PREVENTION SCIENCE PRINCIPLES FOR INTERVENTION
Tracy W. Harachi, M.S.W., Ph.D.*
There is growing consensus that a risk
reduction and protective factor
e n ha nc e m e nt a p p ro a ch is th e m o st
promising approach across a number offields. Interventions that seek to both
reduce risk and enhance protection inmultiple socializing domains will likely bemore effective towards achieving our goalof supporting the healthy development ofc hild r e n. T h e N a t io na l A c a d e m y o fSciences, the Institute of Medicine, andseveral U.S. fede ral governm ental
agencies including the Departments ofEducation and Justice, Office of Juvenile
Justice and Delinquency Prevention,
Centers for Substance Abuse Prevention
and Mental Health Services, and theCenters for Disease Control have adopted
a nd supported a risk a nd protective
f o cu se d a p p ro a c h to p r om o tio n a n dprevention.
Today, many promotion and prevention
i nte r v e nt io n s th a t r e d u ce r is k a n denhance protection have demonstrated
effects in interrupting the processes that
produce adolescent problem behaviors(including violence, crime and substanceu se ) , a s w el l a s p ro m o tin g p os itiv edevelopment (academic success, socialand emotional competence). This is asignificant increase from the early 1970’s
when a review was conducted on behalf of
the O ffice of Ju venile Justice an dDelinquency Prevention of all existingdelinquency prevention programmes withstrong evaluation designs that weresufficiently rigorous and demonstrated* Social Development Research Group,
School of Social Work,
University of Washington,
Seattle, Washington, USA

effectiveness. Of nine programmes withstron g e va lu atio n, only on e show e dpositive results.
I n de linq u en cy p re ve ntio n, m a ny
alternative programmes were tried in theearly 70’s, in which youth were removed
from their urban environment and given
a rural or wilderness challenge type ofexperience; for example, a programmecalled National Intervention Programme
Using Minibikes (NIPUM ) which
consisted of motorcycle riding in thedesert. What we know f rom theevaluation of these programmes is thatinvolvement alone did not appear to
reduce delinquency. While many of theseexperiences were attractive toadolescents and staff, especially innerci t y a d o l e s ce nt s , m o s t o f th e e a r ly
programmes made no effort to change thebasic criminal environment the children
were exposed to on a daily basis. Further,often th es e experiences had little
applicability to children’s lives when they
returned from these outings.
Research has provided us with a set of
preventio n p rinciples f ro m w hich tooperate when considering intervention
options to optimize effectiveness. These
principles include the following:•••

Preventive interventions should focus
both on reducing risk and enhancingprotection.
Preventiveinterventions
shouldtarget individuals exposed to higher
levels of risk.
Address risk and protective factors at
developmentally appropriate stages
and whenever possible, intervene
early.

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RESOURCE MATERIAL SERIES No. 59••

Use data to select priority risk andp r o te cti ve fa cto r s in d e sig na te dcommunities.
Select preventive interventions thathave empirically demonstrated
effectiveness to target the prioritizedrisk and protective factors.

The first principle emphasizes thatprevention strategies should focus on
reducing risk factors and enhancing
protective factors in order to maximize
effectiveness. Both an individual’s level ofr isk and le ve l of p r ote ctio n m a ke adifference. Research has shown that highlevels of protection are not likely to befound in high risk environments. As sucha nd giv e n lik e ly li m ite d re so u rc e s,another principle suggests it is essential
to target individua ls exposed to thehighest levels of risk and the lowest levelso f p r o te ct io n. I t’ s lik e ly t ha t the s eindivid uals will b e cluste red; hence
identifying community areas exposed tohigh le vels o f risk and lo w le vels o fprotection becomes critical.
In order to provide maximum strengthof in terven tion , another prin ciple
suggests that interventions should bechosen which address risk and protective
factors at appropriate developmental
stages. Some risk factors affect children
early in life. These should be addressed
early and new risk factors that are salient
l a t er in l if e s h oul d b e a dd res s e d a s
children mature. The earlier we intervene
the greater the likelihood that we will beable to change risk factors and patterns of
behavior. If we wait until fam ily
m anage me nt pro ble m s produce anabused or neglected child we may havew a it e d t o o l o n g t o p r e v e n t a lo t o fdamage. Therefore, we need to create adevelopmental continuum of prevention
with programmes appropriately placed tor e d u c e r i s k s a s s o c ia t e d w i t h e a c hdevelopmental period.

