A PRIMER ON PREVENTION (Editors note: By Prevention Works of Clallam County. For more information, see www.preventionworkscc.org )
We invite you to help create a Five Year Plan to prevent child abuse and neglect, substance abuse and violence in Clallam County. We trust that together we will be able to agree on the most pressing risk factors found in our community, prioritize appropriate prevention targets, and identify recommended effective program models.
This effort is being sponsored by the Clallam County Commissioners and Prevention Works! A Community Coalition of Clallam County. This coalition advocates, educates, and invests in our children. Through prevention efforts, we work to end child abuse and neglect, substance abuse and violence. Prevention of these behaviors is vitally important in building a thriving community where people work together to make it the best that it can be.
Purpose of creating a prevention plan
· To encourage greater local and external investment in prevention efforts in Clallam County.
· To develop a community wide consensus on prioritization of prevention efforts
· To increase coordination between local agencies in the development of prevention and treatment efforts.
· To increase the use of best practices and research proven programs and strategies by local agencies.
· To educate citizens about the need for and value of prevention efforts in order to reduce child abuse and neglect, substance abuse and violence.
· To give practical ways for the citizens of Clallam County to be involved in prevention efforts
An easy way to understand prevention
A commonly used example of prevention is found in this symbolic tale. Two people, walking along a river, see a child flailing in the water. They reach in and bring him safely to shore. Soon another child is safely pulled out. They realize they have an ongoing problem and call for help. Help arrives, including people and equipment as several more children are pulled from the river. Finally, one rescuer walks upriver and finds a playground, without fencing, next to the steep riverbank. To solve the problem a fence can be erected or the playground moved to another location. In either case, the children will be safe. The two solutions shared one thing in common – both are prevention efforts.
Many times we become so overwhelmed providing services to citizens with problems, that we forget the ultimate solution is preventing those problems. Just as the tale above had more than one preventive solution the same can be said about the challenges we face in our community.
From extensive medical research, we know that eating healthy foods and exercising regularly are critical components for the prevention of heart disease, even when there is a family history of such problems. It not only makes for a healthier life, but it is significantly less expensive than heart surgery and rehabilitation.
Other prevention efforts that have proven that “An ounce of prevention is worth a pound of cure”
· In 1854, there was a cholera epidemic in London. Dr. John Snow concluded that contaminated water from a community well was the main cause of the epidemic. When no one believed him, he simply removed the handle from the pump and the number of cholera cases rapidly declined.
· Children’s car seats and adult seat belts have reduced deaths in car crashes by 70%.
· A thirty-five year study followed every child born on the island of Kauai and found that the role of a positive adult in the lives of children was a critical factor in preventing delinquent behavior.
· Young, low income, single mothers received home nurse visits for the first three years of their child’s life. (The Olds Model). The mothers had a reduced need for social services and their employment rates were higher than the control group. Their children demonstrated better performance in school and had fewer encounters with law enforcement. Economically, the RAND Corporation found these positive differences created a net benefit to society of $34,148 per family served.
Results from recent research that prevention works
· The greatest prevention opportunity is among young people
· Multiple preventive interventions can reduce substance abuse, conduct disorders, antisocial behavior, aggression and child maltreatment.
· The incidence of depression among pregnant women and adolescents can be significantly reduced
· School-based violence prevention can lower the rate of aggressive problems in an average school by one-quarter to one-third.
· Improving family functioning and positive parenting serves as a mediator of positive outcomes and can moderate poverty-related risk.
· School-based preventive interventions aimed at improving social and emotional outcomes can also improve academic outcomes.
· Interventions that target families dealing with challenges such as parental depression and divorce demonstrate efficacy in reducing risk for depression among children and increasing effective parenting.
· Preventive interventions produce benefits that exceed costs with evidence that the strongest results are found for early childhood interventions.
*Adapted from Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities, National Research Council and Institute of Medicine. The National Academies Press. Washington DC. 2009. Page 4.
Definitions for the three levels of prevention
The Universal approach or primary prevention is when everyone has equal access to the program. There are no requirements to participate. It is based on the belief that everyone can benefit from accurate information on topics such as child development.
The Selective approach or secondary prevention is offered to individuals with an elevated risk of a certain behavior. Examples of individuals appropriate for a selective prevention program are very young mothers, children of mothers with signs of depression and children with poor academic performance are. The individuals do not yet have a problem, but they are at risk of certain problems.
The Indicated approach or tertiary prevention is targeted to high-risk individuals who are indentified as having minimal but detectable signs or early symptoms of a behavioral problem. The program aims to keep the problem from recurring. Examples included youth who have used drugs but are not yet addicted, children with poor academic performance, and a family with an active Child Protective Service case open or someone who may have been arrested for drug use or domestic violence.
