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Article

Developmental Targeted Prevention of Conduct Disorder  

Frank Vitaro and Richard E. Tremblay

Traditionally, the term targeted prevention refers to interventions designed to prevent the development of adjustment problems in individuals by reducing risk factors or by implementing protective factors identified in studies of human development. Because risk and protective factors vary with development, a developmental perspective is necessary in order to identify which factors are most relevant at each period of life, based on well-defined and empirically supported etiological models. Moreover, because prevention strategies vary greatly depending on the factors that are targeted at different developmental periods and ages, a developmental perspective suggests that they need to be shaped accordingly. A further expansion of the concept of developmental targeted prevention includes the notion of “stepwise continuous prevention” for the extreme cases who do not revert to normative behavior during a given developmental period. This notion draws on the chronic-disease model of conduct problems and encompasses several developmental periods. The current debate around these issues is important as they apply to the prevention of conduct problems in youth by targeting risk factors during maternal pregnancy, early childhood, childhood, and adolescence. A consensual view of developmental targeted prevention is, however, necessary for prevention efforts to be coordinated and fruitful.

Article

Preterm Birth: Epidemiology, Risk Factors, Pathogenesis, and Prevention  

Xiaojing Zeng, Wen Jiang, Xiaoqing He, and Jun Zhang

Preterm birth is a significant global public health issue. It is defined by the World Health Organization as infants born alive before 37 completed weeks of gestation. The preterm birth rate varies significantly across countries and regions. Globally, an estimated 13.4 million babies were born preterm in 2020 (i.e., 1 in 10 babies worldwide was preterm birth). It is the leading cause of under-5 child mortality worldwide, and preterm infants are particularly vulnerable to respiratory complications, feeding difficulty, poor body temperature regulation, and high risk of infection. Both genetic and nongenetic factors (exposome factors) contribute to the risk of preterm birth. Social and behavioral factors, medical and pregnancy conditions, and environmental exposures are common nongenetic risk factors for preterm birth. Individuals from certain ethnic and racial groups, in low- and middle-income countries, or with a low socioeconomic status are at an increased risk of having preterm birth, and social determinants of health are the root causes of these factors. Existing pregnancy complications, history of preterm birth, and other medical conditions are also common risk factors. Environmental exposures such as air pollution, climate change, and endocrine-disrupting chemicals have been increasingly realized as potential risk factors for preterm birth. Various pathological events in different feto-maternal systems have been reported to be involved in the development of preterm birth. Immunopathogenesis plays a pivotal role, and both pathogenic and nonpathogenic inflammation can induce preterm birth. Oxidative stress, decidual hemorrhage and vascular lesions, uterine overdistension, and cervical insufficiency have all been proposed to contribute to the pathophysiology of preterm birth. Prevention strategies for preterm birth include primary prevention aimed at the modifiable risk factors at the individual and societal levels and therapeutic approaches using pharmaceuticals and mechanical interventions, such as progesterone and cervical cerclage. A comprehensive approach is still needed to reduce the global disease burden of preterm birth.

Article

Violence  

Sheara A. Williams

Violence is a serious social issue that affects millions of individuals, families, and communities every year. It transcends across racial, age, gender, and socioeconomic groups, and is considered a significant public health burden in the United States. The purpose of this entry is to provide an overview of violence as a broad yet complicated concept. Definitional issues are discussed. Additional prevalence rates of select types of violence are presented in addition to risk and protective factors associated with violent behavior. The entry concludes with a summary of approaches to address violence in the context of prevention and intervention strategies.

Article

Information Technology Project Risk as a Dynamic Phenomenon  

Mazen El-Masri and Suzanne Rivard

Information systems (IS) research provides strong evidence for the effect of information technology (IT) project risk and on-project failure. However, no consensus has yet been reached on what constitutes risk and how it should be specified. Existing definitions of the risk construct are diverse leading to fragmented scientific knowledge. This article specifies IT project residual risk as an aggregate multidimensional construct comprised of four dimensions: project sources, undesirable events, risk management mechanisms, and expected outcomes. The construct accentuates the dynamic nature of IT project risk and can help reorganize the abundant risk factors found in the IS literature under its four dimensions while exposing their interactions.

