The primary mental health project: Thirty years after

Summary

This article summarizes the 30‐year history of the Primary Mental Health Project (PMHP), a school‐based program for early detection and prevention of young children's school adjustment problems. The article first describes PMHP's rationale and basic practices, gives examples of how the project has grown and evolved over the years, and summarizes some of its important research findings. The report also reviews several more recent PMHP emphases including its systematic work in program dissemination and its active efforts to develop effective primary prevention program modules. PMHP's approach offers a bona fide alternative to mental health's established, after the fact, restorative ways.     

Protecting Children from the Consequences of Divorce

Summary

The procedures for the Divorce Adjustment Project, a prevention program for children of divorce, are based on three processes: the psychological problems common to many children, aspects of the divorce which hamper child adjustment, and program evaluation data spanning ten years of operation. This fourteen session program consists of two elements: the Children's Support Group and the Kidsbook. The cognitive-behavioral CSGs teach communication, impulse control, decision making, and anger control skills. The Special Topics work to enhance children's self-esteem and provide emotionalsupport and assist children in understanding the divorce events. The Kidsbook assists children in applying the skills learned in the groups to the home, classroom and playground and to foster a productive parental involvement. Practical issues dictating the structure of the program include recruitment, program goals, and the fit between participant characteristics and program elements.     

Successful Program Development Using Implementation Evaluation

SUMMARY

Four methods used to enhance implementation of a resiliency-based early childhood substance abuse and violence prevention initiative are described. Project staff drew up formal agreements with participating programs to ensure administrative support for the intervention, provided high quality training for program implemcnt-ers, used a participatory evaluation approach, and monitored implementation both directly and through practitioners' self-report. The contribution of each of these methods to fidelity of implementation is discussed, and implementation challenges are identified. The growth and success of the project demonstrates the utility of implementation evaluation data for ongoing program development and improvement.     

School-Based Social Competence Promotion as a Primary Prevention Strategy

Abstract

School-based promotion of social competence continues to be a promising strategy for the primary prevention of psy-chosocial difficulties in children. Drawing on more than a decade of experience using this strategy, the authors identify major challenges they have encountered in the process of developing, implementing, evaluating, and maintaining social competence promotion programs in the schools. They emphasize the importance of using a dynamic, social-ecological conceptualization of both social competence and the organizational change process. Particular attention is given to overcoming obstacles to implementation and to long-term adoption of programs. Throughout, examples are drawn from the author's specific experiences with two longitudinal, multi-site projects.     

School Violence in Children and Adolescents

Abstract

This article reviews school violence prevention programs that were published between the years of 1990 and 1999. All the interventions fitting inclusion criteria involved being implemented in a school setting, using a control group, and including a quantitative methodology. Effect sizes were calculated for the final sixteen articles that were reviewed in the meta-analysis. A process of inspection was used in order to come up with treatment characteristics most common to each prevention program. Each study was thus described according to six categories: theoretical base, setting, age group, leader training, duration, and random assignment. Four studies resulted with strong effect sizes; however, a regression analysis was not conducted due to inadequate sample size. A review of the literature suggested that program impact could be significantly affected by the use of cognitive-behavioral strategies, multi-setting atmosphere, and primary (elementary school) prevention. In addition, intuitive support (common knowledge in the social science field) indicated that a qualified program leader and longer length of program could also contribute to the influence of a program. Future researchers are encouraged to use a more comprehensive literature review (e.g., past 20 years) in terms of conducting meta-anal-yses in order to provide a larger sample size adequate enough to see the true effects of different intervention components on outcomes (regression analysis; i.e., additive component effects).     

Design and Implementation of Parent Programs for a Community-Wide Adolescent Alcohol Use Prevention Program

SUMMARY

Project Northland is a comprehensive community trial designed to evaluate programs for the primary prevention of alcohol-related problems during adolescence. It uses a community-wide model, that includes both demand and supply reduction techniques. The first phase of Project Northland (grades 6-8) was completed with the effective implementation of multiple, complementary programs including a multi-year social behavioral curriculum, intensive parental involvement components, peer leadership opportunities, and community-level changes through the formation of local task forces. This article describes the process used for developing and implementing the comprehensive parent interventions used during the first phase of the research, highlighting the elements that led to the successful implementation of the programs with very high participation rates by parents, their young adolescents, teachers, and community members.     