196

Let’s look at data produced from ourwork with six states in the D iffusion
Project (NIDA funding, PI: Hawkins).
School children in this study represent a
statewide sample and have responded tosurvey questions on risk and protective
factors and problem behaviors. Figure 1
examines the prevalence of thirty day
alcohol use by the number of risk andprotective factors reported by the youth.
As the number of risk factors increase,
the general trend for alcohol use also
increases. Additionally, as the number ofprotective factors increases prevalence ofu se lo w e r s. F ig u r e 2 e x a m i n e s th eprevalence of arrests in the past year also
by number of risk and protective factors.
A similar pattern is portrayed with theprevalence of arrests in the past year
highest for those youths with the lowest
level of protection and highest number ofrisk factors.

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Prevalence of 30 Day Alcohol Use by Number of
Risk and Protective Factors
Six State Student Survey of 6th-12th Graders, Public SchoolStudents
100%
90%

Number ofProtectiveFactors

80%

Prevalence

70%

0 to 1
2 to 34 to 56 to 78 to 960%
50%
40%
30%
20%
10%
0%
0 to 1

2 to 34 to 56 to 78 to 910+

Number of Risk Factors••••

Relationship Between Risk andProtection
The more risk factors the greater theprevalence of alcohol use.
Black line (top line) is the group withno protective factors.
Red line (bottom line) has the most,6–7 protective factors.
The more protective factors— thenegative effects of risk go down.

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RESOURCE MATERIAL SERIES No. 59

Prevalence of Arrests in the Past Yearby Number of Risk and Protective Factors
30%Prevalence

25%
Protection, Level 020%

Protection, Level 1
Protection, Level 2

15%

Protection, Level 3
Protection, Level 4

10%
5%0%
L=0

L=1

Risk Factor

L=2

L=3

L=4

Copyright permission from Developmental Research & Programs

Relationship Between Risk andProtection• Similar relationship for arrests inpast year.
• The difference between 1 and 3 riskfactors doesn’t seem so strong.
• Having 4 or more risk factors seems
to reach a critical level where
protection is more important.
These data illustrate both the need tofocus on risk and protection, as well as
highlight the impact of greater exposure.
The following figures also from theDiffusion Project illustrate the principlethat risk and protection can be identified
in geographic clusters. Information suchas this can help determine geographic
priorities in terms of identifying areas ofgreatest need.

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Maine Student Risk Factor Profile
Risk Quartiles
44.38 to 48.39
Aroostook

41.21 to 44.37
Piscataquis

36.63 to 41.20
Somerset
Penobscot

19.91 to 36.62

FranklinWashington

Kennebec Waldo

OxfordHancock
Percentages compiled from the 1995
Maine Student Survey, Grades 6-12

Androscoggin
Knox
Sa LinCuga colda nmbhoerlc
andYork

Social Development Research Group,
University of Washington
Six State Consortium for Needs Assessment P.I.: Andrew O'Donovan
Supported by the Center for Substance Abuse
Prevention; May 1996

Maine Student Protective Factor Profile
Protection Quartiles
36.10 to 47.39Aroostook

30.85 to 36.09
Piscataquis

27.65 to 30.84
Somerset
Penobscot
FranklinOxford

Kennebec Waldo

Androscoggin

24.71 to 27.64
Washington

Knox

Sa Linc
Cuga olnmbdahoerlc
andHancock
Percentages compiled from the 1995
Maine Student Survey, Grades 6-12

York
Social Development Research Group,
University of Washington
Six State Consortium For Prevention Needs
Assessment Studies - P.I.: Andrew O'Donovan
Supported by the Center for Substance Abuse
Prevention,; May 1996

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RESOURCE MATERIAL SERIES No. 59
While these figures illustrate areas ofneed, they do little to help diagnose theindividual risk and protective factors thatshould be targeted. Information is needed
to determine which factors are at higher
levels and therefore should be the focus of
our intervention efforts. Let’s take forexample two neighborhood risk profiles.

The first neighborhood “A” has a uniquerisk factor profile. For this neighborhood,peer antisocial behavior and attitudes
favorable to antisocial behavior appear tobe the risk factors at higher levels asreported by youth in this community.
Th is is fo llo wed by e a rly antiso cial
behavior and sensation seeking behavior.

