School Based Prevention Programs

School-based prevention programs are initiatives implemented into school settings that aim to increase children's academic success and reduce high-risk problem behaviors.

Overview

An estimated 20-40% of youth have a psychiatric disorder, yet up to 80% of those in need do not receive mental health services.[1] Preventing mental health problems and promoting healthy behavior among youth has become a critical policy issue.[2] The Report of the Surgeon General’s Conference on Children’s Mental Health stated the importance of fostering a solid emotional foundation in children in order to facilitate learning.[3] However, children and families face significant barriers to accessing and receiving community-based mental health services.[4] As a result, schools have been identified as ideal avenues through which to reach youth. Universal prevention programs are offered to the general population, while selective prevention programs are intended for groups identified as at risk for developing a problem.[5] This differentiates them from intervention or treatment programs, which are intended for individuals who already have a problem or meet criteria for a disorder.

Approaches

A number of school-based programs have been developed to target specific outcomes, including problems such as bullying, substance use, and antisocial behavior.[6][7][8] Others have been developed to foster positive youth development[9] and academic performance.[10] While each of these programs focuses on distinct issues and outcomes, research suggests that in adolescent-focused initiatives, many utilize the same practice elements, including communication skills, problem solving, insight building, and assertiveness training.[11] These results suggest that certain core skills may be critical to seemingly disparate desired outcomes, which may have implications for clinical decision making as well as policy. A meta-analysis of 213 school-based prevention programs promoting social and emotional learning (SEL) looked at outcomes in six different domains: social and emotional skills, attitudes toward self and others, positive social behaviors, conduct problems, emotional distress, and academic performance.[12] Findings suggested that SEL programs had positive effects across all six domains, demonstrating the broad impact of universal school-based prevention programs

Challenges

While 59% of schools in the U.S. report having programs that foster children’s social and emotional needs,[13] evidence-based initiatives have not been widely implemented. Schools may be unaware of the evidence base, reflecting the gap between research and practice. Schools that are aware of effective programs may lack funding necessary to implement the program. Should schools receive funding for implementation, research shows that programs are often poorly implemented, resulting in low fidelity and weak outcomes.[14] Additionally, some prevention programs may not be a good fit with the local context and may require tailoring. Finally, schools may struggle to sustain programs due to limited resources.

Implementation strategies

While there are significant challenges to implementing evidence-based prevention programs into school settings, there are strategies to increase the success of introducing and sustaining such programs.[15] These strategies include assigning highly committed individuals as project directors or coordinators; encouraging support and cooperation from school administrators, community members and principals; motivating and gaining the support and enthusiasm of teachers; training which will provide knowledge, skills, and desire to continue further; retraining a few years after to reinforce knowledge and continue the commitment of the teacher or school; and gathering feedback to provide instructors with how to improve their skills.

Properly implemented programs are likelier to have good outcomes, which may incentivize policymakers to allocate more funding to these initiatives. Including explicit cost-benefit analysis should be considered when designing programs.[16] Having more structure in the program and implementation process - from training to materials to supervision - may also be beneficial and lead to sustainment.[17]

Further reading

[18] [19] [20] [21]

