0
To Boldly Go where no scientist has gone…                 Creating new solutions for new situations or problems using     ...
We should use evidence-based programs, right?  But what if it is a new situation…  like an epidemic of meth use among firs...
A major threat to validity in Cook & Campbell…                                  …Time of History
35%                                                                                                                       ...
“Madame Secretary…there is a big, unexpectedbug in the problem you want us to solve…”
“Madame Secretary…there is a big, unexpectedbug in the problem you want us to solve…”
What are the options?
What are the options?  Punt…do nothing?
What are the options?  Punt…do nothing?  Argue that there is no problem? The data are wrong?
What are the options?  Punt…do nothing?  Argue that there is no problem? The data are wrong?  Insist on choosing a program...
What are the options?  Punt…do nothing?  Argue that there is no problem? The data are wrong?  Insist on choosing a program...
What is an eco-behavioral assessment?            Rates of                                                 Bio-            ...
What is an eco-behavioral assessment?            Rates of                                                 Bio-            ...
What is an eco-behavioral assessment?            Rates of                                                 Bio-            ...
What is an eco-behavioral assessment?            Rates of                                                 Bio-            ...
What is an eco-behavioral assessment?            Rates of                                                 Bio-            ...
What is an eco-behavioral assessment?            Rates of                                                 Bio-            ...
Antecedents in eco-behavioral assessment             Rates of                                                 Bio-        ...
Behaviors in an eco-behavioral assessment             Rates of                                                 Bio-       ...
Behaviors in an eco-behavioral assessment             Rates of                                                 Bio-       ...
Behaviors in an eco-behavioral assessment             Rates of                                                 Bio-       ...
Consequences in an eco-behavioral assessment            Rates of                                                 Bio-     ...
Consequences in an eco-behavioral assessment            Rates of                                                 Bio-     ...
Consequences in an eco-behavioral assessment            Rates of                                                 Bio-     ...
Consequences in an eco-behavioral assessment            Rates of                                                 Bio-     ...
Relation frames in an eco-behavioral assessment            Rates of                                                  Bio- ...
Relation frames in an eco-behavioral assessment            Rates of                                                  Bio- ...
Relation frames in an eco-behavioral assessment            Rates of                                                  Bio- ...
Relation frames in an eco-behavioral assessment            Rates of                                                  Bio- ...
Relation frames in an eco-behavioral assessment            Rates of                                                  Bio- ...
Relation frames in an eco-behavioral assessment            Rates of                                                  Bio- ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
Physiology in an eco-behavioral assessment             Rates of                                                 Bio-      ...
N o w        What?
Clin Child Fam Psychol Rev  DOI 10.1007/s10567-008-0036-x  Evidence-based Kernels: Fundamental Units of Behavioral  Influen...
What is a kernel?      Is the smallest unit of scientifically proven behavioral      influence.  •   Is indivisible; that ...
Relational   Antecedent      Reinforcement              Physiological                                                     ...
Kernels are buildingblocks of behavior change  Humans survive individually and collectively by  influencing the behavior o...
Using kernels to build              population-level change…                   Problem                              Kernel...
Public-health kernel case study
30.0%                                                                                  12.0%                              ...
30.0%                                                                                     12.0%                           ...
30.0%                                                                                      12.0%                          ...
!"##$#%&()*+&,-./012!/3&0/4415-6&72!&/33&Kernels lower cost of training, support & change… & !"#$%&(&)*"+,$%&!"#$%&-.&/%01...
Tactics                 of              Scientific                Evaluating               MURRAYUnderstanding fundamental ...
Muir KA, Milan MA J Appl Behav Anal. 1982 Fall;15(3):455-60.Parent reinforcement for child achievement: theuse of a lotter...
Lifespan example of one kernelfor prevention, intervention and                       treatment
If kernels are so good…
If kernels are so good…
Lessons for the      day and future    for more info, check out;www.slideshare.net/drdennisembry
Creating Evidence-Based Practices When None Exist
Creating Evidence-Based Practices When None Exist
Upcoming SlideShare
Loading in...5
×

Creating Evidence-Based Practices When None Exist

385

Published on

On April 28, 2011, the Assistant Secretary of Health and Human Services for Research and Evaluation asked Dr. Dennis Embry to speak at the Pew Trust in Washington, DC. He was asked to answer a key question regarding evidence-informed strategies: “When evidence-based programs are not available to meet the needs of a particular population, then how should/can we use evidence to inform innovation?” Here is the powerpoint for this well-received presentation.

