Using Prevention Science to Guide Community Action

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Using Prevention Science to Guide Community
Action
J. David Hawkins, Ph.D. Endowed Professor of
Prevention Social Development Research
Group School of Social Work University of
Washington jdh_at_u.washington.edu www.sdrg.org
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Objectives

• A science-based public health approach to
  violence prevention.
• Advances in identifying effective and ineffective
  youth violence prevention policies and programs.
• A strategy for enhancing protection, reducing
  risk and preventing youth violence.
• A process for community wide youth violence
  prevention.

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History of Delinquency Prevention in the U.S.

• Before 1980, nine experimental tests of
  delinquency prevention programs were conducted in
  the U.S.
• NONE found desired effects in preventing
  delinquency. (Berleman, 1980)

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The Premise of Prevention Science

• To prevent a problem before it happens, the
  factors that predict the problem must be changed.

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Advances in Prediction

• Longitudinal studies have identified predictors
  of delinquency, violence, and other problem
  behaviors Called Risk factors.
• AND predictors of positive outcomes including
  success in school
• Called Promotive and protective factors.

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Risk Factors forAdolescent Problem Behaviors
Depression Anxiety
Violence
School Drop-Out
Teen Pregnancy
Delinquency
Substance Abuse
Risk Factors
 
 
 
 
 
 
Community
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Availability of Drugs
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Availability of Firearms
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Community Laws and Norms Favorable Toward Drug
Use, Firearms, and Crime
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Media Portrayals of Violence
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Transitions and Mobility
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Low Neighborhood Attachment and Community
Disorganization
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Extreme Economic Deprivation
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Risk Factors for Adolescent Problem Behaviors
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Risk Factors for Adolescent Problem Behaviors
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Risk Factors forAdolescent Problem Behaviors
Depression Anxiety
Violence
School Drop-Out
Teen Pregnancy
Delinquency
Substance Abuse
Risk Factors
 
 
 
 
 
 
Individual/Peer
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Early and Persistent Antisocial Behavior
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Rebelliousness
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Friends Who Engage in the Problem Behavior
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Favorable Attitudes Toward the Problem Behavior
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Early Initiation of the Problem Behavior
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Gang Membership
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Constitutional Factors
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Promotive and Protective Factors

• Individual Characteristics
• High Intelligence
• Resilient Temperament
• Competencies and Skills
• In social domains of family, school, peer group
  and neighborhood
• Prosocial Opportunities
• Reinforcement for Prosocial Involvement
• Bonding
• Healthy Beliefs and Clear Standards for Behavior

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Prevalence of Attacked to HurtBy Risk and
Protection Levels
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Prevalence of Academic SuccessBy Number of Risk
and Protective Factors
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What Is Known AboutPredictors of Youth Violence

• Risk protective factors are found in
  communities, families, schools, peer groups and
  individuals.
• The same risk protective factors predict
  violence and other health and behavior problems
  of youth.
• Risk protective factors show much consistency
  in effects across races and genders in samples
  from the US, the UK, Australia and the
  Netherlands.
• The more risk factors present, the greater
  likelihood of violence, and the less likelihood
  of successful outcomes.
• Protective factors reduce effects of exposure to
  risk -- the greater the level of protection, the
  less likelihood of violence.

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Advances in Prevention

• Controlled studies have identified both
  ineffective and effective prevention and youth
  development policies and programs.

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What Doesnt Work?Negative Effects

• Waivers to Adult (Criminal Courts)

• Scared Straight

• D.A.R.E.