References
  1. Merikangas, Kathleen Ries; He, Jian-ping; Burstein, Marcy; Swendsen, Joel; Avenevoli, Shelli; Case, Brady; Georgiades, Katholiki; Heaton, Leanne; Swanson, Sonja (2011). "Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of the National Comorbidity Survey–Adolescent Supplement (NCS-A)". Journal of the American Academy of Child & Adolescent Psychiatry. 50 (1): 32–45. doi:10.1016/j.jaac.2010.10.006. PMC 4408275. PMID 21156268.
  2. "The Study of Implementation in School-Based Preventive Interventions: Theory, Research, and Practice (Volume 3)" (PDF).
  3. U.S. Public Health Service, 2000, p. 3
  4. KAZDIN, ALAN E. (Oct 1997). "Parent Management Training: Evidence, Outcomes, and Issues". Journal of the American Academy of Child & Adolescent Psychiatry. 36 (10): 1349–1356. doi:10.1097/00004583-199710000-00016. PMID 9334547.
  5. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities.
  6. Lösel, Friedrich; Beelmann, Andreas (2003-05-01). "Effects of Child Skills Training in Preventing Antisocial Behavior: A Systematic Review of Randomized Evaluations". The Annals of the American Academy of Political and Social Science. 587 (1): 84–109. doi:10.1177/0002716202250793. ISSN 0002-7162.
  7. Tobler, Nancy S.; Roona, Michael R.; Ochshorn, Peter; Marshall, Diana G.; Streke, Andrei V.; Stackpole, Kimberly M. (2000). "School-Based Adolescent Drug Prevention Programs: 1998 Meta-Analysis". Journal of Primary Prevention. 20 (4): 275–336. doi:10.1023/A:1021314704811. ISSN 0278-095X.
  8. "NIDA Study Shows School-Based Prevention Program Reduces Problem Behaviors in Fifth-Graders by Half". National Institutes of Health (NIH). 2015-08-30. Retrieved 2016-11-21.
  9. Catalano, Richard F.; Berglund, M. Lisa; Ryan, Jean A. M.; Lonczak, Heather S.; Hawkins, J. David (2004-01-01). "Positive Youth Development in the United States: Research Findings on Evaluations of Positive Youth Development Programs". The Annals of the American Academy of Political and Social Science. 591 (1): 98–124. doi:10.1177/0002716203260102. ISSN 0002-7162.
  10. "Learning influences". Psychology and Educational Practice. 1997.
  11. Boustani, Maya M.; Frazier, Stacy L.; Becker, Kimberly D.; Bechor, Michele; Dinizulu, Sonya M.; Hedemann, Erin R.; Ogle, Robert R.; Pasalich, Dave S. (2014-02-07). "Common Elements of Adolescent Prevention Programs: Minimizing Burden While Maximizing Reach". Administration and Policy in Mental Health and Mental Health Services Research. 42 (2): 209–219. doi:10.1007/s10488-014-0541-9. ISSN 0894-587X. PMID 24504979.
  12. Durlak, Joseph A.; Weissberg, Roger P.; Dymnicki, Allison B.; Taylor, Rebecca D.; Schellinger, Kriston B. (2011-01-01). "The Impact of Enhancing Students' Social and Emotional Learning: A Meta-Analysis of School-Based Universal Interventions". Child Development. 82 (1): 405–432. doi:10.1111/j.1467-8624.2010.01564.x. ISSN 1467-8624. PMID 21291449.
  13. Foster, Susan; Rollefson, Mary; Doksum, Teresa; Noonan, Denise; Robinson, Gail; Teich, Judith (2004-11-30). School Mental Health Services in the United States, 2002-2003. SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI).
  14. Gottfredson, Denise C.; Gottfredson, Gary D. (2002-02-01). "Quality of School-Based Prevention Programs: Results from a National Survey". Journal of Research in Crime and Delinquency. 39 (1): 3–35. doi:10.1177/002242780203900101. ISSN 0022-4278.
  15. Fagan, Abigail A.; Mihalic, Sharon (2003). "Strategies for Enhancing the Adoption of School-Based Prevention Programs: Lessons Learned from the Blueprints for Violence Prevention Replications of the Life Skills Training Program". Journal of Community Psychology. 31 (3): 235–253. doi:10.1002/jcop.10045.
  16. "Benefits and Costs of Prevention and Early Intervention Programs for Youth" (PDF).
  17. Gottfredson, Denise C.; Gottfredson, Gary D. (2002-02-01). "Quality of School-Based Prevention Programs: Results from a National Survey". Journal of Research in Crime and Delinquency. 39 (1): 3–35. doi:10.1177/002242780203900101. ISSN 0022-4278.
  18. Evans, Caroline B.R.; Fraser, Mark W.; Cotter, Katie L. (2014). "The effectiveness of school-based bullying prevention programs: A systematic review". Aggression and Violent Behavior. 19 (5): 532–544. doi:10.1016/j.avb.2014.07.004.
  19. Gottfredson, D; Gottfredson, G (2002). "Quality of School-Based Prevention Programs: Results from a National Survey". Journal of Research in Crime and Delinquency. 39: 3–35. doi:10.1177/002242780203900101.
  20. Pentz, Mary Ann (2014). "Integrating Mindfuldness into School-Based Substance Use and Other Prevention Programs". Substance Use and Misuse. 49 (5): 617–619. doi:10.3109/10826084.2014.879796. PMID 24611859.
  21. Zenzen, Wanda; Kridli, Suha (July 2009). "Integrative Review of School-Based Childhood Obesity Prevention". Journal of Paediatric Health Care. 23 (4): 242–258. doi:10.1016/j.pedhc.2008.04.008. PMID 19559992.
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