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
385
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
3
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • Transcript of "Creating Evidence-Based Practices When None Exist"

    1. 1. To Boldly Go where no scientist has gone… Creating new solutions for new situations or problems using evidence-based kernels and applied designsApril 28, 2011 By Dennis D. Embry, Ph.D. Forum on Emphasizing Evidence-Based Programs for Children and Youth President/Senior Scientist Sponsored by the Office of the Assistant Secretary for Planning and PAXIS Institute • Tucson, AZ Evaluation (ASPE), U.S. Department of Health and Human Services (HHS)
    2. 2. We should use evidence-based programs, right? But what if it is a new situation… like an epidemic of meth use among first-time new mothers eligible for home-visiting, and no home visiting programs were ever tested for meth? But what if it is a rising new problem… like foster children with multiple psychiatric disorders and medications for which there are no randomized trials? But a new setting with no evidence base… like problem behaviors in after-school programs? But an old problem with only descriptive studies… like violent felony youth offenders re-entering community?
    3. 3. A major threat to validity in Cook & Campbell… …Time of History
    4. 4. 35% Born 1946-1955 30% Born 1966-1975 Born 1936-1945 Cumulative Probability 25% Born 1956-1965 20% 15% 10% 5% 0% 0 5 10 15 20 25 30 35 40 45 50 Age of Onset of Depression 3 out-of-4 41 million out What American’s Sleep 17-24 year of 75 million eat today deprivation children predicts rise olds unfit for violence, is epidemic, prescribed US military psychotropic depression, and predicts service drugs in 2009 bipolar & suicide. rise in MEBs. What does this mean for home What if this is not What does this mean What do parenting visiting programs? over-diagnosis? for HHS programs? programs do with this?No evidence-based programs have been tested in these current contexts
    5. 5. “Madame Secretary…there is a big, unexpectedbug in the problem you want us to solve…”
    6. 6. “Madame Secretary…there is a big, unexpectedbug in the problem you want us to solve…”
    7. 7. What are the options?
    8. 8. What are the options? Punt…do nothing?
    9. 9. What are the options? Punt…do nothing? Argue that there is no problem? The data are wrong?
    10. 10. What are the options? Punt…do nothing? Argue that there is no problem? The data are wrong? Insist on choosing a program from the National Registry of Effect Programs or Practices (but there are none that are proven to work)?
    11. 11. What are the options? Punt…do nothing? Argue that there is no problem? The data are wrong? Insist on choosing a program from the National Registry of Effect Programs or Practices (but there are none that are proven to work)? Use eco-behavioral assessments, evidence-based kernels and applied behavior analysis designs to evolve a solution?
    12. 12. What is an eco-behavioral assessment? Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    13. 13. What is an eco-behavioral assessment? Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Physical Medium cues or Rate events Settings before behaviors High Rate Settings
    14. 14. What is an eco-behavioral assessment? Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate IncreaseExamples Settings Physical or Medium cues or decrease Rate events in rate, Settings before duration behaviors or High Rate intensity Settings
    15. 15. What is an eco-behavioral assessment? Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Increase After aExamples Settings Physical behavior, or Medium cues or decrease increase or decrease Rate events in rate, future rate, Settings before duration duration or behaviors or intensity of High Rate intensity that behavior Settings
    16. 16. What is an eco-behavioral assessment? Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Increase After a WordsExamples Settings Physical behavior, altering or rate, cues or decrease increase or Medium decrease duration, Rate events in rate, intensity future rate, Settings before duration or duration or general- behaviors or intensity of High Rate intensity that behavior ization of Settings behavior
    17. 17. What is an eco-behavioral assessment? Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Increase After a WordsExamples Settings Physical behavior, altering Extrinsic or or rate, internal bio- cues or decrease increase or Medium decrease duration, physical events Rate events in rate, intensity that change future rate, Settings before duration or rate, duration duration or general- or intensity of behaviors or intensity of High Rate intensity that behavior ization of behavior Settings behavior
    18. 18. Antecedents in eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Using ATM machine increases drug relapse Physical cues or Spanking a child with ADHD or oppositional Medium objects defiance disorder increases child’s Rate dangerous behaviors Settings BEFORE behaviors Verbal praise by teacher or foster parent High Rate flips out children with sexual abuse Settings