Understanding the different categories of strategies and programs
This is a critically important issue. There are two levels of research which gives us a level of confidence in prevention programs. The first level is research which monitors long-term findings on hundreds of research based programs. At the national level two such programs are the Olds Home Visiting and Perry Preschool. After twenty-five years of study on families participating in the Olds Model program compared to those not receiving home visits, the evaluation revealed that there were long term positive results for both the mother and child. The Perry Preschool Program involves an intensive preschool experience and also has shown positive findings based on decades of research. These and numerous other programs are referred to as “Best Practices or Model Programs.”
Other programs have been evaluated and show promising results, but have been in existence for fewer years and have been research less extensively are referred to as “Promising Practices”. Sometimes such programs show early good results, but long term results do not match the earlier findings and are subsequently discontinued, or modified to be more effective. Programs shown to be effective in the long run become “Best Practices”.
The second form of research is centered on broad concepts such as brain function. As new research emerges, programs are often developed to utilize these concepts. Such programs are known as “Community innovative programs” These programs are undertaken with a commitment to evaluate their outcomes in hopes they will become a promising practice.
New information, such as a growing body of brain research on infants from newborns to kindergarten, fuels the latter two categories. Recent brain research is the foundation on which our state is promoting, through policy and budget allocations, early learning programs and quality child care. Quality child care, with a home visiting element, is endorsed by Washington State Children’s’ Trust (the only agency dedicated to prevention of child abuse and neglect) as one of the most significant ways to reduce child abuse and neglect.
Definitions of child abuse and neglect, domestic violence and substance abuse
CHILD ABUSE AND NEGLECT – an act or a failure to act, or the cumulative effects of a pattern of conduct, behavior, or inaction, that evidences a serious disregard for consequences of such magnitude as to constitute a clear and present danger to a child’s health, welfare, or safety and can be physical, verbal or both.
DOMESTIC VIOLENCE – a pattern of behavior with the intent of making someone do something against his or her will (i.e., control over them) by the use or the threat of intimidation and physical violence.
SUBSTANCE ABUSE – addictive use of a drug, either legal or illegal. Legal drugs include controlled prescription medications, alcohol, and tobacco. While alcohol and tobacco are legal for adults, underage use is also listed as substance abuse. There is a wide range of drugs that are abused.
These three issues are often closely connected. Reported cases of child abuse and neglect and incidents of violence in Clallam County are frequently related to substance abuse. There are numerous statistics available that indicate the level of these challenges in our county. Among them are rates that are higher than the state’s average for: rates of reported child abuse and neglect, children living in households below the poverty level and juvenile drug arrests. Other data shows that educational achievement rates and median income are lower in Clallam County than the state averages. Clallam County also has higher rates for teen suicide, juvenile delinquency, school dropout and children accessing emergency room services. These are all signs that our community is in need of more prevention efforts.
History of Prevention Works!
Prevention Works! A Community Coalition of Clallam County began in 1998 with a group of six individuals. The early mission statement – “To prevent child abuse and neglect, substance abuse, and violence in Clallam County” serves as the cornerstone for this prevention plan. At its inception the coalition was focused on healthy early brain development of children and designed its research-based strategies to serve families with children ranging from prenatal to age 5.
In 2003, the coalition incorporated two other community coalitions and expanded its focus to foster prevention efforts for families with children of all ages. During the following year, the coalition became a 501(c) 3 non profit organization. Today, Prevention Works! has grown to almost 300 members that include citizens from all areas of our county. It has been very successful in blending prevention funding from a variety of sources to bring in over one million dollars in new prevention funding to the community. Evaluation of all its programs and trainings is an important part of the organization. Positive outcomes for its parent education and home visiting programs have been documented. Prevention Works! is recognized for its use of Best Practices, Promising Approaches, and a continuing commitment to evaluating its programming efforts. Some of the coalition’s numerous accomplishments and successes include:
· Winner of a 2000 Washington State Exemplary Substance Abuse Prevention Program Award
· Recipient of an unsolicited $200,000 gift from the Carolyn Foundation in 2001
· Sponsorship of over 80 professional/community trainings attended by almost 5,000 local citizens and professionals
· Nominated for two national awards by the Washington State Division of Alcohol and Substance Abuse
· In 2007 and 2008, recorded over 6,900 hours of volunteer time in meetings, programming and training events, valued at over $133,500.
Prevention not only works, but it is the most cost-effective investment that a community can make to meet the many challenges that we face. We’re excited to work with you and other members of our community to create a 5-YEAR PREVENTION PLAN for the citizens of Clallam County; because we know it is possible to improve the lives of all our children and their families.
As Henry Ford said, “If you think you can or you think you can’t, either way you will be right.”
