Elsevier

Addictive Behaviors

Volume 25, Issue 6, November–December 2000, Pages 955-964
Addictive Behaviors

Evaluating the evidence of effectiveness for preventive interventions: Using a registry system to influence policy through science

https://doi.org/10.1016/S0306-4603(00)00131-3Get rights and content

Abstract

In order to deal with the serious problems of drug use, delinquency, and mental health problems in this country, policy makers, communities, practitioners, and advocates need to identify prevention programs that have empirical support and at the same time meet their own community needs regarding acceptability, cost, and training, and supervision. An “evidence-based” approach to prevention, one that identifies the scientific knowledge about what prevention programs work, for whom, and under what circumstances, should play a critical part in this process. The premise of this evidence-based approach is that the wide adoption of prevention programs that have been found to be successful in rigorous evaluations, will lead to successful population-based prevention strategies. A web-based registry, or database that describes the available scientific information on individual preventive trials, would be of high potential use to policy makers engaged in prevention planning for their communities. This presentation describes a model registry based on descriptions of 167 preventive trials aimed at children aged 0–6. Empirical findings are presented regarding two critical components of the registry, the measurement of the quality of the trial and the strength of evidence for a beneficial effect produced by each intervention. Implications for the use of such a registry are also discussed.

Section snippets

Methods

This article uses a recent bibliography of preventive trials for children below the age of 6 that specifically target the prevention of behavioral, emotional, or social problems through behavioral, psychosocial, or educational preventive interventions (Mrazek & Brown, 1998). Funded by the Invest in Kids Foundation, this project used a three-stage process for identifying relevant trials. Inclusion criteria included all trials that targeted one of the following areas: (1) interventions that were

Description of the trials

A total of 214 relevant scientific papers were obtained at the end of the three stages of screening, and they were based on 167 separate trials. All but one of the 214 reports discussed a single preventive trial. The lone exception involved two closely related interventions that were tested with separate random assignments.

The Cochrane score can be used as a benchmark to compare the design quality of one set of trials in one field against another. Scores below 7 are typically considered of low

Conclusions

We have focused on two important aspects of the scientific literature on prevention: the quality of the trial design and the strength of the outcomes. Both appear to be quantifiable and therefore it should be possible to summarize this information for policy makers and others who need to be informed about prevention science. This statement by itself is important since there have been disagreements about the possibility that design quality could be quantified appropriately. This project

Acknowledgements

The authors wish to thank Drs. Patricia Mrazek, Clemens Hosman, William Bukoski, Ellen Sogolow, Sheppard Kellam, and Tony Biglan for many helpful discussions on the uses of a registry system in prevention to inform policy. In addition, we thank the advisory board of the International Classification of Preventive Trials for their guidance in helping to organize the literature on prevention. Some of these ideas have directly influenced this paper, other ideas have provided a foundation for the

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