    19. 19. Behaviors in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Teachers send negative homeExamples Settings notes to foster parents about foster child at school. Medium Home visitors make “cold” rather Rate Settings than “warm” referrals for ATOD treatment High Rate Children with behavior problems Settings have low rates of physical activity
    20. 20. Behaviors in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Teachers send negative homeExamples Settings notes to foster parents about foster child at school. Medium Home visitors make “cold” rather Rate Settings than “warm” referrals for ATOD treatment High Rate Children with behavior problems Settings have low rates of physical activity
    21. 21. Behaviors in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Teachers send negative home IncreaseExamples Settings notes to foster parents about foster or child at school. Medium decrease Home visitors make “cold” rather Rate in rate, Settings than “warm” referrals for ATOD duration treatment or High Rate intensity Children with behavior problems Settings have low rates of physical activity
    22. 22. Consequences in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Foster kid acts up inExamples Settings math, gets sent to principals office— Medium escaping math Rate Settings Traumatized foster kid freezes when High Rate adult blows speaks Settings loudly at school
    23. 23. Consequences in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Foster kid acts up inExamples Settings math, gets sent to principals office— Medium escaping math Rate Settings Traumatized foster kid freezes when High Rate adult blows speaks Settings loudly at school
    24. 24. Consequences in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Foster kid acts up inExamples Settings math, gets sent to principals office— Medium escaping math Rate Settings Traumatized foster kid freezes when High Rate adult blows speaks Settings loudly at school
    25. 25. Consequences in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate After a Foster kid acts up inExamples Settings behavior, math, gets sent to increase or principals office— Medium decrease escaping math Rate future rate, Traumatized foster Settings duration or kid freezes when intensity of adult blows speaks High Rate Settings that behavior loudly at school
    26. 26. Relation frames in an eco-behavioral assessment Rates of Bio- Relational Target Antecedents Behaviors Consequences Physiological- Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    27. 27. Relation frames in an eco-behavioral assessment Rates of Bio- Relational Target Antecedents Behaviors Consequences Physiological- Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    28. 28. Relation frames in an eco-behavioral assessment Rates of Bio- Relational Target Antecedents Behaviors Consequences Physiological- Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    29. 29. Relation frames in an eco-behavioral assessment Rates of Bio- Relational Target Antecedents Behaviors Consequences Physiological- Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    30. 30. Relation frames in an eco-behavioral assessment Rates of Bio- Relational Target Antecedents Behaviors Consequences Physiological- Frames Behaviors Epigenic Low Rate WordsExamples Settings altering rate, Medium duration, Rate intensity Settings or general- High Rate ization of Settings behavior
    31. 31. Relation frames in an eco-behavioral assessment Rates of Bio- Relational Target Antecedents Behaviors Consequences Physiological- Frames Behaviors Epigenic Low Rate Words ProblematicExamples Settings altering settings rate, focus on Medium duration, DSM Rate intensity Successful Settings or settings general- focus on High Rate ization of behavior behavior change Settings
    32. 32. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    33. 33. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    34. 34. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    35. 35. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    36. 36. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Medium Rate Settings High Rate Settings
    37. 37. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low RateExamples Settings Extrinsic or internal bio- Medium physical events Rate that change Settings rate, duration or intensity of High Rate behavior Settings
    38. 38. Physiology in an eco-behavioral assessment Rates of Bio- Consequence Relational Target Antecedents Behaviors Physiological- s Frames Behaviors Epigenic Low Rate Too muchExamples Settings omega-6 & too Extrinsic or little omega-3 in internal bio- Medium diet of mom’s in physical events Rate home visiting that change program Settings rate, duration Foster child or intensity of High Rate chronically behavior sleep deprived Settings
    39. 39. N o w What?
