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Verity F, Richards J, Read S, Wallace S. Towards a contemporary social care 'prevention narrative' of principled complexity: An integrative literature review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e51-e66. [PMID: 33991131 DOI: 10.1111/hsc.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/23/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
Prevention has become increasingly central in social care policy and commissioning strategies within the United Kingdom (UK). Commonly there is reliance on understandings borrowed from the sphere of public health, leaning on a prevention discourse characterised by the 'upstream and downstream' metaphor. Whilst framing both structural factors and responses to individual circumstances, the public health approach nonetheless suggests linearity in a cause and effect relationship. Social care and illness follow many trajectories and this conceptualisation of prevention may limit its effectiveness and scope in social care. Undertaken as part of a commissioned evaluation of the Social Services and Wellbeing Act (2014) Wales, a systematic integrative review was conducted to establish the key current debates within prevention work, and how prevention is conceptually framed, implemented and evaluated within the social care context. The databases Scopus, ASSIA, CINAHL and Social Care Online were initially searched in September 2019 resulting in 52 documents being incorporated for analysis. A further re-run of searches was run in March 2021, identifying a further 14 documents, thereby creating a total of 66. Predominantly, these were journal articles or research reports (n = 53), with the remainder guidance or strategy documents, briefings or process evaluations (n = 13). These were categorised by their primary theme and focus, as well as document format and research method before undergoing thematic analysis. This highlighted the continued prominence of three-tiered, linear public health narratives in the framing of prevention for social care, with prevention work often categorised and enacted with inconsistency. Common drivers for prevention activity continue to be cost reduction and reduced dependence on the care system in the future. Through exploring prevention for older people and caregivers, we argue for an approach to prevention aligning with the complexities of the social world surrounding it. Building on developments in complexity theory in social science and healthcare, we offer an alternative view of social care prevention guided by principles rooted in the everyday realities of communities, service users and caregivers.
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Affiliation(s)
- Fiona Verity
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Jonathan Richards
- Welsh Institute for Health and Social Care, University of South Wales, Pontypridd, UK
| | - Simon Read
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Sarah Wallace
- Welsh Institute for Health and Social Care, University of South Wales, Pontypridd, UK
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Weller O, Sagers L, Hanson C, Barnes M, Snell Q, Tass ES. Predicting suicidal thoughts and behavior among adolescents using the risk and protective factor framework: A large-scale machine learning approach. PLoS One 2021; 16:e0258535. [PMID: 34731169 PMCID: PMC8565727 DOI: 10.1371/journal.pone.0258535] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/29/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Addressing the problem of suicidal thoughts and behavior (STB) in adolescents requires understanding the associated risk factors. While previous research has identified individual risk and protective factors associated with many adolescent social morbidities, modern machine learning approaches can help identify risk and protective factors that interact (group) to provide predictive power for STB. This study aims to develop a prediction algorithm for STB among adolescents using the risk and protective factor framework and social determinants of health. METHODS The sample population consisted of more than 179,000 high school students living in Utah and participating in the Communities That Care (CTC) Youth Survey from 2011-2017. The dataset includes responses to 300+ questions from the CTC and 8000+ demographic factors from the American Census Survey for a total of 1.2 billion values. Machine learning techniques were employed to extract the survey questions that were best able to predict answers indicative of STB, using recent work in interpretable machine learning. RESULTS Analysis showed strong predictive power, with the ability to predict individuals with STB with 91% accuracy. After extracting the top ten questions that most affected model predictions, questions fell into four main categories: familial life, drug consumption, demographics, and peer acceptance at school. CONCLUSIONS Modern machine learning approaches provide new methods for understanding the interaction between root causes and outcomes, such as STB. The model developed in this study showed significant improvement in predictive accuracy compared to previous research. Results indicate that certain risk and protective factors, such as adolescents being threatened or harassed through digital media or bullied at school, and exposure or involvement in serious arguments and yelling at home are the leading predictors of STB and can help narrow and reaffirm priority prevention programming and areas of focused policymaking.
