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The current youth mental health crisis has highlighted a substantial unmet need for effective, accessible, culturally sensitive mental health services and interventions. Schools have the potential to address this gap through the provision of evidence-based mental health interventions and services that meet the needs of their diverse student bodies. The National Institute of Mental Health (NIMH) supports school mental health research that relies on partnerships between academic researchers and school communities to develop optimized interventions that bridge the research-to-practice gap. This article highlights current NIMH priorities in school mental health research and provides additional context for recent federal investments targeting the expansion of school-based mental health infrastructure and interventions. [ABSTRACT FROM AUTHOR]

Sexual harassment is an intractable problem that harms the students, community, culture, and success of institutes of higher education (IHEs). The alarming prevalence of sexual harassment at IHEs highlights the urgent need for effective prevention programs. However, there are few empirically supported preventive interventions that effectively target the factors that most impact the determinants, trajectory, and short- and intermediate-term effects of sexual harassment. In this paper, we overview the problem of sexual harassment and propose an organizing framework to help IHEs develop effective interventions to prevent sexual harassment. Guided by prevention science, we propose a framework—modified from SAMHSA's (2019) guidelines for prevention practitioners—that underscores the criticality of trauma- and equity-informed characteristics in prevention programs. We offer a discussion on how IHEs must consider and evaluate the empirical evidence of effectiveness, flexibility, cultural competency, and sustainability when developing and adapting prevention programs to reduce and—ultimately—ameliorate sexual harassment. We conclude with recommendations that can provide a roadmap for higher education stakeholders and researchers to prevent this urgent public health concern. [ABSTRACT FROM AUTHOR]

In an ongoing series of interviews, Challenges Advisory Board member and Nova Institute for Health Fellow Alan C. Logan meets with thought leaders, scientists, scholars, healthcare professionals, artisans, and visionaries concerned about health at the scale of persons, places, and the planet. Here, Dr. Diana H. Fishbein responds to a set of questions posed by Challenges. For over forty years, Dr. Fishbein, a neuroscientist and criminologist by training, has been at the forefront of research examining the intersections of biological, environmental, social, and physical factors as they relate to brain development, functioning, risky behavior, and life outcomes. Within this broad-ranging career, Dr. Fishbein was among the very first to conduct a dietary intervention study (eliminating refined carbohydrate foods) examining behavioral outcomes (i.e., nutritional psychiatry). This, combined with related research endeavors and experiences, led to a wider-lens view of prevention research, a desire to understand the physiological mechanisms that explain heterogeneity in positive and/or unfavorable outcomes in prevention programs, and a dynamic career devoted to the science of prevention. Here, Dr. Fishbein reflects on her career and its many twists and turns through a range of interdisciplinary work. Shediscusses prevention science through the lens of future possibilities and the need for scientists to lean toward advocacy and supporting evidence-based policy changes. Prevention science, as Dr. Fishbein explains, is at the heart of the many interconnected challenges of our time. [ABSTRACT FROM AUTHOR]

School counselors support the academic, career, and social/emotional development of all students in their care, and one important method of delivery of a comprehensive school counseling program is the use of classroom instruction. In this exploratory, sequential mixed-methods study, we examined participant responses from nine focus groups regarding the school counselors' experiences with delivery of classroom lessons, in combination with a national survey of 247 practicing school counselors. Results underscored participants' desire to spend more time in classrooms and ongoing barriers to classroom access. We discuss implications for school counseling practice and school counselor education. [ABSTRACT FROM AUTHOR]

Objective The objectives of this topical review are to (1) increase understanding of pediatric medical traumatic stress (PMTS) in pediatric urology populations through literature review, (2) identify a theoretical model to guide prevention of PMTS in this population, and (3) provide clinical care recommendations based on the model identified. Authors introduce a new term "uropsychology" to describe psychological practice that specializes in the treatment of urology patients. Methods Pediatric uropsychologists from 5 pediatric medical care centers gathered to discuss their experience with treating PMTS in their settings and to review existing literature related to PMTS in pediatric urology, PMTS in other populations, and established models for prevention. Authors provide recommendations based on literature review for preventing PMTS in a pediatric urology population. Results Gaps in the evidence base for preventing PMTS in this population are identified. Authors provide a series of clinical care recommendations, utilizing clinical experience, and the Pediatric Psychosocial Preventative Health Model (PPPHM) as a framework. Conclusions While there is limited research on PMTS in pediatric urology populations, urologic interventions can be perceived as invasive, painful, distressing, and traumatic. Application of the PPPHM can guide prevention and intervention efforts. Future research is needed to characterize PMTS in this population, evaluate the efficacy of trauma-informed prevention and intervention practices, and develop screening measures that accurately identify at-risk patients. Authors recommend intradisciplinary collaboration among uropsychologists, urology specialists, and patients and families to create formal standards of care, avenues for other future research, and equitable access to uropsychology care. [ABSTRACT FROM AUTHOR]

