• By Dartington SRU
  • Posted on Friday 11th November, 2011

Prevention science down under

Australia spends an estimated AUD$22 billion on preventable conditions in childhood. If nothing is done to stem the tide, it is projected it will increase to $40 billion by 2040. Efforts thus far in the country have centered on treatment but can an argument be made for using advances in prevention science to guide more efficient and cost-effective future initiatives?The well-documented increase in psycho-social difficulties faced by children in the UK (Collishaw et al., 2004; 2010) appears to be a problem facing Australia as well. The prevalence of social and emotional problems affecting Australian children and adolescents is at an all-time high and looks set to increase. Many of these conditions also become problems in later adulthood that are “costly, complex and disabling”. But these problems are not inevitable, say three psychologists from the Universities of Melbourne and Western Australia. Evidence from the US, in particular, suggests that initiatives based on prevention science have a good chance not only of reducing the risk for negative outcomes but also enhancing children’s health and development. Could this be successful down under?There are challenges. There is a tendency to look to the successes of public health campaigns, such as mandatory seat belt use, to inform the prevention of social and emotional difficulties. These “single-solution approaches”, for example using drug education to prevent substance abuse, typically fail to have any meaningful impact. These failures in the name of prevention undermine the framework. What about multi-component developments that have been tested? A review of prevention programs that work in early childhood suggests that relatively few meet basic standards of evidence. In the field of child abuse prevention, for example, of the numerous Australian prevention initiatives using community education, personal safety education, family support and parent education, as well as child-focused and offender programs, few have evaluative data. “Many… are simply believed to work.”,Furthermore, difficulties in implementing programs at the front-line mean that, even where evidence-based interventions influence children’s services, few children and families have access to effective assistance. The authors argue that a “culture change” in the service sector is required to respond to problems with multiple causes. “Whole-of-government policy responses and integrated approaches to prevention” are needed with a “greater degree of cross-disciplinary and cross-sectoral collaboration than currently exists.” In Australia, initiatives such as the family violence prevention program Keep Them Safe in New South Wales provide encouraging signs that this is possible.A much-needed step in the Australian context, say the authors, is the establishment of a recognized forum for key stakeholders to exchange ideas, knowledge and the latest innovations. One possibility is the Australian Research Alliance for Children and Youth, which was formed in response to evidence about the negative trends in well-being. “With adequate resourcing, could become an important vehicle for advancing prevention science in Australia.” Given the momentum that prevention science has gathered in the US and the UK, it would be easy to overlook the fact that in Australia, it is still embryonic and struggling for recognition amid the focus on treatment services. Source: Sanson, A.V., Havighurst, S.S. and Zubrick, S.R. (2011) The science of prevention for children and youth, Australian Review of Public Affairs, 10 (1), 79-93. References:Collishaw, S. Maughan, B., Goodman, R. and Pickles, A. (2004) Time trends in adolescent mental health, Journal of Child Psychology and Psychiatry, 45 (8), 1350-1362.Collishaw, S. Maughan, B., Natarajan, L. and Pickles, A. (2010) Trends in adolescent emotional problems in Engand: a comparison of two national cohorts twenty years apart, Journal of Child Psychology and Psychiatry.

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