BOX S-4Recommendations: Continuing a Course of Rigorous Research

Overall

• Research funders* should fund preventive intervention research on (1) risk and protective factors for specific disorders; (2) risk and protective factors that lead to multiple mental, emotional, and behavioral problems and disorders; and (3) promotion of individual, family, school, and community competencies. (4-3)
• Research funders should invest in studies that (1) aim to replicate findings from earlier trials, (2) evaluate long-term outcomes of preventive interventions across multiple outcomes (e.g., disorders, academic outcomes), and (3) test the extent to which each prevention program is effective in different race, ethnic, gender, and developmental groups. (10-1)
• The National Institutes of Health and other federal agencies should increase funding for research on prevention and promotion strategies that reduce multiple MEB disorders and that strengthen accomplishment of age-appropriate developmental tasks. High priority should be given to increasing collaboration and joint funding across institutes and across federal agencies that are responsible for separate but developmentally related outcomes (e.g., mental health, substance use, school success, contact with justice). (12-5)
• Research funders should strongly support research to improve the effectiveness of current interventions and the creation of new, more effective interventions with the goal of wide-scale implementation of these interventions. (7-2)

Screening Linked to Interventions

• Research funders should support a rigorous research agenda to develop and test community-based partnership models involving systems such as education (including preschool), primary care, and behavioral health to screen for risks and early mental, emotional, and behavioral problems and assess implementation of evidence-based preventive responses to identified needs. (8-1)

Implementation

• The National Institutes of Health should be charged with developing methodologies to address major gaps in current prevention science approaches, including the study of dissemination and implementation of successful interventions. (10-2)
• Research funders should fund research and evaluation on (1) dissemination strategies designed to identify effective approaches to implementation of evidence-based programs, (2) the effectiveness of programs when implemented by communities, and (3) identification of core elements of evidence-based programs, dissemination, and institutionalization strategies that might facilitate implementation. (11-1)
• Research funders should fund research on state- or community-wide implementation of interventions to promote mental, emotional, or behavioral health or prevent MEB disorders that meet established scientific standards of effectiveness. (11-2)

Adaptation

• Research funders should prioritize the evaluation and implementation of programs to promote mental, emotional, or behavioral health or prevent MEB disorders in ethnic minority communities. Priorities should include the testing and adoption of culturally appropriate adaptations of evidence-based interventions developed in one culture to determine if they work in other cultures and encouragement of adoption when they do. (11-3)

Neuroscience Linkages

• Research funders, led by the National Institutes of Health, should dedicate more resources to formulating and testing hypotheses of the effects of genetic, environmental, and epigenetic influences on brain development across the developmental span of childhood, with a special focus on pregnancy, infancy, and early childhood. (5-1)
• The National Institutes of Health should lead efforts to study the feasibility and ethics of using individually identified genetic and other neurobiological risk factors to target preventive interventions for MEB disorders. (5-4)
• Research funders, led by the National Institutes of Health, should dedicate resources to support collaborations between prevention scientists and basic and clinical developmental neuroscientists. Such collaborations should include both basic science approaches and evaluations of the effects of prevention trials on neurobiological outcomes, as well as the use of animal models to identify and test causal mechanisms and theories of pathogenesis. (5-2)
• Research funders, led by the National Institutes of Health, should fund research consortia to develop multidisciplinary teams with expertise in developmental neuroscience, developmental psychopathology, and preventive intervention science to foster translational research studies leading to more effective prevention efforts. (5-3)

Economic Analyses

• The National Institutes of Health, in consultation with government agencies, private-sector organizations, and key researchers, should develop outcome measures and guidelines for economic analyses of prevention and promotion interventions. The guidelines should be widely disseminated to relevant government agencies and foundations and to prevention researchers. (9-1).
• Funders of intervention research should incorporate guidelines and measures related to economic analysis in their program announcements and provide supplemental funding for projects that include economic analyses. Once available, supplemental funding should also be provided for projects with protocols that incorporate recommended outcome measures. (9-2)

Competencies

• Research funders, led by the National Institutes of Health, should increase funding for research on the etiology and development of competencies and healthy functioning of young people, as well as how healthy functioning protects against the development of MEB disorders. (4-1)
• The National Institutes of Health should develop measures of developmental competencies and positive mental health across developmental stages that are comparable to measures used for MEB disorders. These measures should be developed in consultation with leading research and other key stakeholders and routinely used in mental health promotion intervention studies. (4-2)

Technology

• Research funders should support research on the effectiveness of mass media and Internet interventions, including approaches to reducing stigma. (7-3)

Other Research Gaps

• Research funders should address significant research gaps, such as preventive interventions with adolescents and young adults, in certain high-risk groups (e.g., children with chronic diseases, children in foster care), and in primary care settings; interventions to address poverty; approaches that combine interventions at multiple developmental phases; and approaches that integrate individual, family, school, and community-level interventions. (7-4)