The School-Based Violence Prevention Planning Program

Abstract

Despite a growing research literature identifying evidence-based prevention strategies, schools often adopt programs lacking evidentiary support (Gottfredson and Gottfredson, 2002; Ringwalt et al., 2002). Further, when evidence-based programs are adopted they often suffer from poor implementation (Gottfredson and Gottfredson, 2002). This gap between research and practice defines a need for efforts to further the dissemination and effective implementation of evidence-based prevention strategies. The School-Based Violence Prevention Planning Program (SBV3P) is designed to improve the dissemination of evidence-based prevention strategies by building the capacity of school personnel to identify and effectively implement violence prevention strategies that have substantial empirical support. In this program, prevention planning teams from schools create violence prevention plans by progressing through a structured planning framework emphasizing data-driven decision making and the use of empirically validated violence prevention strategies. To build capacity, participating teams are provided with training, technical assistance, and online resources. Here we present the SBV3P and review a pilot test of this program.     

Evaluation of an Incentive System at a Summer Camp for Youth Experiencing Homelessness

SUMMARY

Children who are homeless often experience emotional and behavioral problems. They also may have difficulty interacting with peers. Programs designed to reward positive behaviors may be successful in improving behavioral functioning for children experiencing emotional distress due to homelessness and related risk factors. Families experiencing homelessness may have a difficult time accessing mental health services. School settings may be optimal environments for implementing programs to improve behavioral and social development for these children. In this paper, we describe the implementation and outcomes of an incentive system, developed to improve school behaviors and interactions for children experiencing homelessness. This system was implemented during a summer camp designed to enrich reading skills. Teachers and aides administered bracelets as secondary reinforcers for positive and prosocial behaviors. Children could purchase primary reinforcers, such as toys and art supplies, with the bracelets. Results were positive, supporting project activities. Future programs and evaluation projects should focus on delivering and evaluating prevention and therapy services for youth experiencing homelessness.     

Introduction

Summary

Rapid population growth in the Third World has been accompanied by the creation of national family planning programs, which attempt to slow growth rates through programs aimed at the prevention of births. These programs represent large scale, modern bureaucratic health delivery systems that are transplanted from the industrialized world. They raise the problem of whether such modern organizations can have an impact on reproductive behavior throughout the Third World. A large scale research program on Asian family planning programs provides some of the answers to these critical questions. First, pooled cross-national time series data indicate that as family planning programs grew and their inputs of staff and funds increased, both contraceptive and birth prevention increased. Further, multiple regression analyses indicate a positive impact of program inputs on both contraceptive use rates and birth prevention, even when levels of social and economic development are controlled. There is also, however, much variance among countries in their patterns of both program performance and birth prevention. Four country cases are examined-the Philippines, Malaysia, South Korea, and Indonesia-to show that the character of political organization has an impact on the performance of these modern bureaucratic birth prevention organizations.     

School Violence Interventions in the Safe Schools/Healthy Students Initiative

Abstract

The Safe Schools/Healthy Students Initiative was designed to encourage collaboration among school districts and local community service providers in the provision of behavioral health prevention and early intervention efforts. These efforts would address the physical safety of students as well as provide mental health, violence prevention, and social skills services. One local SS/HS Initiative brought together community and school collaborators in an ambitious agenda that included 14 distinct programs that addressed the needs of over 110,000 students in a large school district. The purpose of the current paper is to report the results of the evaluation of two of the programs designed to reduce violent and disruptive behavior in schools. The programs include a school-based anger management program and a community-based, alternative-to-suspension program. Working in cooperation with program staff and the school district, quasi-experimental designs were used to measure change over time for students. The two studies demonstrate the application of multiple methodologies in evaluating the effectiveness of prevention and early intervention efforts with the aim of providing data to support program improvement and sustainability.     

Breaking Fresh Ground

ABSTRACT

In the present paper, the author introduces her roles and duties at her current job. The author then describes how she got into community psychology and primary prevention and how her graduate school and previous work experiences have influenced her current work. Focusing on primary prevention, the author delineates how the two community psychology concepts -primary prevention and action research -can be applied to the promotion of adolescent mental health in the Korean society. The author then adds advice for foreign students who are considering studying community psychology in the U.S.     

Supporting and Strengthening Family Functioning

Abstract

The thesis of this article is that family resource programs which employ prevention models fail to recognize that the prevention of poor outcomes cannot be equated with the strengthening of family functioning. Evidence from divergent but conceptually coherent lines of research is presented which indicates that the absence of problems does not necessarily mean the presence of positive functioning. The use of promotion models which are more consistent with the aims and principles of family resource programs is advanced as a way of bridging the gap between intervention models, family support principles, and family resource program practices.     

