Handbook of Prevention

Americans are "healing themselves" (Heckler, 1985) and prevention has taken root (McGinnis, 1985a). We are altering our lifestyle to reduce physical and mental health risks. Perhaps as important is the fact that the science of prevention is beginning to catch up with the practices of prevention, although some might argue that the popularity of these practices far outstrips sound theoretical and empirical foundations. The chapter authors in this volume examine the theoretical and empirical foundations of many current prevention practices and, where data exist, discuss the status of prevention efforts. Where substantial prevention is not yet on the horizon, the authors attempt to point us in the right direction or at least share with the reader some of the risk factors that should be addressed in our research. We hope that readers will be stimulated to discuss the issues raised, advance the current research, and, where possible, adopt the prevention and health promotion strategies that are supported by sound theoretical and empirical work. This volume can in no way be comprehensive with respect to the current work in prevention; however, we hope that we have provided a sampling of prevention activities and issues that appear together in one volume for perhaps the first time. The primary intent of this volume is modest, and the reader should not attempt to find continuity among the various chapters. The only binding among these contributions is their focus on prevention.

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1 Methodological Issues in Prevention.- 1. Introduction.- 1.1. Theoretical Issues.- 1.2. Entry.- 2. Methodological Issues.- 2.1. Goals.- 2.2. Assessment Issues.- 2.3. Screening.- 2.4. Experimental and Quasi-Experimental Designs.- 2.5. Control Group Issues.- 2.6. Generalization and Maintenance.- 2.7. Cost-Benefit Analysis.- 2.8. Meta-analysis.- 2.9. Social Validation.- 2.10. Monitoring Treatment Integrity.- 3. Future Directions.- 4. References.- 2 Genetic Factors in Psychopathology: Implications for Prevention.- 1. Introduction.- 2. Review of the Literature on the Genetics of Psychopathology.- 2.1. Schizophrenia.- 2.2. Affective Disorders.- 3. Genetic Markers.- 3.1. Linkage Analysis.- 3.2. Restriction Enzyme Techniques.- 4. Biological Markers.- 4.1. Computerized Tomography and Enlarged Ventricles.- 4.2. Cholinergic-induced REM Sleep.- 5. Biobehavioral Markers.- 5.1. Attention and Information Processing.- 5.2. Pursuit Eye Movements.- 6. Genetic Markers and Prevention.- 7. Genetics and Prevention/Intervention in Psychiatric Disorders.- 7.1. Drug Use.- 7.2. Stress.- 7.3. Family Communication.- 8. Conclusion.- 9. References.- 3 Prevention during Prenatal and Infant Development.- 1. Introduction.- 2. Historical Foundations.- 3. Current Issues.- 3.1. Prevention during the Prenatal Period.- 3.2. Prevention during the Perinatal Period.- 3.3. Prevention during the Postnatal Period.- 4. Summary.- 5. References.- 4 Prevention of Developmental Disorders.- 1. Introduction.- 2. Infantile Autism.- 2.1. Differential Diagnosis.- 2.2. Prenatal, Perinatal, and Neonatal Factors.- 2.3. Family Background.- 2.4. Prognosis.- 2.5. Problems in Early Recognition.- 2.6. Intervention.- 3. Developmental Dysphasia.- 3.1. Differential Diagnosis.- 3.2. Family Background.- 3.3. Prognosis.- 3.4. Early Recognition and Intervention.- 4. Developmental Dyslexia.- 4.1. Differential Diagnosis.- 4.2. Family Background.- 4.3. Prognosis.- 4.4. Early Recognition and Intervention.