Building an evidence-based multitiered system of supports for high-risk youth and communities.

Abstract

The mental, emotional and behavioral health problems of high-risk youth and youth living in high-risk communities are not inevitable and can be prevented. A shift from the nation's focus on treating disease and illness after it occurs to a concentrated effort on preventing the root causes of these problems is needed. Prevention science suggests a comprehensive multitiered approach that provides evidence-based prevention supports for children and youth at each developmental stage and across multiple social contexts is likely to result in the greatest health impact and return on investment. However, actually implementing this approach at a neighborhood level has remained a challenge and an ongoing research gap especially in high-risk communities. This article describes a process and provides a case study example for implementing a comprehensive, multitiered approach in a high-risk community. This includes assessing and prioritizing the specific needs of individuals and communities; selecting evidence-based programs based upon assessed needs; and creating a continuum of programs to improve the health and well-being of youth across developmental age spans, social contexts, and levels of risk. Operational details and challenges for organizing and implementing this comprehensive approach are also described. We estimate that the collective impact of a multitiered evidence-based approach, implemented with fidelity, could conservatively result in a 30 to 40% reduction in problem behaviors. (PsycINFO Database Record

Multiple Measures of Family and Social Support as Predictors of Psychological Well-Being: An Additive Approach

“…programs (Kingston, Mihalic, & Sigel, 2016); to more recent types of support such as the support one receives from an online network of support (Kramer, Boon, Schotanus-Dijkstra, van Ballegooijen, Kerkhof, & van der Poel, 2015;Melling & Houguet-Pincham, 2011;Schotanus-Dijkstra, Havinga, van Ballegooijen, Delfosse, Mokkenstorm, & Boon, 2014;Watkins & Jefferson, 2013). What each of these studies has in common is the singular perspective from which social support is often studied.…”

State Department and Provider Agency Utilization of Evidence-Based Program Registries in Behavioral Healthcare and Child Welfare

“…Evidence-based program registries (EBPRs) are web-based compilations of programs/models, or systematic reviews of such programs/models, that apply research-based criteria to rate their efficacy or effectiveness for support of programmatic decision-making. Such EBPRs are typically operated by government agencies or non-profit organizations (Burkhardt et al, 2015; Gillen et al, 2013; Government Accountability Office 10-30, 2009; Kingston et al, 2016; Means et al, 2015; Westbrook et al, 2017). Most EBPRs assess the effectiveness of individal programs, while others focus on evidence reviews, meta-analyses, and assessment of different program models and clinical approaches.…”

“…EBPRs relevant to behavioral healthcare review and evaluate evidence-based programs (EBPs) related to substance misuse, mental health, child welfare, criminal justice, and some facets of the education system (i.e., dropout prevention) (Gillen et al, 2013; Goesling et al, 2017; Hennessy et al, 2006; Horne, 2017). These EBPRs carefully screen, select, and evaluate the supporting research studies of program effectiveness using explicit sets of criteria and standards of evidence (Gillen et al, 2013; Hennessy et al, 2006; Paulsell et al, 2014; Westbrook et al, 2017), and usually provide summaries of these evaluations in the form of an “evidence rating” meant to inform and facilitate decision-making (Burkhardt et al, 2015; Kingston et al, 2016; Means et al, 2015). More details describing EBPRs may be found in Burkhardt et al (2015) and Means et al (2015).…”

Socio-Sportive Experience and Informal Education of Children and Young People: Contributions to the Citizenship of New Generations

“…However, it is considered that although a given young person may not show these signs, he/she may be at risk of social exclusion for being inserted in risk contexts or situations that increase the probability of facing difficulties in his/her integration in society [6]. The term "young people at risk" has been used in the literature [7], [8], when referring to young people involved in crimes such as drug trafficking, vandalism, violence and theft, who live in socially disadvantaged contexts with little or no family support. Social projects that use sport, through methodologies of empowerment and valorisation of the civic competencies of young people at risk, have been appearing more and more, and this increase is largely due to the special attention given to these practices by Community funding programmes.…”