Using Prevention Science to Guide Community Action

1. 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 jdh@u.washington.edu www.sdrg.org

2. 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.

3. 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)

4. The Premise of Prevention Science To prevent a problem before it happens, the factors that predict the problem must be changed.

5. 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.

6. Risk Factors forAdolescent Problem Behaviors Risk Factors Substance Abuse Delinquency Teen Pregnancy School Drop-Out Violence Depression & Anxiety 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     

7. Risk Factors Substance Abuse Delinquency Teen Pregnancy School Drop-Out Violence Depression & Anxiety 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

8. Risk Factors Substance Abuse Delinquency Teen Pregnancy School Drop-Out Violence Depression & Anxiety School Academic Failure Beginning in Late Elementary School       Lack of Commitment to School      Risk Factors for Adolescent Problem Behaviors

9. Risk Factors forAdolescent Problem Behaviors Risk Factors Substance Abuse Delinquency Teen Pregnancy School Drop-Out Violence Depression & Anxiety Individual/Peer  Early and Persistent Antisocial Behavior      Rebelliousness    Friends Who Engage in the Problem Behavior      Favorable Attitudes Toward the Problem Behavior     Early Initiation of the Problem Behavior      Gang Membership    Constitutional Factors    

10. 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

11. Prevalence of “Attacked to Hurt”By Risk and Protection Levels

12. Prevalence of Academic SuccessBy Number of Risk and Protective Factors

13. What Is Known AboutPredictors 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.

14. Advances in Prevention Controlled studies have identified both ineffective and effective prevention and youth development policies and programs.

15. 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.

16. Prenatal & Infancy Programs Early Childhood Education Parent Training After-school Recreation Mentoring with Contingent Reinforcement Youth Employment with Education Organizational Change in Schools Classroom Organization, Management, and Instructional Strategies School Behavior Management Strategies Curricula for Social Competence Promotion Community & School Policies Community Mobilization Effective Programs and Policies Have Been Identified in a Wide Range of Areas (Hawkins & Catalano, 2004)

17. 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/

18. 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

19. Nurse-Family PartnershipEvidence of Effect Reductions in: • Prenatal Health Problems. • Subsequent Births. • Welfare and Food Stamp Use. • Maternal Arrests (61%) and Convictions (72%).

20. Nurse-Family PartnershipEvidence of Effect Reductions in: • Maternal Unemployment. • Child abuse, neglect, and injuries (48%). • Child Arrests (59%) and Adjudications as PINS (90%) @ age 15.

21. 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

22. PATHSEvidence of Effect • Decreased conduct problems, including aggression. • Improved self-control. • Improved understanding and recognition of emotions. • Improved conflict resolution strategies. • Improved cognitive planning.

23. 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

24. Bullying Prevention ProgramEvidence of Effect • Reductions in bully/victim problems of 50 percent. • Reductions in antisocial behavior (theft, vandalism, truancy). • Improvement in school climate.

25. 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

26. Risk Factors Addressed By the SSDP Intervention X X X X X X X X X Family School Individual/Peer

27. Healthy Behaviors The Goal… …for all children and youth Healthy Beliefs and Clear Standards …in families, schools, and peer groups Ensure… Bonding –Attachment –Commitment …to families, schools, and peer groups Build… By providing… Opportunities Skills Recognition …in families, schools, and peer groups Be Aware of… Individual Characteristics The Social Development Strategy

28. Seattle Social Development ProjectCore Components • Teacher Training in ClassroomInstruction and Management • Parent Trainingin Behavior Management and Academic Support • Child Social and Emotional Skill Development

29. 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

30. 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

31. 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

32. Support Structures • School Staff • Implementation team training • 7 days of teacher training • Coaching • Principal support • Family • Training in each parenting curriculum

33. Late Tx Full Intervention Full Intervention Control Control 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 Grade Age

34. Effects of SSDP Intervention on School Bonding from Age 13 to 18 Hawkins, Guo, Hill, Battin-Pearson & Abbott (2001)

35. Late Tx Full Intervention Full Intervention Control Control SSDP Intervention Effects Compared to Controls By age 18 Youths in the Full Intervention had less heavy alcohol use: less lifetime violence: fewer lifetime sex partners: less grade repetition: 25.0% Control vs. 15.4% Full 59.7% Control vs. 48.3% Full 61.5% Control vs. 49.7% Full 22.8% Control vs. 14.0% Full Late Tx Grade Age

