The Economic Stimulus and the

Health of Americans: An Opportunity Is Being Missed

As members of the prevention science community, we are concerned about the research priorities of the National Institutes of Health as indicated by its plans for spending the $10 billion in stimulus funds allocated under the American Recovery and Reinvestment Act of 2009.

President Obama has clearly articulated an agenda for bringing about change in our communities through evidence-based programs and comprehensive efforts to address the risk factors that put people at risk for multiple problems. Yet the American Recovery and Reinvestment Act of 2009 and NIH funding of research that would advance these priorities is extremely limited.

Biological and behavioral research has brought us to the point where it is possible to substantially improve human wellbeing in most American communities.(1) Nevertheless, actual wellbeing—especially in impoverished communities—lags far behind what the evidence shows could occur. Prevention science can help us reach that goal.

Psychological, behavioral, and physical health problems are inter-related for both adolescents and adults. (2,3) Youth with multiple problems cost the nation more than $400 billion per year.(3) These problems co-occur with a host of others, including major marital discord, unemployment, and on-the-job conflict.(4,5) All of these problems are significant risk factors for physical illness.(6) Self-regulation, positive behavior (e.g., physical activity and healthy eating), prosocial behavior, academic achievement, and job performance are also highly inter-related and are negatively correlated with problem behaviors.(7,8) Encouraging young people’s positive behavior can put them on a positive developmental trajectory that leads to happier and more productive lives.(9,10)

The just-released National Research Council and Institute of Medicine report on prevention(1) documents numerous interventions that can prevent these costly problems. Yet the NIH priorities for expenditure of the supplement money provide little support for the research that is needed to translate existing knowledge into nationwide improvements in people’s psychological, behavioral, and physical health.

What is needed is research on how to combine and scale up preventive interventions so that they are implemented in entire communities and have an impact on multiple problems. (1) There is ample evidence that such results can be achieved, but only if a new generation of ambitious and large-scale experimental evaluations of preventive interventions are funded. This is precisely the research agenda we need if the Obama administration’s vision for America is to be achieved.

All of the undersigned have indicated their support for this statement. If you would like your name added, email Tony@ori.org.

Anthony Biglan, PhD, Senior Scientist and Director, Center on Early Adolescence, Oregon Research Institute, Past President, Society for Prevention Research, Member, Institute of Medicine Committee on Prevention

Brian R. Flay, DPhil, Professor, Department of Public Health, Director, Youth Core, Hallie Ford Center for Healthy Children and Families, Oregon State University

Christopher R. Agnew, PhD, Associate Professor of Psychological Sciences, Purdue University

Carolyn Aldwin, PhD, Professor, Department of Human Development & Family Sciences, Oregon State University

Carol G. Allred, PhD, President/Developer, Positive Action, Inc.

Shaffdeen A. Amuwo, PhD, MPH, Associate Dean for Urban Health and Diversity Programs, Clinical Associate Professor of Public Health Sciences, University of Illinois at Chicago, School of Public Health

Tammy L. Anderson, PhD, Associate Professor, Department of Sociology and Criminal Justice, University of Delaware

Judy Andrews, PhD, Senior Scientist, Oregon Research Institute

Michael W. Arthur, PhD, Social Development Research Group, School of Social Work, University of Washington

Marc S. Atkins, PhD, Professor of Psychology and Psychiatry, Director of Psychology Training, University of Illinois at Chicago, Institute for Juvenile Research

Robert C. Bailey, PhD, MPH, Professor of Epidemiology, School of Public Health, University of Illinois at Chicago

William Baldyga, MA, DrPH, Associate Director, Institute for Health Research and Policy, University of Illinois at Chicago

Michael T. Bardo, PhD, Professor of Psychology, Director, Center for Drug Abuse Research Translation (CDART), University of Kentucky

Manuel Barrera Jr., PhD, Arizona State University

Karl E. Bauman, PhD, Professor Emeritus, Public Health, The University of North Carolina at Chapel Hill

Carl Bell, MD, President/CEO, Community Mental Health Council, Inc., Chicago and Director of the Institute for Juvenile Research, University of Illinois at Chicago

Michael L. Berbaum, PhD, Director, Methodology Research Core, Institute for Health Research and Policy, University of Illinois at Chicago

