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Transcript
Developmental Epidemiology
and Prevention
David Foxcroft, Oxford Brookes University
Talk Outline
• What is Developmental Epidemiology?
• What do we know about early development and
adverse outcomes?
• What are the different types of Prevention?
• What are some good examples of developmental
prevention?
Developmental Epidemiology
Describes the links between lifecourse
development and risk behaviours,
disease and disorder
Lifecourse Development and Health
• Early risk and protective factors are significant
determinants of multiple risk behaviours
• Four risk behaviours are major causes of NonCommunicable Diseases (NCDs): smoking,
drinking, poor diet and lack of exercise
• NCDs now account for most death and
disability worldwide
Lifecourse Development and Health
• Early risk and protective factors are significant
determinants of multiple risk behaviours
• Four risk behaviours are major causes of NonCommunicable Diseases (NCDs): smoking,
drinking, poor diet and lack of exercise
• NCDs now account for most death and
disability worldwide
Risk factors (red) and protective factors (blue) associated with tobacco,
alcohol or illicit drug use, and risky sexual behaviour
Risk factors (red) and protective factors (blue) associated with tobacco,
alcohol or illicit drug use, and risky sexual behaviour
Risk factors (red) and protective factors (blue) associated with tobacco,
alcohol or illicit drug use, and risky sexual behaviour
Search Institute 40 Developmental Assets: Support, Empowerment,
Boundaries and Expectations, Commitment to Learning, Positive Values, Social
Competencies, Positive Identity
Talk Outline
• What is Developmental Epidemiology?
• What do we know about early development and
adverse outcomes?
• What are the different types of Prevention?
• What are some good examples of developmental
prevention?
Different types of Prevention
• Environmental: interventions to limit the availability of
maladaptive behaviour opportunities, through system wide
policies and restrictions
• Developmental: interventions to promote adaptive
behaviours, and prevent maladaptive behaviours, through the
socialization of appropriate norms, values and habits
• Cognitive: interventions to address existing cognitions about
specific behaviours, through persuasion: providing
information, raising awareness and challenging preconceptions
Focus on Developmental Prevention
• Life Skills Training (LST), the Strengthening Families
Programme 10-14 (SFP10-14) and the Good Behaviour Game
(GBG) are all examples of developmental prevention
highlighted in Cochrane reviews: all are designed to impact on
socialization and social development of young people
• Effective developmental prevention provides substantial
added value due to impact on multiple risk behaviours: the
return on investment for developmental prevention can be
substantial: e.g. $36 for every $1 spent on GBG
Examples of Developmental Prevention: SFP10-14
Conclusions
Developmental Epidemiology
• Early risk and protective factors are important determinants
of risk behaviours and health outcomes
Prevention
• Community-oriented developmental prevention can have a
significant impact on risk factor trajectories
Challenges
• We need a better understanding of how early risk and
protective factors and risk behaviours compound into
different trajectories; & how prevention effects are
moderated by e.g. gender