- 5. Attention Deficit Disorder.- 5.1. Diagnosis.- 5.2. Differential Diagnosis.- 5.3. Family Background.- 5.4. Prognosis.- 5.5. Early Recognition and Intervention.- 6. References.- 5 Prevention of Achievement Deficits.- 1. Identification.- 1.1. General Approaches.- 1.2. Individually Referred Assessment.- 1.3. Environmental Risk.- 2. Problems and Prospects.- 3. Intervention.- 4. Preventive Projects.- 4.1. Experimental.- 4.2. Social Programs.- 5. Outcomes.- 5.1. Immediate Effects.- 5.2. Persistent Effects.- 5.3. Different Measures.- 5.4. Relative Effectiveness.- 6. Conclusion.- 7. References.- 6 Prevention of Childhood Behavior Disorders.- 1. Introduction.- 2. Prevention Necessitates Prediction.- 2.1. Development.- 2.2. Environmental Change.- 2.3. Measurement Adequacy.- 3. Identification of High-Risk Populations.- 3.1. Poverty and Low SES.- 3.2. Violence in the Media.- 3.3. School Characteristics.- 3.4. Quality of Peer Relationships.- 3.5. Marital Discord.- 3.6. Parental Psychopathology.- 3.7. Parents Who Engage in Antisocial Behavior and Alcohol Abuse.- 3.8. Child Abuse.- 4. Criteria for Evaluating Preventive Interventions.- 5. Possible New Prevention Targets.- 5.1. Childhood Depression.- 5.2. School Refusal.- 5.3. Attention Deficit Disorder with Hyperactivity.- 6. Summary and Directions for Future Research.- 7. References.- 7 Promoting Children's Social Skills and Adaptive Interpersonal Behavior.- 1. Introduction.- 2. The Rationale for School-based Preventive Interventions.- 3. An Educational Model for Promoting Adaptive Social Behavior.- 4. Coaching Isolated Children in Social Skills to Improve Interpersonal Relations: Secondary Prevention Efforts.- 5. Classroom-based Social Problem-solving Training: Primary Prevention Efforts.- 6. Integrating Coaching and SPS Intervention Research: Summary and Future Directions.- 6.1. Combining Coaching and SPS Training in One Intervention Package.- 6.2. Designing Coaching Interventions for the Classroom.- 6.3. Videotaping Interventions.- 6.4. Developing System-Level Interventions.- 6.5. Sensitivity to the Developmental Levels of Children.- 6.6. Social-Skills Training Program Evaluation Issues.- 6.7. A Final Comment.- 7. References.- 8 Prevention of Marital and Family Problems.- 1. Historical Review.- 1.1. Family Life Education (FLE).- 1.2. Parent Education (PE).- 1.3. Marriage Prevention Programs (MPP).- 2. Recent Advances.- 2.1. Prevention Programs for Couples.- 2.2. Preventive Programs for Parents.- 2.3. Family Programs.- 3. Current Issues.- 3.1. Obstacles.- 4. Future Directions.- 5. Summary and Conclusion.- 6. References.- 9 Prevention of Crime and Delinquency.- 1. Diversion.- 1.1. Conceptual Basis.- 1.2. Interventions.- 2. Family Violence.- 2.1. Conceptual Basis.- 2.2. Interventions.- 3. Competence Building.- 3.1. Conceptual Basis.- 3.2. Interventions.- 4. Effective Discipline Techniques.- 4.1. Conceptual Basis.- 4.2. Interventions.- 5. Situational Crime Prevention.- 5.1. Conceptual Basis.- 5.2. Interventions.- 6. Future Directions.- 7. References.- 10 Prevention of Schizophrenic Disorders.- 1. Introduction.- 2. Theory and Review of Literature.- 2.1. Historical Review.- 2.2. Recent Advances.- 3. Current Issues.- 3.1. Prevention Directed at Children of Disturbed Parents.- 3.2. Primary Prevention Directed at Broader Targets.- 4. Future Directions.- 4.1. Obstacles to Progress.- 4.2. Promising Leads for Futher Pursuit.- 4.3. Conclusion.- 5. References.- 11 Efforts to Prevent Alcohol Abuse.