Marlene J. Berg, PhD, Associate Director for Training, Institute for Community Research

Cady Berkel, PhD, Prevention Research Center, Arizona State University

Marvin W. Berkowitz, PhD, Sanford N. McDonnell Professor of Character Education, Co-Director, Center for Character and Citizenship, University of Missouri, St. Louis

Len Bickman, PhD, Professor of Psychology, Psychiatry and Public Policy, Associate Dean for Research and Director Center for Evaluation and Program Improvement, Vanderbilt

Zeynep Biringen, PhD, Professor, Director of Family & Developmental Studies Graduate Program, Dept. of Human Development & Family Studies, Colorado State University

Richard J. Bonnie, JD, Harrison Foundation Professor of Medicine and Law, Hunton & Williams Research Professor, Professor of Psychiatry and Neurobehavioral Sciences, Director of Institute of Law, Psychiatry and Public Policy, University of Virginia School of Law

Daniel Bontempo, PhD, Research Assistant Professor, Human Development & Family Studies, Oregon State University

Robert F. Boruch PhD, University Trustee Chair Professor, Graduate School of Education and Statistics Department, Wharton School, University of Pennsylvania

Kris Bosworth, PhD, Smith Endowed Chair in Prevention and Education, University of Arizona

Gilbert J. Botvin, PhD, Professor and Director, Institute for Prevention Research, Weill Cornell Medical College

Paul Brandt-Rauf, Dean, School of Public Health, University of Illinois at Chicago

Jonathan Bricker, PhD, Assistant Member, Cancer Prevention Research Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, University of Washington

C. Hendricks Brown, PhD, Professor and Director, Prevention Science and Methodology Group, Department of Epidemiology and Public Health, University of Miami

Louis Brown, PhD, Research Scientist, Prevention Research Center, Penn State University

Dorothy C. Browne, PhD, Professor, Sociology and Social Work, North Carolina Agricultural and Technical State University

Brian Bumbarger, PhD, Director, Evidence-Based Prevention & Intervention Support Center, Prevention Research Center, Penn State University

Linda L. Caldwell, PhD, Professor of Recreation, Park and Tourism Management and Human Development and Family Studies, Co-Director, Leisure, Health, and Well Being Lab, Penn State University

Deborah M. Capaldi, PhD, Senior Scientist, Oregon Social Learning Center

Felipe González Castro, PhD, MSW, Professor, Department of Psychology, Arizona State University, Affiliated Faculty at Southwest Interdisciplinary Research Center, School of Social Work, and School of Justice and Social Inquiry

Richard Catalano, PhD, Professor and Director, Social Development Research Group, University of Washington

Frank Chaloupka, PhD, Distinguished Professor, Economics and Public Health, Director, Health Policy Center, University of Illinois at Chicago

Patricia Chamberlain, PhD, Senior Scientist, Oregon Social Learning Center and Center for Research to Practice

Laurie Chassin, PhD, Regents’ Professor, Department of Psychology (Clinical), College of Liberal Arts and Sciences, Arizona State University

JeeWon Cheong, PhD, Assistant Professor, Department of Psychology, University of Pittsburgh

Daniel Close, PhD, Associate Professor, Family and Human Services, University of Oregon

Mary Cluskey, PhD, RD, Associate Professor, Nutrition and Exercise, Oregon State University

Doug Coatsworth, PhD, Associate Professor of Human Development, Penn State University

Linda M. Collins, PhD, Professor of Human Development and Family Studies and Director, The Methodology Center, Penn State University, President-Elect, Society for Prevention Research

Karen Conrad PhD, RN, MPH, Research Associate Professor, Health Policy and Administration, School of Public Health, University of Illinois at Chicago

Kendon J. Conrad PhD, MSPH, Professor of Health Policy and Administration, School of Public Health, University of Illinois at Chicago

Linda B. Cottler, PhD, MPH, Professor of Epidemiology, Director, Epidemiology and Prevention Research Group, Department of Psychiatry, Washington University School of Medicine

K. Michael Cummings, PhD, MPH, Professor of Oncology, 2009 Recipient of the American Cancer Society Luther Terry Award, Roswell Park Cancer Institute

Faith G. Davis, PhD, Professor and Senior Associate Dean, School of Public Health, University of Illinois at Chicago