The purpose of this commentary on the special issue of Prevention Science, "International Responses to Prevention Intervention Research During Human Ecosystem Disruptions," is to review the six target articles included in this issue, evaluate their results, and highlight the myriad ways in which diverse teams of prevention scientists mobilized to conduct rigorous scientific research during major human ecosystem disruptions (HEDs). The articles included in this issue consider both the etiology of mental and behavioral health challenges (i.e., substance use, mental health, behavioral problems) during HEDs and preventive intervention efforts aimed at addressing these challenges (i.e., adaptation and implementation of evidence-based interventions in novel contexts). This commentary discusses each article with emphasis on the respective contributions that prevention science teams have made to public health during major HEDs. Even in the most challenging contexts, prevention scientists have been at the forefront of public health efforts and have evidenced the vital role of prevention science for public health during HED events. The commentary concludes by highlighting the critical roles that prevention scientists can play in addressing critical public health issues during large-scale HEDs. [ABSTRACT FROM AUTHOR]

The historic momentum from national conversations on the roots and current impacts of racism in the USA presents an incredible window of opportunity for prevention scientists to revisit how common theories, measurement tools, methodologies, and interventions can be radically re-envisioned, retooled, and rebuilt to dismantle racism and promote equitable health for minoritized communities. Recognizing this opportunity, the NIH-funded Prevention Science and Methodology Group (PSMG) launched a series of presentations focused on the role of Prevention Science to address racism and discrimination guided by a commitment to social justice and health equity. The current manuscript aims to advance the field of Prevention Science by summarizing key issues raised during the series' presentations and proposing concrete research priorities and steps that hold promise for promoting health equity by addressing systemic racism. Being anti-racist is an active practice for all of us, whether we identify as methodologists, interventionists, practitioners, funders, community members, or an intersection of these identities. We implore prevention scientists and methodologists to take on these conversations with us to promote science and practice that offers every life the right to live in a just and equitable world. [ABSTRACT FROM AUTHOR]

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming. [ABSTRACT FROM AUTHOR]

Critical congenital heart disease (CHD) presents a lasting threat to quality of life through its adverse impact on neurodevelopmental and psychosocial outcomes. As recognition of this threat has increased, so too has an appreciation for the role of pediatric neuropsychologists in supporting families affected by CHD. But there is more to offer these families than traditional neuropsychological services, which tend to focus on secondary/tertiary forms of prevention. Now that many children with CHD are diagnosed prenatally, it may be possible to begin mitigating CHD-related risks and promoting positive outcomes earlier than ever before. Through primary prevention-oriented fetal neuropsychological consultation, as well as close collaboration with allied specialists, pediatric neuropsychology has an opportunity to re-envision its typical borders and more familiar practice models; to forge early and enduring partnerships with families; and to help promote the best possible neurodevelopmental trajectories, beginning before children are even born. In this conceptual review, we survey and integrate evidence from developmental science, developmental origins of health and disease, maternal-fetal medicine, and cardiac neurodevelopmental literatures, along with current practice norms, arriving ultimately at two central conclusions: 1) there is an important role to fill on multidisciplinary teams for the pediatric neuropsychologist in fetal cardiac care and 2) role expansion (e.g., through valuing broader-based training, flexing more generalist skills) can likely improve neuropsychological outcomes earlier than has been standard for pediatric neuropsychologists. Such a reimagining of our practice may be considered primary prevention neuropsychology. Implications for care in various settings and pragmatic barriers to implementation are discussed. [ABSTRACT FROM AUTHOR]

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In an ongoing series of interviews, Challenges Advisory Board member and Nova Institute for Health Fellow Alan C. Logan meets with thought leaders, scientists, scholars, healthcare professionals, artisans, and visionaries concerned about health at the scale of persons, places, and the planet. Here, Dr. Diana H. Fishbein responds to a set of questions posed by Challenges. For over forty years, Dr. Fishbein, a neuroscientist and criminologist by training, has been at the forefront of research examining the intersections of biological, environmental, social, and physical factors as they relate to brain development, functioning, risky behavior, and life outcomes. Within this broad-ranging career, Dr. Fishbein was among the very first to conduct a dietary intervention study (eliminating refined carbohydrate foods) examining behavioral outcomes (i.e., nutritional psychiatry). This, combined with related research endeavors and experiences, led to a wider-lens view of prevention research, a desire to understand the physiological mechanisms that explain heterogeneity in positive and/or unfavorable outcomes in prevention programs, and a dynamic career devoted to the science of prevention. Here, Dr. Fishbein reflects on her career and its many twists and turns through a range of interdisciplinary work. Shediscusses prevention science through the lens of future possibilities and the need for scientists to lean toward advocacy and supporting evidence-based policy changes. Prevention science, as Dr. Fishbein explains, is at the heart of the many interconnected challenges of our time.

By age 18, 22-27% of adolescents have experienced depressive symptoms increasing their risk of peripheral mental health and social issues. Despite the development of effective depression prevention programs, issues related to dissemination persist. This study aims to identify ways of increasing the likelihood of dissemination by a) investigating how prevention effects differ based on the professional background of the prevention program group leader and b) evaluating adolescent depression prevention in terms of comprehensive prevention – prevention with the breadth to reduce peripheral mental health and social issues. This cluster-randomized trial included 646 eighth-grade students recruited from German secondary schools. Adolescents were randomized into three conditions: teacher-led prevention, psychologist-led prevention, or school-as-usual. Results from hierarchical linear models reveal differences in effects based on implementation type and adolescent gender and provide preliminary evidence for a wider reach of depression prevention such that, regardless of implementation type or gender, the tested program was effective in reducing hyperactivity over time. Taken together, our findings warrant further research and suggest that depression prevention programs may have an effect on some peripheral outcomes, but not others, and that these effects may differ based on the profession of the group leader and adolescent gender. With continued empirical research investigating the efficaciousness of comprehensive prevention, this type of prevention has the potential to impact a larger proportion of the population and improve the cost-benefit ratio of prevention, thus increasing the likelihood of dissemination. [ABSTRACT FROM AUTHOR]