    40. 40. Clin Child Fam Psychol Rev DOI 10.1007/s10567-008-0036-x Evidence-based Kernels: Fundamental Units of Behavioral Influence Basic understanding of kernels Dennis D. Embry Æ Anthony Biglan Embry, D. D. and A. Biglan (2008). "Evidence-Based Kernels: Fundamental Units of Behavioral Influence." Clinical Child & Family Ó The Author(s) 2008. This article is published with open access at Springerlink.com Abstract This paper describes evidence-based kernels, This paper presents an analysis of fundamental units of Psychology Review 11(3): 75-113. fundamental units of behavioral influence that appear to behavioral influence that underlie effective prevention and underlie effective prevention and treatment for children, treatment. We call these units kernels. They have two adults, and families. A kernel is a behavior–influence defining features. First, in experimental analysis, procedure shown through experimental analysis to affect a researchers have found them to have a reliable effect on A R T I C L E COMMUNITY-BASED Using kernels for population change PREVENTION USING SIMPLE, Embry, D. D. (2004). "Community-Based Prevention Using Simple, LOW-COST, EVIDENCE-BASED KERNELS AND BEHAVIOR Low-Cost, Evidence-Based Kernels and Behavior Vaccines." VACCINES Dennis D. Embry PAXIS Institute Journal of Community Psychology 32(5): 575. A paradox exists in community prevention of violence and drugs. GoodC linical C hild and Family P sychology R eview, Vol. 5, N o. 4, D ecember 2002 ( C 2002)T he G ood B ehavior G ame: A B est P ractice C andidateas a U niversal B ehavioral V accine Behavioral vaccines for disease controlD ennis D . E mbry1 Embry, D. D. (2002). "The Good Behavior Game: A Best Practice A “ behavioral vaccine” provides an inoculation against morbidity or mortality, impactingphys- Candidate as a Universal Behavioral Vaccine." Clinical Child & Family Psychology Review 5(4): 273-297. ical, mental, or behavior disorders. A n historical example of a behavioral vaccine is antiseptic hand washing to reduce childbed fever. I n current society, issues with high levels of morbidity, LY such as substance abuse, delinquency, youth violence, and other behavioral disorders ( multi- problems) , cry out for a low-cost, widespread strategy as simple as antiseptic hand washing. C ongruent research findings from longitudinal studies, twin studies, and other investigations N suggest that a possibility might exist for a behavioral vaccine for multiproblem behavior. A O simple behavioral strategy called the G ood B ehavior G ame ( G B G ) , which reinforces inhibi- tion in a group context of elementary school, has substantial previous research to consider its use as a behavioral vaccine T he G B G is not a curriculum but rather a simple behavioral
    41. 41. What is a kernel? Is the smallest unit of scientifically proven behavioral influence. • Is indivisible; that is, removing any part makes it inactive. Produces quick easily measured change that can grow much bigger change over time. Can be be used alone OR combined with other kernels to create new programs, strategies or policies. • Are the active ingredients of evidence-based programs • Can be spread by word-of-mouth, by modeling, by non professionals. • Can address historic disparities without stigma, in part because they are also found in cultural wisdom.
    42. 42. Relational Antecedent Reinforcement Physiological Frame Kernel Kernel Kernel Kernel Changes Creates verbalHappens BEFORE Happens AFTER the biochemistry of relations for the the behavior behavior behavior behavior Embry, D. D., & Biglan, A. (2008). Evidence-Based Kernels: Fundamental Units ofFour Types of Kernels Behavioral Influence. Clinical Child & Family Psychology Review, 39.
    43. 43. Kernels are buildingblocks of behavior change Humans survive individually and collectively by influencing the behavior or other humans The 2008 paper by Embry and Biglan identifies 52 evidence based kernels that can be used to design or or improve programs.
    44. 44. Using kernels to build population-level change… Problem Kernel #1 Observed Proximal Observed Effect Kernel Proximal Kernel #2 Effect Kernel Big Kernel #3 Change Effect Observed Proximal Effectt
    45. 45. Public-health kernel case study
    46. 46. 30.0% 12.0% 25.0% 10.0% 20.0% 8.0% 15.0% 6.0% 10.0% 4.0% 5.0% 2.0% 0.0% 18.0% United States United States 40.0% 16.0% 35.0% 14.0% 30.0% 12.0% 25.0% 10.0% 20.0% 8.0% 15.0% 6.0% 10.0% 4.0% 5.0% 2.0% Source: YRBS, US Centers for Disease Control Source: YRBS, US Centers for Disease Control 0.0% 0.0% 1995 1997 1999 2001 2003 2005 2007 1995 1997 1999 2001 2003 2005 2007 = Trend = Wyoming = Wisconsin =United StatesPopulation level example of use of kernelsEmbry, D. D. and A. Biglan (2009). Reward and Reminder: An Environmental Strategy for Population-Level Prevention. National Registry of Effective Programs and Practices, Substance Abuse and Mental Health Administration.
    47. 47. 30.0% 12.0% 25.0% 10.0% 20.0% 8.0% 15.0% Youth Who Smoked During the Last 30 Days 6.0% Youth Who Smoked Every Day the Last 30 Days Baseline Reward and Reminder Baseline Reward and Reminder 45.0% 18.0% 10.0% Wyoming 4.0% Wyoming 40.0% 16.0% 5.0% 35.0% 2.0% 14.0% 30.0% 12.0% 0.0% 25.0% 10.0% 18.0% 20.0% 8.0% United States United States 40.0% 15.0% 16.0% 6.0% 10.0% 4.0% 35.0% 5.0% 14.0% 2.0% 0.0% 30.0% 12.0% 18.0% Wisconsin Wisconsin 40.0% 16.0% 25.0% 10.0% 35.0% 14.0% 20.0% 30.0% 8.0% 12.0% 25.0% 10.0% 15.0% 6.0% 20.0% 8.0% 10.0% 15.0% 4.0% 6.0% 10.0% 4.0% 5.0% 5.0% 2.0% 2.0% Source: YRBS, US Centers for Disease Control Source: YRBS, US Centers for Disease Control 0.0% 0.0% 0.0% 1995 1997 1999 2001 2003 2005 2007 1995 1997 1999 2001 2003 2005 2007 = Trend = Wyoming = Wisconsin =United StatesPopulation level example of use of kernelsEmbry, D. D. and A. Biglan (2009). Reward and Reminder: An Environmental Strategy for Population-Level Prevention. National Registry of Effective Programs and Practices, Substance Abuse and Mental Health Administration.
