Powerpoint presentation from Dennis Embry. Presented at the 2010 Research to Practice Conference

1. Using Evidence-Based Kernels:
The DNA for Prevention, Intervention & Treatment
Dennis D. Embry, Ph.D., Senior Scientist and President, PAXIS Institute
Co-Investigator, Promise Neighborhood Research Consortium, ORI
1
Objectives today
Identify what kernels are or are not and the types
of kernels What behavior would you like to change?
Work through several examples of applying kernels
to common problems
Make a plan to use a kernel to influence a behavior
of concern to the participants
2
Darwin Meets Mendel
Darwin documented the big picture.
Mendel documented the two types of genes—
qualitative and quantitative. Nobody paid any
attention to quantitative genes until the early
1990s. Now, we know them as polygenetics
and epigenesis.
Biology has the genome and proteinomics.
Physics has periodic table.
What does behavioral science have?
3
Homo influencer?
Do humans influence each other?
Why do we influence each other?
How long have we been influencing each other?
Is there a science of influencing other humans?
What are the tools that we influence each other?
4
Thursday, December 2, 2010

2. Other Humans are principal source of safety. Other Humans are principal vertebrate predator.
The Unique Human Evolutionary Niche
5
How do humans influence each other to be How do humans influence each other for
more protective of one another? harm to other?
6
What are the fundamental units of behavioral
influence used by modern humans?
7
What were the fundamental
units of behavioral influence
used by humans 40,000
years ago?
About 40,000 years ago, with the appearance of the Cro-
Magnon culture, tools became markedly more sophisticated,
incorporating a wider variety of raw materials such as bone and
antler. They also included new implements for making clothing,
engravings, and sculptures. Fine artwork, in the form of
decorated tools, beads, ivory carvings of humans and animals,
clay figurines, musical instruments, and cave paintings,
appeared over the next 20,000 years.
8
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3. 9
10
11
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
12
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4. 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 often found in cultural wisdom.
13
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.
14
What are these? What are these?
How might these be selected by consequences?
15
What are these? What are these?
How might these be selected by consequences?
16
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5. 52 Examples of Kernels
Antecedents
Reinforcements
Physiological
Relational frames
17
= Public Posting Kernel
Antecedent
Kernel
Happens
BEFORE the
behavior
= radar
18
Kernel Description Behaviors Affected References
Combinations of visual, kinesthetic and/or auditory
Non-verbal cues that single shifting attention or task in Reduces dawdling, increases time on task or Rosenkoetter, & Fowler, 1986; Krantz, & Risley, 1977; Abbott et al., 1998;
transition cues patterned way, coupled with praise or occasional engaged learning; gives more time for instruction Embry et al., 1996
rewards.
Antecedent Stop lights in Traffic light signals when behavior is appropriate/
(Cox, Cox, & Cox, 2000; Jason & Liotta, 1982; Jason, Neal, & Marinakis,
desirable or inappropriate/undesirable in real time, Decreases noise, off task behavior, or increases
Kernel school settings or
traffic settings
and connected to some kind of occasional stopping in dangerous intersections
1985; Lawshe, 1940; Medland & Stachnik, 1972; Van Houten & Malenfant,
1992; Van Houten & Retting, 2001; Wasserman, 1977)
reinforcement.
These may be lines or other cues such as ropes or Decreases dangerous behavior; decreases
Boundary cues and (Carlsson & Lundkvist, 1992; Erkal & Safak, 2006; Marshall, et al., 2005;
rails that signal where behavior is safe, acceptable pushing and shoving; increases waiting behavior
railings or desired in a queue; reduces falls
Nedas, Balcar, & Macy, 1982; Sorock, 1988)
Happens Cooperative, Planned activities happen during children play time
Decreases aggression and increases social
competence; also affects body mass index, and (Bay-Hinitz, Peterson, & Quilitch, 1994; Leff, Costigan, & Power, 2004;
BEFORE the Structured peer
play
that involve rules, turn taking, social competencies,
and cooperation with or without “soft competition.”
