An Early Community-Based Intervention for the Prevention of Substance Abuse and Other Delinquent Behavior

First Delinquent Behavior Among Pre-Pubescent Children: A Development Paradigm Alongside Family SES

The present study investigated what explains and accounts for first pre-pubescent delinquent behaviors among children. This was based on the notion that a developmental paradigm (e.g., self-control) alongside family socio-economic status (SES) can provide a passable explanation for the first and early delinquent behavior. A nationally representative sample of eighth graders (N = 3,449, 50% boys) from the Korea Youth Panel Survey (KYPS) was reviewed in terms of first delinquent behaviors. Results revealed that pre-pubescent boys started to drink at an earlier age than girls, whereas pre-pubescent girls engaged in relational bullying earlier than their male counterparts. Children's onset of delinquency age was inversely associated with family SES, but was positively associated with their degree of self-control. Different types of first delinquency were distinguished by levels of parental education as well as child's self-control. Implications of the findings are discussed.

Practitioner review: Effective ingredients of prevention programs for youth at risk of persistent juvenile delinquency--recommendations for clinical practice

BACKGROUND

There is a lack of knowledge about specific effective ingredients of prevention programs for youth at risk for persistent delinquent behavior. The present study combines findings of previous studies by examining the effectiveness of programs in preventing persistent juvenile delinquency and by studying which particular program, sample, and study characteristics contribute to the effects. Information on effective ingredients offers specific indications of how programs may be improved in clinical practice.

METHOD

A literature search in PsychINFO, ERIC, PubMed, Sociological Abstracts, Criminal Justice Abstracts, and Google Scholar was performed. Only (quasi)experimental studies and studies that focused on adolescents at risk for (persistent) delinquent behavior were included. Multilevel meta-analysis was conducted on 39 studies (N = 9,084). Participants' ages ranged from 6 to 20 years (M = 14 years, SD = 2.45).

RESULTS

The overall effect size was significant and small in magnitude (d = 0.24, p < .001). Behavioral-oriented programs, focusing on parenting skills training, behavioral modeling, or behavioral contracting yielded the largest effects. Multimodal programs and programs carried out in the family context proved to be more beneficial than individual and group-based programs. Less intensive programs yielded larger effects.

CONCLUSIONS

Prevention programs have positive effects on preventing persistent juvenile delinquency. In order to improve program effectiveness, interventions should be behavioral-oriented, delivered in a family or multimodal format, and the intensity of the program should be matched to the level of risk of the juvenile.

The effects of the prevention program 'New Perspectives' (NP) on juvenile delinquency and other life domains: study protocol for a randomized controlled trial

BACKGROUND

New Perspectives (NP) is a prevention program aiming to prevent that youth at onset of a criminal career will develop a persistent criminal behaviour pattern. The effects of NP on juvenile delinquency and other life domains are investigated, using a randomized controlled trial (RCT).

METHOD/DESIGN

In the present study at-risk youth aged 12 to 23 years are assigned randomly to the intervention (N = 90, NP) or control condition consisting of care as usual (N = 90, CAU). After screening, random assignment, and consent to participate, adolescents and their parents are requested to complete questionnaires. Data are collected at four points in time: at baseline (before the start of the intervention), after 3 months, after 6 months (post-test) and 1 year after treatment (follow-up). Primary outcome measures include involvement in delinquent behaviour and recidivism. Secondary outcome measures include parenting behaviour, life events, prosocial behaviour, deviant and prosocial peers, externalizing behaviour, cognitive distortions, moral reasoning, self-worth, anxiety, depression, client satisfaction, therapeutic alliance and motivation. Standardized questionnaires and interviews are used to collect data. Moderator analyses will also be conducted in order to examine the influence of ethnic background, gender and age on the program effectiveness.

DISCUSSION

The present study will provide new insights in the effects of a prevention program targeting youth at risk for the development of a persistent criminal career.

TRIAL REGISTRATION

Dutch trial register number NTR4370. The study is financially supported by a grant from ZonMw, the Dutch Organization for Health research and Development, grant number 157004006. The study is approved by the Ethics Committee of the University of Amsterdam, approval number 2011-CDE-01.

Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis

Background

Community engagement has been advanced as a promising way of improving health and reducing health inequalities; however, the approach is not yet supported by a strong evidence base.

Objectives

To undertake a multimethod systematic review which builds on the evidence that underpins the current UK guidance on community engagement; to identify theoretical models underpinning community engagement; to explore mechanisms and contexts through which communities are engaged; to identify community engagement approaches that are effective in reducing health inequalities, under what circumstances and for whom; and to determine the processes and costs associated with their implementation.

Data sources

Databases including the Cochrane Database of Systematic Reviews (CDSR), The Campbell Library, the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment (HTA) database, the NHS Economic Evaluation Database (NHS EED) and EPPI-Centre’s Trials Register of Promoting Health Interventions (TRoPHI) and Database of Promoting Health Effectiveness Reviews (DoPHER) were searched from 1990 to August 2011 for systematic reviews and primary studies. Trials evaluating community engagement interventions reporting health outcomes were included.

Review methods

Study eligibility criteria: published after 1990; outcome, economic, or process evaluation; intervention relevant to community engagement; written in English; measured and reported health or community outcomes, or presents cost, resource, or implementation data characterises study populations or reports differential impacts in terms of social determinants of health; conducted in an Organisation for Economic Co-operation and Development (OECD) country. Study appraisal: risk of bias for outcome evaluations; assessment of validity and relevance for process evaluations; comparison against an economic evaluation checklist for economic evaluations. Synthesis methods: four synthesis approaches were adopted for the different evidence types: theoretical, quantitative, process, and economic evidence.

