Chapter 10 - Prevention Flashcards
Prevention
programs designed to prevent problems before they start (i.e. through spreading education)
- e.g., education programs on the importance of washing your hands
Health Promotion
Programs designed to increase activities or lifestyles (i.e., good nutrition, regular exercise, and adequate sleep) that promote physical health benefits
What idea is prevention based on?
Early intervention –> target programs for children and adolescents because they have the time to build positive coping skills to help prevent problems from developing later
- distress is preventable
Types of Prevention
- Universal
- Selective (/targeted)
- Indicated
- Treatment
Universal Prevention
Targets everyone within a population
- Few very good programs, some deleterious
- e.g., commercial campaigns, school programs (e.g., all 6th graders in the district), seat belts
Selective Prevention
Targets people at an elevated risk of developing a particular disorder/problem (but they are not showing signs yet)
- Fewer programs offered but results are promising
- Services for at-risk youth and targets risk factors (i.e., teaching coping skills, providing/enhancing protective factors)
- e.g. school meal programs for lower SES students, teen mom programs
Indicated Prevention
Targets people with subclinical signs for a particular disorder, but they do not meet threshold for a diagnosis
- Effective but not so much in the long-term
- Inspired by motivational therapies
- Hoping to prevent problems from getting worse into clinical levels
Risk Reduction Model
An approach to prevention that reduces risk and promotes protective factors; relies on research to guide intervention
- Considers influences both “within” and “outside” the person (i.e., individual factors, school/work context, family/social factors, life events and situations, community and cultural factors)
- Considers risk factors and protective factors across contexts
Evaluation of Prevention Programs
- Fidelity: monitoring the implementation of programs to ensure prevention is conducted as planned
- Examining short and long-term outcomes, are they consistent?
- Look at Incidence rates and Numbers Needed to Treat (NNT)
Incidence Rate
A way to measure the success of a prevention program: Did less people go on to develop the problem after the program compared to those who did not receive the program?
- number of new cases of a specific problem
Number Needed to Treat (NNT)
A way to measure the success of a prevention program: The number of people who needed to receive the intervention in order to prevent one person from developing the condition
Evidence-Based Parenting Programs
Want to promote supportive and caring parenting to protect children and youth from developing disorders.
- Home visitation programs: target at-risk parents (e.g., single, teenage moms) where a nurse comes to visit during and after pregnancy to address mother’s concerns; teaching self- and child-care skills and promotion of the use of the health care system
- Incredible Years: prevention program developed for parents with children at risk for developing conduct problems. Promotes adult-child interactions to facilitate positive development in child, including boundary setting for negative behaviours and promoting positive behaviours
Violence Prevention Programs
Programs to address the physical abuse of children (by parents/adults) via parenting programs
Programs addressing youth violence (bullying and conduct disorder)
- Bullying prevention programs: training teachers on how to respond, anti-bullying programs
- Fast Track Program: targeting high-risk kindergarteners (for conduct disorder), interventions at child, parent, and classroom levels; had positive effects seen long-term
Why is parent involvement important for intervention?
It increases the effect of improvement/risk reduction
Programs for the Prevention of Internalizing Disorders
Prevention of anxiety disorders: Coping Koalas Program
- selective prevention program targeting school children with mild to moderate anxiety problems
- 10 group therapy sessions
- 3 parent sessions
- 50% reduction in incidence of anxiety disorders after program
- has also worked in universal settings!
Prevention of drepression:
- Universal programs ineffective
- selective and indicated programs somewhat effective
- NNT = 22 across lifespan prevention efforts
Universal Prevention Programs for Substance Use
Environmental prevention: effective to a certain point
- e.g., smoking bans, restrictions on where drinking/smoking is permitted, regulation of substances
- Public often disagrees and will push back because it infringes on their autonomy
School-based prevention: limited evidence for efficacy, less than 15% of programs are evidence-based… waste of time and effort
- DARE was a flop
- Universal programs shown to be less effective for those already using
- Life Skills Training Program & Strengthening Families Program: enhancing generic skills, drug refusal skills, reduction of biased drinking norms, parent involvement; mild effectiveness (NNT= 12-33), families don’t often participate because they’re busy
Selective Prevention Programs for Substance Use
-Target groups at risk
- Uncommon bc of lack of undersanfing of risk
- More effective than universal programs
- More effective when interactive with peer involvement
Indicated Prevention Programs for Substance Use
- Brief alcohol interventions, 1-4 sessions
- Effective for problematic substance users (50% reduction)
- Limitations: time limited effect (relapse by 6 months), cannot be delivered stand-alone, need to follow up
Prevention Programs for Loss and Trauma (which one does not work? Which does?)
Critical Incident Stress Debriefing: well intended but assumes that everyone heals the same; group therapy where everyone talks about their trauma closer to event occurrence.
- Can be retraumatizing
- Trying to prevent development of PTSD but ignores natural healing processes (which can look different for everyone)
Cognitive-behavioural interventions: have positive impact for traumatized children/youth
- provides knowledge about trauma and its effects
- Normalizes reactions to extreme situations
- Emphasizes coping skills
- Developing skills to reduce avoidant coping mechanisms
