Embry saving-california-keynote-oct 2010

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Dr. Embry was a keynote speaker at the California Alcohol and Drug Programs Conference in Sacramento on October 13, 2010. This talk drew a standing ovation for outlining how simple prevention science could save tens of thousands of California children from mental, emotional, behavioral and health disorders. The impact of these strategies could save hundreds of millions of dollars in the short term and billions of dollars in a few years for a cash-strapped state.

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Embry saving-california-keynote-oct 2010

  1. 1. tweet with #ADP2010con and @drdennisembry Saving America, Saving California, Saving Our Futures Evidenced-Based Kernels for Population-Level Prevent Rapid Results See www.paxis.org by Dennis D. Embry, Ph.D. www.youtube.com /drdennisembry PAXIS Institute October 12, 2010 Copyright © 2010, PAXIS Institute, All rights reserved. May be shared in its entirety with notice and attribution. Monday, October 18, 2010 1
  2. 2. Our hopes for our children, our grandchildren or our children of choice… Text your hope to: 22333 “110310…your hope…” Monday, October 18, 2010 2
  3. 3. What will you get to protect this baby’s future when it goes home from hospital? Monday, October 18, 2010 3
  4. 4. What will you get to protect your child when they get their first bike? Monday, October 18, 2010 4
  5. 5. Monday, October 18, 2010 5
  6. 6. Preventing mental, emotional and disorders in our children… Monday, October 18, 2010 6
  7. 7. Protect your child from growing up to have a major mental illness? Monday, October 18, 2010 7
  8. 8. Protect your child from growing up to have a major addiction? Monday, October 18, 2010 8
  9. 9. Mental, emotional and behavioral disorders are preventable by our own hands. Monday, October 18, 2010 9
  10. 10. 2009: Institute of Medicine Report Disturbing, disruptive and aggressive behaviors have been increasing in the United States for more than 20 years. The United States has more of these problems than many other rich countries. Monday, October 18, 2010 10
  11. 11. Nearly 75 percent of the nation's 17- to 24-year- olds are ineligible for service • Medical/physical problems, 35 percent. • Illegal drug use, 18 percent. • Mental Category V (the lowest 10 percent of the population), 9 percent. • Too many dependents under age 18, 6 percent. • Criminal record, 5 percent. Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd Monday, October 18, 2010 11
  12. 12. Nearly 75 percent of the nation's 17- to 24-year- olds are ineligible for service • Medical/physical problems, 35 percent. • Illegal drug use, 18 percent. • Mental Category V (the lowest 10 percent of the population), 9 percent. • Too many dependents under age 18, 6 percent. • Criminal record, 5 percent. Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd Monday, October 18, 2010 12
  13. 13. !"#$%"&'$()#*+ ,!-./0!,#'+ )#+ 2!"..+ ,#',(-()2,2>+ )#&.$9)#*+ O,(!"#0+ ABP65+ -,(&,#'C>+ @3,9,#+ ABQ6Q+ -,(&,#'C>+E("#&,+AB765+-,(&,#'C>+'1,+?#)',9+R)#*9/!+AB76B+-,(&,#'C>+@-")#+A4S6P+-,(&,#'C>+"#9+F'".0+ AP56G+-,(&,#'C6+ + FIGURE 2 Manufacturing, Employment in Enterprises with fewer than 20 Employees, 2006 B3//H/ (#"( P23<-476 ('"& 5<76C ()"$ G-?<376;7 '!"$ >M7;8 '*"( >F;<O/36789 ''"* J/F=N/76789 '&"! L7M78 ')"# J/<K/36789? &$"# J23F7C &!"( :8;</9=I;84920 &!"& D378H/ &!") G-?<3;7 &+"! >F/9/8 &+"+ E/64;-0 &("* D;86789 &("& B/3078C &(") @/8073A &'"! :8;</9=><7</? &&"& 53/6789 $"% ,-./012-34 !"# ) &) ') () +) !"#$"%&'()'*+%,)+$&,#-%.'"*/0(1*"%& Source: Authors’ analysis of OECD data. + !"#$%&' (+ 21/32+ '1,+ (,2$.'2+ %/(+ !"#$%"&'$()#*+ "%',(+ 2,'')#*+ '1,+ &$'/%%+ %/(+ "+ 2!"..+ ,#',(-()2,+ !$&1+ Monday, October 18, 2010 13
  14. 14. !"#$%&'!(%$)*#+)#,%-''#$)*$.&.+,$,#/0123#&$.4$)*5#-%!)6#*7$#18#4!9)*.+$,#"!.#:7+47#*7$#;<=>#7-,# +)*$.)-*+!)-''(#4!%&-.-?'$#@-*-2## # FIGURE 3 Manufacturing, Employment in Enterprises with fewer than 500 Employees, 2001 LE7/BA4< )!#% F/4<9 )'#% 3K4.- )$#( J4K4- &+#) G0/I07<4-15 &%#" 6700=0 &!#" G0:2H04<4-1 &'#+ GE7:49 &$#$ F70<4-1 &"#' CB5/7.4 &*#+ ,-./012D.-A1E8 %&#( CB5/74<.4 %!#) @0<A.B8 %!#( >0-847? %! ;74-=0 %'#& ;.-<4-1 !&#! 3:010- !%#& 60784-9 !%#% ,-./0123/4/05 !"#$ * $! !* &! "** !"#$"%&'()'*+%,)+$&,#-%.'"*/0(1*"%& Source: Authors’ analysis of OECD data. # !"#$%&'($)*'+,"('-) Monday, October 18, 2010 14
