Valerie B. Shapiro

Lending “Strength” to the Assessment of Preschool Social-Emotional Health

This paper compares the advantages of a strength-based perspective to the long-standing pathology-based approach to assessment. Theoretical advantages to strength-based assessment, such as greater compatibility with early prevention efforts and increased acceptance by multiple stakeholders, are suggested. The Devereux Early Childhood Assessment (DECA), a reliable measure of within-child protective factors in preschoolers, is used to empirically validate the utility of strength-based assessment. The authors found the DECA to discriminate between groups of preschoolers with and without emotional and behavior problems, the DECA Total Protective Factor Scale to predict group membership just as well as the DECA Behavioral Concerns Screener, and the DECA assessment of protective factors to predict behavioral concerns as well as a standardized assessment of risk. These empirical findings, combined with the presented theoretical rationale, indicate that a strength-based perspective and the resilience model have great utility for universal use with preschool populations.

Sustainability of the Communities That Care Prevention System by Coalitions Participating in the Community Youth Development Study

PURPOSE Community prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended. METHODS The Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks. RESULTS Twenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person. CONCLUSIONS This study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes.

Person-Environment Interaction in the Prediction of Alcohol Abuse and Alcohol Dependence in Adulthood

BACKGROUND Behavioral disinhibition (externalizing/impulsivity) and behavioral inhibition (internalizing/anxiety) may contribute to the development of alcohol abuse and dependence. But tests of person-by-environment interactions in predicting alcohol use disorders are needed. This study examined the extent to which interactions between behavioral disinhibition, behavioral inhibition and family management during adolescence predict alcohol abuse and alcohol dependence at age 27. METHODS This study used longitudinal data from a community sample of 808 men and women interviewed from ages 10 to 27 in the Seattle Social Development Project. Zero-order correlations followed by a series of nested regressions examined the relationships between individual characteristics (behavioral disinhibition and behavioral inhibition/anxiety) and environment (good vs. poor family management practices during adolescence) in predicting alcohol abuse and dependence criterion counts at age 27. RESULTS Behavioral disinhibition and poor family management predicted increased likelihood of both alcohol abuse and alcohol dependence at age 27. Behavioral inhibition/anxiety was unrelated to both outcomes. Youths high in behavioral disinhibition were at increased risk for later alcohol abuse and dependence only in consistently poorly managed family environments. In consistently well-managed families, high levels of behavioral disinhibition did not increase risk for later alcohol abuse or dependence. CONCLUSIONS Behavioral disinhibition increases risk for alcohol abuse and dependence in early adulthood only for individuals who experience poor family management during adolescence. Interventions seeking to reduce environmental risks by strengthening consistent positive family management practices may prevent later alcohol abuse and dependence among individuals at risk due to behavioral disinhibition.

Prevention System Mediation of Communities That Care Effects on Youth Outcomes

This study examined whether the significant intervention effects of the Communities That Care (CTC) prevention system on youth problem behaviors observed in a panel of eighth-grade students (Hawkins et al. Archives of Pediatrics and Adolescent Medicine 163:789–798 2009) were mediated by community-level prevention system constructs posited in the CTC theory of change. Potential prevention system constructs included the community’s degree of (a) adoption of a science-based approach to prevention, (b) collaboration on prevention activities, (c) support for prevention, and (d) norms against adolescent drug use as reported by key community leaders in 24 communities. Higher levels of community adoption of a science-based approach to prevention and support for prevention in 2004 predicted significantly lower levels of youth problem behaviors in 2007, and higher levels of community norms against adolescent drug use predicted lower levels of youth drug use in 2007. Effects of the CTC intervention on youth problem behaviors by the end of eighth grade were mediated fully by community adoption of a science-based approach to prevention. No other significant mediated effects were found. Results support CTC’s theory of change that encourages communities to adopt a science-based approach to prevention as a primary mechanism for improving youth outcomes.

Disseminating Effective Community Prevention Practices: Opportunities for Social Work Education.

