In the same week that the Supreme Court overturned a century of precedent and made it legal for corporations to campaign for their favored candidates, I received a copy of Richard Wilkinson and Kate Pickett’s new book, The Spirit Level. What a sad and ironic convergence. Read More »
November 27, 2009
Reaping the Benefits of Prevention Science
Anthony Biglan and Brian Flay
This is an exciting time in America. We are witnessing the first significant effort to comprehensively address concentrated poverty in a generation and numerous efforts to ensure that all young people develop successfully. Examples of these efforts include the Obama Administration’s Promise Neighborhood initiative (inspired by the success of the Harlem Children’s Zone), the Department of Education’s Race to the Top, and a National Prevention System that a federal interagency task force has been discussing.
There is solid evidence that these ambitious efforts can succeed. The recently released Institute of Medicine report on prevention identifies numerous evidence-based programs, policies, and practices that can ensure young people’s successful development. All of the proposed efforts will draw on this knowledge.
But these efforts could fail if they do not use the scientific tools that got us this far.
Traditionally, once a program’s value has been shown by one or two rigorous experimental evaluations, it is widely implemented without further evaluation. But such a practice is risky for at least three reasons.
First, it is well-documented that a program’s benefit cannot be replicated unless the program is implemented with fidelity. If we do not measure fidelity and verify that benefits are being achieved, the quality and thereby the impact of our interventions will deteriorate.
Second, we cannot be sure that an intervention that worked for one population will work when it is tried in a different, and perhaps more challenging environment. This is especially true when we first begin to implement evidence-based interventions in high poverty neighborhoods where they have not been tried before.
Third and most important, if good science does not accompany these important efforts, we simply won’t know if they are working. Two things are paramount: good measures and good experimental evaluations. Read More »
October 22, 2009
Hopes for the Promise Neighborhood Research Consortium
I have often been struck that when I start on a research project, I have trouble really seeing and feeling what can be achieved. As I look back on my work, I often think that—if only I had realized just what the world would look like when we were done, that vision or sense of it might have made our work both easier and better. I think in particular about what it would have been like if we had assumed that not only would the intervention we were testing have been stronger, but we would have planned for its dissemination and sustainability more effectively. In that vein, I thought it might be good to try to envision what our little adventure might look like in two, five, and ten years.
(I don’t say any of this to say this is what we must do. Don’t forget I am planning to cut back in two years and retire in five. And I don’t want our dreams to become our burden.)
What We Could Accomplish in the Next Two Years
We have gotten fifty neighborhoods at various levels of involvement with the PNRC. All of them have registered and get information from our website about evidence-based practices. Twenty or so have implemented one or more of our recommended measures and are using our website to collect data and to display it to their residents, policymakers, and organizations funding them. Thanks to materials we produce from their data, they are able to effectively publicize to residents and policymakers the importance of the outcomes that our measures document and, increasingly, public attention and practice is shaped by evidence and discussion about the outcomes and processes that our measures assess.
At least twenty neighborhoods, are implementing programs that we have specified and informed them about. We have partnered with them in securing funding for these programs. Solid designs (interrupted time series designs?) are in place to detect the impact of these programs. The measures that these neighborhoods are collecting are just the ones needed to detect effects of these programs.
Many more neighborhoods have residents and neighborhood organization leaders who are using kernels to influence prosocial behavior. In many cases, good experimental designs are being used evaluate the use of the kernels. (Our success with the kernels followed our working out the nettlesome issues of conflict of interest and ownership. J )
Our work on policy, which has been distilled down to one page fact sheets, as well as high quality reviews of the empirical evidence is influencing policy making and advocacy in twenty to thirty of our communities and our repository of policies has become the place that local, state, and national policy makers look to guidance about the most useful policies.
Many more unregistered users of the website are getting information from it about evidence-based prevention.
Our online journal has been started. Just as scientific publications went from Latin in the time of Newton to English in the time of Priestly, we have evolved new and more effective ways of communicating scientific knowledge through an online journal that makes use of all of the possibilities of the internet and makes the knowledge simultaneously accessible to both scientists and nonscientists. As a result, science is once again an integral part of public discussion, as it was in Priestley’s and Franklin’s day.
Through partnerships with neighborhoods and communities, we have helped many neighborhoods get funding to implement effective interventions to reduce poverty and improve outcomes for children and youth. And we have become a key resource for evaluating these initiatives.
Geoffrey Canada likes us!
The White House has a ceremony celebrating the Promise Neighborhoods and we are invited. (Don’t forget to take a souvenir napkin.)
We have succeeded in getting additional funding. Some of the funding is for an NIH funded center on prevention in high poverty neighborhoods. The rest is for specific groups of investigators who are conducting various trials in multiple sets of neighborhoods; they are all part of the Center.