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Affiliation(s)
- Orion Weller
- Department of Computer Science, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Computer Science, Brigham Young University, Provo, Utah, United States of America
| | - Luke Sagers
- Department of Biomedical Informatics, Harvard University, Cambridge, Massachusetts, United States of America
- Department of Statistics, Brigham Young University, Provo, Utah, United States of America
| | - Carl Hanson
- Department of Public Health, Brigham Young University, Provo, Utah, United States of America
| | - Michael Barnes
- Department of Public Health, Brigham Young University, Provo, Utah, United States of America
| | - Quinn Snell
- Department of Computer Science, Brigham Young University, Provo, Utah, United States of America
| | - E. Shannon Tass
- Department of Statistics, Brigham Young University, Provo, Utah, United States of America
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Bangdiwala SI, Hassem T, Swart LA, van Niekerk A, Pretorius K, Isobell D, Taliep N, Bulbulia S, Suffla S, Seedat M. Evaluating the Effectiveness of Complex, Multi-component, Dynamic, Community-Based Injury Prevention Interventions: A Statistical Framework. Eval Health Prof 2018; 41:435-455. [PMID: 30376737 DOI: 10.1177/0163278717709562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dynamic violence and injury prevention interventions located within community settings raise evaluation challenges by virtue of their complex structure, focus, and aims. They try to address many risk factors simultaneously, are often overlapped in their implementation, and their implementation may be phased over time. This article proposes a statistical and analytic framework for evaluating the effectiveness of multilevel, multisystem, multi-component, community-driven, dynamic interventions. The proposed framework builds on meta regression methodology and recently proposed approaches for pooling results from multi-component intervention studies. The methodology is applied to the evaluation of the effectiveness of South African community-centered injury prevention and safety promotion interventions. The proposed framework allows for complex interventions to be disaggregated into their constituent parts in order to extract their specific effects. The potential utility of the framework is successfully illustrated using contact crime data from select police stations in Johannesburg. The proposed framework and statistical guidelines proved to be useful to study the effectiveness of complex, dynamic, community-based interventions as a whole and of their components. The framework may help researchers and policy makers to adopt and study a specific methodology for evaluating the effectiveness of complex intervention programs.
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Affiliation(s)
- Shrikant I Bangdiwala
- 1 Department of Statistics, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.,2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa.,4 Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tasneem Hassem
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Lu-Anne Swart
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Ashley van Niekerk
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Karin Pretorius
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Deborah Isobell
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Naiema Taliep
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Samed Bulbulia
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Shahnaaz Suffla
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
| | - Mohamed Seedat
- 2 Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.,3 Violence, Injury and Peace Research Unit, South African Medical Research Council-University of South Africa, Cape Town, South Africa
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Ringwalt C, Sanford C, Dasgupta N, Alexandridis A, McCort A, Proescholdbell S, Sachdeva N, Mack K. Community Readiness to Prevent Opioid Overdose. Health Promot Pract 2018; 19:747-755. [PMID: 29400083 DOI: 10.1177/1524839918756887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Effective community-based actions are urgently needed to combat the ongoing epidemic of opioid overdose. Community readiness (CR) has been linked to communities' support for collective action, which in turn has been associated with the success of community-wide prevention strategies and resulting behavior change. Our study, conducted in North Carolina, assessed the relationship between CR and two indices of opioid overdose. County-level data included a survey of health directors that assessed CR to address drug overdose prevention programs, surveillance measures of opioid overdose collected from death records and emergency departments, and two indicators of general health-related status. We found that counties' rates of CR were positively associated with their opioid-related mortality (but not morbidity) and that this relationship persisted when we controlled for health status. North Carolina counties with the highest opioid misuse problems appear to be the most prepared to respond to them.
