Healthy Child Manitoba (HCM) is unique in the Western Hemisphere, as the only provincial or state level strategy for the comprehensive support and prevention of children's issues from prenatal through young adulthood. All data are linked, with care for confidentiality, so that the impact of provincial initiatives can be evaluated. Dr. Embry was a keynote speaker outlining what might happen in the next decade of Healthy Child Manitoba.
3. We must move in the right
direction, with all due speed for
the next decade—not just for
the children of Manitoba, but
also as the Inukshuk for the
Western Hemisphere.
Thursday, November 18, 2010 3
7. FREE DOWNLOAD
Embry, D. D., & Biglan, A. (2008).
Evidence-Based Kernels:
Fundamental Units of Behavioral
Influence. Clinical Child & Family
Psychology Review, 39.
Download at:
www.pubmed.gov
Described in the 2009 IOM Report, p. 210
Thursday, November 18, 2010 7
8. Relational
Antecedent Reinforcement Physiological
Frame
Kernel Kernel Kernel
Kernel
Changes Creates verbal
Happens BEFORE Happens AFTER the
biochemistry of relations for the
the behavior behavior
behavior behavior
Embry, D. D., & Biglan, A.
(2008). Evidence-Based
Four Types of Kernels
Kernels: Fundamental Units
of Behavioral Influence.
Clinical Child & Family
Psychology Review, 39.
Thursday, November 18, 2010 8
9. What is a kernel?
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.
Thursday, November 18, 2010 9
11. Community Prenatal Ages 0-2 Ages 3-5
Text Text Text Text
Primary Intermediate Early Teens Later Teens
Thursday, November 18, 2010 11
12. Your take away task for communities and families…
List five ideas you can take back to your
community or even your own family
Explain the benefits of how these five things
Ask others to try one or more of these thing
Ask them use their social and electronic
networks to spread these ideas
For the benefit of all children and families in
Manitoba
Thursday, November 18, 2010 12
14. Obesity
Conduct
Disorders
Homicide &
Suicide
Early Sex
Early
Pregnancy
Addictions
Aggression
Disease
School
failure
Epigensis results in a risky path or a healthy path
Thursday, November 18, 2010 14
16. Redness, rubor, a response of body tissues to
injury or irritation; characterized by pain and
swelling and redness and heat.
Excitation, excitement, fervor, fervour the state of
being emotionally aroused and worked up
Inflaming arousal to violent emotion
Firing, ignition, kindling, lighting
the act of setting on fire or catching fire
Hypothesis: Evolutionary “inflammatory” processes
Thursday, November 18, 2010 16
17. Threat from parasites, Threat from humans
bacteria, and viruses who might kill or steal
Thursday, November 18, 2010 17
20. Substance Work Obesity,
Early Mental Illness Violence Cancer School
Abuse Problems etc
Sex Failure
Mood Reward Executive Behavioral
Attention
Stability Delay Function Competencies
Immune-
STD’s Motor Healing Special
Skills Multi-Inflammatory Threat Reaction Functions Ed
Major Ecologic Causes of the Dual Inflammatory Threats to Children & Youth
Physiological Antecedents Reinforcement Verbal Relations
Thursday, November 18, 2010 20
21. K R
Path Path
Evolutionary Path
of a Child’s Life
Probability of short-life and doubtful
Probability of long-life and reproductive success
reproductive success
Thursday, November 18, 2010 21
22. Obesity
Conduct
Disorders
Homicide &
Suicide
Early Sex
Early
Pregnancy
Addictions
Aggression
Disease
School
Disabilities
failure
R PATH = Risky behaviors or health
Thursday, November 18, 2010 22
23. Physically and Successful in
emotionally life-long
healthy learning
Safe and Socially engaged
secure Healthy Child and responsible
Manitoba
Thursday, November 18, 2010 23
24. Community Prenatal Ages 0-2 Ages 3-5
Text Text Text Text
Primary Intermediate Early Teens Later Teens
Thursday, November 18, 2010 24
40. Apparent consumption o inoleic acid (% of dietary energy) among
Australia, Canada, UK and USA for the years 1961–2000
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“Risky” Beh.