Results

The theoretical synthesis identified key models of community engagement that are underpinned by different theories of changes. Results from 131 studies included in a meta-analysis indicate that there is solid evidence that community engagement interventions have a positive impact on health behaviours, health consequences, self-efficacy and perceived social support outcomes, across various conditions. There is insufficient evidence – particularly for long-term outcomes and indirect beneficiaries – to determine whether one particular model of community engagement is likely to be more effective than any other. There are also insufficient data to test the effects on health inequalities, although there is some evidence to suggest that interventions that improve social inequalities (as measured by social support) also improve health behaviours. There is weak evidence from the effectiveness and process evaluations that certain implementation factors may affect intervention success. From the economic analysis, there is weak but inconsistent evidence that community engagement interventions are cost-effective. By combining findings across the syntheses, we produced a new conceptual framework.

Limitations

Differences in the populations, intervention approaches and health outcomes made it difficult to pinpoint specific strategies for intervention effectiveness. The syntheses of process and economic evidence were limited by the small (generally not rigorous) evidence base.

Conclusions

Community engagement interventions are effective across a wide range of contexts and using a variety of mechanisms. Public health initiatives should incorporate community engagement into intervention design. Evaluations should place greater emphasis on long-term outcomes, outcomes for indirect beneficiaries, process evaluation, and reporting costs and resources data. The theories of change identified and the newly developed conceptual framework are useful tools for researchers and practitioners. We identified trends in the evidence that could provide useful directions for future intervention design and evaluation.

Funding

The National Institute for Health Research Public Health Research programme.

The Effectiveness of an After-school Program Targeting Urban African American Youth

The present study reports on the effectiveness at one-year follow-up of an after-school prevention program targeting 6(th) grade African American youth residing in high-risk urban areas. The program, conducted on-site over the school-year period, involved a group mentoring approach emphasizing remedial education and an appreciation of African American cultural heritage in promoting school bonding, social skills development, and greater academic achievement. Behavioral and adjustment outcome data were obtained from two participating middle-school sites (intervention and comparison, involving 237 and 241 students, respectively) serving essentially equivalent urban communities. Results of the study revealed significant effects for academic achievement and behavior in terms of grade point average and teacher ratings that favored students at the intervention site. At this site, greater participation of parents in the intervention program was found to be positively related to improvement of the children in grade point average. No differential site-related changes in negative behavior were observed.

Should we ask our Children about Sex, Drugs and Rock & Roll?: Potentially Harmful Effects of Asking Questions About Risky Behaviors

Research shows that asking questions can fundamentally change behavior. We review literature on this question-behavior effect, which demonstrates that asking questions changes both normal and risky behaviors. We discuss potential explanations for the effect and review recent findings that reveal interesting moderators of the influence of questions on behavior. We then highlight the potential impact of the question-behavior effect in an important public health context: screening adolescents for risky behavior. While medical guidelines emphasize the importance of asking adolescents questions about substance (drug, alcohol) use and sexual behaviors, research on the question-behavior effect suggests that asking adolescents about risky behaviors has the potential to increase the frequency with which they engage in these behaviors. We argue that the act of screening or measuring risky behavior is potentially counterproductive. We emphasize the importance of interventions beyond screening, and suggest ways in which screening can be carried out to minimize its impact. In short, asking questions about behaviors can change behavior, and asking questions about risky behaviors may itself be a risky undertaking.

Effectiveness of interventions to prevent youth violence a systematic review

OBJECTIVES

To identify interventions effective in preventing youth violent behavior and commonalities of effective and ineffective interventions.

METHODS

A systematic review of the literature on the effectiveness of youth violence interventions was conducted. Interventions were categorized according to the level of the intervention: primary (implemented universally to prevent the onset of violence), secondary (implemented selectively with youth at increased risk for violence), and tertiary (focused on youth who had already engaged in violent behavior). An intervention was considered effective if one or more violence outcome indicators was reported as significantly different at the p<0.05 level, and ineffective if none of the violence outcome indicators was significantly different at the p<0.05 level. Data collection and analysis were conducted in 2003 and updated in 2006.

RESULTS

Forty-one studies were included in the review. Overall, 49% of interventions were effective. Tertiary-level interventions were more likely to report effectiveness than primary- or secondary-level interventions. Effective interventions evaluated by randomized controlled trials included Responding in Peaceful and Positive Ways, Aban Aya Youth Project, Moving to Opportunity, Early Community-Based Intervention Program, Childhaven's Therapeutic Child-Care Program, Turning Point: Rethinking Violence, and a multisystemic therapy program. Differences among programs and within subpopulations could not be assessed because of inadequate data.

CONCLUSIONS

Increasing effectiveness was reported as the level of intervention increased from primary to tertiary. Approaches to evaluate prevention interventions need to be clarified and standardized.

ADOLESCENT RESILIENCE: A Framework for Understanding Healthy Development in the Face of Risk

Adolescent resilience research differs from risk research by focusing on the assets and resources that enable some adolescents to overcome the negative effects of risk exposure. We discuss three models of resilience-the compensatory, protective, and challenge models-and describe how resilience differs from related concepts. We describe issues and limitations related to resilience and provide an overview of recent resilience research related to adolescent substance use, violent behavior, and sexual risk behavior. We then discuss implications that resilience research has for intervention and describe some resilience-based interventions.