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Affiliation(s)
| | | | - Nabarun Dasgupta
- 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | | | - Agnieszka McCort
- 1 University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | | | - Nidhi Sachdeva
- 2 NC Department of Health and Human Services, Raleigh, NC, USA
| | - Karin Mack
- 3 Centers for Disease Control and Prevention, Atlanta, GA, USA
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Shapiro VB, Hawkins JD, Oesterle S. Building Local Infrastructure for Community Adoption of Science-Based Prevention: The Role of Coalition Functioning. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 16:1136-46. [PMID: 26017632 DOI: 10.1007/s11121-015-0562-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The widespread adoption of science-based prevention requires local infrastructures for prevention service delivery. Communities That Care (CTC) is a tested prevention service delivery system that enables a local coalition of community stakeholders to use a science-based approach to prevention and improve the behavioral health of young people. This paper uses data from the Community Youth Development Study (CYDS), a community-randomized trial of CTC, to examine the extent to which better internal team functioning of CTC coalitions increases the community-wide adoption of science-based prevention within 12 communities, relative to 12 matched comparison communities. Specifically, this paper examines the potential of both a direct relationship between coalition functioning and the community-wide adoption of science-based prevention and a direct relationship between functioning and the coalition capacities that ultimately enable the adoption of science-based prevention. Findings indicate no evidence of a direct relationship between four dimensions of coalition functioning and the community-wide adoption of a science-based approach to prevention, but suggest a relationship between coalition functioning and coalition capacities (building new member skills and establishing external linkages with existing community organizations) that enable science-based prevention.
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Affiliation(s)
- Valerie B Shapiro
- School of Social Welfare, University of California at Berkeley, 120 Haviland Hall #7400, Berkeley, CA, 94720, USA.
| | - J David Hawkins
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA, 98115, USA
| | - Sabrina Oesterle
- Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave NE, Suite 401, Seattle, WA, 98115, USA
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Kim BKE, Oesterle S, Hawkins JD, Shapiro VB. Assessing Sustained Effects of Communities That Care on Youth Protective Factors. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2015; 6:565-589. [PMID: 26951879 PMCID: PMC4778969 DOI: 10.1086/684163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The Communities That Care (CTC) prevention system seeks to build community capacity for a science-based approach to the promotion of healthy youth development. Prior research shows the positive effects of CTC on youth protective factors during CTC implementation. This research tests sustained effects of CTC on youth protective factors 1 year after external support to communities for CTC implementation ended. METHOD Data come from a community-randomized trial of CTC in 24 communities across 7 states. A panel of 4,407 youth in CTC and control communities was surveyed annually from Grade 5 through Grade 10. Youth reported their exposure to protective factors identified in the social development model. Global test statistics are calculated to examine effects of CTC across 15 protective factors in 5 domains (community, school, family, peer, and individual) assessed in Grade 10, 1 year after study support for CTC implementation ended. Analyses also examine variation in sustained effects by gender and baseline risk levels. RESULTS Global effects of CTC on protective factors across all domains are not sustained in Grade 10. However, sustained domain-specific effects are observed in the individual domain for males, in the peer domain for females, and in the individual domain for youth with low-to-medium risk at baseline. CONCLUSIONS Greater emphasis on strengthening protective factors during high school might be needed to sustain broad effects of CTC on protective factors observed during middle school.
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Affiliation(s)
- B K Elizabeth Kim
- Center for Prevention Research in Social Welfare at the University of California, Berkeley
| | | | - J David Hawkins
- Social Work Endowed Professor of Prevention in the School of Social Work, University of Washington
| | - Valerie B Shapiro
- School of Social Welfare, University of California, Berkeley, and serves as an analyst for the Social Development Research Group as well as the Devereux Center for Resilient Children
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Shapiro VB, Oesterle S, Hawkins JD. Relating coalition capacity to the adoption of science-based prevention in communities: evidence from a randomized trial of Communities That Care. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 55:1-12. [PMID: 25323784 PMCID: PMC4501494 DOI: 10.1007/s10464-014-9684-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Coalition-based efforts that use a science-based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science-based approach to prevention in communities. Using data from 12 coalitions participating in a community-randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community-wide adoption of a science-based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta-regression analyses found that CTC had a greater impact on the adoption of a science-based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages).
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Affiliation(s)
- Valerie B Shapiro
- School of Social Welfare, University of California at Berkeley, 120 Haviland Hall #7400, Berkeley, CA, 94720, USA,
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