Might SEL programs affect mental health at the population level? Contribution to a roundtable discussion

Transcription

1 Might SEL programs affect mental health at the population level? Contribution to a roundtable discussion Charli Eriksson, Professor em., Public Health Sciences, Department of Health Sciences, Örebro University charli.eriksson@oru.se Three concerns 1. Behavioral programs - focus on the individual towards choice, change, mastery 2. Knowledge gaps implementation and going global research challenges 3. Need for systems thinking and actions 1

2 1: CHOICE CHANGE MASTERY Awareness Information Positive attitude Personal motivation Skills training Action Adoption Sustainability Peer influence Participation Partnership Ownership Framework for Positive Youth Development Academically Successful Coordinated School, Family, and Community Programming Social, Emotional, and Academic Learning Healthy Character Development Engaged Citizens CASEL at UIC 2

3 Why Research on Intervention Methods Why research? Good intentions are not enough Therefore: Evidence-based s is needed And Translation into practice But(25 years of implementation research M Doda) If they don t like it, they don t do it RE-AIM model A planning and evaluation framework used to conceptualize the public health or population-based impact of an Glasgow et al Am J Public Health, 1999; 89:

4 A type III error = evaluating an that has not been adequately implemented Reach Participation rate and representativeness of participants Effectiveness Effects on primary and multiple outcomes of interest (including negative outcomes) Adoption Participation rate and representativeness of setting Implementation Extent to which is delivered as intended Maintenance Long-term effects of and extent of continuation of Implementation Science Effects Performance assessment (Fidelity) Training Selection Coaching Integrated and compensatory Political support Facilitative administration Decision support data system Leadership Drivers Technical Adaptive Fixsen & Blase,

5 2. Knowledge gaps Stages of research and evaluation problem definition solution generation innovation testing demonstration dissemination programme management epidemiology and demography community needs and analysis social behavioural organisational research theory assessment of outcome understanding of process assessment of cost and benefits performance monitoring What is the problem? How might it be solved? Did the solution work? Can the programme be repeated / refined? Key research questions Can the Can the programme programme be widely be reproduced? sustained? 2. Knowledge gaps problem definition Stages of research and evaluation Present Public Health Research solution generation innovation testing demonstration dissemination programme management epidemiology and demography community needs and analysis social behavioural organisational research theory assessment of outcome understanding of process assessment of cost and benefits performance monitoring What is the problem? How might it be solved? Did the solution work? Can the programme be repeated / refined? Key research questions Can the Can the programme programme be widely be reproduced? sustained? 5

6 Organise, develope, intervene KNOWLEDGE MANAGEMENT CYCLE Effect and Process Studies DEVELOP KNOWLEDGE 10 % Evidence without capacity is an empty shell Plan Do Evaluate Research integrated Work-proces Implement Publish USE KNOW- LEDGE Judge Evidence-proces Collect Review SHARE KNOW- LEDGE REFLECT ON KNOWLEDGE - Best packages or formulas - Best principles of professional quality Let us do this together Disseminating research findings A review of 28 approaches showed that these were underpinned by at least in part by one or more of three theoretical approaches: Persuasive communication Diffusion of innovations theory Social marketing Wilson et al. Implementation Science, 2010, 5:91. 6

7 Diffusion of innovationse. Rogers, 2003) Laggards 100% Early adopters Majority Does as others Does 68% Innovators 2,5 % 0 Time 3. The River a human being has fallen into the river Rescue Medical Care Construct a Bridge Prevention Learn how to swim Health Promotion Change the river Physical planning + Politics 7

8 Importance of contextual factors Main determinants of health Source: Whitehead & Dahlgren,

9 Mediating Outcomes/ Results HEALTH death, disease, disability quality of life, participation, equality Healthy Lifestyle Effective Care, Protection and Service Supportive Environment Output of Public Health Work Health Literacy Social Action and Influence Healthy Policy and Organisation Public Health Work Information, Education, Communication Social Mobilisation Advocacy Political work Population level effects Health promotion = health education x healthy public policy or education x social mobilization x public policy 9