1. Broad street pump) where did the cholera epidemic take place?
    London in 1854
  2. Broad street pump) what was the name of the physician that plotted and investigated 578 cases in the city?
    John Snow
  3. Broad street pump) what did John snow find when investigating?
    Broad street pump use
  4. Broad street pump) what happened when the pump was disabled?
    The epidemic subsided
  5. What is considered to be one of the founding events in the field of public health?
    Broad street pump
  6. Lessons from the broad street pump) even if you do not know how to cure a problem...
    You may still be able to prevent it
  7. Lessons from the broad street pump) you do not need to know the cause of a problem to prevent it...
    You just need to understand something about the mechanisms through which the problem is transmitted or sustained
  8. Lessons from the broad street pump) you can often prevent a problem through...
    Changing some aspect of human behavior
  9. Lessons from the broad street pump) while individual behavior change can contribute to prevention...
    Complete prevention of a problem often relies upon public action
  10. Rationale for promoting prevention) George Albee thought process of one-to one therapy (2)
    -It is a limited mode of helping and there is no way we can assign one professional for one person only

    -mental health therapy is also not available or effective with everyone
  11. Rationale for promoting prevention) instead of treating disorders,
    • Why not prevent them from occurring to begin with?
    • *John snow and public health model
  12. 2 approaches for prevention
    -preventing psychiatric disorders problem behaviors and social problems

    -promoting competence, wellness, and capacity to address problems
  13. caplan model: primary prevention (2)
    -given to an entire population when they're is no known need or distress

    -reduce exposure to potentially harmful circumstances

    ex) vaccines , pre-school programs
  14. Caplan's model: secondary prevention (3)
    - intervention at early signs of difficulty

    -assumes that there is a reliable way of identifying people at risk

    -risk does not mean problems will develop
  15. Caplans model: secondary prevention: what is a person that is labeled  "at risk"
    • Describes person in a situation that puts them at risk
    • *drug abuse
    • *teen pregnancy
    • *dropping out of high school
  16. Caplan model: tertiary prevention: (30
    - focuses open groups with an existing disorder

    -population level strategy rather than 1on1 rehab

    -can be difficult to distinguish from treatment
  17. Caplan model: tertiary prevention: interventions aimed at? (2)
    -preventing further problems

    -limiting or addressing disability
  18. US institute of medicine report) Universal preventative measures
    For everyone in a given population group

    Ex) TV ads about why drugs are bad
  19. US institute of medicine report) selective preventative  measures
    For groups of people at above average risk for specific problems

    Ex) screening for colon cancer after 45 years old
  20. US institute of medicine report) indicated preventative measures
    • For individual people who are at high risk for developing disorder in the future especially if they show early symptoms
    • ***not treatment for full disorder

    Ex) programs for children who experienced child abuse
  21. Population focus of prevention) what do prevention programs focus on?
    • Reducing the rate of disorders within a population
    • **programs need to measure their success
  22. Population focus of prevention) incidence
    • The rate of new cases of a disorder during a give period
    • *usually a year
  23. Population focus of prevention) prevalence
    The total number of cases in a population
  24. Population focus of prevention) prevention programs aim to lower the incidence of new cases which...
    Lower the prevalence in a population
  25. Prevention vs Promotion) promotion
    • Help people develop skills and abilities that support well being and health
    • **help people function to their fullest potential
    • **ex) encourage seniors to be physically active
  26. There are often debates over ______ _____ to prevention or promotion efforts
    resource allocation
  27. Risk and resiliency)  Emmy werner: Kauai longitudinal study (3)
    -followed children burned on the island and followed for 40 yrs

    -30% had risk factors in their lives

    • -2/3 of the children who had 4 or more risk factors in infancy developed problems before adulthood
    • *meaning that 1/3 did not develop serious problems
  28. Resiliency) definition
    Ability of some individuals to overcome adverse conditions and experience healthy development
  29. Factors associated with resilience) what are some individual difference?  (5)
    -cognitive abilities

    -self perceptions of competence, worth, confidence

    -temperament & personality

    -self regulation skills

    -positive outlook on life
  30. Factors associated with resilience) individual differences: cognitive abilities examples
    -iq scores

