SCOPE Thought Piece, Question #2: What have we learned to date in our prevention efforts that practitioners should know about?

Alan Berkowitz, Ph.D.

There are many specific prevention approaches that have been shown to be effective in scientific studies.  Broadly speaking, these approaches attempt to change both the peer culture and/or the larger environment in which problems occur and may involve teaching at-risk individuals specific skills.  Sharing information and/or knowledge alone has been shown to not be effective.  Good prevention therefore requires understanding the causes and contributing elements of a problem, identifying those which can be modified through prevention practices, and then creating a delivery system that can effectively transform them.

More broadly, specific characteristics of effective prevention that cut across different approaches and best practices have been identified which must be followed. All of the major prevention organizations – the Centers for Disease Control, the Higher Education Center, and the Prevention Institute, for example, have elaborated these best practices. In one article (Nation et. al. 2003), a group of prevention experts identified nine critical elements of success:  comprehensive, varied teaching methods, sufficient dosage, focus on positive relationships, theory driven, appropriately timed, socio-culturally relevant, evaluated, and implemented with well-trained staff. In my own work (Berkowitz, 2007) I have used the following terms to describe effective prevention:  developing a vision of the bigger picture (comprehensiveness), creating synergy (intensiveness), tailoring prevention to the community and its constituents (relevance), being informed by accurate knowledge (data-driven), and growing health (emphasizing the positive).

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