Risk Factor Profile, Neighborhood A
1.00
0.80

Z-Score Value

0.60
0.40
0.20
0.00
-0.20
-0.40
-0.60
-0.80

Priorities for Neighborhood A(i) Peer Antisocial Behavior(ii) Attitudes Favorable to AntisocialBehavior(iii) Early Antisocial Behavior(iv) Sensation Seeking Behavior

200

Rebelliousness

Sensation Seeking

Peer Antisocial Behavior

Peer Rewards for Antisocial Behavior

Early Initiation of Antisocial Behavior

Antisocial Behavior

Attds. Favorable to Antisocial Behavior

Low School Commitment

Low Academic Achievement

Family History of Antisocial Behavior

Family Conflict

Favorable Family Attitudes

Poor Family Discipline

Poor Family Management

Laws and Norms

Perceived Availability

Transitions and Mobility

Community Disorganization

Low Neighborhood Attachment-1.00

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Z-Score Value

Risk Factor Profile, Neighborhood B
1.00
0.80
0.60
0.40
0.20
0.00
-0.20
-0.40
-0.60

Priorities for Neighborhood B
Family History of Antisocial
Behavior(ii) Early Initiation of Antisocial
Behavior(iii) Antisocial Peers(iv) Low Academic Achievement(v) Transitions and Mobility(i)C ontrast the risk profile ofneighborhood ”A” to the risk profile forneighborhood ”B”. For this neighborhood,a family history of antisocial behavior isreported as a higher level of risk by youth
in this community. This is followed byearly initiation of antisocial behavior andi nv o lv e m e n t w it h a nt is o ci a l p e e rs .
Further, youth in Neighb orhood “A”
report that low academic achievement
and high transitions and mobility are thenext more frequent risks. On the otherhand, poor family management includingp o o r f a m ily d iscip lin e ap p e ar to b e
relatively low risks in this neighborhood.

Rebelliousness

Sensation Seeking

Peer Rew ards f or Antisocial Behavior

Peer Antisocial Behavior

Early Initiation of Antisocial Behavior

Antisocial Behavior

Attitudes Favorable to Antisocial Attitudes

Low School Commitment

Low Academic Achievement

Family History of Antisocial Behavior

Family Conflict

Favorable Family Attitudes

Poor Family Discipline

Poor Family Management

Law s and Norms

Perceived Availability

Transitions and Mobility

Community Disorganization

Low Neighborhood Attachment

-0.80
-1.00

Using the inform ation from theneighborhood risk profiles, we would
develop distinctly different logic models
to specify both our targeted risk factors
and chosen interventions. In
neighborhood “A”, we would prioritize
peers who engage in antisocial behavior
as our proximal target. Consequently, we
might choose an intervention such as
parent education and training to reduce
negative peer associations. In contrast forneighb or hoo d “B”, fa m ily histo ry o f
a n ti s o c ia l b e h a v i o r i s t h e p r io r i ty
proximal target and therefore we mightchoose an intervention such as prenatal
an d inf a ncy hom e b ase d service s toaddress this factor. It’s critical to notethat the selection of priority risk factors
does not mean that other factors are notimportant. Rather prioritization helps
with targeting programming to areas
most in need.

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RESOURCE MATERIAL SERIES No. 59
One of the last prevention principles
suggests that using programmes withdemonstrated effects in well-controlled
studies increases the likelihood that theprogramme will be positively evaluatedand reduce the priority risk factors andenhance priority protective factors. It isparticularly important to use evidenceb a s e d p r o g r a m m e s t o in c r e a s e t h echances of successful risk reduction andprotection enhancement.
Multiple U.S. federal agencies now
require com munities to utiliz eempirically supported programmes when
sp en ding gove rnm e nta l b lo ck gra nt
funds. For example, the U.S. Departmentof Education requires communities tos e le ct a p r og ra m m e f r o m its lis t o fapproved programmes when utilizing
f un ds f ro m th e S a f e a nd D rug F re e
Communities Act. Other organizations
such as the Office of Juvenile Justice andDelinquency Prevention have publishedthe “B lue Prints Progra mm e” w hichhighlights programmes that havedemonstrated effectiveness. Anotherexample is the Center for Mental HealthServices that has a listing for promising
violence prevention programmes. Whilethe criteria to demonstrate effectivenessvaries across agencies, these programmes
are required to affect a change in either aproximal risk factor or protective factor ora change with the target problem
behavior. Additionally, the results must
be derived from studies that have either
an experimental or quasi-experimental
design.
The accountability of where publicdollars are being spent has significantlyincreased. Encouraging communities toimplement programmes that havedemonstrated effectiveness increases thelikelihood that money will be spent on
programmes which will reach theintended goal of reducing adolescent202

problem behaviors such as delinquency.
Therefore more and more agencies areadopting this type of emp irically
sup ported me nu-driven a pp ro ach tointervention selection. The challenge toprevention scientists and community
programmes is to ensure that research be
co nducted to p rovide the needed
empirical support for promisingprogra mm es. M ore over, p reventio nscience offers a set of principles that can
assist com munities in allocatingr e s o u r c e s to w a r d s m a x i m i z in g i t ’ s
prevention efforts.