The present study examined the impact of the CASEL School Guide , an innovative model of implementation support for systemic SEL, on the social, emotional, and academic development of elementary grade students in schools implementing the evidence-based PATHS® Program. The study tested a 2-year intervention model in a cluster randomized design with 28 low-performing, urban, high-poverty elementary schools. We expected that the School Guid e model of support would promote greater fidelity of PATHS implementation by teachers and improvement in students' social-emotional, behavioral, and academic outcomes compared to schools delivering PATHS with the standard model of support. We examined whether staff perceptions of administrative social-emotional leadership at baseline had a direct effect on outcomes and moderated the effect of the School Guide. The analytic approach included 3-level growth curve models and hierarchical linear modeling. A consistent 3-way interaction of time, condition, and baseline leadership level emerged for most outcomes. Specifically, students in schools with low levels of social-emotional leadership at the beginning of the study were more likely to be rated as gaining social-emotional competence and attentional skills over time if the school was receiving the School Guide model of support compared to the standard support for PATHS. A similar pattern was true for teacher ratings of aggression, which decreased over time at a more rapid rate for students in School Guide schools where the administration had lower baseline levels of social-emotional leadership. PATHS implementation was similar regardless of support condition so other mechanisms must be driving the improvements in student outcomes. Implications for practice and research are discussed. [ABSTRACT FROM AUTHOR]

It is well known that perceptions of intervention characteristics (e.g., cost, source, evidence strength and quality) are a critical link from dissemination to implementation. What is less known is the process by which researchers understand the characteristics most valued by key intermediaries (i.e., real-world decision-makers), particularly in the federal system of Cooperative Extension. In Extension, university-based specialists are available to assist county-based agents in program selection, delivery, and evaluation. For this work, a sequential explanatory mixed-methods design was used to conduct surveys and semi-structured interviews, informed by the Diffusion of Innovations theory and Consolidated Framework for Implementation Research. Educators and specialists were recruited across 47 states to identify characteristics of health promotion interventions that facilitate the adoption decision-making process. Analysis of intervention attribute importance survey data was conducted through a one-way ANOVA with Bonferroni post hoc test to determine individual variable differences between responses. Interviews underwent a conventional content analysis. In total, 121 educators and 47 specialists from 33 states completed the survey. Eighteen educators and 10 specialists completed interviews. Educators and specialists valued components such as the community need for the intervention, and potential reach compared with other components including previous delivery settings and external funding of the intervention (p <.05). Qualitative data indicated divergence between educators and specialists; educators valued understanding the intervention cost (time and training) and specialists valued the evidence base and external funding available. Intervention developers should communicate information valued by different stakeholders to improve the adoption of evidence-based interventions. [ABSTRACT FROM AUTHOR]

Problem Behavior Theory (PBT) is an influential psychosocial theory that has shaped—and continues to shape—much research on adolescent development in the United States and abroad. It is the product of over a half‐century of research conducted by psychologists‐cum‐behavioral scientists Lee and Richard Jessor. This article engages two striking features of the history of PBT. First, it tracks how, and to what effect, a theory elaborated to explain the so‐called "deviant behavior" of a group of Native Americans was extended to explain the "problem behavior" of white, middle‐class, settler youth, before coming to circulate as a universal theory of adolescent behavior. Second, it explores how a theory that was meant to explain individual behaviors by connecting them to their larger social contexts came to be embraced by researchers who have been criticized for doing precisely the opposite. To do so, this article draws from Indigenous and Settler Colonial Studies scholarship and sheds light on how the logics of settler colonialism and neoliberalism have participated in the coproduction of PBT and its reception. [ABSTRACT FROM AUTHOR]

The recently released National Drug Control Strategy (2022) from the White House Office of National Drug Control Policy (ONDCP) lays out a comprehensive plan to, not only enhance access to treatment and increase harm reduction strategies, but also increase implementation of evidence-based prevention programming at the community level. Furthermore, the Strategy provides a framework for enhancing our national data systems to inform policy and to evaluate all components of the plan. However, not only are there several missing components to the Strategy that would assure its success, but there is a lack of structure to support a national comprehensive service delivery system that is informed by epidemiological data, and trains and credentials those delivering evidence-based prevention, treatment, and harm reduction/public health interventions within community settings. This paper provides recommendations for the establishment of such a structure with an emphasis on prevention. Systematically addressing conditions known to increase liability for behavioral problems among vulnerable populations and building supportive environments are strategies consistently found to avert trajectories away from substance use in general and substance use disorders (SUD) in particular. Investments in this approach are expected to result in significantly lower rates of SUD in current and subsequent generations of youth and, therefore, will reduce the burden on our communities in terms of lowered social and health systems involvement, treatment needs, and productivity. A national strategy, based on strong scientific evidence, is presented to implement public health policies and prevention services. These strategies work by improving child development, supporting families, enhancing school experiences, and cultivating positive environmental conditions. [ABSTRACT FROM AUTHOR]

