- Identify problem or disorder andreview informationto determine its extent
- With an emphasis on risk and protectivefactors, review rele-vant information—both from fields out-side prevention andfrom existing pre-ventive intervention research programs
- Design, conduct,and analyze pilotstudies and confirmatory and replication trials ofthe preventiveintervention program
- Design, conduct,and analyze large-scale trials of thepreventive interven-tion program
- Facilitate large-scale implementationand ongoing evalua-tion of the preventiveintervention programin the community
- Review diagnosticinformation• Review epidemiologicaldata on incidence andprevalence• Review information oncosts to society• Initiate partnership withthe community• Determine level ofcommunity concern
- Review relevantinformation fromphysical health, thecore biological and behavioral sciences, and epidemiology ofmental disorders, in-cluding age of onset• Review research ontreatment of mentaldisorders• Review research onrisk and protective factors for onset ofmental disorders• Review illustrativepreventive interventionresearch programsthat meet examinationcriteria
- Choose a theoreticalmodel to guide theintervention• Design the form of theintervention, includingactivities, changetechnologies, and sites• Determine theoreticaland technological feasibility• Recruit and train interveners• Identify and secure co-operation from participants• Choose the researchmethodology, including, forthe risk reduction model,short-term and intermediate outcome measures to determine malleability of theorized risk and protectivefactors and long-term out-come measures to determineeffects on incidence ofproblem or disorder• Determine efficacy in pilotstudies and confirmatory andreplication trials• Document thoroughly
- Work to enhancecooperation betweenresearchers andcommunity organizationpersonnel• Adjust form of programas necessary• Adjust trial design asnecessary for scale-up• Conduct multiplegenerations of field trialsto ensure continuedefficacy and to distinguishcore elements (needed toensure fidelity in programadopted by community)from adaptable characteristics• Conduct final trial to determine effectiveness• Document thoroughly
- Provide a manualoutlining program anddelineating core elementsand adaptable characteristics• Facilitate decision aboutadding an evaluationcomponent
Feedback LoopF I G U R E 16-4Recommended steps for designing, implementing, and evaluating prevention programsSOURCE: Institute of Medicine (1994).Summary: Reducing risks for mental disorders.Washington, DC: National Academy Press, pp. 32
- Reprinted with permission.
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