Don C. Des Jarlais, PhD, Professor, Epidemiology and Population Health, Albert Einstein College of Medicine (former Commissioner, US National Commission on AIDS)

Jim Derzon, PhD, Senior Evaluation Specialist, Battelle, Centers for Public Health Research and Evaluation

Ralph DiClemente, PhD, Professor, Rollins School of Public Heath, Emory University

Lisa Dierker, PhD, Professor, Psychology, Wesleyan University

Thomas J. Dishion, PhD, Director, Child and Family Center, Professor of Psychology and School Psychology, University of Oregon

Lorah D. Dorn, PhD, Professor of Pediatrics and Research Director, Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center

Inez R. Drummond, EdD, Manager, Safe and Drug Free Schools & Communities, Office of Specialized Services Coordinated School Health, Chicago Public Schools

David DuBois, PhD, Professor, Institute for Health Research and Policy University of Illinois at Chicago

Joseph A. Durlak, PhD, Professor of Psychology, Loyola University Chicago

J. Mark Eddy, PhD, Senior Scientist, Oregon Social Learning Center

John Elder, PhD, Professor, School of Public Health, San Diego State University

Maurice J. Elias, PhD, Professor, Psychology Department, Rutgers University, Academic Director, Rutgers Civic Engagement and Service Education Partnerships Program, President, Div, 27, APA, Society for Community Research and Action, Director, Developing Safe & Civil Schools

Dennis D. Embry, PhD, President/CEO, PAXIS Institute

Sherry Emery, PhD, Senior Scientist, Institute for Health Research and Policy, University of Illinois at Chicago

Susan T. Ennett, MSPH, PhD, Associate Professor, Public Health, University of North Carolina at Chapel Hill

Tom Eversole, DVM, MS, Director, Strategic Development for a College of Public Health & Human Sciences, College of Health and Human Sciences, Oregon State University

Michael Fagen, PhD, MPH, Clinical Assistant Professor of Community Health Sciences, School of Public Health, University of Illinois at Chicago

Stephen B. Fawcett, PhD, Director, Work Group for Community Health and Development & World Health Organization (WHO) Collaborating Centre, Kansas Health Foundation Distinguished Professor of Applied Behavioral Science, University of Kansas, Lawrence

Mark Feinberg, PhD, Senior Research Scientist, Prevention Research Center, Penn State University

Diana Fishbein, PhD, Senior Fellow and Program Director, Transdisciplinary Behavioral Science Program, RTI International

Philip A. Fisher, PhD, Senior Research Scientist, Oregon Social Learning Center, Professor of Psychology, University of Oregon

Victoria Follette, PhD, Foundation Professor, Psychology, University of Nevada Reno

Marion S. Forgatch, PhD, Senior Scientist Emeritus, Oregon Social Learning Center, Executive Director, Implementation Sciences International, Inc.

Jean Forster, PhD, MPH, Professor, School of Public Health, University of Minnesota

Luisa Franzini, PhD, Associate Professor of Management, Policy, and Community Health, University of Texas School of Public Health

Sylvia Furner, PhD, Associate Professor of Epidemiology, School of Public Health, University of Illinois at Chicago

Scott Gest, PhD, Associate Professor of Human Development, Penn State University

Karen Glanz, PhD, MPH, Charles Howard Candler Professor of Behavioral Sciences and Health Education, Georgia Cancer Coalition Distinguished Research Scholar and Director, Emory Prevention Research Center, Rollins School of Public Health, Emory University

Ron Glick, PhD, Professor Emeritus, Director, Network for Dissemination of Curriculum Infusion, Northeastern Illinois University, Chicago

Lizbeth Ann Gray, MSW, PhD, Assistant Dean for Academic Programs, Associate Professor, Human Development and Family Sciences, College of Health and Human Sciences, Oregon State University

Lawrence W. Green, DrPH, Professor, University of California at San Francisco

Mark T. Greenberg PhD, Bennett Chair of Prevention Research, Director, Prevention Research Center, Penn State University

Deborah Gross, DNSc, RN, FAAN, Leonard and Helen Stulman Professor in Mental Health and Psychiatric Nursing, Johns Hopkins University School of Nursing and, School of Medicine, Dept. of Psychiatry and Behavioral Sciences

