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2o C Parte 3 Primary Prevention Mental Health Programs


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Esto es parte de la unidad 4 (4.3).

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2o C Parte 3 Primary Prevention Mental Health Programs

  1. 1. PRIMARY PREVENTION MENTAL HEALTH PROGRAMS <ul><li>Current outcome research. </li></ul><ul><li>Durlak y Wells. </li></ul><ul><li>Recommendations: </li></ul><ul><li>- Precision of theory </li></ul><ul><li>- Desingn </li></ul><ul><li>- Program evaluation. </li></ul>
  2. 2. <ul><li>Commentators give recommendations to investigate some of the major questions facing the feald: </li></ul><ul><li>- Who </li></ul><ul><li>- What </li></ul><ul><li>- Where </li></ul><ul><li>- When </li></ul><ul><li>- How of prevention </li></ul>
  3. 3. Recent Research <ul><li>No single study is perfect and contains every possible feature. </li></ul><ul><li>Collectively are notable in several respects. </li></ul><ul><li>In terms of methodology: researches have studied relatively larges samples. </li></ul>
  4. 4. <ul><li>In terms of outcome studies have focused </li></ul><ul><li>- levesls of antisocial </li></ul><ul><li>- aggresive behavior </li></ul><ul><li>- risk status </li></ul><ul><li>- subsequent development of clinical disorders. </li></ul>
  5. 5. Prevention in other areas <ul><li>Several commentators like Cowen or Kolbe Weissberg and Bell noted the influence of interconnectedness of young´s people physical psychological and social development. </li></ul><ul><li>Weissberg and Bell wanted to include in the review all types of preventions but this was a demanding task. </li></ul>
  6. 6. <ul><li>Their suggestions raised an important point. Prevention research are very parochial and categorical in nature. </li></ul><ul><li>An examination of the reference lists of publish studies suggests that authors in one field rarely acknowledge the work of those in other areas. </li></ul>
  7. 7. <ul><li>In this case one well done studies can help as models in other areas and findings drawn across areas can provide convergent validity for theorical or conceptual instance. </li></ul>
  8. 8. <ul><li>Their research presents findings from several well-done studies whose initial focus was not mental health per se, which have achieved some positive mental health some positive mental health-related outcomes which were attained in addition to the positive impact achieved on the main trust on the intervention </li></ul>
  9. 9. Prevention in other areas <ul><li>Yoshikawa noted that the in three studies to asses long-term impact on serious adolescent behavior problems (antisocial and delinquency behavior) obtained positive results. </li></ul><ul><li>The effect sizes for these outcome data wich were collected during follow-up periods of 10 years. </li></ul>
  10. 10. <ul><li>And additional study of early childhood intervention conducted in turkey has also been successful in preventing adolescent delinquency. </li></ul>
  11. 11. <ul><li>It is not possible to identify what specific factors are responsible for these findings. These early interventions have been complex, multiyear, multicomponent programs combining early childhood education with a variety of family support services. </li></ul>
  12. 12. <ul><li>Several elementary-level academic interventions emphasizin peer tutoring or organizational changes in school policies and practices have also resulted in better peer relations , decreases in disruptive behavior and improved self-concepts. </li></ul>
  13. 13. <ul><li>Some physical health promotion programs have also had positive behavioral effects </li></ul>
  14. 14. Specific issues Study inclusion and classification Several commentators raised questions from some of the criteria for inclusion in the methods of classification or subdivision of studies and disagreed about the research and saw it more as a single step or a hypothesis for future studies.
  15. 15. <ul><li>Trickett (1997) lamented the fact that there are no data on the ecological impact of mental health prevention and data analysis were limited to individual level of analysis. </li></ul><ul><li>And this impression was the result of the decision to analyze only outcome measures and assess children and adolescents level of adjustment. </li></ul>Ecological Impact
  16. 16. <ul><li>The data collected more frequently assessed changes in attitudes of parents or teachers, teacher-child interactions, and finally, any assessment of how the psychological climate of the building was affected by the intervention. </li></ul><ul><li>It is often very difficult to determine whether prevention programs are sustained over time, however, publication practices do not encourage the inclusion of such information as part of a study of results. </li></ul>
  18. 18. <ul><li>Three commentaries discussed the findings that </li></ul><ul><li>programs exclusively devoted to parent training did </li></ul><ul><li>not produce significant positive effects. </li></ul><ul><li>In our view, involving parents in training programs </li></ul><ul><li>remains a challenge. </li></ul>PARENT PROGRAMS
  19. 19. <ul><li>Positive changes occurred among high-attending </li></ul><ul><li>parents, but only 9% of the target population </li></ul><ul><li>attended any meetings, and only 55% of the </li></ul><ul><li>participants attended at least 7 of the 15 scheduled </li></ul><ul><li>sessions. </li></ul>PARENT PROGRAMS
  20. 20. <ul><li>One recent group of investigators took several steps </li></ul><ul><li>to develop a culturally sensitive intervention for inner </li></ul><ul><li>city African American parents including seeking the </li></ul><ul><li>input and support of parents and local community </li></ul><ul><li>leaders when preparing and advertising the program. </li></ul>PARENT PROGRAMS
  21. 21. <ul><li>These findings bring to mind Schinke's observation </li></ul><ul><li>that &quot;...little is known about ways to galvanize family </li></ul><ul><li>members into preventive action in a predictably </li></ul><ul><li>effective manner&quot; </li></ul>PARENT PROGRAMS
  23. 23. <ul><li>Cost analyses of prevention programs are needed. </li></ul><ul><li>Current data are very encouraging. </li></ul>COST ANALYSES
  24. 24. <ul><li>Cost-benefit analyses have indicated that preventive </li></ul><ul><li>interventions focused on physical health promotion, </li></ul><ul><li>early childhood education and childhood injury are </li></ul><ul><li>very cost-effective, and can return $8, $13, or over $45 </li></ul><ul><li>in benefits for every dollar spent. </li></ul>COST ANALYSES
  25. 25. <ul><li>We offer three cautions regarding cost analyses: </li></ul><ul><li>First, although money is not the only important consideration, several analyses have only included costs and benefits that can be easily translated into monetary figures. </li></ul>COST ANALYSES
  26. 26. <ul><li>Prevention might not always save money in the long </li></ul><ul><li>run, but still be a worthwhile social investment if the </li></ul><ul><li>many social and personal benefits prevention </li></ul><ul><li>produces are included in the analysis. </li></ul><ul><li>Much depends on the way cost analysis is conducted. </li></ul>COST ANALYSES
  27. 27. <ul><li>Second, support for prevention should not be </li></ul><ul><li>contingent on the results of cost analyses because </li></ul><ul><li>that would impose a higher standard for prevention </li></ul><ul><li>than for other types of programs. </li></ul>COST ANALYSES
  28. 28. <ul><li>Third, positive results from a cost analysis do not automatically translate into more acceptance of prevention at the decision-making and policy level. </li></ul><ul><li>Although a cost analysis is one important aspect of </li></ul><ul><li>program evaluation, it is necessary to consider the </li></ul><ul><li>administrative, political, and personal factors that </li></ul><ul><li>influence program support and maintenance. </li></ul>COST ANALYSES