appears to reduce ADHD symptoms, and increase
academics afterwards; reduces social rejection in
Mikami, Boucher, & Humphreys, 2005; Murphy, et al., 1983; Ridgway,
Northup, Pellegrin, LaRue, & Hightsoe, 2003)
behavior middle school
(Barker & Jones, 2006; Ben Shalom, 2000; Bray & Kehle, 2001; Buggey, 2005; Clare,
Drawn, photographic or video model viewer/listener Increases academic engagement; increases attention; Jenson, Kehle, & Bray, 2000; Clark, Beck, Sloane, Goldsmith, & et al., 1993; Clark, Kehle,
increases recall and long term memory; improves behavior; Jenson, & Beck, 1992; Clement, 1986; R. A. Davis, 1979; Dowrick, 1999; Dowrick, Kim-
Self-modeling engaging targeted behavior, receiving rewards or reduces dangerous behavior; increases social competence; Rupnow, & Power, 2006; Elegbeleye, 1994; Hartley, Bray, & Kehle, 1998; Hartley, Kehle, &
recognition. improved sports performance; reduced health problems Bray, 2002; Hitchcock, Prater, & Dowrick, 2004; Houlihan, Miltenberger, Trench, Larson, & et
al., 1995; Kahn, Kehle, Jenson, & Clark, 1990; Kehle, Bray, Margiano, Theodore, & Zhou,
2002; Law & Ste-Marie, 2005; Lonnecker, Brady, McPherson, & Hawkins, 1994; Meharg &
(Agran, et al., 2005; Blick & & Woltersdorf, 1990; Owusu-Bempah& Frank, 1990; Buggey, 1995;
Lipsker, 1991; Meharg Test, 1987; Boyle & Hughes, 1994; Brown & Howitt, 1985; Owusu-
Reductions in alcohol, tobacco use; reductions in illness Buggey, Toombs, Gardener, & Cervetti, 1999; Burch, Clegg, & Bailey, 1987; Carr & Punzo, 1993; Cavalier,
Coding target behavior with a relational frame, which symptoms from diabetes; increased school achievement; changes Bempah & Hodges, 1983;Clare, et al., 2000;McLoughlin,Kehle, & Truscott, 2001; Dalton, Martella, &
Ferretti, &
Howitt, 1997; Possell, Kehle, Clarke, Bray, & Bray, 1999; Ram & McCullagh, 2003;
Reamer, Brady, & Hawkins, 1998; Rickards-Schlichting, Kehle, & Bray, 2004; Rickel & Fields,
Self-monitoring is often charted or graphed for public or semi-public in other social competencies or health behaviors; reductions in Marchand-Martella, 1999; de Haas-Warner, 1991; R. M. Foxx & Axelroth, 1983; Glasgow, Klesges,
Godding, & Gegelman, 1983; Glasgow, Klesges, & Vasey, 1983; Gray & & Simon, 1997; Walker &
1983; Schunk & Hanson, 1989; Schwartz, Houlihan, Krueger, Shelton, 1992; Hall & Zentall,
display, occasioning verbal praise from others ADHD, Tourettes and other DSM-IV disorder; improvement in 2000; K. R. Harris, Friedlander, 1992; Wedel & Fowler, 1984; Woltersdorf, 1992) 1990; Hitchcock,
Clement, Saddler, Frizzelle, & Graham, 2005; Hertz & McLaughlin,
brain injured persons et al., 2004; Hughes, et al., 2002; Kern, Dunlap, Childs, & Clarke, 1994; Martella, Leonard, Marchand-
Martella, & Agran, 1993; M. Y. Mathes & Bender, 1997; McCarl, Svobodny, & Beare, 1991; McDougall &
Brady, 1995; McLaughlin, Krappman, & Welsh, 1985; Nakano, 1990; O'Reilly, et al., 2002; Petscher &
Bailey, 2006; Possell, et al., 1999; Rock, 2005; Selznick & Savage, 2000; Shabani, Wilder, & Flood, 2001;
After hearing or seeing some content, person is told Shimabukuro, Prater, Jenkins, & Edelen-Smith, 1999; Stecker, Whinnery, & Fuchs, 1996; Thomas,
Paragraph Abrams, & Johnson, 1971; Todd, Horner, &G. Mathes, Fuchs, Fuchs, Henley,Winn, Skinner,
(Bean & Steenwyk, 1984; P. Sugai, 1999; Trammel, Schloss, & Alper, 1994; & et al.,
to “shrink” meaning to 8-10 words, full sentence; Improved reading responses and retention Allin, & Hawkins, 2004; Wood, Murdock, & Cronin, 2002; Wood, Murdock, Cronin, Dawson, & Kirby, 1998)
Shrinking praise typically happens for good summaries.
