Annual Research Review: Universal and targeted strategies for assigning interventions to achieve population impact

Dodge, Kenneth A.

doi:10.1111/jcpp.13141

Cited by 57 publications

(46 citation statements)

References 47 publications

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“…In this year’s JCPP Annual Research Review, Kenneth Dodge, a Professor of Public Policy, wrote disarmingly of the lack of interventions that achieve population impact for child psychopathology (Dodge, 2020). ‘A change is needed' he wrote.…”

Section: Can Pgs Be Applied To Child and Adolescent Psychiatry Practice?mentioning

confidence: 99%

Editorial: Polygenic scores in child and adolescent psychiatry – strengths, weaknesses, opportunities and threats

Ronald

2020

Child Psychology Psychiatry

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Polygenic scores estimate an individual’s genetic liability for a particular disorder or trait. They are based on current knowledge of the trait’s genetic architecture and focus on common genetic variants. In this editorial, I will discuss some of the strengths, weaknesses, opportunities and threats (SWOT) to polygenic scores within the context of child and adolescent psychiatry. I consider how the potential application of polygenic scores in health settings has some parallels with existing practices, but that polygenic scores also undoubtedly raise unique challenges. This SWOT analysis is accompanied by discussion of some new findings using polygenic scores in this issue of Journal of Child Psychology and Psychiatry.

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Section: Can Pgs Be Applied To Child and Adolescent Psychiatry Practice?mentioning

confidence: 99%

Editorial: Polygenic scores in child and adolescent psychiatry – strengths, weaknesses, opportunities and threats

Ronald

2020

Child Psychology Psychiatry

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“…Meta-analyses have reviewed the effects of different delivery formats. Interpretations of the value of reported effect sizes (ES) from this body of work need to consider a number of factors [10]. For example, the importance of an effect can depend on intervention costs, ease of delivery, scale-up penalties, school attendance and academic/social benefits, changes in health care utilisation, numbers of new cases averted and spill over effects to peers [10].…”

Section: Introductionmentioning

confidence: 99%

“…Interpretations of the value of reported effect sizes (ES) from this body of work need to consider a number of factors [10]. For example, the importance of an effect can depend on intervention costs, ease of delivery, scale-up penalties, school attendance and academic/social benefits, changes in health care utilisation, numbers of new cases averted and spill over effects to peers [10]. Small ES from relatively inexpensive, scalable interventions (e.g., in schools where the infrastructure exists), that reach large sections of the population at a time of vulnerability to mental health disorder could have substantial practical importance, considering the high prevalence of anxiety, its psychosocial and economic impact, and that so few young people access support via other means [2].…”

Section: Introductionmentioning

confidence: 99%

“…Meta-analyses of these report small-to-moderate post-test ES in the range of 0.2-0.5 on anxiety symptoms in children and adolescents [11][12][13][14][15][16][17][18][19][20]. Although 12 month effects from universal programs have been reported for depressive symptoms [10,21], similar outcomes from universal programs for anxiety symptoms are rare, with only a few studies reporting ES spanning small, marginal, or no effects at 12 and/or 24 months [12, 14-17, 19, 20]. Targeted approaches for depression, delivered in school to at-risk young people, appear more effective than universal approaches, suggesting that intervention effectiveness increases with symptom severity [21,22] However, findings from studies of targeted approaches to reduce anxiety symptoms are mixed.…”

Section: Introductionmentioning

confidence: 99%

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Indicated prevention interventions for anxiety in children and adolescents: a review and meta-analysis of school-based programs

Hugh‐Jones

Beckett

Tumelty

et al. 2020

Eur Child Adolesc Psychiatry

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Anxiety disorders are among the most common youth mental health disorders. Early intervention can reduce elevated anxiety symptoms. School-based interventions exist but it is unclear how effective targeted approaches are for reducing symptoms of anxiety. This review and meta-analysis aimed to determine the effectiveness of school-based indicated interventions for symptomatic children and adolescents. The study was registered with PROSPERO [CRD42018087628]. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library for randomised-controlled trials comparing indicated programs for child and adolescent (5-18 years) anxiety to active or inactive control groups. Data were extracted from papers up to December 2019. The primary outcome was efficacy (mean change in anxiety symptom scores). Subgroup and sensitivity analyses explored intervention intensity and control type. We identified 20 studies with 2076 participants. Eighteen studies were suitable for meta-analysis. A small positive effect was found for indicated programs compared to controls on selfreported anxiety symptoms at post-test (g = − 0.28, CI = − 0.50, − 0.05, k = 18). This benefit was maintained at 6 (g = − 0.35, CI = − 0.58, − 0.13, k = 9) and 12 months (g = − 0.24, CI = − 0.48, 0.00, k = 4). Based on two studies, > 12 month effects were very small (g = − 0.01, CI = − 0.38, 0.36). No differences were found based on intervention intensity or control type. Risk of bias and variability between studies was high (I 2 = 78%). Findings show that school-based indicated programs for child and adolescent anxiety can produce small beneficial effects, enduring for up to 12 months. Future studies should include long-term diagnostic assessments.

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confidence: 99%

Commentary: Enabling efficient and full application of prevention strategies for population mental health — reflections on Dodge (2020)

Tolan

2020

Child Psychology Psychiatry

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Dodge (2020) provides a challenging and compelling formulation for more systematic determination of prevention component selection. The essay reminds us that population impact should be front and center in prevention specifically and public health organization in general. Dodge brings forth numerous issues in the science and the application of knowledge about prevention that warrant more research support and study. These issues include the need to recognize the existence of and increase the number of proven programs, the need for better and more extensive knowledge about impact variation across populations, and more attention to strengths and capabilities as guides for prevention. His essay also reminds us of the nuance and complexities in attempting to compare effect sizes and cost–benefit ratios of universal versus selective efforts. In addition, he provides compelling rationale for formalization of how prevention is organized and implemented in local community efforts. Further, in refocusing on the centrality of population effects in intervention application, Dodge also reminds us of the attendant principles of health equity and social justice in how we implement and judge the benefits of interventions. This essay provides a compelling argument for a strategy to realize the potential of the accumulating evidence of prevention as vital for addressing mental health and development.

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Annual Research Review: Universal and targeted strategies for assigning interventions to achieve population impact

Cited by 57 publications

References 47 publications

Editorial: Polygenic scores in child and adolescent psychiatry – strengths, weaknesses, opportunities and threats

Editorial: Polygenic scores in child and adolescent psychiatry – strengths, weaknesses, opportunities and threats

Indicated prevention interventions for anxiety in children and adolescents: a review and meta-analysis of school-based programs

Commentary: Enabling efficient and full application of prevention strategies for population mental health — reflections on Dodge (2020)

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