Early childhood education and primary prevention

Summary

Early childhood education is emerging as a major method of primary prevention of social and personal problems. Studies of early childhood programs, such as the Ypsilanti Perry Preschool Project, have found positive long‐term consequences for participating children with significantly improved educational performances including high school graduation rates and college attendance; improved rates of employment and self‐support; and reduced rates of crime, teen pregnancy, and welfare utilization. This paper gives a brief overview of the research project and the curriculum methods employed. As the country becomes aware of the need for prevention rather than correction, high quality early childhood education will be employed widely.     

An Assessment of the Relationship Between the Quality of School-Based Tobacco Prevention Programs and Youth Tobacco Use

SUMMARY

This study presents data from an assessment of substance use prevention programs in 23 elementary and middle schools in northern and central Illinois. The quality of prevention programming was assessed based on program intensity, focus on tobacco, staff resources designated for prevention programs, and implementation of the Centers for Disease Control and Prevention recommendations for tobacco prevention. Data from these four dimensions were used to calculate a Quality Index Score. Multilevel logistic regression analysis was used to assess the relationship between individual level variables, school level variables and the outcomes of reported current tobacco use, intent to use tobacco in the coming year, and perceived efficacy of substance use prevention programs. No significant effects were found, indicating that exclusive use of even high quality school-based prevention programs may not be sufficient in changing youth behavior. However, school-based prevention programs may be an important component of a broader ecological approach that uses multiple, community-wide strategies to promote normative change.     

School Violence Prevention

Abstract

School violence has many faces and many casualties. In varying degrees it touches students, parents, educators and communities of every school world wide. At the local level, communities are seen as playing a significant role in violence prevention. Generally, community-based violence prevention approaches involve the assessment of local problems, identification of target issues, selection of a range of interventions, and the encouragement of collaboration among civic groups, the juvenile justice system, local leaders, and young people themselves. These programs are generally judged as successful if they are able to address risk factors effectively for individual youths, strengthen those factors that provide protection and enhance resiliency, provide sufficient support and effective supervision, and increase pro-social attitudes by providing youth with a sense of having an increased stake in their local communities. Although too few educators are aware of its impact, the women's community has been involved in this work for decades. In this paper I discuss the results of interviews with members of the women's community in Atlantic Canada who have developed proactive violence prevention initiatives. I will concentrate on their efforts to bring those programs into the schools and their experiences of the successes and challenges they encounter.     

Welcome baby programs

SUMMARY

Several successful prevention programs are recognized as exemplars of implementation. Complicated multidimensional interventions with different goals and directed at different target populations have been conducted with a high degree of fidelity using a common set of strategies. Future research priorities involve identifying the specific factors that promote implementation and determining what levels of implementation are necessary to achieve maximum program impact.     

Effectiveness of a Cancer Education Program for Women Attending Rural Public Health Departments in North Carolina

SUMMARY

The Western North Carolina Cancer Awareness Program (CAP) was a four-year program, funded by the National Cancer Institute, to increase education and support services for the prevention and early detection of breast, cervical, and skin cancer among women receiving care in six rural county public health departments. Three health departments were selected as intervention units, and the remaining three health departments served as comparison units. Women age 20 and older were randomly selected in each health department. Women in the intervention group received a comprehensive health education program that included easy-to-read printed materials and telephone counseling dealing with breast, cervical, and skin cancer. Theoretical guidelines for development of the intervention program included the PRECEDE Model and the Health Belief Model. Overall, the results indicated that personalized education, which includes the combination of readable printed materials and telephone contact, can be effective in increasing some early detection behaviors for breast and skin cancer among women who attend public health departments. The value of telephone counseling as a comparatively inexpensive approach to individualizing health education has significant implications for the development of similar cancer education programs for underserved populations.     

Evaluation of a Theater-Based Youth Violence Prevention Program for Elementary School Children

Abstract

The present study evaluated the impact of Urban Improv (UI), a theater-based youth violence prevention (YVP) program developed for inner-city youth, on three behavioral and psychological outcome domains: aggressive behaviors, prosocial behaviors, and scholastic attention and engagement. This study compared outcomes for 77 elementary school students in classrooms designated to receive UI with those of 63 students from matched control classrooms. Findings revealed that students who received UI were superior to matched controls on all outcome domains. Findings support UI as a promising practice for YVP with urban elementary school students and suggest that greater attention should be focused on application of theater-based programs in YVP.