Article

Diabetes in South Asians  

Sara Garduño‐Diaz and Santosh Khokhar

As of 2023, it is estimated that Type 2 diabetes (T2D) affects approximately 783 million people worldwide, with South Asians presenting the highest age-adjusted comparative diabetes prevalence among adults (90,204.5 people). Ethnicity has been highlighted as a major risk factor for the development of T2D with central adiposity, insulin resistance, and unfavorable lipid profile identified as predominant signals of alarm. Leading databases, including Web of Science, Medline, PubMed, Google Scholar, and ScienceDirect, were consulted, and manual searches were carried out for cited references in leading diabetes-related journals. Genetic predisposition, central adiposity, and unfavorable lifestyles, including physical inactivity and an unhealthy diet, have been found to be associated with the prevalence of T2D in migrant South Asians. Additionally, “Westernization,” acculturation, socioeconomic factors, and lack of awareness regarding seriousness and consequences of the disease have also been identified as contributors to the development of T2D in this population. However, the higher prevalence of T2D in migrant South Asians may not be entirely attributed to genetic predisposition; hence, ethnicity and associated modifiable risk factors warrant further investigation. Preventive measures and appropriate interventions are limited by the lack of ethnic-specific cut-off points for anthropometric and biological markers, as well as by the absence of reliable methods for dietary and physical activity assessment.

Article

Fall Prevention and Interventions for Older People  

Claudia Meyer and Lindy Clemson

Across the globe, falls among older people can have grave consequences for individuals and for the healthcare and aged-care systems more broadly. The synergy between intrinsic and situational risk factors adds complexity to the identification and management of falls, as does the public health response at primary, secondary, and tertiary levels of prevention. Falls among people age 65 years and over are recognized as a geriatric syndrome and as a marker of frailty, with increasing rates among those experiencing other chronic conditions, such as Parkinson’s disease, stroke, and dementia. Prevention or management of falls requires a combination of strategies as single or multicomponent interventions. Multimodal exercise, combining balance and functional exercise, environmental adaptation, medication reduction and withdrawal, cataract surgery, single-lens glasses, vitamin D supplementation, management of foot problems and footwear, and cardiac pacing have a degree of evidence to support their implementation. Multicomponent programs, such as i-FOCIS and PDSAFE, have important benefits for specific population groups. Importantly, over the past few decades, falls prevention has shifted from a biomedical approach to a holistic biopsychosocial model. This model aids promotion of a whole-of-community approach through building healthy public policy, creating supportive environments, and strengthening personal skills and community action. The biopsychosocial approach also focuses attention on understanding local contexts, ensuring that falls prevention interventional research can be adapted and fit-for-purpose for low-, middle- and high-income countries. The uptake of falls prevention evidence into practice and policy still faces challenges and new frontiers. Supporting the adoption, implementation, and sustainability of interventions is complex at the individual level, the service provider level, and the healthcare system level. Practice-change frameworks and models are useful, such as those utilized in the Stopping Elderly Accidents, Deaths and Injuries (USA), iSOLVE (Australia), and STRIDE (USA) trials. Falls prevention is complex, yet solutions can be relatively simple. Working together with older people, health professionals and community health leaders can champion ways of bringing falls prevention activities to scale. Research collaboration between stakeholders is a crucial mechanism for drawing together unique perspectives to address ongoing gaps and concerns.

