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The remarks that came out of our work group are summarized in seven points that fit nicely with themes that have been articulated this morning. These points are not listed in order of priorities, but in order of how and when they came up in the conversation.
First, there is a desire and a need for behavioral engineers to help translate and adapt current prevention models to the many diverse potential prevention venues. The real challenge presented in our group was whether the building blocks derived from what I am going to term the "prototype models" that we have built over the last decade can be extended to all segments and settings of those in need of prevention activities.
Second, we need to determine if other viable models exist. That is, are there important approaches that have evolved from a grassroots community level that could be viable in dealing with the vast prevention needs in the country? We need to characterize and evaluate these; there was a need on the part of the people who were developing these grassroots models to have them evaluated and characterized.
It also came out of our discussion that we may have to adapt the evaluation paradigms that we currently use to try to capture these models and test their viability in a way that we are not currently equipped to do. This may require new evaluation tools to give these new models a fair test and evaluation.
Point number three speaks directly to an issue that Mr. Copple raised this morning. There is an apparent gap in communication between the prototype model developers and all levels of consumers, whether they be communities, States, or local organizations. There is a need to somehow close this communication gap to bring us together. I thought that the remarks of Dr. Johnson this morning were on point with regard to that issue. There appears to be an evolving national network that would permit a catalysis of this clo-sing of the gap among the various segments of prevention-concerned communities. It will be interesting to see whether there is a way we can catalyze the closing of this gap through NIDA and other organizations and individuals that are sponsors and participants in this conference.
The fourth point is a perceived need for greater organization, coordination, and assistance in interpretation of the data provided by diverse information sources, particularly about the nature and extent of risk and protective factors, the nature of the problems, and the nature of the solutions and their applicability across the broad venues in which prevention programs occur. This includes a dissemination of evaluation results, and I think this is right on target with what you have asked for in your remarks to us.
Fifth, there is a need to develop an ongoing process, possibly [a new] organization or utilizing established organizations, to directly link research and researchers to potential consumers at all levels - local units, community alliances, school-based programs, concerned politicians, and others. Again, we need some way to catalyze this process of communication. It seems that the building blocks are all in place. They are all rubbing up against each other, but the neural growth has not occurred yet.
Sixth, there is a need to provide systematic technical assistance to extend prevention evaluation - not just prevention programs but prevention evaluations - to all venues in which prevention programs occur. A point was made, likely a valid point, that many local programs have short-term funding and that it is almost impossible within the confines of such funding to get a program up and functioning, let alone to conduct a meaningful evaluation. There is a real need perceived by the individuals conducting the program - not the scientists, not the evaluators, but people conducting the program - for a way to evaluate and demonstrate the efficacy or, candidly, the inadequacy, of the programs that were delivered, so that the programs can be improved and disseminated at the local level.
The seventh and last point on which the group had some consensus was the need to better specify the distinctions within risk factor models, particularly the need to characterize protective and resilience factors and processes. We need to better specify what these factors are and to provide a clear understanding of them for the individuals who have to make use of these factors. This includes the differences between markers and mediators and how they work as processes, with particular emphasis on identifying the nature of the resilience process. This also ties in with some of Dr. Leshner's remarks about the need to emphasize protection and what things may inoculate communities or individuals or settings.
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