• By Dartington SRU
  • Posted on Monday 09th July, 2012

Prevention science – All is revealed

Prevention science is a relatively young field that has developed rapidly over the last 40 years. In 2005 the Society for Prevention Research commissioned a taskforce to develop a definition of prevention science and set out specific training needs for future prevention researchers. The resulting report, Standards of Knowledge for the Science of Prevention, offers an insight into who prevention scientists are and what they do.The primary goal of prevention science, according to the taskforce, is “to improve public health by identifying malleable risk and protective factors, assessing the efficacy and effectiveness of preventive interventions and identifying optimal means for dissemination and diffusion.”As such, it is necessarily a multi-disciplinary enterprise, requiring expertise from many fields. Specialists in biological, cognitive behavioral and social sciences contribute to understanding the ways in which positive and negative health can come about. Clinical scientists and experts in behavior change are needed for developing and implementing interventions. Economists are essential for working out the cost-effectiveness of interventions.As the taskforce puts it: “Prevention scientists include epidemiologists, psychologists, physicians, sociologists, social workers, educators, health practitioners, public health scientists, biostatisticians, nurses, geographers, mental health counsellors, anthropologists, policy analysts economists, criminologists, neuroscientists, and geneticists.”Since no individual possesses every skill, the authors further note that “carefully selected team members with expertise from practice, intervention development, and study design and methodology are necessary to meet the challenges described.”As well as stating what prevention science is and who prevention scientists are, the taskforce also lays out how prevention scientists work and the principles which do or should guide them. The work typically involves a cycle of activities, from research to understand predictors of problems and positive developmental outcomes, through developing interventions that create change in individuals and environments; and to testing whether those interventions work in controlled conditions and then, if promising, in the real world of services, before disseminating proven products more widely. Most, if not all of the programs listed in clearinghouses of evidence-based programs have been created in this way. The concepts of risk and protective factors and they way in which they interact to produce negative or positive outcomes in children as they grow up and enter adulthood are integral to prevention science, as is an ecological perspective – the idea that individuals, their families, schools, communities and larger socio-political and physical environments are interdependent.Alongside what some may regard as the more hi-tech elements of prevention science, such as the use of complex statistical techniques or analyses of the contribution to development of gene-environment interactions, prevention science has a more obviously human side. As the taskforce puts it: “The design of effective interventions which seek change in individuals and environments must address the role of human motivation, intentions, and self-efficacy.”Prevention science is also driven by a desire to promote social justice. The taskforce defines this as “the ethical and moral imperative to understand why certain population subgroups have a disproportionate burden of disease, disability, and death, and to design and implement prevention programs and systems and policy changes to address the root causes of inequities.” Prevention strategies that contribute to social justice include increasing access to services for all, for example by reducing transport barriers, creating interventions that are culturally and linguistically competent, and improving communication between providers and clients.Another area where the very human side of prevention science comes to the fore is in the need to ensure that preventive interventions are sustainable. This involves a range of activities, according to the taskforce. One is building community and organizational capacity through management, advocacy, and training. Another is developing and disseminating simple and user-friendly materials and tools.Community members should be involved in every step of developing and testing interventions, and methods for recouping money saved from the reduced need for heavy-end interventions need to be developed and institutionalized. Where possible, interventions should be built on or integrated into pre-existing service structures.Last, prevention science acknowledges that there are a variety of risks and types of protection that contribute in different ways to outcomes within and across populations. This is why it is critical to understand this through epidemiological surveys and reflect it in program design.**********Reference:Society for Prevention Research. (2011). Standards of Knowledge for the Science of Prevention. Fairfax, VA: Society for Prevention Research.

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