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Prevention Science Expanding Worldwide

Due in part to the worldwide investment and success in child health care more children are surviving into adolescence. The worldwide burden of disease has shifted to non-communicable diseases and behavior problems. Unsafe driving, mental health (self-inflicted injuries), and violence are now the three leading causes of adolescent mortality. Alcohol, tobacco, and drug misuse are implicated in those three leading causes as well as carrying their own harmful effects into adulthood.  Sexually-transmitted infections (STI), HIV (AIDS virus) and teen pregnancy with maternal hemorrhage and abortion are the 7^th and 8^th causes of mortality among female adolescents. The economic and social costs from these behavior problems have risen worldwide and are accelerating in low-income and middle-income countries.

This study from the School of Social Work, University of Washington, along with collaborating institutions from around the globe, describes 40 years of prevention science research progress. This includes identification of precursors that affect the likelihood of adverse health outcomes including risk factors that predict an increased likelihood of problems and protective factors that decrease the likelihood of such problems. This has led to research based prevention policies and programs that target these risk and protective factors.  Many have shown short-term and long-term success. The article describes specific policies and programs that illustrate the wide-ranging prevention approaches that have shown effectiveness at different developmental periods, in risk groups, and around the globe.

The article also describes the challenges faced in bringing about worldwide application of proven prevention policies and programs aimed at reducing adolescent mortality and morbidity. Three solutions to these challenges are described: First: government, public health agencies, schools and parents must recognize  a) adolescent health as a priority, b) that behavior problems are implicated in poor health outcomes in adolescence and adulthood, and c) that there are effective prevention policies and programs. Second: research is needed on translating efficacious prevention approaches to a range of communities and countries. This translation must recognize local conditions and acknowledge that policy or program core ingredients need to be preserved. Third: programs must be chosen based on a community’s local need.  Governments and communities need to build prevention coalitions, and regularly assess local risk and protective factors and behavior problems in their youth.  These local data can be prioritized and matched to proven interventions in order to reach targeted youth.

The study concludes that these actions to reduce behavior problems during adolescence is likely to reduce mortality and morbidity worldwide, thus reducing the burden of health problems well into adulthood.

(Catalano, RF, Fagan, AA, Gavin, LE, Greenberg, MT, Irwin, CE, Ross, DA, Shek, DTL: Worldwide application of prevention science in adolescent health. The Lancet 379:1653-1664, 2012)

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