Early exposure to maternal depression is a key risk factor for child mental illness (MI), but there are limited programs that interrupt intergenerational transmission. The BRIDGE "Building Regulation in Dual Generations" Program treats maternal MI using Dialectical Behavior Therapy Skills with a paired curriculum that promotes non-reactive and emotionally validating parenting designed to improve child mental health and ultimately prevent MI. The pilot feasibility trial (n = 28 dyads) included mothers and their preschool-aged children. The 20-week program was completed in a group-based format using mixed methods questionnaires and interviews. Results indicate high feasibility and acceptability (86% retention). Consistent improvements were seen across program targets and outcomes including maternal depression (d = 1.02) and child mental health (d = 1.08), with clinically significant symptom reductions for 85% of clients. Mothers with higher adversity exhibited greater reductions in parenting stress. Qualitative results highlighted efficacy in promoting positive parent–child relationships, rewarding parenting experiences, competence, and child development. Evidence suggests high feasibility and accessibility for BRIDGE in addressing intergenerational mental health needs. There was strong satisfaction with the program material and efficacy across key outcomes. BRIDGE holds promise for offering a transdiagnostic approach to preventing child MI in families of at-risk preschool aged children. [ABSTRACT FROM AUTHOR]

The sense of school belonging is defined as the extent to which students feel personally accepted, respected, included and supported by others in the school environment. Given that certain authors regard school belonging as the key factor in the adequate development of children and youth, this paper aims to summarize and present theoretical and research findings that testify to the importance of the sense of school belonging for students' positive development and prevention of behavioral problems. In addition, the basic tenets of prevention science and the positive development perspective are discussed, and the relationship between these two approaches is analyzed. The results of our review suggest that the sense of school belonging is related to a wide range of academic and developmental outcomes, such as academic achievement and motivation, school engagement, prosocial behavior, life satisfaction, self-esteem, positive identity, well-being, adaptive adjustment, etc. In other words, past research has indicated that, depending on the extent to which the sense of school belonging is developed, its effects can be interpreted within the context of risk and protective/promotion factors in students' mental health and behavioral problems. The above implies that actors in the education system must not lose sight of the importance of the sense of school belonging for students' reaching their full potential. Moreover, taking into account the striving of prevention science to identify and enhance the factors underpinning protective processes, further research is needed on the factors and mechanisms of development of the sense of school belonging.

Existing research on childhood adversity and health risk across the lifespan lacks specificity regarding which types of exposures to assess and when. The purpose of this study was to contribute to an empirically-supported framework to guide practitioners interested in identifying youth who may be at greatest risk for a lifelong trajectory of health disparities. We also sought to identify the point in childhood at which screening for adversity exposure would capture the largest group of at risk individuals for triage to prevention and intervention services. Participants (n = 4036) collected as part of the Midlife in the United States study reported their medical status and history including physical (cardiovascular disease, hypertension, obesity, diabetes, cancer) and mental health (depression, substance use problems, sleep problems). Participants indicated whether they were exposed to 7 adversities at any point in childhood and their age of exposure to 19 additional lifetime adversities before the age of 18. Parent drug abuse, dropping out or failing out of school, being fired from a job, and sexual assault during childhood exhibited the largest effect sizes on health in adulthood, which were comparable to the effects of childhood maltreatment. Childhood adversity screening in early adolescence may identify the largest proportion of youth at risk for negative health trajectories. The results of this descriptive analysis provide an empirical framework to guide screening for childhood adversity in pediatric populations. We discuss the implications of these observations in the context of prevention science and practice.

As part of the Global Smart Drinking Goals campaign launched in 2018 in 6 "City Pilots" around the world, the Businesses That Care (BTC; Empresas Que se Cuidan in Spanish) prevention system was developed and implemented in Zacatecas, Mexico. BTC is a private business sector adaptation of the Communities That Care prevention system. BTC is designed to address underage alcohol use through a combination of a company-led prevention system, an adapted family-based prevention program with parents employed at participating companies, and environmental prevention strategies for company employees. BTC was designed to be congruent with other health and safety efforts in the region (e.g., media campaign, road safety, and school prevention efforts). This study presents the feasibility and adoption of the BTC system in Zacatecas. Process implementation measures indicated successful participant recruitment, retention, and adherence to intervention protocols. The first 4 stages of BTC implementation were completed within 14 months, with Stage 5 being interrupted by the COVID-19 pandemic. BTC Prevention Committee members, made up of employees from BTC participating companies, received 9 out of 10 BTC trainings/workshops during this time. Results provide evidence of the acceptability and feasibility for private companies to implement a prevention system approach for reducing youth alcohol use. [ABSTRACT FROM AUTHOR]

Network meta-analysis is a popular statistical technique for synthesizing evidence from studies comparing multiple interventions. Benefits of network meta-analysis, over more traditional pairwise meta-analysis approaches, include evaluating efficacy/safety of interventions within a single framework, increased precision, comparing pairs of interventions that have never been directly compared in a trial, and providing a hierarchy of interventions in terms of their effectiveness. Network meta-analysis is relatively underutilized in prevention science. This paper therefore presents a primer of network meta-analysis for prevention scientists who wish to apply this method or to critically appraise evidence from publications using the method. We introduce the key concepts and assumptions of network meta-analysis, namely, transitivity and consistency, and demonstrate their applicability to the field of prevention science. We then illustrate the method using a network meta-analysis examining the comparative effectiveness of brief alcohol interventions for preventing hazardous drinking among college students. We provide data and code for all examples. Finally, we discuss considerations that are particularly relevant in network meta-analyses in the field of prevention, such as including non-randomized evidence. [ABSTRACT FROM AUTHOR]