36. Late Tx Full Intervention Full Intervention Control Control SSDP Intervention Effects Compared to Controls By age 21, full intervention group had: More high school graduates: More attending college: Fewer selling drugs: Fewer with a criminal record: 81% Control vs. 91% Full 6% Control vs. 14% Full 13% Control vs. 4% Full 53% Control vs. 42% Full Late Tx Grade Age

37. 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: saos@wsipp.wa.gov Institute Publications: www.wa.gov/wsipp

38. Over 30 well-researched studies, mostly of programs for 3 & 4 year olds from low income families. Key findings: • improved education outcomes, increased high school graduation higher test scores lower special education lower grade repetition • reduced crime, • reduced child abuse & neglect. Evidence of decay in early test score outcomes, but still statistically significant by high school graduation. Benefits Per Youth $14,426 Reduced crime $3,957 Increased high school graduation $10,320 Reduced K-12 grade repetition $150 $4,590 Cost Per Youth $3.14 Benefits Per Dollar of Cost Selected Findings Early Childhood Education$17,202$7,301$9,901 A home visitation program, with active nationwide dissemination. NFP isdelivered by nurses and isfor low income, soon-to-be first time mothers. Evidence of: • reduced crime for mothers and children, • reduced child abuse & neglect, • improved education outcomes. Website: www.nursefamilypartnership.org/ Nurse Family Partnership$26,298$9,118$17,180 Functional Family Therapy$16,455$2,140$14,315 Aggression Repl. Trng.$9,564$759$8,805 Life Skills Training$746$29$717 Two programs for juvenile offenders and their families, conducted by trained therapists. FFT and ART have been implemented statewide in Washington State’s juvenile courts. Evidence of reduced crime when the model is followed. Websites: www.fftinc.com/ and www.aggressionreplacementtraining.org Seattle Soc. Dev. Project$14,246$4,590$9,837 Guiding Good Choices$7,605$687$6,918 Multi-D Treat. Foster Care $26,748$2,459 $24,290 A three-year program for middle school youth designed to prevent tobacco, alcohol, and marijuana use. Delivered by classroom teachers. Key findings: Delayed initiation of • tobacco, • alcohol, • illicit drugs. Website: www.lifeskillstraining.com/ Intensive Juv. Supervision $0$1,482 -$1,482 7 of 10 A multi-year grade school and middle school training program for parents (family management training) and teachers (classroom management, interactive teaching) for children with low socioeconomic status. Evidence of:• reduced crime, • increased high school graduation, • reduced grade repetition Website: http://depts.washington.edu/sdrg/ A multimedia training program (parenting skills, peer pressure refusal skills for students) implemented with families of middle school children. Evidence of:• reduced crime, • reduced alcohol initiation Website:www.channing-bete.com/positiveyouth/pages/FTC/FTC-GGC.html Multidimensional Treatment Foster Care is an alternative to group facilities for youth with chronic & severe criminal behavior. Delivered by trained families, the goal is to return the youth to the family; the primary family also receives therapy. Evidence of:reduced crime Website: www.oslc.org/ HF We meta-analyzed 19 studies of intensive supervision programs for juvenile offenders. No statistically significant effect on recidivism rates. Mentoring program. Evidence: increased test scores, delayed alcohol and drug initiation.Website: www.bbbsa.org

39. 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.)

40. Empowering Communities to Prevent Youth Violence • Youths in different neighborhoods and communities are exposed to different levels of risk and protection.

41. Distribution of Risk in a City

42. Madison Middle School Risk Profile 8th Grade 2002 Peer-Individual Estimated National Value

43. Nova High School Risk Profile 10th Grade 2002 Peer-Individual Peer-Individual Estimated National Value

44. 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.

45. 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.

46. The Communities That Care Operating System Get Started Creating Communities That Care Implement and Evaluate Get Organized Develop a Profile Create a Plan

47. The Communities That Care Operating System Get Started Creating Communities That Care Implement and Evaluate Get Organized Develop a Profile Create a Plan • Community readiness assessment. • Identification of key individuals, stakeholders, and organizations.

48. The Communities That Care Operating System Get Started Creating Communities That Care Implement and Evaluate Get Organized Develop a Profile Create a Plan • Training key leaders and board in CTC • Building the community coalition.

49. The Communities That Care Operating System Get Started Creating Communities That Care Implement and Evaluate Get Organized Develop a Profile Create a Plan • Collect risk/protective factor and outcome data. • Collect information on community resources • Construct a community profile from the data.

50. Peer-Individual Estimated National Value