1994; Spencer, Scruggs, & Mastropieri, 2003)
19
Prize Bowl/Mystery
Motivator Kernel
Reinforcement
Kernel
Happens AFTER
the behavior
20
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6. Kernel Description Behaviors Affected References
Person or group receives spoken (or Examples: Cooperation, social competence, academic (Leblanc, Ricciardi, & Luiselli, 2005; Lowe & McLaughlin, 1974; Marchant
engagement, academic achievement, positive-parent child
signed) recognition for engagement in & Young, 2001; Marchant, Young, & West, 2004; Martens, Hiralall, &
Verbal Praise target acts, which may be descriptive or
interactions, positive marital relations, better sales Bradley, 1997; Matheson & Shriver, 2005; C. M. Robinson & Robinson,
performance; reduced disruptive or aggressive behavior; 1979; S. Scott, Spender, Doolan, Jacobs, & Aspland, 2001)
simple acknowledgements reduced DSM-IV symptoms
Reinforcement Peer-to-peer written A pad or display of decorative notes are
Examples: social competence, academic (Cabello & Terrell, 1994; Embry, Flannery, Vazsonyi, Powell, & Atha, 1996;
praise--“Tootle” Notes, posted on a wall, read aloud, or placed in a
Kernel compliments books/ photo type album in which behaviors
achievement, work performance, violence,
Farber & Mayer, 1972; Heap & Emerson, 1989; Mayer, Butterworth,
Nafpaktitis, & Sulzer-Azaroff, 1983; Mayer, Mitchell, Clementi, Clement-
aggression, physical health, vandalism Robertson, & et al., 1993; Skinner, Cashwell, & Skinner, 2000)
praise notes receive written praise from peers
Tokens or symbolic rewards for positive
behavior result in random rewards from Academic achievement, disruptive behavior, (Thorpe, Darch, & Drecktrah, 1978; Thorpe,
Principal Lottery status person (e.g., principal, authority aggression Drecktrah, & Darch, 1979)
figures) such as positive phone calls home
Happens AFTER Safety or Tokens or reward tickets given out for
Safety behaviors, accident reduction,
(Geller, Johnson, & Pelton, 1982; Putnam, Handler, Ramirez-
Performance observed safety or performance behavior, Platt, & Luiselli, 2003; Roberts & Fanurik, 1986; Saari &
the behavior Lottery which are entered into lottery
improved sales or work performance Latham, 1982)
Music is played or stopped in real time, Increased weight gain of babies, improved baby (Allen & Bryant, 1985; Barmann & Croyle-Barmann, 1980; Barmann, Croyle-Barmann, & McLain, 1980;
Bellamy & Sontag, 1973; Blumenfeld & Eisenfeld, 2006; Cevasco & Grant, 2005; Cook & Freethy, 1973;
development possibly, work performance, academic
Contingent music based on observed behavior of the achievement, attention and focus (ADHD symptoms
Cotter, 1971; W. B. Davis, Wieseler, & Hanzel, 1980; Dellatan, 2003; Deutsch, Parks, & Aylesworth, 1976;
Eisenstein, 1974; Harding & Ballard, 1982; Hill, Brantner, & Spreat, 1989; Holloway, 1980; Hume &
Crossman, 1992; Jorgenson, 1974; Larson & Ayllon, 1990; Madsen, 1982; McCarty, McElfresh, Rice, &
individual or group. down); reduced aggression Wilson, 1978; McLaughlin & Helm, 1993; Standley, 1996, 1999; Wilson, 1976; D. E. Wolfe, 1982)