Article

Race, Ethnicity, and Street Gang Involvement in an American Context  

Adrienne Freng

Race and ethnicity represent a pivotal issue in almost any conversation regarding gang members. These two concepts have been invariably linked in both research and the larger social world. Images of this connection invade our social milieu and appear frequently in movies, television, news, and music. However, academic research also contributes to this perception. Much of the early work, as well as a significant portion of the qualitative work on gangs, perpetuates the continued examination of racial and ethnic homogeneous gangs, with a focus on African American and Hispanic groups. This work ignores increasing problems among other racial and ethnic groups, such as Asians and Native Americans, within the literature. More recently, however, the intricacies of this relationship are becoming clearer, including the growing involvement of White individuals and the fact that gangs are increasingly multiracial. Furthermore, with the development of the Eurogang project in the late 1990s, research regarding these groups in Europe, as well as in other countries across the world, has become more plentiful, further expanding our knowledge regarding gangs and the role of race and ethnicity, as well as immigration and migration. As the relationship between race and ethnicity and gang membership takes on more meaning, numerous explanations have been developed to account for this connection. Much of the research, both past and present, centers on the association between race and ethnicity and the impacts of social disorganization, discrimination, immigration, and cumulative disadvantage. Community and environmental factors play a crucial role in explaining why gangs thrive in communities often occupied by racial and ethnic minorities. Relatedly, external threats, specifically violence from other groups, can provide the impetus for gang development in neighborhoods marked by disorder; thus, other explanations center on violence and the role that gangs play in mitigating this threat while serving as a protective factor for the youth in the community. The risk factor approach, gaining more prominence in gang literature, investigates individual risk for gang membership, as well as the cumulative effects of risk factors. These various frameworks assist in beginning to understand the underlying factors contributing to gang membership. With regard to policy recommendations, investigating “race and ethnicity specific” risk factors as well how these risk factors might impact programming remain key. In order to fully comprehend the development of gangs, a number of gang researchers have called for the need to understand the different historical experiences of racial and ethnic groups within the United States. For example, the histories of Hispanic and African American groups impact their experiences and thus may result in different pathways to gang membership. And yet, in many respects, these groups are still treated as single entities, ignoring their distinct histories. In fact, there remains a paucity of information regarding cross-group comparisons that examine actual differences between racial and ethnic groups. Without a closer examination of the relationship between race, ethnicity, and gang membership, effective gang policies and practices will remain out of reach.

Article

Adolescents: Practice Interventions  

David L. Hussey

This chapter summarizes literature and research related to advances in direct practice work with adolescents. Social workers are on the forefront of developing and utilizing a variety of evidence-based practices to address complex client and community needs.

Article

Life Span: Development and Infancy (Birth to Age Three)  

Cathleen A. Lewandowski

Infancy and young childhood are characterized by rapid cognitive, emotional, and physical development. Each year is marked by specific developmental tasks. Infants need positive parenting, a safe environment, and attention to their basic physical needs. A strong bond with caregivers is also necessary, as this lays the foundation for trust, allowing infants to explore their world. Many of the risk factors, such as prenatal exposure to alcohol and drugs, malnutrition, and abuse and neglect, can be remedied. Interventions such as home visiting, family leave, and nutrition programs are inexpensive and effective, and should receive more attention from social work. Infancy and young childhood are the most crucial periods in a child's development. There is a dynamic and continuous interaction between biology and experience that shapes early human development. Human relationships are the building blocks of healthy development, and children are active participants in their own development.

Article

Community Violence  

Muhammad M. Haj-Yahia, Neil B. Guterman, and Maria João Lobo Antunes

Community violence is a widespread concern that is receiving increasing attention by social workers. We consider here the problem of community violence and the present understanding of its rates, risk factors, protective factors, consequences, and some orientations for prevention and intervention. Growing evidence identifies a multifaceted and multisystemic ecological perspective of risk and protective factors linked with community violence exposure and its effects. Current research points to potentially helpful ameliorative and preventive strategies for social workers to consider at the micro and macro levels; however, the main focus of this article is on the macro-level factors and processes.

