and Behavioral Health Forum on Promoting Children's Cognitive, Affective – författare

Over the last three decades, researchers have made remarkable progress in creating and testing family-focused programs aimed at fostering the cognitive, affective, and behavioral health of children. These programs include universal interventions, such as those for expecting or new parents, and workshops for families whose children are entering adolescence, as well as programs targeted to especially challenged parents, such as low-income single teens about to have their first babies, or the parents of children with autism. Some family-focused programs have been shown to foster significantly better outcomes in children, including enhanced educational performance, and reduced rates of teen pregnancy, substance abuse, and child conduct and delinquency, as well as reduced child abuse. The favorable cost-benefit ratios of some of these programs are due, in part, to the multiple and far-ranging effects that family-focused prevention programs targeting children can have. Other family-focused programs have shown success in smaller academic studies but have not been widely applied, or have not worked as effectively or failed when applied to more diverse real-world settings.

Strategies for Scaling Effective Family-Focused Preventive Interventions to Promote Children''s Cognitive, Affective, and Behavioral Health is the summary of a workshop convened by the Institute of Medicine Forum on Promoting Children''s Cognitive, Affective, and Behavioral Health to explore effective preventive interventions for youth that can modify risk and promote protective factors that are linked to mental, emotional, and behavioral health, and how to apply this existing knowledge. Based on the 2009 report Preventing Mental, Emotional, and Behavioral Disorders Among Young People, this report considers how to build a stronger research and practice base around the development and implementation of programs, practices, and policies that foster children''s health and well-being across the country, while engaging multi-sectorial stakeholders. While research has advanced understanding of risk, promotive, and protective factors in families that influence the health and well-being of youth, a challenge remains to provide family-focused interventions across child and adolescent development at sufficient scale and reach to significantly reduce the incidence and prevalence of negative cognitive, affective, and behavioral outcomes in children and adolescents nationwide, as well as to develop widespread demand for effective programs by end users. This report explores new and innovative ways to broaden the reach and demand for effective programs and to generate alternative paradigms for strengthening families.

Over the past few decades there have been major successes in creating evidence-based interventions to improve the cognitive, affective, and behavioral health of children. Many of these interventions have been put into practice at the local, state, or national level. To reap what has been learned from such implementation, and to explore how new legislation and policies as well as advances in technology and analytical methods can help drive future implementation, the Institute of Medicine-National Research Council Forum on Promoting Children''s Cognitive, Affective, and Behavioral Health held the workshop "Harvesting the Scientific Investment in Prevention Science to Promote Children''s Cognitive, Affective, and Behavioral Health" in Washington, DC, on June 16 and 17, 2014.

The workshop featured panel discussions of system-level levers and blockages to the broad implementation of interventions with fidelity, focusing on policy, finance, and method science; the role of scientific norms, implementation strategies, and practices in care quality and outcomes at the national, state, and local levels; and new methodological directions. The workshop also featured keynote presentations on the role of economics and policy in scaling interventions for children''s behavioral health, and making better use of evidence to design informed and more efficient children''s mental health systems. Harvesting the Scientific Investment in Prevention Science to Promote Children''s Cognitive, Affective, and Behavioral Health summarizes the presentations and discussion of the workshop.

Many measurement systems to monitor the well-being of children and guide services are implemented across the community, state, and national levels in the United States. While great progress has been made in recent years in developing interventions that have been shown to improve the cognitive, affective, and behavioral health of children, many of these tested and effective interventions have yet to be widely implemented. One potential reason for this lag in implementation is a need to further develop and better utilize measures that gauge the success of evidence-based programs as part of a broad effort to prevent negative outcomes and foster children''s health and well-being.

To address this issue, the Institute of Medicine Forum on Promoting Children''s Cognitive, Affective, and Behavioral Health held a workshop in Washington, DC, on November 5-6, 2014. The workshop featured presentations on the use of data linkage and integration to inform research and practice related to children''s cognitive, affective, and behavioral health; the use of quality measures to facilitate system change in health care, classroom, and juvenile justice settings; and tools developed to measure implementation of evidence-based prevention programs at scale to support sustainable program delivery, among other topics. Workshop presenters and participants discussed examples of innovative design and utilization of measurement systems, new approaches to build on existing data systems, and new data systems that could support the cognitive, affective, and behavioral health and well-being of children. This report summarizes the presentation and discussions of the event.