Improved academic engagement and achievement, (Beersma, et al., 2003; Hoigaard, S?fvenbom, &
Soft Team Groups compete on some task, reduced disruptive behavior, increased sales,
increased funding raising, increased safety; reduced
Tonnessen, 2006; Kivlighan & Granger, 2006; Koffman,
competition performance, or game. smoking; changed brain chemistry favoring attention Lee, Hopp, & Emont, 1998; Neave & Wolfson, 2003;
and endurance Tingstrom, Sterling-Turner, & Wilczynski, 2006)
Peer-to-peer Increased academic achievement; reduced (Allsopp, 1997; Delquadri, Greenwood, Stretton, & Hall, 1983;
Dyad or triad take turns asking questions,
ADHD and conduct problems; long-term DuPaul, Ervin, Hook, & McGoey, 1998; Fantuzzo & Ginsburg-Block,
tutoring give praise or points and corrective
effects on school engagement; decreased 1998; Greenwood, 1991a, 1991b; Maheady, Harper, & Sacca,
feedback 1988; Maheady, Sacca, & Harper, 1988; Sideridis, et al., 1997)
special education needs.
21
Omega 3 kernel
30%
Physiological
Percentage with Psychosis at 12 months
Kernel 27.5%
24%
18%
Changes 12%
biochemistry of
behavior 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.
22
Reduced
Felony
Violent
Offences
Among
Prisoners
with
recommended
daily
amounts
of
vitamins,
minerals
and
essen=al
fa>y
acids
Ratio of Disciplinary Incidents Supplementation/Baseline
1.00
Ac=ve
-­‐37.0% Placebo
-­‐10.1%
0.75
p
‹
0.005
p
=
ns
0.50
Active
0.25 Placebo
0
Before supplementation During supplementation
UK
maximum
security
prison
-­‐
338
offences
among
172
prisoners
over
9
months
treatment
in
a
compared
to
9
months
baseline.
Gesch
et
al.
Br
J
Psychiatry
2002,
181:22-­‐28
23
Consilience Issues (pardon a digression)
Parsimony or Occams’ Razor:
"Pluralitas non est ponenda sine neccesitate" or
"plurality should not be posited without necessity."
The words are those of the medieval English
philosopher and Franciscan monk William of
Ockham (ca. 1285-1349).
Links to meta theories versus depending on
mezzo-theories—e.g., “selection by consequences
that embraces evolution, neural plasticity, and
principles of reinforcement.”
24
Thursday, December 2, 2010

7. 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 less Theory
the result of eating fish 60-day supply of omega-3 (n3) and more Almost all adolescent
pro-inflammatory risky behaviors have now
high in omega-3 not omega-3 in
omega-6 (n6) in breast been documented to be
savannah animals subcutaneous fat from milk related to low n3 and
mother’s diet high n6 in US diet
See Broadhurst, Cunnane, & See HIbbeln et al. (2007).Maternal seafood
change in last 50 years
Crawford (1998). Rift Valley lake fish See Ailhaud et al. (2006).Temporal changes
consumption in pregnancy and
in dietary fats: Role of n6
and shellfish provided brain-specific neurodevelopmental outcomes in childhood Hibbeln et al. (2006). Healthy intakes of n-3
polyunsaturated fatty acids in excessive
nutrition for (ALSPAC study): an observational cohort
adipose tissue and n-6 fatty acids: estimations considering
early Homo study worldwide diversity.