In the United States, about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral (MEB) disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect one in five families and cost

Reciprocal Relations between Coalition Functioning and the Provision of Implementation Support

247 million annually. Some strategies for preventing MEB disorders in young people have been developed, tested, and found to be effective in preventing the onset, persistence, and severity of psychological disorders, drug abuse, and delinquency. Unfortunately, tested and effective prevention policies, programs, and practices are not widely used. This article highlights recent advances in prevention science and describes some opportunities and challenges in advancing the use of science-based prevention in communities. The chapter concludes by exploring the potential role of social work education in developing a workforce ready to increase community access to effective prevention strategies.

Relating Coalition Capacity to the Adoption of Science-Based Prevention in Communities: Evidence from a Randomized Trial of Communities That Care

Community coalitions have been promoted as a strategy to help overcome challenges to the dissemination and implementation of evidence-based prevention programs. This paper explores the characteristics of coalitions that enable the provision of implementation support for prevention programs in general and for the implementation of evidence-based prevention programs with fidelity. Longitudinal cross-lagged panel models were used to study 74 Communities That Care (CTC) coalitions in Pennsylvania. These analyses provide evidence of a unidirectional influence of coalition functioning on the provision of implementation support. Coalition member knowledge of the CTC model best predicted the coalition’s provision of support for evidence-based program implementation with fidelity. Implications for developing and testing innovative methods for delivering training and technical assistance to enhance coalition member knowledge are discussed.

A strengths-based approach to supervised visitation in child welfare

Abstract Coalition-based efforts that use a science-based approach to prevention can improve the wellbeing of community youth. This study measured several coalition capacities that are hypothesized to facilitate the adoption of a science-based approach to prevention in communities. Using data from 12 coalitions participating in a community-randomized trial of the prevention strategy Communities That Care (CTC), this paper describes select measurement properties of five salient coalition capacities (member substantive knowledge of prevention, member acquisition of new skills, member attitudes toward CTC, organizational linkages, and influence on organizations), as reported by coalition members, and examines the degree to which these capacities facilitated the community leader reports of the community-wide adoption of a science-based approach to prevention. Findings indicated that the five coalition capacities could be reliably measured using coalition member reports. Meta-regression analyses found that CTC had a greater impact on the adoption of a science-based prevention approach in 12 matched pairs of control and CTC communities where the CTC coalition had greater member (new skill acquisition) and organizational capacities (organizational linkages).

Science-Based Prevention through Communities That Care: A Model of Social Work Practice for Public Health

This article describes a strengths-based approach to supervised visitation within the child welfare system of the United States. Supervised visitation gives parents accused of abuse or neglect the opportunity to spend time with children temporarily removed from their care. Although supervised visitation has the potential to be a tool for promoting successful reunification by maintaining or growing caregiver relationships with children, and pursuing and monitoring caregiver skill acquisition, the risk-management objective that underlies child protection services creates a challenging context for strengths-based approaches. There is a need to articulate a practice model that navigates the tension between the dual aims of child welfare services: risk management and fostering change that leads to a successful reunification. The model for supervised visitation described in this article embraces resilience theory, grounded in strengths-based strategies to build protective factors. This article first describes the collaborative construction of the Joan Sherman Program for Resilient Children through the integration of insights from diverse stakeholders, research evidence, and strengths-based practice principles. Six aspects of the model are described in depth: enhancing the visitation environment, strengths-based assessment, resilience meetings between workers and caregivers, stable visitation routines, activities to promote resilience, and progress check-ups. The article also describes the training programme developed to build workforce capacity and support model implementation. The article concludes by reflecting upon the successes of, and challenges to, the implementation of a strengths-based approach to supervised visitation in the child welfare system and proposes that the model be subjected to a comprehensive programme evaluation.

Variation in the Effect of Communities That Care on Community Adoption of a Scientific Approach to Prevention

This article describes a public health orientation to drug and alcohol abuse prevention; reviews the state of the science underlying a risk and protective factor approach to alcohol and drug abuse prevention; describes Communities That Care, a community practice model that makes use of this evidence; and considers how this model reflects four important principles of social work practice. The intent of this article is to provide guidance to social workers who support the National Association of Social Works intention to make prevention practice central to the provision of alcohol and drug abuse services by social workers.