Article

Pregnant and Parenting Adolescents  

Cynthia Franklin and Melissa Reeder

Adolescent parenthood continues to be a public health concern despite the fact that the numbers of adolescent births have been declining over the past decade. The United States ranks number one in adolescent pregnancies out of all the industrialized nations. While reducing the number of adolescent pregnancies is important, supporting those who do become young parents is equally vital and an important concern for social workers. This chapter covers the demographics of adolescent parents as well as the risk and protective factors associated with adolescent pregnancy and parenthood. In addition, it reviews the current state of program development and the need for additional research and evaluation.

Article

Risk Assessment  

Tim Brennan, William Dieterich, and William Oliver

From rudimentary conceptions of risk in the late 18th century, risk assessment slowly evolved toward a more multifaceted conceptualization of risk and progressed to more sophisticated methods to calibrate offender risk levels. This story largely involves the struggles in criminology and applied agencies to achieve a successful “science-to-practice” advancement in risk technologies to support criminal justice decision making. This has involved scientific measurement issues such as reliability, predictive validity, construct validity, and ways to assess the accuracy of predictions and to effectively implement risk assessment methods. The urgent call for higher predictive accuracy from criminal justice policymakers has constantly motivated such change. Over time, the concept of risk has fragmented as diverse agencies, including pretrial release, probation, courts, and jails, have sought to assess specific risk outcomes that are critical for their policy goals. Most agencies are engaged in both risk assessment and risk reduction, with the latter requiring a deeper assessment of explanatory factors. Currently, risk assessment in criminal justice faces several turbulent challenges. The explosive trends in information technology regarding data access, computer memories, and processing speed are combining with new predictive analytic methods that may challenge the currently dominant techniques of risk assessment. A final challenge is that there is, as yet, insufficient standardization of risk assessment methods; nor are there any common language or definitions for offender risk categories. Thus, recent proposals for standardization are examined.

Article

Prevention of Suicide  

Danuta Wasserman

Around 700,000 people take their lives each year worldwide. Suicide accounts for approximately 1.3% of all deaths and therefore represents a major public health problem. The global age-standardized suicide rate is 9 per 100,000 population, yet there are large variations among genders, ages, countries, and world regions. The stress–vulnerability model of suicidal behaviors has been proposed to explain how a diathesis, developed through the influence of genetic and neurodevelopmental factors in relation to perinatal, postnatal, and life experiences, interacts with different risk and protective factors that either decrease or enhance the individual’s level of resilience to stress and suicidal risk. Public health suicide prevention strategies include suicide means restriction, reducing harmful substance use, promoting responsible media reporting, public-awareness campaigns, gatekeeper trainings, school-based interventions, crisis helplines, and postvention. Mental health strategies comprise identification, treatment, and rehabilitation of persons in distress and at risk for suicide. Multicomponent strategies that use a combination of evidence-based methods from public and mental health sectors are recommended. Future work should aim at enhancing the quality of epidemiological data, improving the research on protective and ideation-to-action factors, expanding the quantity and quality of data coming from low- and middle-income countries, and evaluating the cost-effectiveness of different suicide prevention strategies.

Article

Suicide and Public Policy  

Janelle Stanley and Sarah Strole

The historical context of suicidal behavior and public policies addressing suicide arose simultaneously within the United States, and both reflect a culture of discrimination and economic disenfranchisement. Systems of oppression including anti-Black racism, restrictive immigration policy, displacement of American Indigenous communities, religious moralism, and the capitalist economic structure perpetuate high-risk categories of suicidality. Suicidal behavior, protective factors, and risk factors, including firearms, are examined in the context of twentieth and early twenty first century public policy. Recommendations for public policy will be discussed with consideration for policies that impact communities disproportionately and social work ethics, such as right to die laws and inconsistent standards of care.