development and relationship to obesity
25
Kernel Description Behaviors Affected References
Pleasant greeting with Affects donations; social status an
Friendly physical and verbal perceptions of safety or harm; affects (Edwards & Johnston, 1977; Ferguson, 1976; T. Field, 1999; Fry,
or without positive 1987; Howard, 1990; la Greca & Santogrossi, 1980; Schloss,
gestures, on a frequent basis. behavior streams of aggression, hostility or Schloss, & Harris, 1984)
physical touch
politeness
Physiological (Diego, et al., 2002; T. Field, N. Grizzle, et al., 1996; T. Field, Kilmer,
Massage, Any method of rubbing, stroking Reduces aggression, arousal, cortisol,
Kernel brushing or and therapeutic touch applied to depressive symptoms, PTSD
Hernandez-Reif, & Burman, 1996; T. Field, Seligman, Scafidi, &
Schanberg, 1996; T. M. Field, 1998; T. M. Field, Grizzle, Scafidi, &
Schanberg, 1996; Jones, Field, & Davalos, 1998; Scafidi & Field,
stroking the body symptoms, and pain 1996)
Using a turtle metaphor, child holds self,
Turtle verbal frame, breaths through nose, and Reduces arousal and aggression (Heffner, Greco, & Eifert, 2003; Robin,
engage in sub-verbal or verbal self- against peers or adults Schneider, & Dolnick, 1976)
Technique coaching, with peer or adult reinforcement
Changes “Rough and Tumble” Several times per week child or adolescent Reduces aggression, teaches self-control, may improve status
among same-sex peers; changes c-fos gene expression in
(Boulton & Smith, 1989; Gordon, Kollack-Walker, Akil, &
engages in rough and tumble play, causing Panksepp, 2002; Hines & Kaufman, 1994; Jacklin, DiPietro, &
biochemistry of Free Play with higher
status conspecific
increased arousal and self-control mediated
laboratory animals; the behavior may be especially important to
the development of positive behavior among boys and unique Maccoby, 1984; Paquette, 2004; Pellegrini & Smith, 1998;
by status adult or peer Reed & Brown, 2001; E. Scott & Panksepp, 2003)
behavior
contribution of fathering
(Antunes, Stella, Santos, Bueno, & de Mello, 2005; Atlantis, Chow, Kirby, & Singh, 2004;
Aerobic play Daily or many times per week child or adult Reduces ADHD symptoms, reduces depression;
engage running or similar aerobic solitary reduces stress hormones; may increase cognitive
Berlin, Kop, & Deuster, 2006; Blue, 1979; Blumenthal, et al., 2005; Crews, Lochbaum, &
Landers, 2004; Doyne, Chambless, & Beutler, 1983; Dunn, Trivedi, Kampert, Clark, &
Chambliss, 2005; Dunn, Trivedi, & O'Neal, 2001; Dustman & et al., 1984; Khatri, et al., 2001;
or behavior activities, game, or food gathering behavior function; decreases PTSD Kubesch, et al., 2003; Manger & Motta, 2005; Marin & Menza, 2005; Phillips, Kiernan, &
King, 2003; M. B. Stein, 2005; Stella, et al., 2005)
Progressive Person tenses and relaxes sequence of Reduces panic, fear, anxiety; decreases negative (Larsson, Carlsson, Fichtel, & Melin, 2005; Norlander, Mo?s,
muscles in combination with anxiety attributions; decreases phobic responses with & Archer, 2005; Pawlow & Jones, 2005; Wencai, Xinhu, Kele,
muscle relaxation evoking stimulus paired with evoking stimuli & Yiyuan, 2005)
Zinc Evolving evidence shows that the addition of zinc (Akhondzadeh, Mohammadi, & Khademi, 2004; Arnold, et al.,
15 mg per day eaten or to the diet or by supplementation increases the 2005; Arnold & DiSilvestro, 2005; Bilici, et al., 2004; McGee,
supplementation or effectiveness of drug treatment and/or may Williams, Anderson, McKenzie-Parnell, & Silva, 1990;
dietary consumption supplemented prevent ADHD symptoms. Sandyk, 1990)
26
Motivational (values expression) kernel
Relational A Simple Gift Example: My Values1
Please provide responses to questions about your ideas, your beliefs, and your life. Please bear in mind that,
Frame there are no right or wrong answers. There are just answers important to you.