Joel W. Grube, PhD, Director and Senior Research Scientist, Prevention Research Center, Pacific Institute for Research and Evaluation

Larry Gruder, PhD, Professor, School of Community & Global Health, Claremont Graduate University

Katherine Gunter, PhD, Assistant Professor and Extension Specialist, Department of Nutrition and Exercise Sciences, Oregon State University

Denise Dion Hallfors, PhD, Senior Research Scientist, Pacific Institute for Research and Evaluation

Bonnie Halpern-Felsher, PhD, Associate Professor, Department of Pediatrics, University of California, San Francisco

Anna Harding, PhD, Professor, Department of Public Health, Oregon State University

S. Marie Harvey, PhD, Professor & Chair, Department of Public Health, Oregon State University

R. Steven Harrison, PhD, President, Bach Harrison, LLC

Alan J. Hawkins, PhD, CFLE, Professor of Family Life, Brigham Young University

Steven C. Hayes, PhD, Foundation Professor, Department of Psychology, University of Nevada

Richard E. Heyman, PhD, Research Professor, Family Translational Research Group, Department of Psychology, Stony Brook University, State University of New York

Judith Hibbard, DrPH, Professor, Department of Planning, Public Policy, and Management, University of Oregon

Susan L. Hughes, DSW, Co-Director, Center for Research on Health and Aging, Institute for Health Research and Policy, and Professor of Community Health Sciences, School of Public Health, University of Illinois at Chicago

Jack F. Hollis, PhD, Senior Investigator, Kaiser Permanente Center for Health Research

Karen Hooker, PhD, Director, Center for Healthy Aging Research, Professor, Human Development and Family Sciences, Oregon State University

Hyman Hops, PhD, Senior Scientist, Oregon Research Institute

Nick Ialongo, PhD, Professor, School of Public Health, The Johns Hopkins University

Robert J. Jagers, PhD, Associate Professor, School of Education, University of Michigan

Leonard A. Jason, PhD, Professor of Psychology and Director, Center for Community Research, DePaul University

Patricia Jennings, PhD, Research Scientist, Prevention Research Center, Penn State University

Peter Ji, PhD, Research Assistant Professor, Psychology, University of Illinois at Chicago

Knowlton Johnson, PhD, Senior Scientist, Pacific Institute for Research & Evaluation-Asheville

Lloyd D. Johnston, PhD, Distinguished Research Scientist, Research Professor, & Principal Investigator: Monitoring the Future (MTF) and Youth, Education, & Society (YES), University of Michigan, Institute for Social Research

Bruce J. Joleaud, MA, CSADC, NCACII, Prevention Coordinator, Network for Dissemination of Curriculum Infusion, Northeastern Illinois University

Eileen Kaspar, Manager Graduate Programs/Exec. Asst. to the Chair, Dept. Public Health, Oregon State University

Sheppard G. Kellam, MD, Professor Emeritus, John Hopkins Bloomberg School of Public Health and Founding Director, AIR Center for Integrating Education and Prevention Research in Schools

Douglas Kirby, PhD, Senior Research Scientist, Education, Training, and Research Associates

Laura P. Kohn-Wood, PhD, Associate Professor, Department of Educational and Psychological Studies, School of Education, University of Miami

Kelli A. Komro, MPH, PhD, Associate Professor, Department of Epidemiology & Health Policy Research, College of Medicine and Associate Director, Institute for Child Health Policy, University of Florida

Karol L. Kumpfer, PhD, Professor, Department of Health Promotion and Education, University of Utah (former Director, SAMHSA CSAP)

Peter A. Lachenbruch, PhD, Professor, Department of Public Health, Oregon State University, Past President, American Statistical Association

Theresa LaFramboise, PhD, Associate Professor of Counseling Psychology, Stanford University, Member, Institute of Medicine Committee on Prevention

Sandra C. Lapham, MD, MPH, Executive Director, Behavioral Health Research Center of the Southwest, a Center of Pacific Institute for Research and Evaluation

Charles W. LeHew, PhD, Center for Population Health and Health Disparities, University of Illinois at Chicago

Susan R. Levy, PhD, Professor Emerita of Public Health and Education and Fellow, Institute for Health Research and Policy, University of Illinois at Chicago

