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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 [email protected] www.sdrg.org 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. 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) The Premise of Prevention Science To prevent a problem before it happens, the factors that predict the problem must be changed. 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. Risk Factors for Adolescent Problem Behaviors Depression & Anxiety Violence School Drop-Out Teen Pregnancy Delinquency Substance Abuse Risk Factors Community Availability of Drugs Availability of Firearms Community Laws and Norms Favorable Toward Drug Use, Firearms, and Crime Media Portrayals of Violence Transitions and Mobility Low Neighborhood Attachment and Community Disorganization Extreme Economic Deprivation Risk Factors for Adolescent Problem Behaviors Depression & Anxiety Violence School Drop-Out Teen Pregnancy Delinquency Substance Abuse Risk Factors Family Family History of the Problem Behavior Family Management Problems Family Conflict Favorable Parental Attitudes and Involvement in the Problem Behavior Risk Factors for Adolescent Problem Behaviors Delinquency Teen Pregnancy School Drop-Out Violence Depression & Anxiety Lack of Commitment to School Substance Abuse Academic Failure Beginning in Late Elementary School Risk Factors School Risk Factors for Adolescent Problem Behaviors School Drop-Out Violence Depression & Anxiety Teen Pregnancy Delinquency Substance Abuse Risk Factors Individual/Peer Early and Persistent Antisocial Behavior Rebelliousness Early Initiation of the Problem Behavior Gang Membership Constitutional Factors Friends Who Engage in the Problem Behavior Favorable Attitudes Toward the Problem Behavior 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 Prevalence of “Attacked to Hurt” By Risk and Protection Levels 60% Prevalence 50% 40% 30% 20% Protection, Level 0 Protection, Level 1 Protection, Level 2 Protection, Level 3 Protection, Level 4 10% 0% Risk, Level Risk, Level Risk, Level Risk, Level Risk, Level 0 1 2 3 4 Prevalence of Academic Success By Number of Risk and Protective Factors Six State Student Survey of 6th-12th Graders, Public School Students 100% 90% Number of Protective Factors 80% Prevalence 70% 0 2 4 6 8 60% 50% 40% 30% 20% 10% 0% 0 to 1 2 to 3 4 to 5 6 to 7 Number of Risk Factors 8 to 9 10+ to to to to to 1 3 5 7 9 What Is Known About Predictors 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. Advances in Prevention Controlled studies have identified both ineffective and effective prevention and youth development policies and programs. What Doesn’t 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. Effective Programs and Policies Have Been Identified in a Wide Range of Areas 1. Prenatal & Infancy Programs 2. 3. 4. 5. Early Childhood Education 6. Youth Employment with Education 7. Organizational Change in Schools Parent Training After-school Recreation Mentoring with Contingent Reinforcement 8. Classroom Organization, Management, and Instructional Strategies 9. School Behavior Management Strategies 10. Curricula for Social Competence Promotion 11. Community & School Policies 12. Community Mobilization (Hawkins & Catalano, 2004) 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/ 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 Nurse-Family Partnership Evidence of Effect Reductions in: Prenatal Health Problems. Subsequent Births. Welfare and Food Stamp Use. Maternal Arrests (61%) and Convictions (72%). Nurse-Family Partnership Evidence of Effect Reductions in: Maternal Unemployment. Child abuse, neglect, and injuries (48%). Child Arrests (59%) and Adjudications as PINS (90%) @ age 15. 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 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. 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 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. 