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Mental Health

Prevention Research

Center for Prevention and Early Intervention

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Center for the Prevention of Youth Violence

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The prevention area within the Department of Mental Health includes researchers from multiple disciplines and collaborations with several other Departments and Schools at Johns Hopkins who are focused on examining issues related to the prevention of mental health problems, substance abuse, and behavioral problems across the life course. Researchers in this area are involved in developing, fielding, testing, refining, training, advocating, and bringing to scale prevention programs directed at a range of mental health and behavioral problems affecting children, adolescents, adults and the elderly.

Faculty and students, in partnership with community stakeholders, are engaged in a series of interrelated projects that address all levels of the prevention continuum, including mental health promotion, universal, selective, and indicated prevention programs, and prevention in populations with already existing problems or co-morbid conditions. These activities aim to reduce the incidence and prevalence of mental and behavioral disorders among children, youth, and adults through the implementation of prevention programs in a variety of ecological contexts, including peers, schools, families, workplaces, and communities. Prevention research activities in the department include the prevention of violence, child sexual abuse, substance abuse problems, aggressive-disruptive behavior problems, anxiety, depression, age-related cognitive impairment, and Alzheimer’s disease, as well as the promotion of positive parenting and individual behaviors and increasing resiliency.

One common element of many of these initiatives is the application of epidemiologic findings to the development of novel prevention programs, enhancements to existing programs, adaptations of programs to ensure fit with cultural, developmental, and contextual factors, and the integration of different programs. There is a particular interest in bridging efficacy and effectiveness research to aid the implementation of preventive interventions in populations. Several faculty have expertise in the design, conduct, and analysis of group-randomized trials and the collaboration with service providers, educational systems, and community-based organizations.

A second area in prevention research focuses on the development and application of different methodological approaches to examine the impacts of prevention programs and to determine for whom and under what circumstances prevention programs are most effective. An area of particular interest is methods useful in the extrapolation of data to populations for estimating return on investment. Studies also are conducted to determine the economic impact of preventive interventions and examine genetic modifiers of program outcomes.

A third area of prevention research focuses on Type II translational research.  The National Institutes of Health has defined Type II translational research as research aimed at enhancing the adoption, implementation, and sustainability of evidence-based or scientifically-validated interventions by service systems (e.g., health care settings, community-based organizations, schools). There is a related interest in the impact of policies on prevention programming and the adoption of evidence-based programs.

Three research centers support prevention research projects: the Johns Hopkins Center for Prevention and Early Intervention, funded by the National Institute of Mental Health (NIMH) and the National Institute of Drug Abuse (NIDA), the Johns Hopkins Center for the Prevention of Youth Violence, funded by the Centers for Disease Control and Prevention (CDC), and the Moore Center for the Prevention of Child Sexual Abuse, which is funded by the Stephen and Julia Moore family.

The Johns Hopkins Center for Prevention and Early Intervention is a collaborative effort between the JHU Bloomberg School of Public Health and our community partners in prevention and early intervention (the Baltimore City Public Schools System, Family League of Baltimore City, Baltimore Mental Health Systems, and the Maryland State Department of Education), and prevention and early intervention researchers at Morgan State University, Pennsylvania State University, the University of California at Los Angeles, the University of Alabama, Columbia University, and Stanford University. The Center is supported by the National Institutes of Mental Health and Drug Abuse. The mission of the Center is (1) to improve school-based preventive and early treatment interventions for children and adolescents by bridging epidemiologic, intervention, services, and dissemination and training research through the development of a research structure and research strategies capable of evaluating the effectiveness and sustainability of promising and evidence-based interventions; (2) to identify factors that inhibit or facilitate improved prevention and treatment practices and outcomes; (3) to disseminate the knowledge gained in order to improve prevention and treatment research and dissemination and training practices; and (4) to develop within our collaborating community partners the capacity to carry out and disseminate state of the art prevention and early intervention research and evaluations.

