embry saving-california-keynote-oct 2010

Saving America, Saving California, Saving Our FuturesEvidenced-Based Kernels for Population-Level Prevent Rapid Results

by Dennis D. Embry, Ph.D.

PAXIS Institute

October 12, 2010

Copyright © 2010, PAXIS Institute, All rights reserved. May be shared in its entirety with notice and attribution.

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1Monday, October 18, 2010

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Our hopes for our children, our grandchildren or our

children of choice…Text your hope to: 22333

“110310…your hope…”


What will you get to protect this baby’s future when it goes home from hospital?


What will you get to protect your child when they get their first bike?


Preventing mental, emotional and disorders in our children…


Protect your child from growing up to have a major mental illness?


Protect your child from growing up to have a major addiction?


Mental, emotional and behavioral disorders are preventable by our

own hands.


Disturbing, disruptive and aggressive behaviors have been increasing in the United States for more than 20 years.

The United States has more of these problems than many other rich countries.

2009:Institute of Medicine Report


Nearly 75 percent of the nation's 17- to 24-year-olds are ineligible for service

• Medical/physical problems, 35 percent.

• Illegal drug use, 18 percent.

• Mental Category V (the lowest 10 percent of the population), 9 percent.

• Too many dependents under age 18, 6 percent.

• Criminal record, 5 percent.

Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd


http://www.missionreadiness.org/PAEE0609.pd


Nearly 75 percent of the nation's 17- to 24-year-olds are ineligible for service

• Medical/physical problems, 35 percent.

• Illegal drug use, 18 percent.

• Mental Category V (the lowest 10 percent of the population), 9 percent.

• Too many dependents under age 18, 6 percent.

• Criminal record, 5 percent.

Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd




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Two to three times as many American children are being prescribed psychiatric drugs…


American children are less healthy than the children in 21 other rich countries


Are America’s economy, safety and future secure when our children are unhealthy in body, mind and behavior?


American children and youth will have a shorter lifespan than current adults

Youthanasia


What can we do to change the present & futures of our children?


Rapid


If we just hit the problem harder…


Embry, D. D., & Biglan, A. (2008). Evidence-Based Kernels:

Fundamental Units of Behavioral Influence. Clinical Child & Family

Psychology Review, 39.

Download at:

FREE DOWNLOAD

www.pubmed.gov


http://www.pubmed.gov

http://www.pubmed.gov

Is the smallest unit of scientifically proven behavioral influence.

• Is indivisible; that is, removing any part makes it inactive.

Produces quick easily measured change that can grow much bigger change over time.

Can be be used alone OR combined with other kernels to create new programs, strategies or policies.

• Are the active ingredients of evidence-based programs

• Can be spread by word-of-mouth, by modeling, by non professionals.

• Can address historic disparities without stigma, in part because they are also found in cultural wisdom.

What is a kernel?


Four Types of Kernels

AntecedentKernel

ReinforcementKernel

Relational FrameKernel

PhysiologicalKernel

Happens BEFORE the behavior

Happens AFTER the behavior

Creates verbal relations for the

behavior

Changes biochemistry of

behavior

Embry, D. D., & Biglan, A. (2008). Evidence-Based

Kernels: Fundamental Units of Behavioral Influence. Clinical Child & Family

Psychology Review, 39.


What is a behavioral vaccine?It is a simple procedure (a kernel or a recipe of kernels) that, when used repeatedly, reduce morbidity and mortality and/or increase wellbeing or health.

Behavioral vaccines can be used by individuals, families, schools, businesses, organizations to produce rapid population level change.

Embry, D. D. (2004). "Community-Based Prevention Using Simple, Low-Cost, Evidence-Based Kernels and Behavior Vaccines." Journal of Community Psychology 32(5): 575.


If kernels are so good…


Publication:Prinz, Sanders, Shapiro, Lutzker & Whitaker (2009). Population-based prevention of child maltreatment: The U.S. Triple P System Population Trial. Volume 10, March Issue, Prevention Science.http://www.springerlink.com/content/104965/

Funded by the US Centers for Disease Control, Grant # U17/CCU42231 to Dr. Ron Priinz, and Dr.Matt Sanders


http://www.springerlink.com/content/104965/

http://www.springerlink.com/content/104965/

Why not launch a marketing campaign to get families to use Triple P when in two years…


10

12

13

15

16

Rat

es p

er 1

,000

Chi

ldre

n (0

-8 Y

ears

)

