THE IMPACT OF

PREVENTION SCIENCE

Prevention science is a well-established area of research designed to improve the health and wellbeing of individuals and communities by identifying malleable risk and protective factors, assessing the efficacy and effectiveness of programs, interventions and policies, and developing an optimal means for dissemination and diffusion of that knowledge. Prevention strategies focus on ways to intervene before a problem emerges or worsens, avoiding adverse outcomes and their costs, and enhancing conditions conducive to healthy child and adolescent development, good mental and physical health, and strong families and communities. By intervening prior to onset or escalation of any given problem—whether it be at the individual level or within systems—a preventative approach can halt or redirect what might otherwise lead to a cascade of negative consequences.

For the past 50 years, prevention science has drawn from a diverse range of disciplines--including the behavioral, social, psychological and neuro sciences--to understand the origins of social problems at the individual, community and societal level (e.g., addiction, violence, trauma, human trafficking, poverty). Moreover, the field has developed protective measures to either inoculate individuals against negative outcomes or reduce the incidence of the factors that cause them.  For example, one of the most notable successes within prevention science in recent decades has been the decline in rates at which adolescents begin to smoke tobacco. Evidence-based interventions, public health strategies, including large-scale educational campaigns, have led to a significant decline in adolescents who initiate cigarette smoking. Prevention science has also impacted a variety of other health and wellbeing outcomes with the development of evidence-based programs that: 1) encourage daily physical activity to protect against chronic disease (heart disease, diabetes, cancer); 2) disrupt pathways to substance abuse and addiction; 3) improve educational outcomes with the advancement of early and pre-school education opportunities; 4) prevent youth and adult crime; and 5) intervene with perpetrators and victims of interpersonal and domestic violence. Full appreciation of the wide-ranging benefits prevention science offers can be achieved by ongoing consideration of its findings and well-tested practices at various stages in the legislative decision-making process.

While prevention science has led to improvements in a variety of health and social outcomes for both individuals and communities, significant issues (e.g., opioid addiction, violence, poverty) have not yet been adequately addressed in many settings and populations. Despite its growing recognition, prevention science has not been utilized anywhere near its full potential and is often not implemented with quality and accountability. Too often, effective prevention programs are not funded at a scalable level to improve community-level outcomes or are not sustained. This implementation gap keeps prevention science from effectively preventing the problems we seek to address.  As such, consideration should be given to ways in which legislative processes can support the development, evaluation and implementation of evidence-based programs and policies, and to scale up existing successful programs for dissemination to communities.

When implemented effectively, the application of well-tested practices and policies generated by prevention science can lead to substantial cost-savings by investing in upstream strategies (e.g., programs that prevent drug use in adolescents, provide early education, strengthen children to resist poor developmental outcomes and support positive mental health) to avoid downstream costs (e.g., the financial and human burden to communities associated with treating drug addiction, juvenile delinquency and school dropout). Programs that can be implemented in one delivery system and across many public systems are the most cost efficient and exert wide scale benefits. By addressing common risk factors (e.g., family dysfunction, child maltreatment, poverty, , lead exposure, caregiver addiction), studies have shown potential to reduce a whole host of adverse outcomes, from children not ready for school  and adolescent misconduct to chronic disease.

For example, previous legislation led to tobacco prevention programs implemented in the schools that have conveyed significant savings in healthcare with residual effects in juvenile/criminal justice sectors. Also compelling is the reduction by more than half of youth incarceration levels and costs, with overall reductions in youth violence, over the past 10 years through the through the adoption of programs that provide effective alternatives to arrest and incarceration. Prevention science can inform the development of new programs, as well as deployment of prevention practices that are ultimately more effective than many existing federally-funded programs. Providing scientifically based guidance and resources to legislators has potential to incorporate lessons learned from prevention science without reinventing the wheel and, in effect, improving cost-effectiveness. Therefore, we created the formation of a Congressional Prevention Policy Caucus (CPPC) to be comprised of lawmakers, staffers, and expert advisors.