Intellectual and developmental disabilities (IDD) involve challenges with both cognitive functioning and activities of daily living. The field of IDD science and practice has often applied a Quality of Life framework to promoting well‐being for those with IDD, however health disparities persist. Taking a prevention science approach to promoting health and quality of life may be a particularly effective way to decrease health disparities among individuals with IDD by addressing the challenging biopsychosocial risks that individuals with IDD experience during early childhood. This commentary discusses the promise of applying prevention science theory, research, and practice to promoting the quality of life of individuals with IDD, while recognizing the historical, methodological, and ethical challenges to doing so. Several opportunities for research partnerships between prevention scientists and applied IDD researchers are proposed for basic science research, community‐based participatory research, Type 1 translational research, and Type 2 translational research. [ABSTRACT FROM AUTHOR]

Recent decades of education policy, research, and practice have brought focus on a positive education approach as applied within tiered service delivery frameworks to meet diverse needs of varied intensities. Related, the science of implementation has begun to increase understanding of supports to strengthen use of a positive education approach within tiered service delivery frameworks. To date, the body of work has fostered important shifts in how problems are viewed and addressed using a positive lens, supporting more equitable opportunity in education. To realize the full potential, however, there is a need to integrate theory and science as embedded within a whole child, school, and community lens. We propose that positive education will advance equity when grounded in integrated theory and science across developmental systems theory, prevention science, ecological systems theory, and implementation science. We first provide a brief overview of schools as a context to serve as assets or risks to equity, followed by a discussion of theory and science using a whole child, whole school, and whole community lens. We end with directions for science and practice in advancing a positive education approach. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children's mental health. [ABSTRACT FROM AUTHOR]

In this thought leader commentary, the author makes observations about the findings and recommendations noted in this special issue. The broad scope of these reports from bullying; mental, emotional, and behavioral health; English language and dual language learners; optimal development; the promise of adolescence; optimal health; and shaping summertime experiences enhances our perspective on the important developmental time of childhood, adolescence, and young adulthood. Two broad perspectives—positive youth development and distinctive risky behaviors—are highlighted among other important themes. The author observes that the Board on Children, Youth, and Families of the National Academies of Sciences, Engineering, and Medicine could add value in synthesizing the implications of these studies for federal, state, and local agencies; communities; and the youth population itself, identifying both commonalities and research gaps across these reports. Such a synthesis could provide a roadmap including common and unique predictors, evidence-based interventions to address these predictors, and perspectives on integrative and complementary aspects of community, state, and federal systems. Advocacy is needed to take evidence summarized in these reports to scale. In this context, evidence-based practices from promotion to treatment backed by new implementation research in scale-up are likely to return immense benefits to society.

Recent decades of education policy, research, and practice have brought focus on a positive education approach as applied within tiered service delivery frameworks to meet diverse needs of varied intensities. Related, the science of implementation has begun to increase understanding of supports to strengthen use of a positive education approach within tiered service delivery frameworks. To date, the body of work has fostered important shifts in how problems are viewed and addressed using a positive lens, supporting more equitable opportunity in education. To realize the full potential, however, there is a need to integrate theory and science as embedded within a whole child, school, and community lens. We propose that positive education will advance equity when grounded in integrated theory and science across developmental systems theory, prevention science, ecological systems theory, and implementation science. We first provide a brief overview of schools as a context to serve as assets or risks to equity, followed by a discussion of theory and science using a whole child, whole school, and whole community lens. We end with directions for science and practice in advancing a positive education approach.

Objective: This mixed-methods study examined perceived acceptability and appropriateness of a novel digital mental health program targeting anxiety risk (i.e., perfectionism or error sensitivity) in 5-to-7-year-old children and their parents., Methods: Parent-child dyads participated in a modular, web-based cognitive-behavioral program targeting negative overreactions to making mistakes. The program, "Making Mistakes", consisted of a 6-month series of short video clips, journaling activities, and weekly reminders, and modules were delivered to caregivers and children separately. 86 dyads completed self-report measures, 18 of whom participated in semi-structured interviews, following completion of the primary program module. A standard thematic analysis was used to elucidate themes from the parent and child interview content., Results: Our quantitative and qualitative results were generally aligned. Children and parents viewed the novel digital mental health program as acceptable and appropriate, favoring the cognitive behavioral strategies such as modeling positive reactions to mistakes, responding positively to child mistakes, and emphasizing effort over outcome. Participants also provided helpful feedback related to program content, delivery, and engagement, as well as suggestions to enhance the program., Conclusions: Findings have implications for design and content features of parent-based and dyad-based programs, as well as digital mental health programs focused on reducing anxiety risk., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Children with attention-deficit/hyperactivity disorder (ADHD) are at risk for accidental injuries, but little is known about age-related changes in early childhood. We predicted that ADHD would be associated with greater frequency and volume of accidental injuries. We explored associations between ADHD and injury types and examined age-related changes within the preschool period.Methods: Retrospective chart review data of 21,520 preschool children with accidental injury visits within a large pediatric hospital network were examined. We compared children with ADHD (n = 524) and without ADHD (n = 20,996) on number of injury visits by age, total number of injury visits, injury volume, and injury type.Results: Children with ADHD averaged fewer injury visits at age 3 and 90% more visits at age 6. Children with ADHD had injury visits in more years during the 3-6 age. There were no differences in injury volumes. Among patients with an injury visit at age 3, children with ADHD had 6 times the probability of a subsequent visit at age 6. At age 3, children with ADHD were estimated to have 50% fewer injury visits than children without ADHD, but by age 6, children with ADHD had an estimated 74% more injury visits than children without ADHD. Risk for several injury types for children with ADHD exceeded that for patients without ADHD by at least 50%.Conclusions: Early identification and treatment of preschool ADHD following accidental injury may prevent subsequent injuries. Clinical implications and future directions are discussed with emphasis on the maintenance of parental monitoring into the older preschool years. [ABSTRACT FROM AUTHOR]