• Guided Group Interaction Positive Peer Culture

• Gun Buyback Programs

• Peer Counseling Programs

• Summer Job Programs for At Risk Youth

Adapted from Sherman et al., 1997.
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Effective Programs and Policies Have Been
Identified in a Wide Range of Areas

• Prenatal Infancy Programs
• Early Childhood Education
• Parent Training
• After-school Recreation
• Mentoring with Contingent Reinforcement
• Youth Employment with Education
• Organizational Change in Schools

• Classroom Organization, Management, and
  Instructional Strategies
• School Behavior Management Strategies
• Curricula for Social Competence Promotion
• Community School Policies
• Community Mobilization

(Hawkins Catalano, 2004)
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Lists of Rigorously Tested and Effective Youth
Violence Prevention Approaches

• Blueprints for Violence Prevention
• www.colorado.edu/cspv/blueprints/
• Communities That Care Prevention Strategies
  Guide
• http//preventionplatform.samhsa.gov/

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Nurse-Family Partnership
Description Nurse home visitation Target
Low-income, at-risk pregnant women bearing their
first child Contact David Olds, M.D.,
Director Prevention Research Center 1825
Marion Street Denver, CO 80218 303-864-5200
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Nurse-Family Partnership Evidence of Effect

• Reductions in
• Prenatal Health Problems.
• Subsequent Births.
• Welfare and Food Stamp Use.
• Maternal Arrests (61) and Convictions (72).

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Nurse-Family PartnershipEvidence of Effect

• Reductions in
• Maternal Unemployment.
• Child abuse, neglect, and injuries (48).
• Child Arrests (59) and Adjudications as PINS
  (90) _at_ age 15.

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Promoting Alternative Thinking Strategies (PATHS)
Description Social and emotional competence
Target Grades K-5 Cost 82/student Yr 1
(training FT consultant included)
Costs in Year 2 reduced by half Contact
Mark Greenberg, Ph.D., Director Prevention
Research Center, Penn State University 110
HDFS-Henderson Building South University Park,
PA 16802 814-863-0112
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PATHS Evidence of Effect

• Decreased conduct problems, including aggression.
• Improved self-control.
• Improved understanding and recognition of
  emotions.
• Improved conflict resolution strategies.
• Improved cognitive planning.

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Bullying Prevention Program
Description Reduction of victim/bully problems
Target Grades 4-7 Cost Full-time
consultant, minimal classroom costs Contact
Dan Olweus, Ph.D. Research Center for Health
Promotion (HEMIL) University of
Bergen Christiesgt. 13, N-5015 Bergen,
Norway 47-55-58-23-27
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Bullying Prevention Program Evidence of Effect

• Reductions in bully/victim problems of 50
  percent.
• Reductions in antisocial behavior (theft,
  vandalism, truancy).
• Improvement in school climate.

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Seattle Social Development Project
Description Promote bonding to school and family
by increasing youths opportunities, skills and
recognition for prosocial involvement. Target
Grades 1-6 (ages 6-12) Contact J. David
Hawkins Ph.D. Social Development Research
Group University of Washington www.sdrg.org
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Risk Factors Addressed By the SSDP Intervention
Family
School
Individual/Peer
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The Social Development Strategy
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Seattle Social Development Project Core Components

• Teacher Training in Classroom Instruction and
  Management
• Parent Trainingin Behavior Management and
  Academic Support
• Child Social and Emotional Skill Development

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Intervention Component Teacher In-Service

• Proactive classroom management (grades 1-6)
• Establish consistent classroom expectations and
  routines at the beginning of the year
• Give clear, explicit instructions for behavior
• Recognize and reward desirable student behavior
  and efforts to comply
• Use methods that keep minor classroom disruptions
  from interrupting instruction

• Effective Direct Instruction (grades 1-6)
• Assess and activate foundation knowledge before
  teaching
• Teach to explicit learning objectives
• Model skills to be learned
• Frequently monitor student comprehension as
  material is presented
• Re-teach material when necessary

• Cooperative learning (grades 1-6)
• Involve small teams of students of different
  ability levels and backgrounds as learning
  partners
• Provide recognition to teams for academic
  improvement of individual members over past
  performance

