Why study prevention research? Because prevention theories assist us to identify how we can prevent problem behavior from occurring - and that takes the guesswork out of planning.

Prevention Theory

Theory is important. They are the guiding principles that underlie your prevention approach. Theories explain behavior and suggest ways to achieve behavior change. They can explain the dynamics of behavior - why substance abuse, violence or teen pregnancy occurs. Theories can explain the processes for changing behavior and the effects of external influences on behavior. They can help you identify the most suitable target population, methods for accomplishing change, and what should be monitored, measured and compared through evaluation. Theory can help you answer all the "WHY?" "WHAT?" and "HOW?" questions.

There are many different theories to consider. Some theories deal with how and why individuals change their behavior; other theories deal with how communities or systems change. A good substance abuse prevention theory should:

• Identify the factors that predict substance abuse;
• Explain the mechanisms through which they operate;
• Identify the internal and external variables that influence these   mechanisms, including cultural factors;
• Predict points to interrupt the course leading to substance abuse; and
• Specify the interventions to prevent the onset of substance abuse.

An outline of four commonly used theories in substance abuse prevention can be found at http://www.tanglewood.net/services/knowledgebase/84.htm. This site provides a summary of the following theories:

• Cognitive-Affective
• Social Learning
• Conventional Commitment / Social Attachment
• Comprehensive

Risk and Protective Factor Theory

For over 20 years, two researchers from the University of Washington (J. David Hawkins, PhD and Richard F. Catalano, PhD) have been examining what contributes to or protects against a child's developing problem behaviors. Through years of collecting and analyzing evidence, they have found that there are conditions that contribute to, or safeguard against, substance abuse and other problem behaviors. They call these conditions risk and protective factors.

Hawkins and Catalano discovered that risk and protective factors are associated with four problem behaviors: substance abuse, violence, delinquency, teen pregnancy and school drop-out. These risk and protective factors are organized into the important areas - or domains - of a young person's life: individual/peer; family; school; and community. To prevent a problem from occurring, it is necessary to identify both the factors that increase the likelihood of that problem developing, and those factors that decrease that likelihood. It is important to note that Hawkins' and Catalano's risk and protective factor approach is the only theory about problem behaviors that is proven to be predictive.

The risk and protective approach has some similarities to the so-called medical model. Hawkins and Catalano wanted to develop a theory that looked at problem behaviors like doctors look at disease. Using the medical model, a doctor can predict the likelihood that a problem will develop (e.g., a disease or disorder) based on the variables that exist within a person and in his or her environment. If a problem develops, the doctor will intervene to try and reduce the factors that are causing the problem (e.g., through medication or surgery). An example is heart disease.

Risk Factors: Each risk factor is associated with more than one problem behavior. This is important because it means that reducing risk factors is likely to have a positive effect on more than one problem behavior. On the other hand, not all risk factors are linked to every problem behavior (for example, availability of drugs is linked to substance abuse, but not to teen pregnancy).

Hawkins and Catalano make some generalizations about risk factors:

• Risks exist in multiple domains, so prevention efforts will be more   effective if they are comprehensive (effect change in several domains);
• The more risk factors that are present, the greater the risk. While it   may not be possible to address every single risk factor that is present,   reducing the overall number can have a significant impact on future   problem behaviors.
• Risk factors show the same effect across different races, cultures and   classes.
• Risk factors can be buffered by protective factors. Therefore,   increasing the presence of protective factors can have a positive affect   on the problem behavior you're trying to change.

Protective Factors: There are some individual characteristics (such as gender or a resilient temperament), that can protect kids from engaging in problem behaviors - but the catch is that you really can't do anything to change these characteristics - kids are either born with them or not (e.g., it's a protective factor to be female). Going back to the medical model, it's kind of like knowing that someone has a history of heart disease in his or her family. You can't do anything about it, but knowing about the history can help you to take preventive action.

Bonding: The protective factors that have been validated by Hawkins' and Catalano's research all relate, fundamentally, to bonding. Bonding is the attachment, commitment and belief that develop in children who are attached to pro-social families, friends, school and community. According to this theory, youth who are bonded in a positive way to their peers, family, school and community, are less likely to engage in negative behaviors.

Bonding will only take place, however, if all three of the following conditions are present:

• Children must be given the opportunity for involvement in productive,   pro-social roles in all four domains;
• They must be given the skills to be successfully involved in those   roles; and
• They must be given recognition and reinforcement for their pro-social   involvement

"Positive bonding makes up for many other disadvantages caused by other risk factors or environmental characteristics. Children who are attached to positive families, friends, school, and community, and who are committed to achieving the goals valued by these groups are less likely to develop problems in adolescence. Studies of successful children who live in high-risk neighborhoods or situations indicate that strong bonds with a caregiver can keep children from getting in trouble.

Children must be provided with opportunities to contribute to their community, family, peers and school. The challenge is to provide children with meaningful opportunities that help them feel responsible and significant.

Children must be taught the skills necessary to effectively take advantage of the opportunity they are provided. If they don't have the necessary skills to be successful, they experience frustration and/or failure. Children must also be recognized and acknowledged for their efforts. This gives them the incentive to contribute and reinforces their skillful performance."