    -attentional skills

    -executive functioning skills
  31. Factors associated with resilience) individual differences: self perceptions of competence, worth, confidence
    -Self efficacy

    -self esteem
  32. Factors associated with resilience) individual differences: temperament and personality

  33. Factors associated with resilience) individual differences: self regulation skills
    -impulse control

    -affect and arousal regulation
  34. Factors associated with resilience) individual differences: positive outlook on life

    -belief that life has meaning and faith
  35. Factors associated with resilience) relationships differences: (3)
    -parenting quality

    -close relationships with competent adults

    -connection to pro-social and rule abiding peers
  36. Factors associated with resilience) community resources and opportunities (4)
    -good schools

    -connection to pro-social organizations

    -neighborhood quality

    -quality of social services and health care
  37. Prevention & promotion programs) Search Institute
    Assess and develop programs to promote developmental assets
  38. Prevention & promotion programs) search institute: what are developmental assets?
    Factors within the child or the child's environment that promote healthy child and youth development
  39. Prevention & promotion programs) communities that care (2)
    -Assess community needs/resources

    -recommend evidence based approaches
  40. Prevention & promotion programs) what are communities that care effective in?
    -reducing adolescent substance abuse and delinquency
  41. What are the 5 steps of communities that care approach?
    1. Get started

    2. Get organized

    3. Develop community profile

    4. Create a plan

    5. implement & evaluate
  42. Prevention equation) Albee equation
    • Stress + physical vulnerability
    • ---------------------------------      
    • Coping skills+ social support+ self-esteem

    • ***this equals to individual level incidence of disorders***
    • *if confused look at power point
  43. Prevention equation) What are the 5 interventions that impact Albee equation?
    1. Reduce or manage perceived stress

    2. Reduce the negative impact of physically biologically based vulnerability

    3. Increase coping skills

    4. Increase perceived social support

    5. Increase self esteem
  44. Prevention equation) Elias equation
    • Stressors + environmental risk factors
    • ------------------------------------------------------------
    • Positive socialization practices + social support resources + opportunities for positive relatedness and connectedness

    **equates to environmental level of incidence of disorders
  45. Prevention equation) 5 interventions that are applied for Elias equation
    1. Reduce/eliminate stressors

    2. Reduce influence/presence of physical risk factors that result in increased vulnerability

    3. Improve socialization practices

    4. Increase accessible social support resources

    5. Increase opportunities for positive relatedness
  46. Risk factors in equation) what are the 3 numerator on the equation?
    -physical vulnerability

    -risk factor

  47. Protective factors : denominators, which are they ? (5)
    • -social competencies
    • *coping skills
    • *developmental assets
    • *positive socialization practices

    -social support

    -social support resources

    -self esteem

    -opportunities for connectedness
  48. Do programs work?) 4 questions to ask to determine effectiveness
    -how well does it work?

    -for whom?

    -under what conditions?

    -what are the mechanisms that account for its effects?
  49. Assessing whether prevention programs work) 2 ways to measure?
    -meta-analytic techniques

    -best practice approaches
  50. Assessing whether prevention programs work) meta-analytic techniques (2)
    -combines quantitative analyses

    -looks for effect size
  51. Assessing whether prevention programs work) META-ANALYTIC technique: what is effect size?
    Strength of the effect of that intervention (IV) on the chosen outcomes (DV)
  52. Assessing whether prevention programs work) best practices approaches (2)
    -reviews qualitative analyses & quantitative data

    • -context dependent
    • *look at programs in settings
  53. Results of prevention of meta-analyses) Duke and wells 1997: how many primary prevention programs were aimed at children and adolescents?
  54. Results of prevention of meta-analyses) results from durlak and wells 1997
    59% to 82% of program participants surpassed the performance of children in control groups
  55. Results of prevention of meta-analyses) durlak and wells 1998 results
    Average participant was better off than 70% of control group members
  56. Results of prevention of meta-analyses) durlak and wells 1998: how secondary or indicated prevention programs for children?
  57. Meta-analysis) 5 documented significant effects for wide range of prevention programming (5)
    -prevention of childhood and adolescent depression