Please circle the 1st, 2nd and 3rd most important value from this list
Kernel Athletic ability 1 2 3
Being good at art 1 2 3
Being smart or getting good grades 1 2 3
Creativity 1 2 3
Independence 1 2 3
Living in the moment 1 2 3
Membership in a social group (such as your community, racial group or club) 1 2 3
Music 1 2 3
Creates verbal Politics 1 2 3
Relationships with friends or family 1 2 3
relations for the Religious values 1 2 3
Sense of humor 1 2 3
behavior Please look at the values you picked as most important to you, and to think about times when these values were important to you. Please describe
in a few sentences why the selected values are important to you. Focus on your thoughts and feelings, and don’t worry about spelling, grammar,
or how well written it is. Please list the top two reasons why the values you selected are important to you:
Reason #1:
Cohen, G. L., J. Garcia, et al. (2009). "Recursive Processes in Self-Affirmation:
Intervening to Close the Minority Achievement Gap." Science 324(5925): 400-403. 27
Reason # 2:
Please indicate your level of agreement with four easy-to-agree-with statements concerning the selected values.
Strongly Strongly
Agree Unsure Disagree
Agree Disagree
Kernel
These values have influenced my life
In general, I try to live up to these values.
Description
SA
SA
A
A
U
U
Behaviors Affected
D
D
SD
SD
References
These values are an important part of who I am. SA A U D SD
I care about these values. SA A U D SD
1 Increased rule governed behavior; (Choenarom, Williams, & Hagerty, 2005;
Adjectival Noun for conducted with minority underachieving 7_____”completing this activity with longitudinal follow up for nearly two years on
This is based on an experiment Verbal phrase “I am/we graders, is paired
th
academic achievement. The study was published in Science, a prestigious peer-reviewed journal. Cohen GL,increases behavior associated with the
Relational Belonging to Status with status, belonging, protection or
Garcia J, Apfel N, Master A. Reducing the Racial
Achievement Gap: A Social-Psychological Intervention. Science 2006; 313(5791):1307-1310. Of the 7th grade minority students who wrote about their own Embry, et al., 1996; Gaskell & Smith,
personal values in this 15-minute activity, 50% FEWER received average grades of “D” or below in 9th grade,named group; decreases aggression
safety
Group compared to those who did a similar exercise
Frame within group; may affect physical health
writing about what other people might think about their important values. No one but the students saw what they wrote. 1986; Ju?rez, 2002; Mishima, 2003)
Kernel
Public Individuals sign or pledge self to Voting, contributing money,
collective behavior
(Burns & Oskamp, 1986)
Commitment recycling,
Individuals or groups are divided into Increase aggression and (Roos, 2005; Sherif, 1958, 1968, 1970;
“US” and “THEM” two groups, with differences highlighted
Creates verbal framed around clothing, adornment,
violence by each group toward Sherif, Hogg, & Abrams, 2001; Sherif,
Role Framing
language, social position, etc. each other White, & Harvey, 1955)
relations for the
(Collier, Czuchry, Dansereau, & Pitre, 2001; Czuchry & Dansereau, 1996, 1999, 2003;
behavior Graphic/ node A graphic organizer for goal-based Increased sobriety and goal Czuchry, Dansereau, Dees, & Simpson, 1995; Dansereau, Dees, Greener, & Simpson, 1995;
Dansereau, Joe, & Simpson, 1993; Dees, Dansereau, & Simpson, 1994; Joe, Dansereau,
maps behavior, guided by other status completion; increased treatment Pitre, & Simpson, 1997; Joe, Dansereau, & Simpson, 1994; Melville, Davis, Matzenbacher, &