Article

Health-Related Warning Message Processing  

Christopher B. Mayhorn and Michael S. Wogalter

Warnings are risk communication messages that can appear in a variety of situations within the healthcare context. Potential target audiences for warnings can be very diverse and may include health professionals such as physicians or nurses as well as members of the public. In general, warnings serve three distinct purposes. First, warnings are used to improve health and safety by reducing the likelihood of events that might result in personal injury, disease, death, or property damage. Second, they are used to communicate important safety-related information. In general, warnings likely to be effective should include a description of the hazard, instructions on how to avoid the hazard, and an indication of the severity of consequences that might occur as a result of not complying with the warning. Third, warnings are used to promote safe behavior and reduce unsafe behavior. Various regulatory agencies within the United States and around the globe may take an active role in determining the content and formatting of warnings. The Communication-Human Information Processing (C-HIP) model was developed to describe the processes involved in how people interact with warnings and other information. This framework employs the basic stages of a simple communication model such that a warning message is sent from one entity (source) through some channel(s) to another (receiver). Once warning information is delivered to the receiver, processing may be initiated, and if not impeded, will continue through several stages including attention switch, attention maintenance, comprehension and memory, beliefs and attitudes, and motivation, possibly ending in compliance behavior. Examples of health-related warnings are presented to illustrate concepts. Methods for developing and evaluating warnings such as heuristic evaluation, iterative design and testing, comprehension, and response times are described.

Article

Monitoring Migrants’ Health Risk Factors for Noncommunicable Diseases  

Stefano Campostrini

Noncommunicable diseases (NCDs) have become the first cause of morbidity and mortality around the world. These have been targeted by most governments because they are associated with well-known risk factors and modifiable behaviors. Migrants present, as any population subgroup, peculiarities with regard to NCDs and, more relevantly, need specific information on associated risk factors to appropriately target policies and interventions. The country of origin, assimilation process, and many other migrant health aspects well studied in the literature can be related to migrants’ health risk factors. In most countries, existing sources of information are not sufficient or should be revised, and new sources of data should be found. Existing survey systems can meet organizational difficulties in changing their questionnaires; moreover, the number of changes in the adopted questionnaire should be limited for the sake of brevity to avoid excessive burden on respondents. Nevertheless, a limited number of additional variables can offer a lot of information on migrant health. Migrant status, country of origin, time of arrival should be included in any survey concerned about migrant health. These, along with information on other Social Determinants of Health and access to health services, can offer fundamental information to better understand migrants’ health and its evolution as they live in their host countries. Migrants are often characterized by a better health status, in comparison with the native population, which typically is lost over the years. Public health and health promotion could have a relevant role in modifying, for the better, this evolution, but this action must be supported by timely and reliable information.

Article

Early Life Origins of ASD and ADHD  

Yuelong Ji, Ramkripa Raghavan, and Xiaobin Wang

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by impairments in social interaction and communication and by the presence of restrictive, repetitive behavior. Attention deficit hyperactivity disorder (ADHD) is another common lifelong neurodevelopmental disorder characterized by three major presentations: predominantly hyperactive/impulsive, predominantly inattentive, and combined. Although ASD and ADHD are different clinical diagnoses, they share various common characteristics, including male dominance, early childhood onset, links to prenatal and perinatal factors, common comorbidity for each other, and, often, persistence into adulthood. They also have both unique and shared risk factors, which originate in early life and have lifelong implications on the affected individuals and families and society. While genetic factors contribute to ASD and ADHD risk, the environmental contribution to ASD and ADHD has been recognized as having potentially equal importance, which raises the hope for early prevention and intervention. Maternal folate levels, maternal metabolic syndrome, and metabolic biomarkers have been associated with the risk of childhood ASD; while maternal high-density lipoprotein, maternal psychosocial stress, and in utero exposure to opioids have been associated with the risk of childhood ADHD. As for shared factors, male sex, preterm birth, placental pathology, and early life exposure to acetaminophen have been associated with both ASD and ADHD. The high rate of comorbidity of ASD and ADHD and their many shared early life risk factors suggest that early identification and intervention of common early life risk factors may be cost-effective to lower the risk of both conditions. Efforts to improve maternal preconception, prenatal, and perinatal health will not only help reduce adverse reproductive and birth outcomes but will also help mitigate the risk of ASD and ADHD associated with those adverse early life events.