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Parent Programs

• Raising Healthy Children (grades 1-2)
• Observe and pinpoint desirable and undesirable
  child behaviors
• Teach expectations for behaviors
• Provide consistent positive reinforcement for
  desired behavior
• Provide consistent and moderate consequences for
  undesired behaviors
• Supporting School Success (grades 2-3)
• Initiate conversation with teachers about
  childrens learning
• Help children develop reading and math skills
• Create a home environment supportive of learning
• Guiding Good Choices (grades 5-6)
• Establish a family policy on drug use
• Practice refusal skills with children
• Use self-control skills to reduce family conflict
• Create new opportunities in the family for
  children to contribute and learn

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Social, Cognitive and Emotional Skills Training

• Listening
• Following directions
• Social awareness (boundaries, taking perspective
  of others)
• Sharing and working together
• Manners and civility (please and thank you)
• Compliments and encouragement
• Problem solving
• Emotional regulation (anger control)
• Refusal skills

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Support Structures

• School Staff
• Implementation team training
• 7 days of teacher training
• Coaching
• Principal support
• Family
• Training in each parenting curriculum

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SSDP Intervention Effects Compared to Controls

• By the start of 5th grade, those in the full
  intervention had
• less initiation of alcohol
• less initiation of delinquency
• better family management
• better family communication
• better family involvement
• higher attachment to family
• higher school rewards
• higher school bonding

• At the end of the 2nd grade
• boys less aggressive
• girls less self-destructive

Late Tx
Grade Age
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Effects of SSDP Intervention on School Bonding
from Age 13 to 18
Hawkins, Guo, Hill, Battin-Pearson Abbott (2001)
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SSDP Intervention Effects Compared to Controls
By age 18 Youths in the Full Intervention had
less heavy alcohol use less lifetime
violence fewer lifetime sex partners less
grade repetition
25.0 Control vs. 15.4 Full 59.7 Control vs.
48.3 Full 61.5 Control vs. 49.7 Full 22.8
Control vs. 14.0 Full
Late Tx
Grade Age
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SSDP Intervention Effects Compared to Controls
By age 21, full intervention group had More
high school graduates More attending college
Fewer selling drugs Fewer with a criminal
record
81 Control vs. 91 Full 6 Control vs. 14
Full 13 Control vs. 4 Full 53 Control vs.
42 Full
Late Tx
Grade Age
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Benefits and Costs of Prevention and Early
Intervention Programs for Youth
Steve Aos, Associate Director Washington State
Institute for Public Policy Phone (360)
586-2768 E-mail saos_at_wsipp.wa.gov Institute
Publications www.wa.gov/wsipp
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Over 30 well-researched studies, mostly of
programs for 3 4 year olds from low income
families. Key findings
improved education outcomes, increased high
school graduation higher test scores lower
special education lower grade repetition
reduced crime, reduced child abuse
neglect. Evidence of decay in early test score
outcomes, but still statistically significant by
high school graduation.
Selected Findings
Early Childhood Education 17,202 7,301 9,901
A home visitation program, with active nationwide
dissemination. NFP is delivered by nurses and is
for low income, soon-to-be first time mothers.
Evidence of reduced crime for mothers
and children, reduced child abuse
neglect, improved education outcomes.
Website www.nursefamilypartnership.org/
Nurse Family Partnership 26,298 9,118 17,180
Functional Family Therapy 16,455 2,140 14,315
Aggression Repl. Trng. 9,564 759 8,805
Life Skills Training 746 29 717
Two programs for juvenile offenders and their
families, conducted by trained therapists. FFT
and ART have been implemented statewide in
Washington States juvenile courts. Evidence
of reduced crime when the model is followed.
Websites www.fftinc.com/ and
www.aggressionreplacementtraining.org
Seattle Soc. Dev. Project 14,246 4,590 9,837
Guiding Good Choices 7,605 687 6,918
Multi-D Treat. Foster Care 26,748 2,459
24,290
A three-year program for middle school youth
designed to prevent tobacco, alcohol, and
marijuana use. Delivered by classroom
teachers. Key findings Delayed initiation of
tobacco, alcohol, illicit
drugs. Website www.lifeskillstraining.com/
Intensive Juv. Supervision 0 1,482
-1,482
7 of 10
A multi-year grade school and middle school
training program for parents (family management
training) and teachers (classroom management,
interactive teaching) for children with low
socioeconomic status. Evidence of reduced
crime, increased high school graduation,
reduced grade repetition Website
http//depts.washington.edu/sdrg/
A multimedia training program (parenting skills,
peer pressure refusal skills for students)
implemented with families of middle school
children. Evidence of reduced crime,
reduced alcohol initiation Website
www.channing-bete.com/positiveyouth/pages/FTC/FTC-
GGC.html
Multidimensional Treatment Foster Care is an
alternative to group facilities for youth with
chronic severe criminal behavior. Delivered by
trained families, the goal is to return the youth
to the family the primary family also receives
therapy. Evidence of reduced crime
Website www.oslc.org/
HF
We meta-analyzed 19 studies of intensive
supervision programs for juvenile offenders. No
statistically significant effect on recidivism
rates.
Mentoring program. Evidence increased test
scores, delayed alcohol and drug initiation.
Website www.bbbsa.org
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But