Objective: Unintentional injuries are the leading cause of death for children under 19 years of age. For preschoolers, many injuries occur in the home. Addressing this issue, this study assessed if a storybook about home safety could be effective to increase preschoolers' safety knowledge and reduce their injury-risk behaviors.Methods: Applying a randomized controlled trial design, normally developing English speaking preschool children (3.5-5.5 years) in Southwestern Ontario Canada were randomly assigned to the control condition (a storybook about healthy eating, N = 30) or the intervention condition (a storybook about home hazards, N = 29). They read the assigned storybook with their mother for 4 weeks; time spent reading was tracked, and fidelity checks based on home visits were implemented.Results: Comparing postintervention knowledge, understanding score, and risk behaviors across groups revealed that children who received the intervention were able to identify more hazards, provide more comprehensive safety explanations, and demonstrate fewer risky behaviors compared with children in the control group (ηp2 = 0.13, 0.19, and 0.51, respectively), who showed no significant changes over time in safety knowledge, understanding, or risk behaviors. Compliance with reading the safety book and fidelity in how they did so were very good.Conclusions: A storybook can be an effective resource for educating young children about home safety and reducing their hazard-directed risk behaviors. [ABSTRACT FROM AUTHOR]

In this concluding article for the Special Issue, we attempt to summarize lessons learned from these various implementation and evaluation projects. We focus on the following four points: (a) correcting misperceptions of mental health; (b) identifying, training, and coaching system change implementers; (c) distinguishing strategies for launching versus sustaining systemic interventions; and (d) the role of culture in implementation and outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this Special Issue is to describe innovative school-related initiatives to reduce the population prevalence of youth mental health concerns. In this introduction to the Special Issue, we identify strategies that have not worked as well as those that have promise in improving youth mental health outcomes. We then provide a brief overview of each article in this issue. The first several articles focus on a comprehensive countywide approach to child and youth mental health that developed out of a unique tax initiative. In combination, these projects screen school-age youth in the county three times a year; support all county schools in providing universal, selective, and indicated interventions based on these screening data; deliver a mentoring program and school-based psychiatric care to youth with more intensive needs; and provide no-cost evidence-based evaluations, referrals, and ongoing progress monitoring to any family with concerns about their child's mental health. Three additional articles in the Special Issue expand the focus to include other national models, including a statewide initiative in Georgia to bring mental health services to every school, policy issues related to school mental health in South Carolina, and cost analysis strategies for specifying the economic benefit of mental health initiatives. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the effects of a new research‐informed couple relationship education (CRE) curriculum, ELEVATE, in a diverse sample of 300 adults. Methods: Using a quasi‐experimental design and propensity score adjustments, change trajectories were compared over a 6‐month period with multilevel growth‐curve modeling. Variations in outcomes based on income, family harmony, and relationship length were also explored. Results: Results indicate sustained program effects of ELEVATE over 6 months in four of the nine target outcomes (intimate knowledge of partner, social connections, conflict management skills, and couple relationship quality). Participants experiencing more stressful family contexts at baseline experience a greater amount of change in intentionality, developing a couple identity, use of caring behaviors, relationship quality, and depressive symptoms. Participants in more established relationships experienced greater change in conflict management skills and relationship quality. Participants with higher levels of income experienced greater change in developing a couple identity and social connections. Conclusion: These findings evidence several positive program effects for the ELEVATE program for a broad group of participants and also reveal some distinctions in change patterns for subgroups. Implications: This research provides information relevant to the development of best practices for CRE in diverse communities. [ABSTRACT FROM AUTHOR]

Children learn language through the interactions they have with their parents/caregivers beginning at birth. Hart and Risley (1995) discovered an inequity in the home language input children received from parents/caregivers. Children reared in low-income families received less input (conversations, turns) from parents than did children reared in more advantaged families. Less language input was linked to a disparity in children's vocabulary learning by age 3. The long-term result of this social determinant of early language/literacy learning is a life trajectory of poor educational, economic, and health attainment for many children in families with limited resources, at vast cost to individuals, communities, and the nation. What is needed is an approach to word-gap prevention that is capable of achieving positive individual, community, and population outcomes. Translating research into practice, we developed the Bridging the Word Gap Community Action Planning Guide (BWG-CAPG) using a combined behavior-analytic, community psychology, and public health framework for this purpose (Greenwood et al., 2017). We also developed a progress-monitoring measure, the online BWG Community Check Box Evaluation System, to provide feedback on a community's actions and progress in implementing their plan. Results from an initial pilot investigation within and across three community sectors in a large urban city were promising. BWG Community Check Box results indicated a number of desired outcomes: (a) capacity development and mobilization, (b) community implementation actions, and (c) community changes in practices, programs, and policies. Implications are discussed. [ABSTRACT FROM AUTHOR]