Edward Lichtenstein, PhD, Senior Scientist, Oregon Research Institute

John M. Light, PhD, Associate Scientist, Oregon Research Institute

Bruce Link, PhD, Professor of Epidemiology and Sociomedical Sciences, Mailman School of Public Health, Columbia University

Erika S. Lunkenheimer, PhD, Assistant Professor, Human Development & Family Studies, Colorado State University

David MacKinnon, PhD, Foundation Professor, Department of Psychology (Quantitative, Social), College of Liberal Arts and Sciences, Arizona State University

Katherine MacTavish, PhD, Associate Professor Human Development and Family Sciences, Oregon State University

Jennifer Maggs, PhD, Professor of Human Development, Penn State University

Edward Maibach, MPH, PhD, Professor, Department of Communication and Director, Center for Climate Change Communication, George Mason University

Kimberly Mallett, PhD, Research Scientist, Prevention Research Center, Penn State University

Mark Mattaini, DSW, Associate Professor, University of Illinois at Chicago

Megan McClelland, PhD, Associate Professor, Human Development & Family Sciences, Oregon State University

Scott McConnell, PhD, Fesler-Lampert Chair of Urban and Regional Affairs and Professor, Educational Psychology, Center for Early Education and Development, University of Minnesota

Jeffrey McCubbin, PhD, Professor of Nutrition and Exercise Sciences, Associate Dean for Research, College of Health and Human Sciences, Oregon State University

John McKinlay, PhD, Director, New England Research Institute

Kenneth R. McLeroy, PhD, Professor, School of Rural Public Health, Texas A & M University

Robert J. McMahon, PhD, Professor, Department of Psychology, University of Washington

Robin Mermelstein, PhD, Professor, Psychology and Director, Institute of Health Research and Policy, University of Illinois at Chicago

Jon Miles, PhD, Director, Searchlight Consulting LLC

D. Paul Moberg, PhD, Deputy Director, UW Population Health Institute, Senior Scientist, Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health

Antonio A. Morgan-Lopez, PhD, Senior Research Quantitative Psychologist, Behavioral Health and Criminal Justice Research Division, RTI International

Peter Mulhall, PhD, Director, Center for Prevention Research and Development, Institute of Government and Public Affairs, University of Illinois

Ricardo Munoz, PhD, Psychiatry, University of California San Francisco, Member, Institute of Medicine Committee on Prevention

Nancy G. Murray, DrPH, Assistant Professor, Behavioral Sciences, Michael & Susan Dell Center for Advancement of Healthy Living, Director, Community Engagement Core, Center for Clinical and Translational Sciences, School of Public Health, University of Texas

Pat Newport, Director of Marketing and Advancement, College of Health and Human Sciences, Oregon State University

Job Elom Ngwe, PhD, Associate Professor of Social Work & Coordinator of African and African American Studies, Northeastern Illinois University

Robert Nix, Research Scientist, Prevention Research Center, Penn State University

Judith Ockene, PhD, Professor, Medical School, University of Massachusetts

Lydia O’Donnell, EdD, Senior Scientist and Vice President, Health and Human Development Programs, Education Development Center

Hilda Pantin, PhD, Clinical Associate Professor and Vice Chair, Department of Epidemiology and Public Health/Director, Prevention Division/Associate Director, Center for Family Studies, Miller School of Medicine, University of Miami

Guy S. Parcel, PhD, John P. McGovern Professor in Health Promotion, University of Texas School of Public Health

Mallie J. Paschall, PhD, Prevention Research Center, Berkeley, CA

Mary Ann Pentz, PhD, Professor, Department of Preventive Medicine and Director, Institute for Prevention Research, University of Southern California

Cheryl L. Perry, PhD, Professor, The Rockwell Distinguished Chair in Society and Health, Austin Regional Campus, University of Texas School of Public Health

Karen E. Peters, DrPH, Assistant Professor, Division of Health Policy and Administration, UIC School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago

Bradley S. Peterson, MD, Director of Child & Adolescent Psychiatry, Director of MRI Research, Suzanne Crosby Murphy Professor in Pediatric Neuropsychiatry, Columbia College of Physicians & Surgeons, New York State Psychiatric Institute

John Petraitis, PhD, Professor, Department of Psychology, University of Alaska Anchorage