The Patient Protection and Affordable Care Act (ACA), which was signed into law in 2010, has several provisions that could greatly improve the behavioral health of children and adolescents in the United States. It requires that many insurance plans cover mental health and substance use disorder services, rehabilitative services to help support people with behavioral health challenges, and preventive services like behavioral assessments for children and depression screening for adults. These and other provisions provide an opportunity to confront the many behavioral health challenges facing youth in America.

To explore how the ACA and other aspects of health care reform can support innovations to improve children''s behavioral health and sustain those innovations over time, the Forum on Promoting Children''s Cognitive, Affective, and Behavioral Health held a workshop on April 1-2, 2015. The workshop explicitly addressed the behavioral health needs of all children, including those with special health needs. It also took a two-generation approach, looking at the programs and services that support not only children but also parents and families. This report summarizes the presentations and discussions of this workshop.

Children with disabilities and complex medical and educational needs present a special challenge for policy makers and practitioners. These children exhibit tremendous heterogeneity in their conditions and needs, requiring a varied array of services to meet those needs. Uneven public and professional awareness of their conditions and a research base marked by significant gaps have led to programs, practices, and policies that are inconsistent in quality and coverage. Parents often have to navigate and coordinate, largely on their own, a variety of social, medical, and educational support services, adding to the already daunting financial, logistical, and emotional challenges of raising children with special needs. The unmet needs of children with disabilities and complex medical and educational needs can cause great suffering for these children and for those who love and care for them.

To examine how systems can be configured to meet the needs of children and families as they struggle with disabilities and complex health and educational needs, the National Academies of Sciences, Engineering, and Medicine held a workshop in December 2015. The goal of the workshop was to highlight the main barriers and promising solutions for improving care and outcome of children with complex medical and educational needs. Workshop participants examined prevention, care, service coordination, and other topics relevant to children with disabilities and complex health and educational needs, along with their families and caregivers. More broadly, the workshop seeks actionable understanding on key research questions for enhancing the evidence base; promoting and sustaining the quality, accessibility, and use of relevant programs and services; and informing relevant policy development and implementation. By engaging in dialogue to connect the prevention, treatment, and implementation sciences with settings where children are seen and cared for, the forum seeks to improve the lives of children by improving the systems that affect those children and their families. This publications summarizes the presentations and discussions from the workshop.

Communities provide the context in which programs, principles, and policies are implemented. Their needs dictate the kinds of programs that community organizers and advocates, program developers and implementers, and researchers will bring to bear on a problem. Their characteristics help determine whether a program will succeed or fail. The detailed workings of programs cannot be separated from the communities in which they are embedded.

Communities also represent the front line in addressing many behavioral health conditions experienced by children, adolescents, young adults, and their families. Given the importance of communities in shaping the health and well being of young people, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016, to examine the implementation of evidence- based prevention by communities. Participants examined questions related to scaling up, managing, and sustaining science in communities. This publication summarizes the presentations and discussions from the workshop.

Increasing numbers of evidence-based interventions have proven effective in preventing and treating behavioral disorders in children. However, the adoption of these interventions in the health care system and other systems that affect the lives of children has been slow. Moreover, with few exceptions, current training in many fields that involve the behavioral health of children falls short of meeting the needs that exist. In general, this training fails to recognize that behavioral health disorders are among the largest challenges in child health and that changing cognitive, affective, and behavioral health outcomes for children will require new and more integrated forms of care at a population level in the United States.

To examine the need for workforce development across the range of health care professions working with children and families, as well as to identify innovative training models and levers to enhance training, the Forum on Promoting Children''s Cognitive, Affective, and Behavioral Health held a workshop in November 2016. Workshop panelists and participants discussed the needs for workforce development across the range of health care professions working with children, youth, and families, and identified innovative training models and levers for change to enhance training. This publication summarizes the presentations and discussions from the workshop.