Unleashing The Power Of Prevention

07/21/2016 02:18 pm ET Updated Dec 06, 2017

About a year ago I wrote a piece in this space about the promise of the behavioral sciences for significantly improving human wellbeing. I cited the Institute of Medicine's report on prevention, which concluded, "The scientific foundation has been created for the nation to begin to create a society in which young people arrive at adulthood with the skills, interests, assets, and health habits needed to live healthy, happy, and productive lives in caring relationships with others." (National Research Council and Institute of Medicine, 2009)

If this claim doesn't seem credible, let me describe one example of how the science of prevention is beginning to realize its promise.

Under the leadership of David Hawkins and Rico Catalano, the Social Development Research Group (SDRG) has been studying how to prevent the most common and costly problems of childhood and adolescence. They began in the 1980s, when there was little evidence that any problem could be prevented. But even then, a fair amount was known about the risk factors that made various problems more likely and the factors that protect people from developing problems.

Hawkins and Catalano created Communities That Care, a system for helping communities identify the concerns they have about youth problem development. CTC helps community leaders come together around a common understanding of the risk and protective factors that are influencing the development of problems. Communities do this through surveys of students, which provide information about risk factors such as community laws and norms favorable toward drug use, firearms, and crime; inadequate parental monitoring of their adolescents' behavior; and having friends who engage in problem behavior. The data are used to create a "diagnostic risk profile" unique to that community.

Communities That Care then helps communities choose prevention programs that have already been proven to affect the risk factors the community has prioritized. Hawkins and Catalano tested whether this strategy could prevent youth problems. They identified 24 communities in seven states and randomly assigned half of them to get the program. To assess its impact, each year they surveyed 4,407 students from grades 5 through 10. The survey revealed that students in CTC communities were less likely to be involved in delinquency or to be using alcohol or cigarettes.

A program like this saves money too. The return on investment was impressive. Margaret Kuklinski and her colleagues at SDRG completed a study that found for every dollar spent on the CTC, there was $8.22 in benefit, a 21% return on investment.

Increasingly, tested and effective programs are being implemented all around the world. Since 1999, Brian Bumbarger at the Bennett-Pierce Prevention Research Center at Pennsylvania State University has been supporting and studying Pennsylvania communities using the CTC model to implement preventive interventions guided by local data on risk and protective factors. By 2015, just about every county in the state had at least one evidence-based intervention in place. And since 2007 Pennsylvania has seen an amazing 44% drop in the rate of juvenile delinquency. That has translated into an $85 million reduction in the cost of juvenile justice placements of youth, and the eventual closure of three large youth correctional facilities and numerous short-term secure detention facilities, generating tens of millions in additional cost-savings.


This is not an isolated example of the power of prevention. Since I published The Nurture Effect last year I have been invited to communities all over the country. Slowly, but surely, schools and communities are adopting tested and effective programs that are significantly reducing the number of youth who develop problems such as substance abuse, delinquency, depression, or risky sexual behavior.

We are building the nurturing society. In the end prevention science may prove to be the most important science humans have developed.