What else?
Five Years
Published papers are beginning to accumulate that show the benefits of a variety of interventions in high poverty neighborhoods. One of those papers reports on the impact of massive diffusion of kernels in a series of neighborhoods.
Thanks to the use of kernels and programs like positive action that increase positive reinforcement (caring, support, warmth, appreciation, love, and forgiveness) the levels of violence are found to be declining in neighborhoods where we have succeeded in disseminating these programs and practices.
The Center for the Promise Neighborhood Consortium has continued to articulate and disseminate programs, policies, and practices that are making a difference in the lives of now millions of people. All around the world people come to our website for the most useful information about what works, how to implement it, and how to evaluate.
Our Center has succeeded in creating a “marketplace” in which neighborhood and community leaders, neighborhood residents, policymakers, and early career and established scientists can connect with each other exchange information, support each other’s efforts, and form new teams.
Ten Years
Histories have begun to be written about the eight years of the Obama administration. One of the most impressive accomplishments that is widely noted is that concentrated poverty has begun to decline and there has been a marked increase the proportion of children living in poverty who are succeeding in school and in their social relations. Violence in poverty neighborhoods has declined. Thanks to the adoption of new policies the proportion of families living in poverty is declining across America. At the same time, there is an increased sense across the nation that we are all one people and that it is in everyone’s interest to support the successful development of children—even when they are different from us in race, ethnicity, or economic situation. The vision of one nation that Obama articulated in his first campaign has begun to be achieved.
In many of the accounts of this progress, mention is made of the Promise Neighborhood Research Consortium, which brought the knowledge and tools of the behavioral science community to bear on the problem of neighborhood poverty and contributed to the increased use of data to guide the evolution of more nurturing family, school, workplace, and neighborhood environments.
Looking back over this, I can think of one reason, why we have not generally done this. It can turn into a burden of expectations. That is where the ACT stuff comes in handy. We can have such fears and still work to try and make the world a little bit more like what we can envision and a little bit less like the one we now have.
September 25, 2009
A Sad Little Boy
I got back to Eugene after briefing Virginia legislators on the IOM report and prevention. After three flights, United Airlines had lost my luggage. As I waited in vain for it, I saw a Dad and his two young sons pull a soft bag off the conveyer that had been ripped open in several places. There was a small stuffed animal hanging out of it.
After a little more waiting I went to the United counter to give them my claim check. (Believe me I know the routine.) The Dad and his two sons were there ahead of me. The youngest son–maybe four–was holding his stuffed owl and crying quietly. It had been damaged–not too badly to my adult eye–but I suspect that to him–his dear friend had been hurt. Read More »
September 8, 2009
Prevention and Health Care Costs
Prevention advocates like to tell the story of the town next to a river where drowning people keep floating by. The town stations boats and an EMT crew on the river to save as many as they can. Sometimes they succeed; often they fail. But no one thinks to go up river and see why all these people are falling in. The preventionist does.
In the case of health care reform, it is as though America has decided to move its rescuers half way to the spot where people are falling in. Read More »
September 6, 2009
Nurturance and Football
The world will become more nurturing when many many people begin to look at every situation in terms of whether or not it is nurturing.
University of Oregon running back LaGarette Blount punched a Boise State player after the their game on Thursday night after the player apparently taunted Blount about his pre-game statement that Boise State needed an “ass whoopin.” So far no nurturing in this. Read More »
August 14, 2009
Super Colliders and Nurturing Human Beings
According to CBS’s Sixty Minutes, the new Large Hadron Collider in Geneva, Switzerland cost $8 billion over twenty years. When asked why it was worth spending $8 billion, American physicist, Bob Stanek told Steve Kroft, “It’s in humans’ interest to know everything, right? And why wouldn’t you want to know that?” He went on to say that the research could lead to our ability to tele-transport people.
That’s nice.
Given the resistance to funding science, I don’t want to suggest that we shouldn’t have a super collider. But it got me to thinking about what would happen if we invested a similar amount in behavioral science solutions to our most pressing problems. Read More »
March 29, 2009
The Economic Stimulus and Prevention
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.
March 9, 2009
The Economic Stimulus and the Health of Americans: An Opportunity Is Being Missed
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. Read More »
February 13, 2009
Minimize Toxic Environments
The first thing we need to do to ensure human wellbeing is minimize biologically and psychologically toxic elements in people’s environments. In each of the roles in your life—parent, spouse, worker, policy maker, friend, neighbor—if you minimize your own and other people’s exposure to toxic events, you will be laying the groundwork for a more peaceful, productive society with much less crime, drug abuse, depression, and conflict. Read More »