School Based Prevention Programs
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School-based prevention programs are initiatives implemented into school settings that aim to increase children's academic success and reduce high-risk problem behaviors.


Overview

An estimated 20-40% of youth have a
psychiatric disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitt ...
, yet up to 80% of those in need do not receive mental health services. Preventing mental health problems and promoting healthy behavior among youth has become a critical
policy Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an organ ...
issue. The Report of the Surgeon General’s Conference on Children’s Mental Health stated the importance of fostering a solid emotional foundation in children in order to facilitate learning. However, children and families face significant barriers to accessing and receiving community-based mental health services. As a result, schools have been identified as ideal avenues through which to reach youth. Universal
prevention Prevention may refer to: Health and medicine * Preventive healthcare, measures to prevent diseases or injuries rather than curing them or treating their symptoms General safety * Crime prevention, the attempt to reduce deter crime and crimi ...
programs are offered to the general population, while selective prevention programs are intended for groups identified as at risk for developing a problem. This differentiates them from intervention or treatment programs, which are intended for individuals who already have a problem or meet criteria for a disorder.


Approaches

A number of school-based programs have been developed to target specific outcomes, including problems such as
bullying Bullying is the use of force, coercion, hurtful teasing or threat, to abuse, aggressively dominate or intimidate. The behavior is often repeated and habitual. One essential prerequisite is the perception (by the bully or by others) of an imba ...
, substance use, and
antisocial behavior Antisocial may refer to: Sociology, psychiatry and psychology *Anti-social behaviour * Antisocial personality disorder *Psychopathy *Conduct disorder Law *Anti-social Behaviour Act 2003 *Anti-Social Behaviour Order *Crime and Disorder Act 1998 * ...
. Others have been developed to foster positive youth development and academic performance. While each of these programs focuses on distinct issues and outcomes, research suggests that in adolescent-focused initiatives, many utilize the same practice elements, including communication skills, problem solving, insight building, and assertiveness training. These results suggest that certain core skills may be critical to seemingly disparate desired outcomes, which may have implications for clinical decision making as well as policy. A meta-analysis of 213 school-based prevention programs promoting social and emotional learning (SEL) looked at outcomes in six different domains: social and emotional skills, attitudes toward self and others, positive social behaviors, conduct problems, emotional distress, and academic performance. Findings suggested that SEL programs had positive effects across all six domains, demonstrating the broad impact of universal school-based prevention programs


Challenges

While 59% of schools in the U.S. report having programs that foster children’s social and emotional needs,
evidence-based Evidence-based practice (EBP) is the idea that occupational practices ought to be based on scientific evidence. While seemingly obviously desirable, the proposal has been controversial, with some arguing that results may not specialize to indiv ...
initiatives have not been widely implemented. Schools may be unaware of the evidence base, reflecting the gap between research and practice. Schools that are aware of effective programs may lack funding necessary to implement the program. Should schools receive funding for
implementation Implementation is the realization of an application, or execution of a plan, idea, model, design, specification, standard, algorithm, or policy. Industry-specific definitions Computer science In computer science, an implementation is a real ...
, research shows that programs are often poorly implemented, resulting in low fidelity and weak outcomes. Additionally, some prevention programs may not be a good fit with the local context and may require tailoring. Finally, schools may struggle to sustain programs due to limited resources.


Implementation strategies

While there are significant challenges to implementing evidence-based prevention programs into school settings, there are strategies to increase the success of introducing and sustaining such programs. These strategies include assigning highly committed individuals as project directors or coordinators; encouraging support and cooperation from school administrators, community members and principals; motivating and gaining the support and enthusiasm of teachers; training which will provide knowledge, skills, and desire to continue further; retraining a few years after to reinforce knowledge and continue the commitment of the teacher or school; and gathering feedback to provide instructors with how to improve their skills. Properly implemented programs are likelier to have good outcomes, which may incentivize
policymakers Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an organ ...
to allocate more funding to these initiatives. Including explicit cost-benefit analysis should be considered when designing programs. Having more structure in the program and implementation process - from training to materials to supervision - may also be beneficial and lead to sustainment.


Further reading


References

{{Reflist Prevention Schools programs