  15. 15. Two to three times as many American children are being prescribed psychiatric drugs… Monday, October 18, 2010 15
  16. 16. American children are less healthy than the children in 21 other rich countries Monday, October 18, 2010 16
  17. 17. Are America’s economy, safety and future secure when our children are unhealthy in body, mind and behavior? Monday, October 18, 2010 17
  18. 18. American children and youth will have a shorter lifespan than current adults Youthanasia Monday, October 18, 2010 18
  19. 19. What can we do to change the present & futures of our children? Monday, October 18, 2010 19
  20. 20. Rapid Monday, October 18, 2010 20
  21. 21. Monday, October 18, 2010 21
  22. 22. Monday, October 18, 2010 22
  23. 23. If we just hit the problem harder… Monday, October 18, 2010 23
  24. 24. Monday, October 18, 2010 24
  25. 25. FREE DOWNLOAD Embry, D. D., & Biglan, A. (2008). Evidence-Based Kernels: Fundamental Units of Behavioral Influence. Clinical Child & Family Psychology Review, 39. Download at: www.pubmed.gov Monday, October 18, 2010 25
  26. 26. 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. Monday, October 18, 2010 26
  27. 27. Relational Antecedent Reinforcement Physiological Frame Kernel Kernel Kernel Kernel Changes Creates verbal Happens BEFORE Happens AFTER the biochemistry of relations for the the behavior behavior behavior behavior Embry, D. D., & Biglan, A. (2008). Evidence-Based Four Types of Kernels Kernels: Fundamental Units of Behavioral Influence. Clinical Child & Family Psychology Review, 39. Monday, October 18, 2010 27
  28. 28. What is a behavioral vaccine? It is a simple procedure (a kernel or a recipe of kernels) that, when used repeatedly, reduce morbidity and mortality and/or increase wellbeing or health. Behavioral vaccines can be used by individuals, families, schools, businesses, organizations to produce rapid population level change. Embry, D. D. (2004). "Community-Based Prevention Using Simple, Low-Cost, Evidence-Based Kernels and Behavior Vaccines." Journal of Community Psychology 32(5): 575. Monday, October 18, 2010 28
  29. 29. If kernels are so good… Monday, October 18, 2010 29
  30. 30. Publication: Prinz, Sanders, Shapiro, Lutzker & Whitaker (2009).  Population-based prevention of child maltreatment:  The U.S. Triple P System Population Trial. Volume 10, March Issue, Prevention Science. http://www.springerlink.com/content/104965/ Funded by the US Centers for Disease Control, Grant # U17/CCU42231 to Dr. Ron Priinz, and Dr.Matt Sanders Monday, October 18, 2010 30
  31. 31. Why not launch a marketing campaign to get families to use Triple P when in two years… Monday, October 18, 2010 31
  32. 32. Substantiated Child Maltreatment 16 Control Counties Rates per 1,000 Children (0-8 Years) 15 13 Triple P Counties 12 10 Pre Post Prinz et al., 2009, Prevention Science Monday, October 18, 2010 32
  33. 33. Child Abuse Hospital Injuries 1.80 Rates per 1,000 Children (0-8 Years) 1.68 Control Counties 1.55 1.43 Triple P Counties 1.30 Pre Post Prinz et al., 2009, Prevention Science Monday, October 18, 2010 33
  34. 34. Child Out-of-Home Placements Control Counties 4.50 Rates per 1,000 Children (0-8 Years) 4.13 Triple P Counties 3.75 3.38 3.00 Pre Post Prinz et al., 2009, Prevention Science Monday, October 18, 2010 34
  35. 35. Monday, October 18, 2010 35
  36. 36. Monday, October 18, 2010 36
  37. 37. Monday, October 18, 2010 37
  38. 38. Triple P: Global dissemination from 1996 onwards… Watch  this   Australia   Germany space...... New  Zealand   The  Netherlands Canada Belgium Chile Ireland Switzerland France Scotland Sweden Singapore Portugal England Wales Japan Turkey Iran Hong  Kong Qatar Curacao Austria Romania Monday, October 18, 2010 38
  39. 39. Why not turn about the lives of high risk primary grade children using a teacher kernel recipe? Muriel Saunders, the teacher Monday, October 18, 2010 39