• Prevention approaches that do not work or have
  not been evaluated have been more widely used
  than those shown to be effective.
• (Gottfredson Gottfredson, 2002, Hallfors et al
  2001, Ringwalt et al., 2002.)

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Empowering Communities to Prevent Youth Violence

• Youths in different neighborhoods and communities
  are exposed to different levels of risk and
  protection.

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Distribution of Risk in a City
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Madison Middle School Risk Profile 8th Grade 2002
Peer-Individual
Estimated National Value
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Nova High School Risk Profile 10th Grade 2002
Peer-Individual
Peer-Individual
Estimated National Value
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The Goal for Community Prevention
To identify and address those risk factors
that are most prevalent and those protective
factors that are most depressed with tested and
effective policies and programs.
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Challenges for Community Prevention

• To identify the communitys profile of risk and
  protection.
• To address elevated risks and low protection with
  tested and effective preventive actions.
• To evaluate outcomes to insure desired effects
  are achieved in the community.

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The Communities That Care Operating System
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The Communities That Care Operating System

• Community readiness assessment.
• Identification of key individuals, stakeholders,
  and organizations.

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The Communities That Care Operating System

• Training key leaders and board in CTC
• Building the community coalition.

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The Communities That Care Operating System

• Collect risk/protective factor and outcome data.
• Collect information on community resources
• Construct a community profile from the data.

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Peer-Individual
Estimated National Value
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The Communities That Care Operating System

• Define outcomes.
• Prioritize factors to be targeted.
• Select tested, effective interventions.
• Create action plan.
• Develop evaluation plan.

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Addressing Barriers with Effective Action
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Effective Training for Middle School Parents

• Guiding Good Choices (Spoth et al., 1998)
• Adolescent Transitions Program (Dishion and
  Andrews, 1995)
• Parenting Adolescents Wisely (Gordon et al.,
  1998)
• Creating Lasting Connections (Johnson et al.,
  1996)
• Strengthening Families 10 to 14 Program (Spoth,
  1998)
• Focus on Families (Catalano et al., 1999 1997)

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The Communities That Care Operating System

• Form task forces.
• Identify and train implementers.
• Sustain collaborative relationships.
• Evaluate processes and outcomes.
• Adjust programming.

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• The Communities That Care Prevention Operating
  System is available at
• http//preventionplatform.samhsa.gov/

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Summary and Implications

• Organizations concerned with violence and health
  and behavior problems of youth should
• Collect epidemiologic data on levels of risk and
  protective factors to focus community action on
  the most elevated risks.
• Collaborate to strengthen protection and reduce
  shared risks for these problems.

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Summary and Implications

• Tested and effective policies and programs for
  preventing youth violence are available.
• Use tested and effective approaches where
  possible and appropriate.
• Support rigorous evaluation of these approaches
  in these new contexts.

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Using Prevention Science to Guide Community
Action
J. David Hawkins, Ph.D. Endowed Professor of
Prevention Social Development Research
Group School of Social Work University of
Washington jdh_at_u.washington.edu www.sdrg.org