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SDRG Foundations of Prevention: Epidemiology J. David Hawkins, Ph.D. Social Development Research Group School of Social Work University of Washington jdh@u.washington.edu SWL 579 September 26, 2007

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SDRG Who are you? Where are you from? What school or department? What did you do before starting your current degree program? What is your substantive interest area? Are you currently engaged in research? What do you expect from this course?

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SDRG Universal Selective Indicated Case Identification Standard Treatment for Known Disorders Compliance with long- term treatment (goal: reduction in relapse and recurrence) After-care (including rehabilitation) Source: Institute of Medicine (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Patricia J. Mrazek & Robert J. Haggerty, Eds. Washington DC: National Academy Press The Mental Health Intervention Spectrum for Mental Disorders Prevention Treatment Maintenance

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EPIDEMIOLOGY ETIOLOGY EFFICACY EFFECTIVENESS DISSEMINATION 1. Identify problem or disorder(s) and review information to determine its extent 2. With an emphasis on risk and protective factors, review relevant information- both from fields outside prevention and from existing preventive intervention research programs 3. Design, conduct, and analyze pilot studies and confirmatory and replication trials of the preventive intervention program 4. Design, conduct, and analyze large- scale field trials of the preventive intervention program 5. Facilitate large-scale implementation and ongoing evaluation of the preventive intervention program in the community. The preventive intervention research cycle. Preventive intervention research is represented in boxes three and four. Note that although information from many different fields in health research, represented in the first and second boxes, is necessary to the cycle depicted here, it is the review of the information, rather than the original studies, that is considered to be part of the preventive intervention research cycle. Likewise, for the fifth box, it is the facilitation by the investigator of the shift from research project to community service program with ongoing evaluation, rather than the service program itself, that is part of the preventive intervention research cycle. Although only one feedback loop is represented here, the exchange of knowledge among researchers and between researchers and community practitioners occurs throughout the cycle.

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Components of Prevention Science Epidemiology what is the prevalence in time and space of well being and its predictors; of problems and their predictors? Epidemiology what is the prevalence in time and space of well being and its predictors; of problems and their predictors? Etiology what causes positive or negative outcomes? Etiology what causes positive or negative outcomes? Efficacy trials-can preventive interventions actually prevent problems under favorable conditions? Efficacy trials-can preventive interventions actually prevent problems under favorable conditions? Effectiveness trials- can preventive interventions prevent problems under real world conditions? Effectiveness trials- can preventive interventions prevent problems under real world conditions? Diffusion research- How can tested, effective prevention interventions be disseminated to reduce problems at scale? Diffusion research- How can tested, effective prevention interventions be disseminated to reduce problems at scale? Mrazek and Haggerty, 1994. Mrazek and Haggerty, 1994.

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SDRG Seattle School District Washington Assessment of Student Learning (WASL) Test Results(2003) Proportion of Students Meeting Standards READINGMATH 7 th Grade 33.9% 47.9% 10 th Grade 34.9% 53.1% Seattle Public Schools Data Profile: District Summary, Dec. 2003 http://www.seattleschools.org/area/siso/distsummary/distsum.html

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SDRG 2006 Monitoring the Future Prevalence Rates, 8 th Grade

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Onset of Alcohol Use Communities That Care Trial Adjusted Hazard p