Introduction In Florida, mandated school vision screenings begin around the age of five.   However, a joint statement in the ophthalmology community recommends that primary care providers, including pediatricians, screen for eye and vision symptoms and signs starting at birth. This suggests that pediatricians may be the first to catch signs of early vision loss and refer pediatric patients to an ophthalmologist. This study aims to understand the current vision screening practices of a sample of pediatricians in Florida and how comfort levels with vision screenings may impact ophthalmology referrals. Methods A survey with 36 questions was created by the authors of the study and sent to pediatricians through digital newsletters to the Florida Chapter of the American Academy of Pediatrics and pediatric departments at Florida universities. Descriptive statistics were gathered regarding the demographics of pediatricians surveyed, vision screening attitudes and practices, vision concerns and ophthalmology referrals from pediatric clinics, and the most common reasons for referral to an ophthalmologist. The Jonckheere-Terpstra nonparametric trend test was used to examine whether decreased comfort performing vision screening on a child was associated with lower rates of urgent referrals to an optometrist or ophthalmologist. Results Forty-six responses were collected. Seventy-eight percent of pediatricians reported performing early childhood vision screening (n=36). There was considerable variability in vision screening practices among the pediatricians studied, with only 66% beginning screenings from zero to two years of age (n=24). Fifty percent of respondents reported receiving no previous training on performing vision screening, and less than half of respondents reported feeling "somewhat comfortable" or "extremely comfortable" with performing the exam (n=22, 48%). The trend between decreased comfort performing pediatric vision screening and lower rates of urgent eye care referrals was approaching statistical significance (p=0.0705). The majority of urgent referrals were provided by respondents who were somewhat or extremely comfortable with screening (n=13, 65%). Conclusion From this sample of pediatricians in Florida, most respondents reported performing early childhood vision screening, but there was notable variability in the way screenings were performed among pediatricians. Moreover, many had never received training on performing the exam or did not feel comfortable performing them. Decreased comfort with vision screenings was almost significantly associated with decreased urgent referrals to an ophthalmologist. Future studies should examine whether increased training on vision screenings may help improve standardization of screening practices among pediatrics and comfort with vision screenings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Sharma et al.)

PurposeCommunity prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended.MethodsThe Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks.ResultsTwenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person.ConclusionsThis study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes.

Child maltreatment calls for a broad range of preventative policies and practices, but limited governmental funding and leadership has been devoted to the problem. Effective strategies to prevent maltreatment exist, but they have had limited uptake in the child welfare system. In this article, we trace how government responsibility for the prevention of child maltreatment became centered within the nation's child protection response. Further, we discuss developments in prevention science, review the existing literature on the effectiveness of a range of prevention strategies, and present a public health approach to prevention. The article concludes with a set of recommendations to inform future efforts to prevent child maltreatment through approaches that seek to expand capacity for the implementation of evidence-based prevention programs, while addressing the adverse community experiences that exacerbate risk for child maltreatment. [ABSTRACT FROM AUTHOR]

Comprehensive community initiatives (CCIs) represent a popular method for creating systemic change, yet there is a dearth of evidence on their effectiveness (Zaff, Pufall Jones, Donlan, Lin, & Anderson, 2016). This article presents a systematic review of the evidence on the population‐level impact of CCIs, focusing specifically on documented effects from studies using an experimental or quasi‐experimental design. Of 1,947 articles identified through a database and hand search, 25 articles examining six different CCIs—most of which employed prevention science frameworks—met the review inclusion criteria. The results of this review show that CCIs can strengthen protective factors and reduce risk factors, delay initiation of and reduce substance use, and reduce the likelihood of, and delay engagement in, violent and/or delinquent behaviors. Impacts have been documented as soon as one year after initial intervention, and as early as 7th grade, with effects sustained as long as seven years post‐intervention, and as late as a year post‐high school. However, relative to the prevalence of CCIs as a practical intervention, the evidence base is small, potentially dated, and focused on a narrow set of outcomes and populations. Recommendations for interpreting the evidence base are discussed, including methodological limitations and implications for future work. Highlights: Systematic review of studies using experimental or quasi‐experimental design to assess the impact of comprehensive community initiatives (CCIs)Of 1,947 candidate articles, only 25 articles on six distinct CCIs met the inclusion criteria.CCIs can prevent problem behaviors as soon as one year after intervention and as early as 7th grade.Effects can be sustained up to seven years post‐intervention and as late as a year post‐high school.The evidence base is still relatively small and focused on a narrow set of outcomes and populations. [ABSTRACT FROM AUTHOR]