    48. 48. 30.0% 12.0% 25.0% 10.0% 20.0% 8.0% 15.0% Youth Who Smoked During the Last 30 Days 6.0% Youth Who Smoked Every Day the Last 30 Days Youth Who Smoked During the Last 30 Days Baseline Youth Who Smoked Every Day the Last 30 Days Baseline Reward and Reminder Reward and Reminder 45.0% Baseline Reward and Reminder 18.0% Baseline Reward and Reminder 10.0% 45.0% Wyoming 4.0% 18.0% Wyoming 40.0% Wyoming 16.0% Wyoming 40.0% 16.0% 5.0% 35.0% 2.0% 14.0% 35.0% 14.0% 30.0% 12.0% 0.0% 30.0% 12.0% 25.0% 10.0% 25.0% 18.0% 10.0% 20.0% 8.0% 20.0% United States 8.0% United States 40.0% 15.0% 15.0% 16.0% 6.0% 6.0% 10.0% 4.0% 10.0% 4.0% 35.0% 5.0% 14.0% 2.0% 5.0% 2.0% 0.0% 30.0%0.0% 12.0% 18.0% 18.0% Wisconsin Wisconsin Wisconsin 40.0% Wisconsin 16.0% 25.0% 40.0% 10.0% 16.0% 35.0% 35.0% 14.0% 14.0% 20.0% 30.0% 30.0% 8.0% 12.0% 12.0% 25.0% 25.0% 10.0% 10.0% 15.0% 6.0% 20.0% 20.0% 8.0% 8.0% 10.0% 15.0% 15.0% 4.0% 6.0% 6.0% 10.0% 10.0% 4.0% 4.0% 5.0%5.0% 5.0% 2.0% 2.0% 2.0% Source: YRBS, US Centers for Disease Control Source: YRBS, US Centers for Disease Control 0.0% 0.0% 0.0% 0.0% 1995 1997 1999 2001 2003 2005 2007 1995 1997 1999 2001 2003 2005 2007 = Trend = Wyoming = Wisconsin =United StatesPopulation level example of use of kernelsEmbry, D. D. and A. Biglan (2009). Reward and Reminder: An Environmental Strategy for Population-Level Prevention. National Registry of Effective Programs and Practices, Substance Abuse and Mental Health Administration.
    49. 49. !"##$#%&()*+&,-./012!/3&0/4415-6&72!&/33&Kernels lower cost of training, support & change… & !"#$%&(&)*"+,$%&!"#$%&-.&/%01%$&234$435&.-0&6%$%73%89&:1847"3%8&"18&214;%0<"$& =0%;%134-1& );48%17%>?"<%8& 6%$%73%8& :1847"3%8& 214;%0<"$& /%01%$& Intervention =0%;%134-1& Targeted =0%;%134-1& Universal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ernels provide robustness, cost-efficiency K=K"B)@$=#J89OJ8Q& F(@@$#%FJQHD&J8V& and community sustainability across syndemics and multi-problem behaviors. 1?K;=L(*& )>)*(?$>FJ88OJ8I& S;=?=@$#%& K);@$>$K)@$=#&=;& >=??"#$@P&%==*FJ8MD& J8N& &
    50. 50. Tactics of Scientific Evaluating MURRAYUnderstanding fundamental issues of scientificdesign and testing of behavioral influence
    51. 51. Muir KA, Milan MA J Appl Behav Anal. 1982 Fall;15(3):455-60.Parent reinforcement for child achievement: theuse of a lottery to maximize parent training effects..
    52. 52. Lifespan example of one kernelfor prevention, intervention and treatment
    53. 53. If kernels are so good…
    54. 54. If kernels are so good…
    55. 55. Lessons for the day and future for more info, check out;www.slideshare.net/drdennisembry
    1. A particular slide catching your eye?

      Clipping is a handy way to collect important slides you want to go back to later.

    ×