Clayborne, 2004; Newbern, Dansereau, Czuchry, & Simpson, 2005; Newbern, Dansereau, &
individuals compliance Pitre, 1999; Pitre, Dansereau, & Joe, 1996; Pitre, Dansereau, Newbern, & Simpson, 1998;
Pitre, Dansereau, & Simpson, 1997)
Verbal questioning by status individual Reduction in substance abuse, increase in social (Bernstein, et al., 2005; Burke, Arkowitz, &
Motivational around major goals of target person, competences and related goals; reduction in Menchola, 2003; Resnicow, et al., 2001; Rusch &
Interviewing with clarifying questions about injuries or antisocial behaviors; increase in Corrigan, 2002; D. K. Smith, 2004; Sobell, et al.,
interferring behaviors. healthy behaviors (Monti, et al., 1999) 2003; L. A. R. Stein, et al., 2006)
Media associating Reduces sexually transmitted (Beyth-Marom, Austin, Fischhoff, Palmgren, & et
Media (TV, video, radio) showing
behavior with al., 1993; Downs, et al., 2004; Pechmann, 2001;
“immediate” negative
behavior results in social rejection or diseases; reduces alcohol, Pechmann & Ratneshwar, 1994; Pechmann,
social outcomes escape from social rejection tobacco and other drug use Zhao, Goldberg, & Reibling, 2003)
28
Thursday, December 2, 2010

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What is a behavioral vaccine?
It is a simple procedure (a kernel or a recipe of kernels)
that, when used repeatedly, reduce morbidity and mortality
and/or increase wellbeing or health.
Behavioral vaccines can be used by individuals, families,
schools, businesses, organizations to produce rapid
population level change.
Embry, D. D. (2004). "Community-Based Prevention Using
Simple, Low-Cost, Evidence-Based Kernels and Behavior
Vaccines." Journal of Community Psychology 32(5): 575.
31
“Behavioral health could learn from public
health in endorsing a population health
perspective”—(IOM, page 19).
“Families and children have ready access to
the best available evidence-based prevention
interventions, delivered in their own
communities…in a respectful non-stigmatizing
The story of the Broad
Street water pump during
way”—(IOM, page 387).
the cholera epidemic in
London.
32
Thursday, December 2, 2010

9. What is a public-health
approach?
Potential harm is universal,
Personal or Group Risk is Common,
Stigmatizing Persons or Groups At Risk Reduces
Prevention Results, and/or
More Cost Efficient to Reach All Above “Case
Finding.”
33
Community reinforcement case study
34
PeaceBuilders School-Community Reinforcement Study
Positive Peer-to-Peer Social
Home Notes Notes Competence Violence
35
Injury Prevention Study Using Positive Reinforcement
60%
50%
Change in Nurses’
40% Office Visits from
30% Year to 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. 36
Thursday, December 2, 2010

10. Reward & Reminder case study on tobacco
37
38
39
Reward &
Reminder:
Logic
model
40
Thursday, December 2, 2010

11. Baseline After Reward and Reminder
60%
Wyoming
Percentage of Illegal or Non-Compliant Tobacco Sales to Minors
50%
40%
Reward &
30%
20%
Reminder Impact 10%
on Access 0%
60%
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Wisconsin
50%
40%
30%
20%
10%
0%
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Data Source: Synar Report, SAMSA
41
Reward &
Reminder:
Impact on
prevalence
Source: Youth Risk Behavior Survey (YRBS), Centers for Disease Control
42
Good Behavior Game Case Study
43
Why not turn about the lives of high risk primary
grade children using a teacher invented procedure?
Muriel Saunders,
the teacher
44
Thursday, December 2, 2010