Substantiated Child Maltreatment

Control Counties

Triple P Counties

Pre Post

Prinz et al., 2009, Prevention Science


Child Abuse Hospital Injuries

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1.43

1.55

1.68

1.80

Rat

es p

er 1

,000

Chi

ldre

n (0

-8 Y

ears

)

Control Counties

Triple P Counties

Pre PostPrinz et al., 2009, Prevention Science


Child Out-of-Home Placements

3.00

3.38

3.75

4.13

4.50

Rat

es p

er 1

,000

Chi

ldre

n (0

-8 Y

ears

) Control Counties

Triple P Counties

Pre Post

Prinz et al., 2009, Prevention Science


Triple P: Global dissemination from 1996 onwards…

Australia

New Zealand

Canada

Ireland

Scotland

England

Wales

Iran

Curacao

Germany

The Netherlands

Belgium

Switzerland

Sweden

Singapore

Japan

Hong Kong

Austria

Romania

Watch this space......

France

Portugal

Turkey

Qatar

Chile


Why not turn about the lives of high risk primary grade children using a teacher kernel recipe?

Muriel Saunders,the teacher


Antecedent kernel

Soft Team Competition

Beat the Timer

Group Alerts/Response

Cost

Reinforcement kernel

Mystery Motivator

Reinforcement kernelAntecedent

Kernel

Antecedent kernel


Her invention immediately increases time to learn


Why not turn about the lives of high risk primary grade children using a teacher invented procedure?


Increase in high-school entry

Increase in college entry

Reduced special education service needs

Lifetime reduction of tobacco use by 25% to 50%

Lifetime reduction of psychiatric diagnoses

Lifetime reduction of antisocial behavior and arrests

Lifetime reduction in all serious addictions

Lifetime reduction in suicidal actions

Long-term GBG outcomes from inoculation in just first grade


5 out 9,000 schools = 0.05% of California schools


Inukshuk points the right way…

PhysiologicalKernel


PhysiologicalKernel


Reduce Omega 3 Brain Deficiency


0

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0.50

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1.00

Before supplementation During supplementation

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io o

f D

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ary

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den

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enta

tio

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Reduced Felony Violent Offences Among Prisoners with recommended daily amounts of vitamins, minerals and essen=al fa>y acids

UK maximum security prison -‐ 338 offences among 172 prisoners over 9 months treatment in a compared to 9 months baseline.

Gesch et al. Br J Psychiatry 2002, 181:22-‐28

Ac=ve -‐37.0% p ‹ 0.005

Placebo -‐10.1% p = ns


Why not reproduce the rapid results in America and California to get a 37% reduction in jail violence?It cost the Brits 19¢ per day or $69.35 per year.


0

Time to First Suicide AIempt (days)

0

200 400 600 800

Survival Probability

0.2

0.4

0.6

0.8

1.0

High DHA (n=16)

Low DHA (n=17)

(median split of plasma phospholipid % faIy acids)

InpatientDischarge

Suble>e, Hibbeln et al Am J Psychiatry 2006;163: 1100-‐1102


Why not help our high risk children with omega-3?

0%

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12%

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Per

cent

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with

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Amminger, G. P., M. R. Schafer, et al. (2010). "Long-Chain {omega}-3 Fatty Acids for Indicated Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." Arch Gen Psychiatry 67(2): 146-154.


Why not have invite families to promise clear rules about alcohol, tobacco & drugs if…It produces a 23% reduction binge drinking and 27% reduction delinquency rates among 7th graders in 2 years and this has been adopted nationally by Sweden and being adopted by the State of Tennessee and Manitoba?

Koutakis, N., H. Stattin, et al. (2008). "Reducing youth alcohol drinking through a parent-targeted intervention: the Orebro Prevention Program." Addiction 103(10): 1629-1637.

PS. Effect sizes were 0.35 for drunkenness and 0.38 for delinquency.




“Behavioral health could learn from public health in endorsing a population health perspective”—(IOM, page 19).

“Families and children have ready access to the best available evidence-based prevention interventions, delivered in their own communities…in a respectful non-stigmatizing way”—(IOM, page 387).

The story of the Broad Street water pump during the cholera epidemic in

London.


A public health model versus rationing model of prevention…


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Who will stand with me for saving all the children of California and America

for all our futures?

Thank you…Dennis D. Embry, [email protected] • simplegifts.com

slides show & documents atwww.slideshare.net/drdennnisembry


mailto:[email protected]












embry saving-california-keynote-oct 2010

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