Abstract:

Prevention programs are often initiated in response to large-scale public health problems. While the long-term goals and broader objectives of these programs are important, evaluation can prove challenging unless clearly defined mechanisms, or putative mediators, have been identified. This is particularly true when evaluating family-based programs targeting outcomes among children and adolescents. Drawing on the field of prevention science, Dr. Deardorff will discuss how prevention programs are often based on a theory of change that identifies the specific variables that mediate program effects on problem outcomes (Tein et al., 2004). The “small theory” of the program (Lipsey et al., 1990) describes the program-induced change on a proximal, measurable, and modifiable set of variables (e.g., consistent discipline, family cohesion) that in turn leads to change in the targeted outcome (e.g., child behavior problems).  By evaluating this process, we can document with greater assurance that the prevention program led to positive changes in the proximal and distal variables of interest. In addition, the advantages of one analytic method, structural equation modeling (SEM), to evaluate prevention programs will be discussed. SEM can be a powerful tool for assessing not only how a program works but also for whom it works.