Article

Fetal Deaths in High-Income Countries  

Sarka Lisonkova and K. S. Joseph

Fetal death refers to the death of a post-embryonic product of conception while in utero or during childbirth, and it is one of the most distressing events faced by women and families. Birth following spontaneous fetal death is termed “miscarriage” if it occurs early in gestation, and “stillbirth,” if it occurs beyond the point of viability. There are substantial between-country differences in the criteria used for reporting stillbirths and these differences compromise international comparisons of stillbirth rates. In high-income countries, a majority of fetal deaths occur due to genetic causes, fetal infection, or other pregnancy complications. Congenital anomalies, placental insufficiency, and/or intrauterine growth restriction are frequent antecedents of fetal death. Maternal risk factors include advanced maternal age, high body mass index, smoking and substance use during pregnancy, prior stillbirth, chronic morbidity, and multifetal pregnancy. Disparities in education and socioeconomic status and other factors influencing maternal health also contribute to elevated rates of stillbirth among vulnerable women.

Article

Drowning: Global Burden, Risk Factors, and Prevention Strategies  

Aminur Rahman, Amy E. Peden, Lamisa Ashraf, Daniel Ryan, Al-Amin Bhuiyan, and Stephen Beerman

Drowning has been described as a major global public health problem and has recently been acknowledged by a United Nations Declaration on Global Drowning Prevention. While drowning impacts countries of all income levels, the burden is overwhelmingly borne by low- and middle-income countries (LMICs) who account for 90% of the global death toll. In addition, there is scarce data collection on drowning in LMICs, so the magnitude of drowning may be far greater than is represented. A range of factors including sex, age, education, income, access to water, a lack of swimming skills, certain occupations like commercial fishing, geographically isolated and flood-prone locations, preexisting medical conditions, and unsafe water transport systems, influence the risk of drowning. Some behavioral factors, such as alcohol or drug consumption, not wearing life jackets, and engaging in risky behaviors such as swimming or boating alone, increase drowning risk. Geopolitical factors such as migration and armed conflict can also impact drowning risk. There is a growing body of evidence on drowning prevention strategies. These include pre-event interventions such as pool fencing, enhancing community education and awareness, providing swimming lessons, use of lifejackets, close supervision of children by adults, and boating regulations. Interventions to reduce harm from drowning include appropriate training for recognition of a drowning event, rescue, and resuscitation. An active and/or passive surveillance system for drowning, focusing on individual settings and targeting populations at risk, is required. Drowning requires coordinated multisectoral action to provide effective prevention, rescue, and treatment. Therefore, all countries should aim to develop a national water safety plan, as recommended in the WHO Global Report on Drowning. Further research is required on the epidemiology and treatment of drowning in LMICs as well as non-fatal and intentional drowning in both high-income countries (HICs) and LMICs. Effective and context-specific implementation of drowning prevention strategies, including pilot testing, scale up and evaluation, are likely to help reduce the burden of both fatal and non-fatal drowning in all countries.

Article

Gang Joining  

James A. Densley

This article examines the who, what, where, when, why, and how of gang joining. The question of what youth join when they join gangs speaks to the contested nature of gang definitions and types and the consequences of gang membership, specifically heightened levels of offending and victimization. The type of gang and the obligations of membership influence the joining process. Where youth join gangs, namely, the neighborhood and social context, also impacts individual opportunities and preferences for joining. When youth join gangs is considered in a developmental sense, to include both adolescent and adult onset, in order to account for continuity and change in individual levels of immersion or “embeddedness” in gangs across the life course. Who joins gangs provides a profile of gang membership grounded in the well-documented risk factors for gang membership, but limited by problems of prediction. Why youth join gangs speaks to the push and pull factors for membership, the appeal of gangs, and the selective incentives they offer. Still, motivations for gang membership cannot fully explain selection into gangs, nor can general theories of crime that do not necessarily fit with general knowledge of gangs. How youth join gangs, for example, is more complicated than initiation rites. The mechanisms underlying the selection process can be understood through the lens of signaling theory, with implications for practice.