Evolution Neonates Breast Milk
& Mismatch
In the Rife Valley, the Successful human American infants have
human brain evolution neonates born with been getting steadily Theory
the result of eating 60-day supply of less omega-3 (n3) and Almost all adolescent
fish high in omega-3 omega-3 in more pro-inflammatory risky behaviors have
omega-6 (n6) in breast now been documented
not savannah animals subcutaneous fat from
milk to be related to low n3
mother’s diet
and high n6 in US diet
See Broadhurst, Cunnane, &
Crawford (1998). Rift Valley lake fish
See HIbbeln et al. (2007).Maternal
seafood consumption in pregnancy and
See Ailhaud et al. (2006).Temporal change in last 50 years
changes in dietary fats: Role of n6
and shellfish provided brain-specific neurodevelopmental outcomes in Hibbeln et al. (2006). Healthy intakes of
polyunsaturated fatty acids in excessive
nutrition for childhood (ALSPAC study): an adipose tissue n-3 and n-6 fatty acids: estimations
early Homo observational cohort study considering worldwide diversity.
development and relationship to obesity
Thursday, November 18, 2010 40
41. Low maternal omega-3 consumption from
seafood and
34
Physiological 32
Kernel
30
Percentage of children with
low verbal IQ, WISC-III , 8y
28 Hibbeln et al, Lancet 2007: 369: 578-585
UK
26
r = 0.97
24 r2 = 0.95
F=27.2
22 p<0.02.
20
Changes 18
biochemistry of 16
behavior 14
0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0.55 0.60
-
Estimated omega 3 fatty acids from seafood (en %)
Mother at 32 wk gestation
Thursday, November 18, 2010 41
45. Why not help our serious at-
risk children with omega-3?
30%
Percentage with Psychosis at 12 months
27.5%
24%
18%
12%
6%
4.9%
0%
Omega-3 Placeo
Psychosis
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.
Thursday, November 18, 2010 45
46. Before Omega 3
Omega-3 can improve school
grades and success
Omega 3 Placebo
7
These were gains in
6
After Omega 3 academics after 3
5
months of
4
exposure to fish oil.
3
2
1
0
-1
-2
Reading Spelling See www.durhamtrial.org/
Thursday, November 18, 2010 46
47. The British and Netherlands Prison Studies
Thursday, November 18, 2010 47
49. Reduce Omega 3 and
Micronutrient Brain Deficiency
Thursday, November 18, 2010 49
50. !"#$%"#&'"()*+&,-)("*.&/0"*%"1&23)*4&56-1)*"61&
7-.8&6"%)33"*#"#	-(+&93)$*.1&):&;-.93-*1<&3-*"69(1&9*#&"11"*=9(&:9>+&9%-#1
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Thursday, November 18, 2010 50
51. Why not reproduce the rapid
results in Manitoba to get a
37% reduction in jail violence?
It cost the Brits 19¢ per day or $69.35 per year.
Thursday, November 18, 2010 51
53. A environmental policy
case study in reducing
early rebelliousness, risk
taking and sensation
seeking
This risk factor can be easily measured in early-childhood, and it
predicts lifetime injuries, delinquency, alcohol/drug abuse abuse,
and school difficulties.
Thursday, November 18, 2010 53
60. Study 1 showed preschool intervention alone had short-
term benefits
Study 2 showed preschool plus parenting intervention had
long-term benefits
Study 3 showed strategy could be implemented in 35 Head
Starts nationally
Study 4 showed parents could change child’s behavior from
special story workbook
Study 5 showed behavior change for over 100 preschoolers,
with no adverse effect.
Study 6 showed effort could be successful in a 3-city
multiple baseline in New Zealand
Study 7 is national campaign, adopted by 50% of New
Zealand families
Study 8 replicates city results in US
Thursday, November 18, 2010 60
61. Kernels and 4-P’s used in multi-city/national
Safe Playing campaign
Proclamations in cities and nationally
Endorsements/Sponsorships by prestige organizations AND businesses
Media models of adoption by high-status people
Media models showing rapid results/benefits
Public posting of rates of adoption/use
Competitions between cities on adoptions
Placement in supermarket or other easy venues
Price free after filling out Safe Playing Promise (with address, etc.)
