ethnic subgroups and over time. We also present our process for selecting a risk threshold above which to recommend antiviral treatment and discuss considerations for prospective clinical implementation. This project demonstrates that machine learning tools can be used by health systems to deliver timely, targeted secondary prevention to reduce the risk of serious illness or death.

Youth violence is a significant public health concern with differential impacts on youth who reside in high-burden communities. Structural factors, including institutional practices and policies, contribute to the concentration of youth within neighborhoods where violence is more likely to occur. Across disciplines, scholars have identified structural factors that affect not only the prevalence of violence but also environmental conditions that make violence more likely. Consequently, interventions may fall short of addressing the root causes of violence, perpetuating cycles of harm rather than fostering long-term solutions. It is crucial to advance community and societal level approaches to address macro-level factors influencing youth violence. The Institute of Medicine's Framework for Collaborative Public Health Action suggests that community coalitions may contribute to preventing youth violence by facilitating multisectoral engagement across socioecological levels to promote sustainable change. Guided by this framework, the ThrYve Coalition in Kansas City convened over 40 community partners across 15 sectors to address youth violence (Watson-Thompson et al., 2020). Through a collaborative process, 87 change lever strategies (i.e., strategies to implement program, policy, practice changes) were identified to support community and systems-level improvements aligned with risk and protective factors related to youth violence. Between 2018 and 2022, the ThrYve Coalition implemented more than 199 community changes, addressing social and structural determinants related to youth violence. This study examines the collaborative process for facilitating change as part of a comprehensive community intervention to prevent youth violence.