The Johns Hopkins Center for the Prevention of Youth Violence is funded by the Centers for Disease Control and Prevention (CDC). The goals of the Center are to (1) create and sustain an administrative infrastructure to support implementation and evaluation activities; (2) create, implement, and evaluate a multifaceted, evidence-based approach to youth violence prevention in a high-risk Baltimore community; and (3) integrate training activities for early career researchers, educators, practitioners, community residents, and youth in youth violence prevention to complement the implementation and evaluation activities of the Johns Hopkins Center for the Prevention of Youth Violence. The Center was created with a five-year grant from the CDC in 2000 as an Academic Research Center of Excellence. The Johns Hopkins Center for the Prevention of Youth Violence is one of ten Academic Centers of Excellence. The Center aims to prevent youth violence and promote positive youth development in Baltimore City by creating academic-community collaborations that extend, evaluate and improve efforts to: (1) monitor and detect fatal and non-fatal youth violence; (2) conduct research aimed at identifying malleable factors related to youth violence and research on interventions that reduce youth violence and associated morbidity and mortality; and (3) create policies and practices that prevent youth violence. The Center collaborates with a coalition of researchers, faculty, students and staff from Baltimore-based academic centers and partners, state and local officials, collaborators from Baltimore and Maryland-based agencies and organizations, as well as parents, local residents, and youth.

The Moore Center for the Prevention of Child Sexual Abuse is funded by the Stephen and Julia Moore family.  The goals of the Moore Center are to bring public health expertise and perspectives to the complex policy issues related to the prevention of CSA by engaging in policy analysis, original scholarly research, and agenda-setting public discourse.  We will do so by (1) supporting and conducting interdisciplinary research through collaboration with experts in a variety of fields; (2) educating and training students and professionals through postdoctoral fellowships, graduate courses and curricula; (3) communicating projects and activities to a wide range of internal and external stakeholders; (4) serving as a source of objective, evidence-based information for policy and press activities; and (5) partnering with organizations that complement the Center’s resources and expertise in order to improve our national response to the problem of CSA and particularly to develop a strong prevention orientation and capacity.

Translational Research Program in Disaster Mental Health Department research initiatives have included the development and validation of a systems-based approach for enhancing the capacity of public mental health emergency planning and response.  Conducted within the framework of the Johns Hopkins Center for Public Health Preparedness, and supported by the Maryland Department of Health and Mental Hygiene and the CDC, a series of  research projects enabled us to develop a collaborative model for fostering community disaster preparedness. The approach involves faith-based organizations working with local health departments and supported by academic health centers.  Participants receive two interventions: training in psychological first aid (PFA) and guidance in the development of community disaster plans.  PFA training is intended to both extend mental health response capacity and motivate participation in subsequent congregational and jurisdictional planning.  CDC is funding us to promote national uptake of our research findings and products by leveraging the use of technology and innovation.  Specifically, we are seeking to (1) operationalize and disseminate our field-tested disaster planning tools and products; 2) refine our planning template to identify resources for at-risk populations with mental and behavioral health needs during disasters; (3) create, pilot, and evaluate an online version of our disaster planning template; (4) roll out the final, vetted version of the online planning approach for use by organizations throughout the country; and (5) disseminate to the national network of CDC-supported Public and Emergency Response Learning Centers (PERLCs) PFA Competency Set 1.0. Department faculty led the development of PFA Competency Set 1.0, the first consensus-derived, empirically-supported, competency-based model of psychological first aid training [in press with the American Journal of Public Health].

Looking Ahead

There are several potential areas for future research, including the development and application of innovative statistical methods to prevention research; the investigation of genetic factors as potential moderators of prevention program impacts; the exploration of neurocognitive and neurophysiological factors as both effect modifiers and outcomes of prevention programs; an expanded focus on implementation research, including coaching supports and measurement of implementation quality; models to support the scale-up of evidence-based prevention programs; and the role of policy in supporting high quality implementation of research-based programs.