Hanno Petras, PhD, Assistant Professor, Department of Criminology and Criminal Justice, University of Maryland College Park

John P. Pierce, PhD, Professor of Cancer Research, University of California San Diego

Harold Pollack, PhD, Associate Professor of Social Service Administration, Faculty Chair, Center for Health Administration Studies, University of Chicago

Isaac Prilleltensky, PhD, Dean, School of Education, University of Miami

Marilyn Read, PhD, Associate Professor of Interior Design, Design and Human Environment Department, College of Health and Human Sciences, Oregon State University

John Reid, PhD, Senior Scientist, Co-Founder, Oregon Social Learning Center

Belinda Reininger, DrPH, Associate Professor of Behavioral Science, University of Texas School of Public Health

Ken Resnicow, PhD, Professor, School of Public Health, University of Michigan

Karina Reyes, PhD, Professor, Psychology, University of Illinois at Chicago

Chris Ringwalt, DrPH, Senior Research Scientist, Chapel Hill Center, Pacific Institute for Research and Evaluation

Luanne Rohrbach, PhD, Associate Professor of Research, Department of Preventive Medicine, University of Southern California

Louis Rowitz, PhD, Professor of Community Health and Director of the University of Illinois Center for Public Health Practice, School of Public Health, University of Illinois at Chicago

Marcia Russell, PhD, Senior Research Scientist, Prevention Research Center, Pacific Institute for Research and Evaluation

James Sallis, PhD, Professor, University of San Diego

Robert F. Saltz, PhD, Senior Scientist, Prevention Research Center

Irwin Sandler, Professor, Psychology, Arizona State University

Steven P. Schinke, PhD, D’Elbert and Selma Keenan Professor, School of Social Work, Columbia University

Susan C. Scrimshaw, PhD, President, The Sage Colleges, Troy, NY

Herbert H. Severson, PhD, Senior Scientist, Oregon Research Institute

Timothy Shanahan, PhD, Professor, School of Education and Director, UIC Center for Literacy, University of Illinois at Chicago

Saul Shiffman, PhD, Professor, Psychology, Psychiatry, and Pharmaceutical Sciences, University of Pittsburgh

Michael D. Slater, PhD, Social and Behavioral Sciences Distinguished Professor, School of Communication, The Ohio State University

Sandy Slater, PhD, Senior Research Specialist, Institute for Health Research and Policy, University of Illinois at Chicago

Zili Sloboda, ScD, Senior Research Associate, Institute for Health and Social Policy, The University of Akron / President, Society for Prevention Research

Ed Smith, PhD, Senior Research Scientist, Prevention Research Center, Penn State University

Paula Smith, PhD, Associate Professor, Department of Teaching & Learning and Executive Director, Eunice Kennedy Shriver National Center for Community of Caring, University of Utah

Joanne Sorte, MS, Director, Child Development Lab, Oregon Head Start Prekindergarten Program, Oregon State University

Richard Spoth, PhD, F. Wendell Miller Senior Prevention Scientist and Director, Partnerships in Prevention Science Institute at Iowa State University

Jeffrey Sprague, PhD, Professor and Co-Director, Institute on Violence and Destructive Behavior, University of Oregon

Melissa H. Stigler, PhD, MPH, Assistant Professor, School of Public Health, University of Texas

Michael A. Stoto, PhD, Professor of Health Services Administration and Population Health, Georgetown University

Ann Stueve, PhD, Distinguished Scholar, Education Development Center, Inc.

Daniel Swartzman, JD, MPH, Associate Professor, School of Public Health, University of Illinois at Chicago

José Szapocznik, PhD, Professor, Chair, Department of Epidemiology and Public Health/Associate Dean for Community Development, University of Miami, Miller School of Medicine

John A. Tauras, PhD, Associate Professor, UIC and Research Associate, NBER, Department of Economics, University of Illinois at Chicago

Jeff R. Temple, PhD, Assistant Professor, Department of Obstetrics & Gynecology, University of Texas Medical Branch

Susan Tortolero, PhD, Associate Professor, Behavioral Sciences; Director, Center for Health Promotion and Prevention Research; Director, University of Texas Prevention Research Center, School of Public Health, University of Texas-Houston

