The Case for Prevention Science

In areas as diverse as education, criminal justice, substance abuse, early childhood development, and poverty, prevention science has proven its worth.
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Co-authors are Neil Wollman, PhD, Senior Fellow, Bentley Service-Learning Center at Bentley University in Waltham, MA and Diana H. Fishbein, PhD, C. Eugene Bennett Chair in Prevention Research, Edna Bennett Pierce Prevention Research Center at the Pennsylvania State University in University Park, PA. They are the Co-Directors of the National Prevention Science Coalition to Improve Lives, which is working with Congressional offices across the aisle and with state governments.

While candidates at the national, state, and local levels for the presidency and other offices hone their policy agendas, we implore them to be guided by prevention science. In areas as diverse as education, criminal justice, substance abuse, early childhood development, and poverty, prevention science has proven its worth.

Using behavioral science to inform policymaking is coming of age, as suggested by the President's recent directive that all Federal agencies accommodate it. Another promising development is legislation developed by Speaker Ryan and Senator Murray calling for an Evidence-Based Policy-Making Commission, which would make prevention science indispensable. Yet the unique value of prevention science remains relatively unknown to policymakers and the public.

Prevention science developed over the last forty years as it became more apparent what factors were contributing to problems, such as drug abuse, academic failure, depression, and crime. One of the most important and consistent findings is that most psychological and behavioral problems are inter-related and stem from the same adverse conditions. For example, children who encounter high levels of conflict and criticism (or worse, maltreatment) at home or in school risk not fully developing the self-regulatory skills necessary to prevent aggressive and uncooperative behavior. These behaviors often lead to academic failure, peer rejection, and association with other troubled kids. By early adolescence, groups of troubled youth experiment with substance use, delinquency, and risky sexual behavior. The cost of these troubling outcomes is high: the annual cost due to youth with multiple problems has been estimated at $619 billion in 2015 dollars.

In the past, clinicians and educators implemented effective interventions to address these problems after they developed. But it was soon apparent that a timely intervention could prevent most problems from occurring in the first place. There remains much to learn, but interventions are available now for families and schools to prevent problems as diverse as delinquency, drug abuse, depression, academic failure, and obesity. There is also a wealth of evidence about policies that can reach entire populations to prevent these problems.

In parallel, encouraging evidence indicates an emerging bipartisan interest in addressing the problem of poverty from a more scientific perspective. Both President Obama and Speaker Ryan have made it a priority to reduce poverty. Recent research shows how important prevention science is in addressing poverty. Children raised in poverty are at greater risk not only for all of the problems mentioned above, but also for cardiovascular disease as adults. As the psychologist Greg Miller likes to say, "poverty gets under the skin."

Recent research shows that, when we help families replace harsh discipline practices with patience, caring, and mild, consistent discipline, children do better and families' economic wellbeing improves. Studies of school interventions, such as the Good Behavior Game for elementary students, can increase children's chances of graduating from high school and attending college. Widely and effectively deploying these programs has the potential to reduce intergenerational poverty, improve labor force productivity, and reduce public costs for special education, criminal justice, child protective services, and welfare.

Our ultimate goal is for the nation to develop a World-Class National Prevention System. A comprehensive and effective prevention system would have four facets: (a) An effective system of family supports; (b) Positive behavioral supports in all schools; (c) Ongoing public education about the importance of nurturing environments for child and adolescent development; and (d) A system for monitoring the wellbeing of children, adolescents, and families. A realistic plan for this system can be created if all the agencies and organizations working on health and wellbeing coordinate their efforts.

The bipartisan approach to prevention we see developing can help break government gridlock by stressing humane social policy, saving rather than wasting government money, and providing accountability by using proven interventions and monitoring their impact. The use of tested and effective prevention practices can contribute to reducing the federal deficit, improving the U.S. economy, and eventually strengthening democracy as a whole via a productive and healthy citizenry.

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