  40. 40. Group Alerts/ Beat the Soft Team Response Mystery Timer Competition Cost Motivator Antecedent Antecedent Reinforcement Reinforcement kernel Antecedent kernel kernel kernel Kernel Monday, October 18, 2010 40
  41. 41. Her invention immediately increases time to learn Monday, October 18, 2010 41
  42. 42. Why not turn about the lives of high risk primary grade children using a teacher invented procedure? Monday, October 18, 2010 42
  43. 43. Long-term GBG outcomes from inoculation in just first grade Increase in high-school entry Increase in college entry Reduced special education service needs Lifetime reduction of tobacco use by 25% to 50% Lifetime reduction of psychiatric diagnoses Lifetime reduction of antisocial behavior and arrests Lifetime reduction in all serious addictions Lifetime reduction in suicidal actions Monday, October 18, 2010 43
  44. 44. 5 out 9,000 schools = 0.05% of California schools Monday, October 18, 2010 44
  45. 45. Inukshuk points the right way… Physiological Kernel Monday, October 18, 2010 45
  46. 46. Physiological Kernel Monday, October 18, 2010 46
  47. 47. Monday, October 18, 2010 47
  48. 48. Reduce Omega 3 Brain Deficiency Monday, October 18, 2010 48
  49. 49. Reduced  Felony  Violent  Offences  Among  Prisoners   with  recommended  daily  amounts  of  vitamins,  minerals  and  essen=al  fa>y  acids Ratio of Disciplinary Incidents Supplementation/Baseline 1.00 Ac=ve  -­‐37.0% Placebo  -­‐10.1% 0.75  p  ‹  0.005  p  =  ns 0.50 Active 0.25 Placebo 0 Before supplementation During supplementation UK  maximum  security  prison  -­‐  338  offences  among  172  prisoners  over  9  months  treatment  in  a   compared  to  9  months  baseline.   Gesch  et  al.    Br  J  Psychiatry  2002,  181:22-­‐28 Monday, October 18, 2010 49
  50. 50. Why not reproduce the rapid results in America and California to get a 37% reduction in jail violence? It cost the Brits 19¢ per day or $69.35 per year. Monday, October 18, 2010 50
  51. 51. 1.0 Inpatient Discharge 0.8 0.6 Survival  Probability 0.4 High  DHA    (n=16) Low    DHA    (n=17) 0.2 (median  split  of  plasma  phospholipid  %  faIy  acids) 0 0 200 400 600 800 Time  to  First  Suicide  AIempt  (days) Suble>e,  Hibbeln  et  al  Am  J  Psychiatry  2006;163:  1100-­‐1102   Monday, October 18, 2010 51
  52. 52. Why not help our high risk children with omega-3? 30% Percentage with Psychosis at 12 months 27.5% 24% 18% 12% 6% 4.9% 0% Omega-3 Placeo Psychosis Amminger, G. P., M. R. Schafer, et al. (2010). "Long-Chain {omega}-3 Fatty Acids for Indicated Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." Arch Gen Psychiatry 67(2): 146-154. Monday, October 18, 2010 52
  53. 53. Why not have invite families Relational Frame to promise clear rules about Kernel alcohol, tobacco & drugs if… It produces a 23% reduction binge drinking and 27% reduction delinquency rates among 7th graders in 2 years and this has been adopted nationally by Sweden and being adopted by the State of Tennessee and Manitoba? PS. Effect sizes were 0.35 for drunkenness and 0.38 for delinquency. Koutakis, N., H. Stattin, et al. (2008). "Reducing youth alcohol drinking through a parent-targeted intervention: the Orebro Prevention Program." Addiction 103(10): 1629-1637. Monday, October 18, 2010 53
  54. 54. “Behavioral health could learn from public health in endorsing a population health perspective”—(IOM, page 19). “Families and children have ready access to the best available evidence- based prevention interventions, delivered in their own communities…in The story of the Broad Street water pump during a respectful non-stigmatizing way”— the cholera epidemic in London. (IOM, page 387). Monday, October 18, 2010 54
  55. 55. A public health model versus rationing model of prevention… Monday, October 18, 2010 55
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onday, October 18, 2010 1?K;=L(*& 56
  57. 57. Monday, October 18, 2010 57
  58. 58. Who will stand with me for saving all the children of California and America for all our futures? Thank you… Dennis D. Embry, Ph.D. 520-299-6770 dde@paxis.org www.paxis.org • simplegifts.com slides show & documents at www.slideshare.net/drdennnisembry Monday, October 18, 2010 58
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