- 1. Prevention: A National Priority?.- 1.1. Women, Minorities, the Elderly, Youth, and Prevention.- 2. Prevention of the Fetal Alcohol Syndrome and Drunk Driving.- 2.1. The Fetal Alcohol Syndrome and Prevention.- 2.2. Drunk Driving and Prevention.- 3. Price and Consumption.- 4. Drinking Age and Consumption.- 5. Alcohol Education and Prevention.- 5.1. History of Alcohol Education Efforts.- 5.2. Policy Issues.- 5.3. University-based Programs.- 5.4. S.A.D.D.- 5.5. Secondary-School-based Programs.- 5.6. An Overview.- 6. Prevention in the Workplace.- 6.1. An EAP Consortium.- 7. A Final Word.- 8. References.- 12 Prevention of Oral Diseases.- 1. Introduction.- 2. Theory and Review of Literature.- 2.1. Historical Review.- 3. Methods for the Prevention of Dental Caries.- 3.1. Fluorides.- 3.2. Pit and Fissure Sealants.- 3.3. Other Dental Caries Prevention Methods.- 4. Methods for the Control of Periodontal Diseases.- 5. Methods for Preventing Oral Cancer.- 6. Concluding Comments: Available Preventive Procedures.- 7. Recent Advances.- 7.1. Immunization.- 7.2. Controlled-Release Delivery Systems.- 8. Current Issues and Future Directions.- 8.1. Public Policy.- 8.2. Professional/Public Education and Acceptance of Preventive Methods.- 8.3. Concluding Comment: Current Issues.- 9. Summary and Conclusion.- 10. References.- 13 Behavioral Approaches to Primary and Secondary Prevention of Coronary Heart Disease.- 1. Weight and Cholesterol.- 1.1. Primary Prevention.- 1.2. Secondary Prevention.- 2. Physical Activity and Exercise.- 2.1. Primary Prevention.- 2.2. Secondary Prevention.- 3. Cigarette Smoking.- 3.1. Primary Prevention.- 3.2. Secondary Prevention.- 4. Type A Behavior.- 4.1. Primary Prevention.- 4.2. Secondary Prevention.- 5. Final Comments.- 6. References.- 14 Prevention of Cancer.- 1. The Controllable Risk Factors for Cancer.- 1.1. Prevention of Cancer-A Realistic Goal.- 1.2. The Carcinogenic Process.- 1.3. Risk-Factor Intervention.- 2. Smoking and Cancer.- 2.1. The Health Effects of Smoking.- 2.2. The Benefits of Smoking Cessation.- 2.3. Trends in Smoking Cessation.- 2.4. Smoking Intervention: Research Opportunities and Priorities.- 3. Diet and Cancer.- 3.1. Dietary Fat and Breast Cancer.- 3.2. Research Leads on Dietary Fiber.- 3 3 vitamin A and the Chemoprevention Approach.- 4. Alcohol and Cancer.- 5. Occupational Exposures and Cancer.- 6. Other Risk Factors for Cancer.- 6.1. Radiation (Ultraviolet).- 6.2. Radiation (Ionizing).- 6.3. Estrogens.- 6.4. DES (Diethylstilbestrol).- 6.5. Food Additives.- 6.6. Environmental Pollution.- 7. References.- 15 Injury.- 1. Ten Technical Strategies for Injury Control.- 2. Implementation Strategies.- 2.1. Persuasion.- 2.2. Laws and Administrative Rules.- 2.3. Regulation of Hazardous Agents and Vehicles.- 3. Conclusion.- 4. References.- 16 Prevention of Environmental Problems.- 1. An Overwhelming Problem.- 2. What Can Be Done?.- 3. A Behavior Change Approach to Environmental Protection.- 3.1. The Behaviorist's Perspective.- 3.2. A Historical Perspective.- 3.3. Defining Target Behaviors.- 4. Antecedent Strategies for Environment Preservation.- 4.1. Messages and Educational Packages.- 4.2. Modeling and Demonstrations.- 4.3. Commitment and Goal Setting.- 4.4. Engineering and Design Strategies.- 5. Consequence Strategies for Environment Preservation.- 5.1. Response-Contingent versus Outcome-Contingent Consequences.- 5.2. Feedback Interventions.- 6 An Ecological Perspective.- 7. Communitywide Intervention for Environment Preservation.- 8. References.