Effective Prevention Programs for Children
Robert Hughes, Jr., Ph.D., The Ohio State University
Bin Ong, M.S.,
University of Illinois at Urbana-Champaign
As human service providers and policy makers, we continually ask ourselves, "Can we really make a difference in the lives of children and families living in dangerous communities?" Fortunately, the evidence suggests that we can. During the last decade, researchers and program developers have begun to outline effective prevention efforts for at-risk children, families, and communities. In this article, we provide an overview of their recommendations.
1. Build the program on a theoretical model and research evidence. Prevention programs need to be based on a coherent theory and research, not myths and hunches. For example, David Olds and his colleagues (1986) developed a program to prevent child abuse in which parents of newborns were given ideas and techniques for discipline, play, and language stimulation. The program was based on both theoretical and empirical results that indicate the prenatal and immediate postnatal periods are critical both to child and parenting development. The program also encouraged parenting behaviors critical for the healthy intellectual and social development of their children later in life. Evaluation of this program indicated that parents developed these critical behaviors with their children.
2. Be sensitive to environmental and cultural contexts. Effective programs consider ecological contexts, including features of the family, neighborhood, and community. Perhaps the most important innovation in program development over the last decade has been increased understanding of the influence of context on development. Urie Bronfenbrenner (1979) provides a framework for considering immediate influences, such as schools, family, and child care, and more distant influences, such as cultural values and social policy. Appreciation for cultural values has also been incorporated into program design. In a program targeting Cuban-American adolescents involved in delinquent activities, Rio et al. (1991) helped parents and adolescents understand culture clash across generations, as well as particular cultural issues between parents and adolescents of Latino families. By teaching the family bicultural skills and a transcultural perspective, many families were able to overcome maladaptive family interactions.
3. Address the risk factors and provide protection from harm. Karen Bogen-schneider, Steven Small, and Dave Riley (1990) assert the need to examine both the risk and protection in the environment and to develop interventions that address multiple issues simultaneously. For example, children may be at-risk because of a lack of parental monitoring, association with negative peers, and school difficulties, while protected by good social skills, the presence of a close relationship with one adult, and belonging to a supportive community. Programs that enhance protection and reduce the influence of risk are likely to have a more powerful effect on children. For example, many early substance abuse prevention programs that concentrated only on teaching children found little change in students' behavior over time. However, programs that address both risky behavior and how to prevent substance abuse have been more successful. Prentz et al., (1989) for example, designed a program for sixth and seventh graders involving 10 sessions of classroom training, 10 homework sessions with parents or other family members, mass media programming, and community organizing. The students who participated in the program exhibited less substance abuse in the short term, and maintained those differences three years later.
4. Change the institutions. Although prevention work has focused on changing the behavior of the target person, it is increasingly concerned with changing institutions and environments (Weissberg et al., 1991). A good example of institutional change is the effort to change schools. Many young people, for example, have difficulty making the transition from elementary school to the less structured, more impersonal environment of middle school. To enable students to interact more closely with each other and with particular teachers, school personnel in many communities have arranged for learning to take place in smaller groups, especially during students' first year of middle school-a shift that has benefited many students. Schools, youth agencies, religious institutions, and other community resources have many options for redesigning themselves to address children's needs more effectively.
5. Create programs of sufficient intensity and duration to make a difference. Although not all authors mention intensity and/or duration as a necessary feature of successful programs, those who do are emphatic about its importance. In reference to programs targeting adolescents, Dryfoos (1990) states, "In successful programs, high-risk children are attached to a responsible adult who pays attention to that child's specific needs" (p. 228). Likewise, Lisbeth Schorr (1988) summarizes her review of early childhood intervention by noting, "The programs that work best for children and families in high-risk environments typically offer comprehensive and intensive services" (p. xxi-xxii).
Program strategies and activities also influence the degree to which programs are successful. In the past, programs emphasized using a singular approach; today, they emphasize using a variety of methods to achieve program objectives.
1. Empower program participants. Empowering program participants is essential. Empowerment involves an approach to programming rather than applying simple techniques. Empowerment often begins by involving participants in the design and management of the program. Hughes (1992) suggests that empowerment include an emphasis on competence, partnership, diversity, and mutual support.