We inquire how early in childhood children most at risk for problematic patterns of internalizing and externalizing behaviors can be accurately classified. Yearly measures of anxiety/depressive symptoms and aggressive behaviors (ages 6-13; n = 334), respectively, are used to identify behavioral trajectories. We then assess the degree to which limited spans of yearly information allow for the correct classification into the elevated, persistent pattern of the problem behavior, identified theoretically and empirically as high-risk and most in need of intervention. The true positive rate (sensitivity) is below 70% for anxiety/depressive symptoms and aggressive behaviors using behavioral information through ages 6 and 7. Conversely, by age 9, over 90% of the high-risk individuals are correctly classified (i.e., sensitivity) for anxiety/depressive symptoms, but this threshold is not met until age 12 for aggressive behaviors. Notably, the false positive rate of classification for both high-risk problem behaviors is consistently low using each limited age span of data (< 5%). These results suggest that correct classification into highest risk groups of childhood problem behavior is limited using behavioral information observed at early ages. Prevention programming targeting those who will display persistent, elevated levels of problem behavior should be cognizant of the degree of misclassification and how this varies with the accumulation of behavioral information. Continuous assessment of problem behaviors is needed throughout childhood in order to continually identify high-risk individuals most in need of intervention as behavior patterns are sufficiently realized. [ABSTRACT FROM AUTHOR]

Catherine Bradshaw, PhD, MEd, is a professor and the senior associate dean for research and faculty development at the Curry School of Education and Human Development at the University of Virginia. She was previously the associate editor for the Journal of Research on Adolescence and is currently the editor of Prevention Science. She is a coeditor of the Handbook of School Mental Health (2014), is the editor of Handbook on Bullying Prevention: A Life Course Perspective (2017), and is currently working on two books. [ABSTRACT FROM AUTHOR]

Purpose of Review: Lower urinary tract dysfunction (LUTD), including stress urinary incontinence (SUI), is increasingly recognized as a public health issue due to the prevalence, individual burden, and societal impact. Women are disproportionately affected by UI and are exposed to unique events that affect LUT function including higher rates of LUT infection, childbirth, pelvic floor anatomic changes, and hormonal milieu. The majority of LUTD research and clinical practice has focused on treatment of the most affected subset of women, but there are millions of women living with urinary incontinence that do not seek advice or treatment, and the evidence base for prevention or detection of early symptoms is lacking. Recent Findings: Individual factors such as sociodemographic elements, medical history, physical exam, and comorbidities have been well studied; however, the contribution of family and environmental factors is less well understood. Emerging data suggests that some types of high-impact physical activity in adolescence can confer increased UI risk later in life. Prenatal and postpartum pelvic floor muscle training appears to be beneficial in preventing SUI in some women. Summary: While certain individual risk factors for SUI have been identified, sociocontextual factors also affect health outcomes and can mediate an individual's risk of disease. The social ecological model considers factors within the family/peer, community, and societal levels that can affect an individual's health behaviors. Prevention research that investigates these multiple levels of influence on individual biology and behavior is a fundamental step to better understand the complex factors that impact bladder health and inform LUTS prevention agendas. In addition, strategies to educate girls and women and engage communities in bladder health promotion are essential in order to effectively disseminate scientific findings and implement intervention programs. [ABSTRACT FROM AUTHOR]

Background: Middle childhood (ages 8-12 years) is a critical period for forming behavioral habits and reducing the risk for the development of skin cancer later in life. During this time, children develop more autonomy and spend more unsupervised time away from their parents. Professional agencies recommend that all children engage in regular sun protection behaviors and avoid the sun during peak daytime hours. Unfortunately, in middle childhood, child sun protection often declines and UV radiation exposure increases. Effective parenting involves balancing ways to encourage the child's increasing independence while providing practical assistance to ensure sun protection is implemented., Objective: The goal was to evaluate the feasibility, acceptability, and preliminary effects of Sun Safe Families, a Facebook group intervention for parents of children between 8 and 12 years of age., Methods: The team developed Facebook messages targeting parent knowledge, normative influences, sun safety barriers, planning and goal setting, confidence in implementing sun safety, communication, forming habits, and managing sun safety in risky situations. A total of 92 parents were enrolled, and the groups ran for 6 weeks. Feasibility was measured by enrollment and retention rates. Acceptability was measured by engagement in the Facebook groups. Satisfaction was assessed by a treatment evaluation. At pre- and post-intervention, parents completed measures of child sun protection, UV radiation exposure, sunburn, sun safety knowledge, child risk, barriers, sun protection self-efficacy, planning, sun safe habits, norms for child sun safety, and communication about sun safety., Results: Enrollment (64.3%, 92/143) and retention (94.6%, 87/92) were good. On average, participants viewed 67.6% (56.8/84) of posts, "liked" 16.4% (13.77/84) of posts, commented on 14.8% (12.43/84) of posts, and voted on 46% (6.4/14) of polls. Satisfaction was excellent. From pre- to post-intervention, there were significant increases in child sun protection, sun exposure, and sunburn (P<.01; moderate effect sizes), as well as statistically significant increases in planning and self-efficacy (P<.05) and family norms and parent communication (P<.01)., Conclusions: This study demonstrated high survey retention, acceptability, and satisfaction with the intervention. There were promising preliminary effects on child sun protection behaviors and parent sun protection attitudes and communication with their child. Replication with a larger sample size and a comparison condition is warranted., (©Sharon Manne, Yelena Wu, David Buller, Carolyn Heckman, Katie Devine, Sara Frederick, Justin Solleder, Alexis Schaefer, Shou-En Lu. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.12.2023.)