Source: "Developing Healthy Communities: A Risk and Protective Factor Approach to Preventing Alcohol and Other Drug Abuse," Developmental Research and Program, Inc., 130 Nickerson, Suite 107, Seattle, WA 98109, (800) 736-2630

Healthy Beliefs & Clear Standards: Furthermore, the people and institutions to whom youth are bonded need to express positive norms and standards for behavior, and consistent consequences for not following these standards. Youth are much more likely to follow the healthy beliefs and clear standards of those people and institutions to which they are bonded. If the bond doesn't exist, youth may ignore those messages, or worse, do the opposite.

According to this theory, strategies and activities that strengthen the bonds that tie children to families, schools and communities by providing them with the opportunities and the skills to participate successfully, and the rewards and recognition for their effort, combined with strategies and activities that reduce risk factors, will, together, move children to the desired behavioral outcomes.

There are three criteria that Hawkins and Catalano used before they would include a risk or protective factor in their research-based list: (1) it had to be shown to predict an increase or decrease in problem behavior; (2) those predictions must have been proven true in multiple studies; and (3) those predictions had to hold true over time, demonstrated through the use of longitudinal studies.

Here is a table that shows Hawkins' and Catalano's list of proven risk and protective factors by domain:

DOMAIN	RISK FACTORS	PROTECTIVE FACTORS
Individual/ Peer	• Alienation and rebelliousness • Friends who engage in the problem behavior • Favorable attitudes towards the problem behavior • Early initiation of the problem behavior	• Bonding to peers with healthy beliefs and clear standards: Meaningful opportunities to contribute to the peer group Skills to successfully take advantage of those opportunities Recognition/ acknowledgement of efforts
Family	• Family history of high-risk behavior • Family management problems • Family conflict • Parental attitudes and involvement in the problem behavior	• Bonding to a family with healthy beliefs and clear standards: Meaningful opportunities to contribute to the family Skills to successfully take advantage of those opportunities Recognition/ acknowledgement of efforts
School	• Early and persistent antisocial behavior • Academic failure beginning in elementary school • Low commitment to school	• Bonding to a school that promotes healthy beliefs and clear standards: Meaningful opportunities to contribute to the school community Skills to successfully take advantage of those opportunities Recognition/ acknowledgement of efforts
Community	• Availability of drugs • Community laws and norms favorable toward drug use • Transition and mobility • Low neighborhood attachment and community disorganization • Extreme economic and social deprivation	• Bonding to a community that promotes healthy beliefs and clear standards: Meaningful opportunities to contribute to the community Skills to successfully take advantage of those opportunities Recognition/ acknowledgement of efforts

As mentioned above, only the risk and protective factors shown in the above table have been demonstrated, through the research, to predict the occurrence of problem behaviors such as school drop-out, teen pregnancy, delinquency and substance abuse. However, that doesn't mean that other risk and protective factors don't exist - it simply means that those other potential risk and protective factors don't have enough evaluated research behind them to back them up.

You have probably heard the terms "risk factor" and "protective factor" used before. However, it's important to remember that these terms have very specific definitions, according to Hawkins' and Catalano's research. This can get confusing, because of the way the terms "risk factor" and "protective factor" are used every day in our work to mean lots of different things. But, you have to remember that if you are going to adopt this theory, you need to be very specific about the definitions of these terms.

Developmental Assets Approach

Starting in 1989, the Search Institute began its research on developmental assets. The Institute's framework of 40 developmental assets is an outgrowth of their research into what it takes to create the building blocks necessary for youth to be healthy, caring, principled and productive. The developmental assets theory is considered a "promising" rather than proven approach, due to the fact that no independent research has yet been published to indicate that implementing asset-based approaches reduces or prevents substance abuse or other problem behaviors.

The Institute's list of 40 developmental assets necessary for healthy youth development are divided into "external" and "internal" assets. External assets are those that involve relationships and opportunities provided to young people (e.g., support, empowerment, boundaries, expectations, constructive use of time). Internal assets are those that involve values and skills that young people develop to guide themselves (e.g., commitment to learning, positive values, social competencies and positive identity).

The Search Institute has developed a variety of strategies intended to build assets in young people. All of these strategies require that implementers have:

• An awareness of the framework;
• An assessment of the assets for each youth;
• An inventory of resources available to build assets; and
• The ability to successfully implement and continue the strategies.

Resiliency Approach

The resiliency approach evolved out of the observation that many young people maintain the ability to stay on a positive course despite troubled backgrounds. In 1986, Emmy Werner identified some of the characteristics of those resilient youth:

• Optimistic outlook;
• Self-efficacy or competence;
• Self-discipline (ability to delay gratification and control impulses);
• Problem-solving skills (e.g., think abstractly);
• Nurturing relationships.

Werner identified several environmental factors that foster resiliency in youth, including:

• Younger mothers for boys, older fathers for girls;
• Fewer than four children in the family;
• Steady employment for the mother, especially if she was a single mother;
• Church attendance.

However, other researchers have come to different conclusions about what makes for a resilient child, and the final word is still not in. More research needs to be done on resilience, especially across cultures. The resiliency approach is also considered "promising" rather than proven, due to the lack of published evaluation research on the subject. No research currently exists to show, conclusively, that increasing resilience leads to decreased substance abuse or other problem behaviors.