Edison J. Trickett, PhD, Professor and Chair, Community and Prevention Research Division, Department of Psychology, University of Illinois at Chicago

Rob Turrisi, PhD, Professor, Biobehavioral Health & Prevention Research Center, Penn State University

Jennifer B. Unger, PhD, Professor of Community and Global Health, Claremont Graduate University

Renée K. Van Norman, PhD, BCBA, Assistant Professor in Special Education and Clinical Sciences, University of Oregon

Tina Dodge Vera, Nutrition Education Instructor, Extension Service, Oregon State University

Alexander C. Wagenaar, PhD, Professor of Epidemiology, Program Director for Strategic Initiatives, Associate Director, Public Health Law Research Program, Department of Epidemiology & Health Policy Research and Institute for Child Health Policy, College of Medicine, University of Florida

Robert J .Walden, Chief Financial & Administrative Officer, Pacific Institute for Research and Evaluation

Youfa Wang, MD, PhD, Associate Professor of International Health and Epidemiology, Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University

Margaret R. Weeks, Executive Director, Institute for Community Research, Hartford, Connecticut

Roger P. Weissberg, PhD, LAS Distinguished Professor, University of Illinois at Chicago

Janet Welsh, PhD, Research Scientist, Prevention Research Center, Penn State University

Wayne Wiebel, PhD, Professor of Epidemiology & Biostatistics, School of Public Health, University of Illinois at Chicago

Brian L. Wilcox, PhD, Professor of Psychology, Director, Center on Children, Families, and the Law, University of Nebraska-Lincoln

John K. Worden, PhD, Research Professor Emeritus in Family Medicine, University of Vermont 

References

1.     National Research Council and Institute of Medicine (2009). Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. Committee on Prevention of Mental Disorders and Substance Abuse Among Children, Youth, and Young Adults: Research Advances and Promising Interventions. Mary Ellen O’Connell, Thomas Boat, and Kenneth E. Warner, Editors. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

2.     Biglan, A., Brennan, P., Foster, S., & Holder, H. (2004). Helping adolescents at risk: Prevention of multiple problem behaviors. NY: Guilford.

3.     Nock, M.K., Kazdin, A.E., Hiripi, E., & Kessler, R.C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: Results from the National Comorbidity Survey Replication. Journal of Child Psychology and Psychiatry, 48, 703-713.

4.     Conger, R.D., Ge, X., Elder, G.H., Lorenz, F.O., & Simons, R.L. (1994). Economic stress, coercive family process, and developmental problems of adolescents. Child Development, 65, 541-561.

5.     Roy-Byrne, P.P., Davidson, K.W., Kessler, R.C., Asmundson, G.J.G., Goodwin, R.D., Kubzansky, L. et al. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30, 208-225.

6.     Flay, B.R. (2003). Positive youth development requires comprehensive health promotion programs. American Journal of Health Behavior, 29, 407-14.

7.     Posner, M.I. (2008). Evolution and development of self-regulation: Seventy-seventh James Arthur lecture on the evolution of the human brain. New York: American Museum of Natural History.

8.     Flay, B.R., & Allred, C.G. (2003). Long-term effects of the Positive Action program. American Journal of Health Behavior, 27, S6-S21.

9.     Kellam, S.G., Brown, C.H., Poduska, J.M., Ialongo, N.S., Wang, W., Toyinbo, P. et al. (2008). Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes. Drug & Alcohol Dependence, 95(1), S5-S28.

10.   Biglan, A., & Hinds, E. (2008). Advancing the goals of clinical psychology by evolving prosocial and sustainable communities. Annual Review of Clinical Psychology, 5.

I have just read the NIH priorities for the Challenge Grants to be issued under the American Recovery and Reinvestment Act of 2009. As a member of the Institute of Medicine Committee on Prevention, a member of a NIDA workgroup on prevention priorities, and as the Past President of the Society for Prevention Research, I feel compelled to comment on these priorities.

Despite President Obama’s stated intention to support prevention through evidence-based programs and comprehensive efforts to address the risk factors that put people at risk for multiple problems, the Challenge Grant priorities are wholly absent any funding that would advance the nation’s ability to prevent the psychological and behavioral problems that cost the nation more than $400 billion per year.¹ What is sadly missing in the priorities is any recognition of the relationships among problems or any challenge to put together what we know to produce population-wide changes in wellbeing.

