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A number of conclusions can be drawn about the state of evidence on the effectiveness of prevention and intervention programs to reduce serious offending in early adulthood. First, there are some promising signs that early prevention programs can produce lasting effects on offending and other important life-course outcomes into the early adult years. At the individual level, preschool intellectual enrichment programs look to be especially effective. At the school level, multi-component programs emphasizing classroom behavior management seem to be promising. Second, there are some promising signs that family-based interventions for adjudicated delinquents that operate outside of the juvenile justice system can reduce offending in early adulthood. These include multisystemic therapy and multidimensional treatment foster care. Third, the available evidence about intervention modalities used with both juvenile and adult offenders indicates that their effects are substantially similar. This generality across the major age divide in juvenile and criminal justice implies that such programs should be effective with young adult offenders as well. Fourth, there are a number of evidence-based programs for juvenile and young adult offenders that can produce monetary benefits that exceed costs. Gaps in knowledge and priorities for research are also discussed.

This chapter describes the Communities That Care (CTC) program using examples from 12 communities implementing CTC as part of an efficacy trial. CTC is a community-based strategy that empowers members of a diverse and broad-based coalition to plan, implement and monitor prevention activities intended to promote positive youth development. CTC implementation involves six structured training workshops provided over 6-12 months and the collection of epidemiologic data including an anonymous, school-wide survey of students. When implemented community-wide, the survey allows coalition members to identify the most elevated risk factors and depressed protective factors experienced by youth. The coalition then selects evidence-based prevention policies and programs that target these factors in the major settings affecting young people: schools, families, community service organizations, and the community itself. Communities monitor program implementation and periodically re-administer the youth survey in order to gauge the effectiveness of their efforts.

Implementation is the process of establishing an existing evidence-based prevention program or preventive intervention in a school, family, or community setting. We discuss critical issues in implementing evidence-based prevention programs. Key implementation concepts and principles are defined. Organizational strategies to increase capacity for the implementation of evidence-base programs are discussed. Approaches to monitoring implementation are reviewed. The chapter concludes with a discussion of the challenges associated with implementing effective prevention programs in schools, families, neighborhoods, and communities.

Significant advances in the practice and science of prevention have been made in the last several decades. In the past 25 years, practitioners, policymakers, and researchers across the globe have adopted principles of risk, protection, and public health to guide program design and implementation. Findings from efficacy and effectiveness trials indicate that a number of school, family-, and community-based programs have produced positive effects in reducing or delaying the onset of child and adolescent problems. Characteristics of evidence-based programs have been identified, described, and disseminated to practitioners and policymakers. Finally, cutting-edge issues of program fidelity and adaptation are being tackled in new and systematic ways.Evidence pertaining to the effectiveness of school, family, and community prevention programs for children and adolescents is summarized. Practice, policy, and education challenges facing the prevention field are identified and recommendations for advancing prevention in schools, families, neighborhoods, and communities are delineated.

Evaluation is an essential part of evidence-based programs and policies. It can 1) allow for midcourse corrections and changes, 2) help determine if the program or policy has been effective, and 3) provide information for planning the next program or policy. This chapter reviews some of the key issues to consider in conducting an evaluation and provides linkages to a diverse literature (within and outside public health) for those wishing to go beyond these basics.

This chapter examines the importance of evidence-based policies and rehabilitative programs. Research shows that adjudicating juveniles in criminal courts and imposing adult sentences produces counter-rehabilitative and nondeterrent effects, as documented in two recent comprehensive reports promulgated by the Centers for Disease Control and Prevention and the U.S. Department of Justice. Given the clear scientific evidence and the costs to society as well as to offenders of overly punitive responses to juvenile crime, people have the responsibility to persuade the public and policy makers that available evidence-based preventive and rehabilitative programs are effective, worth the cost, and compatible with reasoned and measured punishment. The chapter then suggests evidence-based persuasion techniques in convincing policy makers and the public.

This chapter discusses the challenges of identifying preventive interventions as effective and of assisting community coalitions to learn about and select EBIs that are a good fit for their community. The scientific standards used to determine intervention effectiveness by various lists of “what works” are compared, and the Blueprints for Healthy Youth Development is highlighted as the database used by coalitions implementing the CTC system. The importance of community resource assessments is also discussed, including the steps taken by CTC coalitions to evaluate their current resources, identify gaps in the delivery of preventive interventions, and determine if current services need to be expanded or new EBIs should be implemented.

The Welfare State emerged during industrialization as a means to ensure the protection of citizens from illness, unemployment, and destitution. Yet, government social program commitments vary across nations, with some less affluent countries performing better than their more affluent counterparts, as demonstrated in league tables. Originating in medicine, the evidence-based policy movement has extended to the social arena, showing how public investments can produce public benefit. However, reviewing extant programs with regard to efficacy and efficiency has lagged.

This final chapter of the volume summarizes the goals and themes discussed throughout. The chapter reiterates the notion that there is mounting evidence suggesting that cycles of poverty and disadvantage can be broken. This research is summarized and stories shared by those who participated in the interviews are discussed in light of the research findings. Steps that can be taken to advance an agenda that promotes hope and fosters resilience in children and families are offered: First, to move a child-focused agenda forward will require the political and societal will to acknowledge that children and families have strengths and assets that, if cultivated, can be immensely helpful in overcoming adversity. Second, ongoing resources and support for education, mental health counseling, job readiness, and financial literacy are needed to keep families from slipping back into self-destructive patterns of behavior as they experience the inevitable setbacks in life. The chapter concludes with lessons and recommendations for research, policy, and programs to inform a hopeful agenda to ameliorate the effects of poverty and economic disadvantage.