David Foxcroft, Oxford Brookes University

Developmental Epidemiology and Prevention

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 Non-Communicable 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 Non-Communicable 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 pre-conceptions

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

ConclusionsDevelopmental 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