Psychological, behavioral, and physical health problems are inter-related for both adolescents and adults.^1,2 These problems co-occur with a host of others, including major marital discord, unemployment, and on-the-job conflict.^3,4 All of these problems are significant risk factors for physical illness.⁴ Self-regulation, positive behavior (e.g., physical activity and healthy eating), prosocial behavior, academic achievement, and job performance are also highly inter-related, and are negatively correlated with problem behaviors.^5,6 Encouraging young people’s positive behavior can put them on a positive developmental trajectory that leads to happier and more productive lives.^7,8 Yet despite the evidence, the Challenge priorities continue to focus on individual problems as though each was completely unrelated to any other and as if a common set of risk factors did not influence multiple problems.

Biological and behavioral research has brought us to the point where it is possible to substantially improve human wellbeing in most American communities.⁹ Yet actual wellbeing—especially in impoverished communities—lags far behind what the evidence shows could occur. The primary reason is that prevention science remains fragmented, with separate groups of investigators funded by different institutes and each studying different psychological disorders or physical illnesses. This disciplinary archipelago obscures common features involved in preventing each problem, and, up to this point, the NIH has not funded research to develop and test interventions that comprehensively improve wellbeing. The Challenge priorities miss an enormous opportunity to do just that.

A new synthesis is necessary. One of the highest priorities for NIH research should be the evaluation of comprehensive interventions that support the development of nurturing family, school, workplace, and neighborhood environments. The just-released IOM report⁹ on prevention provides ample documentation for the fact that environments that support positive behavioral development and reduce biologically and psychologically toxic events, such as abuse and conflict, can prevent multiple public health problems and can contribute to our lives being more caring, meaningful and productive.¹⁰ The next major breakthrough in public health research will result from creating and experimentally evaluating comprehensive interventions to increase the prevalence of such nurturing environments. Yet the Challenge priorities make no contribution whatsoever to this agenda.

NIH and NIDA in particular must modify the Challenge priorities to include some that foster the creation and testing of the kind of comprehensive preventive interventions that are commensurate with what the new administration is so clearly seeking to do.

Here is an example: Research is needed that tests comprehensive neighborhood and community interventions that have the potential to increase the prevalence of health and prosocial behavior and to prevent the development of multiple problems, including drug abuse, antisocial behavior, depression, academic failure, and risky sexual behavior.

If you share these concerns, please add your comments here and go to http://www.facebook.com/home.php?#/group.php?gid=65033804001 and add your name to those who urge NIH to strengthen its prevention research. As more people add their comments, the message will grow in strength. I will endeavor to make the website and its supporters known to the leadership of NIH and the White House.

1. Biglan, A., Brennan, P., Foster, S., & Holder, H. (2004). Helping adolescents at risk: Prevention of multiple problem behaviors. NY: Guilford.

2. Nock, M.K., Kazdin, A.E., Hiripi, E., & Kessler, R.C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: Results from the National Comorbidity Survey Replication. Journal of Child Psychology and Psychiatry, 48, 703-713.

3. Conger, R.D., Ge, X., Elder, G.H., Lorenz, F.O., & Simons, R.L. (1994). Economic stress, coercive family process, and developmental problems of adolescents. Child Development, 65, 541-561.

4. Roy-Byrne, P.P., Davidson, K.W., Kessler, R.C., Asmundson, G.J.G., Goodwin, R.D., Kubzansky, L. et al. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30, 208-225.

5. Flay, B.R. (2003). Positive youth development requires comprehensive health promotion programs. American Journal of Health Behavior, 29, 407-14.

6. Posner, M.I. (2008). Evolution and development of self-regulation: Seventy-seventh James Arthur lecture on the evolution of the human brain. New York: American Museum of Natural History.

7. Kellam, S.G., Brown, C.H., Poduska, J., Ialongo, N., Petras, H., Wang, W. et al. (In press). Effects of a universal classroom behavior management program in first and second grades on young adult behavioral, psychiatric, and social outcomes. Drug & Alcohol Dependence, in press.

8. Flay, B.R., & Allred, C.G. (2003). Long-term effects of the Positive Action program. American Journal of Health Behavior, 27, S6-S21.

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