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 Risk Factors Addressed By the SSDP Intervention Family School X X X X X X Individual/Peer X X X The Social Development Strategy The Goal… Healthy Behaviors Ensure… Healthy Beliefs and Clear Standards By providing… …in families, schools, and peer groups Bonding Build… …to families, schools, and peer groups –Attachment –Commitment Opportunities Skills …for all children and youth Recognition …in families, schools, and peer groups Be Aware of… Individual Characteristics Seattle Social Development Project Core Components Teacher Training in Classroom Instruction and Management Parent Training in Behavior Management and Academic Support Child Social and Emotional Skill Development 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 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 children’s 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 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 Support Structures School Staff – Implementation team training – 7 days of teacher training – Coaching – Principal support Family – Training in each parenting curriculum 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 Late Tx Full Intervention Full Intervention Control Control Grade 1 2 3 4 5 6 7 8 9 10 11 12 Age 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Level of School Bonding Effects of SSDP Intervention on School Bonding from Age 13 to 18 3.10 Full Treatment Late Treatment Control 3.05 3.00 2.95 2.90 2.85 2.80 2.75 2.70 13 14 15 Age 16 Hawkins, Guo, Hill, Battin-Pearson & Abbott (2001) 17 18 SSDP Intervention Effects Compared to Controls By age 18 Youths in the Full Intervention had less heavy alcohol use: 25.0% Control vs. 15.4% Full less lifetime violence: 59.7% Control vs. 48.3% Full fewer lifetime sex partners: 61.5% Control vs. 49.7% Full less grade repetition: 22.8% Control vs. 14.0% Full Late Tx Late Tx Full Intervention Full Intervention Control Control Grade 1 2 3 4 5 6 7 8 9 10 11 12 Age 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 SSDP Intervention Effects Compared to Controls By age 21, full intervention group had: More high school graduates: 81% Control vs. 91% Full More attending college: 6% Control vs. 14% Full Fewer selling drugs: 13% Control vs. 4% Full Fewer with a criminal record: 53% Control vs. 42% Full Late Tx Late Tx Full Intervention Full Intervention Control Control Grade 1 2 3 4 5 6 7 8 9 10 11 12 Age 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 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: [email protected] Institute Publications: www.wa.gov/wsipp Selected Findings Summary of Benefits and Costs (2003 Dollars) Dollars Per Youth (PV lifecycle) Benefits Costs B-C Early Childhood Education Nurse Family Partnership Functional Family Therapy Aggression Repl. Trng. Life Skills Training Seattle Soc. Dev. Project $17,202 $26,298 $16,455 $9,564 $746 $14,246 $7,301 $9,118 $2,140 $759 $29 $4,590 $9,901 $17,180 $14,315 $8,805 $717 $9,837 Guiding Choices $7,605 BenefitsGood Per Youth Reduced crime Multi-D Treat. Foster Care $26,748 Increased high school graduation $0 Intensive Juv. Supervision Reduced K-12 grade repetition Cost Per Youth Benefits Per Dollar of Cost $687 $14,426 $6,918 $3,957$24,290 $2,459 $10,320 -$1,482 $1,482 $150 $4,590 $3.14 7 of 10 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.) Empowering Communities to Prevent Youth Violence Youths in different neighborhoods and communities are exposed to different levels of risk and protection. Distribution of Risk in a City N eighborh oo d #2 In su f fic ie nt n um b e r of st u de n ts in th is are a. No s tu d en ts in t his a re a . N eighborh oo d #1 N eighborh oo d #3 J ohn A. Pollard , P h.D. Dev elopm ental Res earch and Pr ogram s w Ne i gh bo La rh ws Co oo an mm dA dN un tta or i ty ch ms me Di so Fa nt r v g Pe o an rce rabl iza et iv e tio Pe n dA o D rce rug va iv e il a Us dA bi l e va i ty il a of bi l Dr it Po ug or y o f s Ha Fa m n dg Pa il y Fa re M a uns mi nta na ly lA ge Hi Pa ttit s to me re F u a nta ry nt de mi of sF lA ly An Co ttit av ti s ud ora nfl oc es i ct bl e i al Fa T B vo ow eh rab av ard ior le sD to rug An ti s Us oc e i al B Ac eh Lo ad a w em vior Co ic mm Fa itm i lu en re t to Fa Re Sch Ea oo vo be rly l rab lli o Pr u le s E o At ne ar ble ti tu ss ly m In i de Be t i s a h Fa To tio vo n o avi o wa rab r rd fD le An ru At g Us ti tu ti so Lo ci a e de w l s B Pe To eh rce wa av ior i ve rd Dr dR ug isk Us so e Fr fD ien ru gU ds 'U Re s s wa eo e Se rd fD sf ns rug or a ti o s An n ti s Se oc ek i al ing In v olv em Ov ent era ll R i sk Lo Percent At Risk Madison Middle SchoolRisk RiskProfile Profile8th 8th Grade Grade Madison Middle School 2002 2002 100% 90% Community Family School Peer-Individual 80% Survey Participation Rate 2002: 87.4% 70% 60% 50% 40% 30% 20% 10% 0% School 2002 District 2002 Estimated National Value w Ne i gh bo La rh ws Co oo an mm dA dN un tta or i ty ch ms me Di so Fa nt r v g Pe o an rce rabl iza et iv e tio Pe n dA o D rce rug va iv e il a Us dA bi l e va i ty il a of bi l Dr it Po ug or y o f s Ha Fa m n dg Pa il y Fa re M a uns mi nta na ly lA ge Hi Pa ttit