Prevention Research

The understanding of how to reduce risk factors for mental disorders has expanded remarkably as a result of recent scientific advances. This study, mandated by Congress, reviews those advances in the context of current research and provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction. Highlighting opportunities for and barriers to interventions, the book draws on successful models for the prevention of cardiovascular disease, injuries, and smoking. In addition, it reviews the risk factors associated with Alzheimer's disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders and evaluates current illustrative prevention programs. The models and examination provide a framework for the design, application, and evaluation of interventions intended to prevent mental disorders and the transfer of knowledge about prevention from research to clinical practice. The book presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies.

Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.

New Developments in Dementia Prevention Research addresses a dearth of knowledge about dementia prevention and shows the importance of considering the broader social impact of certain risk factors, including the role we each play in our own cognitive health throughout the lifespan. The book draws on primary and secondary research in order to investigate the relationship between modifiable factors, including vascular and psychosocial risks, that may affect the incidence of dementia. Bringing together world-leading expertise from applied science, medicine, psychology, health promotion, epidemiology, health economics, social policy and primary care, the book compares and contrasts scientific and service developments across a range of settings. Each chapter presents these themes in a way that will ensure best practice and further research in the field of dementia prevention is disseminated successfully throughout the world. Perhaps most importantly, chapters also question what type of social responsibility we are prepared to embrace in order to address the challenges inherent in dementia prevalence. New Developments in Dementia Prevention Research includes contributions from leading authorities in brain health and dementia prevention and provides an essential contribution to the discourse on dementia prevention. It will be of great interest to academics, researchers and postgraduate students engaged in the study of the psychological and social aspects of aging and dementia.

This book offers a step-by-step guide to intervention research, including the methods and techniques that researchers, higher degree research students and others can use when pursuing intervention research in schools and other settings. Guided by the Intervention Research Framework, it also provides practical information on linking a program developed using a comprehensive, evidence-based approach, to research and evaluation processes. The handbook also illustrates how to select an appropriate research sample for research; how to develop valid and reliable instruments for measuring change, including how to devise appropriate measures for assessing behavioural change; how to recruit and negotiate with schools (and other settings) for research involving young people; how to measure and incorporate measures of fidelity of implementation to understand dose response and behavior change; and how to optimize data collection and dissemination. The development and longitudinal assessment of the multi award-winning School Health and Alcohol Harm Reduction Project (SHAHRP) – the first alcohol harm reduction study to assess the impact of a school-based classroom intervention on alcohol use, alcohol-related behaviors and alcohol-related harm using a harm reduction paradigm – provides a practical example of the intervention research processes described in this handbook.

Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.

Whoever coined the adage "an ounce of prevention is worth a pound of cure" could not have known how important this adage would become. The challenge of altering the health trajectories of poor lifestyle decisions for such behaviors as smoking, drinking and using illicit drugs, violence, dropping out of school, engagement in risky sexual behaviors and crime through prevention research has led to a new discipline, prevention science. Defining Prevention Science covers this emerging field of science: its goals, its conceptual and theoretical foundations, its methods and especially its utility. Not content to simply differentiate the field from its close allies: epidemiology, psychology, neuroscience, sociology, economics, the text explains how these many disciplines enhance each other at both research and intervention levels and how prevention science draws on these biological, behavioral and social sciences to create an innovative knowledge base that has provided cost-effective, evidence-based prevention interventions and policies. To this end, familiar developmental benchmarks are recast in prevention/health promotion context, from the crucial importance of adolescence in encountering and deterring high-risk behaviors to the risks and resiliencies of single-mother families. An international group of contributors offers current findings, up-to-date methods for effective evidence-based interventions and improvements in research technologies in these key areas: Physical, cognitive and emotional vulnerability across the life course. The roles of developmental influences in prevention. Intervention development, delivery and implementation. Bringing the intervention approach to research design. New directions in analytic methods. Cost analysis and policy implications. Advances in Prevention Science: Defining Prevention Science aims to inspire further refinements in the field and encourage communication among researchers in its own and related disciplines, including public health, epidemiology, psychology, and criminology. This is the first volume in the series, Advances in Prevention Science, that provides the framework for other volume that will focus on such issues as: Prevention Science in School Settings: Complex Relationships and Processes; Preventing Crime and Violence and The Prevention of Substance Use.

This provocative and useful volume is a step-by-step guide to assist professionals in implementing valid and useful community research and creating preventive interventions that have positive and lasting effects on the development of the community. The authors--including James G. Kelly, one of the fathers of prevention--offer valuable suggestions for developing community processes to assist the prevention researcher and the community in designing research that is embedded in the community. Experts focus on the topics that can help establish and sustain effective long-term working relationships with community members. Numerous examples illustrate how the collaborative working relationship can create the variety of resources that are needed to eventually implement policy changes stimulated by the research and help to sustain the impact of the research findings after the research has been completed. This exciting book illustrates how community research related to the prevention of mental illness and the promotion of mental health can be scientific and objective, as well as a positive collaboration between the research staff and community members. Focus upon community needs Emphasize educational activities to support the prevention research Identify points of policy impact before the research begins Enhance the development of social networks and social support systems for the development of competencies Provide criteria for the selection of systemic variables for the research Include reference to the multiple levels of a community which may affect the research topic Specify ways in which participants can identify and own the research topic Outline criteria for assessing the side effects of the prevention research In order to better understand the needs, values, commitments, and resources of the community in which he or she is working, the researcher is encouraged to select research topics derived from underlying community needs, educated the public about prevention, identify points of policy impact, and determine the informal social networks that enhance the development of social competencies in the community. The benefits of the collaborative relationship between prevention researchers and the community are strongly emphasized. A Guide to Conducting Prevention Research in the Community aims to guide citizens and professionals in implementing valid and useful community research and create preventive interventions that have positive and lasting effects on the development of the community.

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.