    -teen pregnancy &n subsequent teen pregnancies

    -childhood obesity

    -childhood and adolescent drug use

    -mentoring programs
  58. Meta-analysis) limitations (2)
    -findings can be difficult to translate into clear guidelines for programs

    -lacks qualitative piece
  59. Principles of effective prevention programs) theory driven and evidence based (3)
    -programs have theoretical justification

    -address risk and protective factors identified in research

    -empirical support of efficacy
  60. Principles of effective prevention programs) comprehensive
    Programs provide multiple interventions in multiple settings to address interrelated goals
  61. Principles of effective prevention programs) appropriately timed (2)
    -programs are provided before the onset of a disorder

    -at an appropriate development stage for the participants or during important life transitions
  62. Principles of effective prevention programs) socioculturally relevant (2)
    -Programs are culturally sensitive

    -incorporate cultural norms when appropriate
  63. Principles of effective prevention programs) behavioral and skills-base (2)
    -Programs include a strong behavioral component that focuses on the acquisition of specific skills

    -ensures opportunities for practicing those skills
  64. Principles of effective prevention programs) sufficient dosage (2)
    -Programs are of a sufficient length and intensity to ensure the desired effects

    -have a booster sessions when appropriate
  65. Principles of effective prevention programs) positive relationships
    Programs specifically promote the development of positive relationships to provide mentoring and social support
  66. Principles of effective prevention programs) second order change
    Programs include a focus on changes in setting and communities
  67. Principles of effective prevention programs) support for staff (2)
    -Programs provide appropriate training for staff

    -ongoing support to ensure effective implementation and evaluation
  68. Principles of effective prevention programs) program evaluation (3)
    -programs have ongoing processes to ensure continual evaluation and improvement, assessment of outcomes, and assessment of community needs
  69. Cost-effectiveness analyses) how does it view prevention/promotion programs?
    As investments
  70. Cost-effectiveness analyses) what do they try to determine?
    The return on that investment
  71. Cost-effectiveness analyses) what do they only look at?
    Relative costs of programs

    *out of several effective programs, which will lower the incidence of the problem for the least amount of money?
  72. 3 strikes of injustice summary
    The 3 strikes policy prevented more crime but cost more than the 4 programs it was being compared to
  73. Cost-Benefit analysis) question they ask
    Are the broad economic benefits greater than the program costs?
  74. Cost-Benefit analysis) what dopes the cost measure?
    -program cost per person served
  75. Cost-Benefit analysis) what does benefit measure? (2)
    -Services not needed

    -earned wages and paid taxes
  76. High scope/ Perry preschool project) what weas it?
    program that provided high quality, academically based day care to children born into poverty
  77. High scope/ Perry preschool project) how was it evaluated?
    Using randomized control trial
  78. Prevention of HIV/AIDS infection) one main factor to preventing?
    Promotion of healthy sexual behaviors
  79. Prevention of HIV/AIDS infection) how many interventions did CDC identify as demonstrating best evidence?
  80. Project safe) who does it target?
    Minority women who have been diagnosed with an STD at a public health clinic
  81. Project safe) goals
    Increase healthy sexual behavior and decrease subsequent STD infections
  82. Prevention of childhood behavior disorders) what does it promote?
    Promotion of positive parenting
  83. Prevention of childhood behavior disorders) incredible years (Webster-Stratton) what is it?
    -parent training program targeted for parents of young children with behavioral problems
  84. Prevention of childhood behavior disorders) incredible years, what does it incorporate?
    Principles of effective prevention programs
  85. Prevention of bullying) what does it promote?
    Safe school climates
  86. Prevention of bullying) olweys bullying prevention program: what is it? (6)
    -give survey on school bullying activity

    -discuss the results of the survey

    -coordinate committee

    -increase supervision in hot spots

    -encourage pro social play

    -have regular class meetings and clear rules
  87. Prevention of bullying) olweys bullying prevention program: is it effective?
    Yes when implemented with high fidelity
  88. Prevention of bullying) olweys bullying prevention program: does it allow for flexibility with the other schools?
    Yes, it tailors to specific schools
  89. Implementation & sustainability ) what does emerging research address?
    Actual implementation of prevention/promotion initiative in local contexts
Card Set
Prevention & Promotion