2. Use a variety of teaching methods. Some prevention programs place a special emphasis on one particular teaching approach (e.g., peer teaching) or opportunity (e.g., school classroom). Increasingly, programs are using a variety of methods and taking advantage of many different opportunities. This comes as program developers appreciate how different methods work with different people. Many programs now teach knowledge and skills coupled with peer coaching, mentoring, and other types of support.
3. Facilitate access to resources including those dealing with basic living needs. A major component of successful prevention programs is the ability of the staff to create access to resources and services. Access refers only in part to coordination and collaboration of programs. For example, Schorr emphasizes the ease with which services can be used and the coherence of those services. According to Schorr, the staff of effective programs "adapt or circumvent traditional professional and bureaucratic limitations when necessary to meet the needs of those they serve" (Schorr, 1989, p. 258). Another aspect of this issue is understanding that providing food, clothing, and shelter is not separate from providing guidance for children. When program providers meet participants' basic needs, they are better able to address other issues, such as parenting or children's school success.
Although many unique factors need to be considered by each community, Lynne Bond and Barry Wagner (1988) provide the most complete guide for program implementation and maintenance.
1. Involve the clients and many community organizations. Community organizations and target clients should be involved in the development of the program to establish ownership of the program. Bond and Wagner (1988) write, "When service deliverers (and pertinent administrators) feel some ownership of a program, they are more likely to use it, and to give it the energy necessary for it to be effective" (p. 350). According to Bond and Wagner, prevention programs are effective because the target group are both recipients and active participants and contributors to the program. Involving participants in the planning process keeps programs focused and enables participants to to develop solutions to their own problems.
2. Develop secure financial resources for programs. Many program developers fail to secure the appropriate financial resources necessary to maintain the program over time. Many good programs are eliminated when the money to pilot them is gone. Bond and Wagner suggest involving community members who can be advocates for the program to help develop a long-range marketing strategy.
3. Develop a long-range evaluation to guide program implementation and program outcomes. Program staff often view evaluation as a burden rather than a tool for guiding program development. Documenting the successes of a program, however, is essential for maintaining programs. This involves collecting information about the implementation of the program to identify more useful program strategies and to revise the program as needed. Both the immediate and long-term outcomes of programs must be recorded to establish long-term support for them. Probably the most successful example of evaluation has been the long-term evaluation of preschool intervention programs (Schwein-hart & Weikart, 1988). The development of carefully controlled experimental studies comparing children who attended enrichment preschool programs with children who did not, then the following the children through school and into adulthood, has been used to demonstrate the worthwhile investment of these programs to legislators, funders, and the public. Few programs last without providing evidence of their success.
4. Create a positive and supportive work environment for staff. Lastly, maintenance of a program requires attention to the needs of the front-line staff. When staff are poorly trained or lack organizational support, even the best designed programs fail. Most prevention programs require time, effort, and emotional commitment from the staff to succeed; when these efforts go unappreciated or are routinely blocked by organizational obstacles, the program is undermined. Program ownership by staff requires that staff be involved in the governance of the program over time. How staff concerns and insights affect decision-making may influence success over the years more than any other factor; it may also create the most challenges because it runs counter to most organizational structures.
This review provides only a rough overview of the essential components of effective prevention programs. To avoid repeating mistakes, lessons learned by past program developers should not be overlooked in the design of future programs. In the face of the complex risk factors, hopeful directions for children are within view.
Bogenschneider, K., Small, S., & Riley, D. (1990, September). An ecological risk-focused approach for addressing youth-at-risk issues. Invited address at the National Extension Youth-at-Risk Summit, Washington, DC.
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Dryfoos, J.G. (1990). Adolescents at risk: Prevalence and prevention. New York: Oxford University Press.
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Prentz, M.A., Dwyer, J.H., MacKinnon, D.P., Flay, B.R., Hansen, W.B., Wang, E.Y.I., & Johnson, C.A. (1989, June 9). A multicommunity trial for primary prevention of adolescent drug abuse: Effects on drug use prevalence. Journal of the American Medical Association, 261(22), 3259-3266.
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