Promotion for every family who wants their child to be safe
Product promises child will be safer in two weeks when steps followed
Thursday, November 18, 2010 61
62. Why not distribute specially
constructed books for
parents with young children…
Reduce dangerous,
impulsive, disturbing
behavior quickly?
Increase social-
competence quickly?
Improve school
readiness quickly?
Embry, D. D. and L. Peters (1985). A three-city evaluation of the diffusion of a pedestrian-safety
injury control intervention. R. S. Division, New Zealand Ministry of Transport, Wellington, NZ.
Thursday, November 18, 2010 62
64. Why not turn about the lives of high risk primary
grade children using a teacher invented procedure?
Muriel Saunders,
the teacher
Thursday, November 18, 2010 64
70. Injury Prevention Study Using Positive Reinforcement
60%
50% Change in
40%
Nurses’ Office
Visits from Year to
30%
Year
20%
10%
0%
-10%
-20%
All Visits Injury Viists Non-Injuries Fighting Injuries Non-Fighting Injuries
Control/Wait List Intervention
Krug, E. G., N. D. Brener, et al. (1997). "The impact of an elementary school-based violence prevention program on
visits to the school nurse." American Journal of Preventive Medicine 13(6): 459-463.
Thursday, November 18, 2010 70
71. Prevention Store
Prevention Science Meets
Retail Consumers
Dennis D. Embry, Ph.D., Society for Prevention Research, Denver, June, 2010
Thursday, November 18, 2010 71
73. How have kernels evolved?
The first (almost certainly antecedents) were selected by
consequence for immediate reinforcement of food, protection, etc.
Early tools come to mind as examples.
The second (physiological) probably also arouse by selection by
consequences by providing relief from physical or emotional
distress.
The third (relational frames) arouse with invention of oral and
written language, selected by consequences to protect against
danger from other humans or natural harm.
The forth (contingent reinforcement) arouse with invention of oral
and written language, selected by consequences for social
advantage within groups and survival advantage of kin.
Thursday, November 18, 2010 73
74. Using kernels to build
population-level change…
Problem
Kernel
#1 Observed
Proximal
Observed Effect
Kernel
Proximal Kernel
#2
Effect
Kernel Big
Kernel
#3 Change
Effect
Observed
Proximal
Effect
t
Thursday, November 18, 2010 74
75. Rule #1 of big change
A big population-level change requires
myriads of reliable, measurable small
behavioral changes in at least 20% to 25% of
the the total population.
Blame is not a kernel. A diagnoses is not a kernel.
“Shoulds” are not a kernel. Blame, diagnoses, and
“shoulds” are personal or group ways of
experiential avoidance for dealing with failure of the
methods to create desired change.
Thursday, November 18, 2010 75
76. Rule #2 of big change
Always maximize the dignity and self-sufficiency of the
persons whose behavior you wish to influence.
If you fail this step, you will be meet resistance,
counter-control and sabotage of the group of persons
to maintain their dignity and self-sufficiency. This is a
basic feature of human social interactions from which
our species has evolved. Dead, disposed or failed
chiefs and leaders liter human history who failed to
observe the key universal feature of human societies.
Thursday, November 18, 2010 76
77. Rule #3 of big change
Pay attention to variations in behavior for improvement.
Small differences—when done by many people—
can make the difference between night and day.
These small differences are the the variation in
quality control that great car companies like
Toyota or Honda to make incremental
improvements. Look for innovations as well as
problems.
Thursday, November 18, 2010 77
78. Rule # 4 Big Change with a
kernel requires other kernels
A kernel that you want to promote to affect a
specific behavior will require other kernels to make
the specific action happen. This because other
behaviors or people will be required before and
after or in other settings for cooperation to happen.
Thursday, November 18, 2010 78
79. Why not use a new word to convey our support
every child being healthy in Manitoba
Thursday, November 18, 2010 79
94. is the gift of our futures
Thursday, November 18, 2010 94
95. Contact: Dr. Dennis D. Embry, PAXIS Institute, PO Box 31205, Tucson, AZ USA
dde@paxis.org • www.paxis.org • www.slideshare.net/drdennisembry
Thursday, November 18, 2010 95