s to me re F u a nta ry nt de mi of sF lA ly An Co ttit av ti s ud ora nfl oc es i ct bl e i al Fa T B vo ow eh rab av ard ior le sD to rug An ti s Us oc e i al **A Be Lo c a ha w de vio Co mi r mm cF ai l itm ur en e t to S ch Fa Re Ea oo vo be rly l rab lli o Pr u le s E o At ne ar ble ti tu ss ly m In i de Be t i s a h Fa To tio vo n o avi o wa rab r rd fD le An ru At g Us ti tu ti so Lo ci a e de w l s B Pe To eh rce wa av ior i ve rd Dr dR ug isk Us so e Fr fD ien ru gU ds 'U Re s s wa eo e Se rd fD sf ns rug or a ti o s An n ti s Se oc ek i al ing In v olv em Ov ent era ll R i sk Lo Percent At Risk Nova High School Risk Profile10th 10th Grade Grade Nova High School Risk Profile 2002 2002 100% 90% Community Family School Peer-Individual Peer-Individual Survey Participation Rate 2002: 79.7% 80% 70% 60% 50% 40% 30% 20% 10% 0% School 2002 District 2002 Estimated National Value 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. Challenges for Community Prevention To identify the community’s 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. The Communities That Care Operating System Get Started Implement and Evaluate Creating Communities That Care Create a Plan Get Organized Develop a Profile The Communities That Care Operating System • Community readiness assessment. • Identification of key individuals, stakeholders, and organizations. Get Started Implement and Evaluate Creating Communities That Care Create a Plan Get Organized Develop a Profile The Communities That Care Operating System • Training key leaders and board in CTC Get Started Implement and Evaluate • Building the community coalition. Creating Communities That Care Create a Plan Get Organized Develop a Profile The Communities That Care Operating System Get Started Implement and Evaluate Creating Communities That Care Create a Plan • Collect risk/protective factor and outcome data. •Collect information on community resources • Construct a community profile from the data. Get Organized Develop a Profile w Ne i gh bo La rh ws Co oo an mm dA dN un tta or i ty ch ms me Di so Fa nt r v g Pe o an rce rabl iza et iv e tio Pe n dA o D rce rug va iv e il a Us dA bi l e va i ty il a of bi l Dr it Po ug or y o f s Ha Fa m n dg Pa il y Fa re M a uns mi nta na ly lA ge Hi Pa ttit s to me re F u a nta ry nt de mi of sF lA ly An Co ttit av ti s ud ora nfl oc es i ct bl e i al Fa T B vo ow eh rab av ard ior le sD to rug An ti s Us oc e i al B Ac eh Lo ad a w em vior Co ic mm Fa itm i lu en re t to Fa Re Sch Ea oo vo be rly l rab lli o Pr u le s E o At ne ar ble ti tu ss ly m In i de Be t i s a h Fa To tio vo n o avi o wa rab r rd fD le An ru At g Us ti tu ti so Lo ci a e de w l s B Pe To eh rce wa av ior i ve rd Dr dR ug isk Us so e Fr fD ien ru gU ds 'U Re s s wa eo e Se rd fD sf ns rug or a ti o s An n ti s Se oc ek i al ing In v olv em Ov ent era ll R i sk Lo Percent At Risk Madison Middle School Risk Profile 8th Grade 2002 100% 90% Community Diffusion Consortium Project Social Development Research Group, University of Washington Family School Peer-Individual 80% Survey Participation Rate 2002: 87.4% 70% 60% 50% 40% 30% 20% 10% 0% School 2002 District 2002 Estimated National Value The Communities That Care Operating System Get Started Implement and • Define outcomes. •Prioritize factors to be Evaluate targeted. • Select tested, effective interventions. • Create action plan. • Develop evaluation plan. Creating Communities That Care Create a Plan Get Organized Develop a Profile Addressing Barriers with Effective Action Factor Addressed Family Management Problems Diffusion Consortium Project Social Development Research Group, University of Washington Program Strategy Developmental Period Prenatal/Infancy Programs prenatal-2 Early Childhood Education 3-5 Parent Training prenatal-14 Family Therapy 6-14 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) Diffusion Consortium Project Social Development Research Group, University of Washington The Communities That Care Operating System • Form task forces. • Identify and train implementers. • Sustain collaborative relationships. • Evaluate processes and outcomes. • Adjust programming. Implement and Evaluate Get Started Creating Communities That Care Create a Plan Get Organized Develop a Profile The Communities That Care Prevention Operating System is available at: http://preventionplatform.samhsa.gov/ 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. 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. 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 [email protected] www.sdrg.org