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The inaugural meeting of the European Society for Prevention Research took place in Amsterdam in November 2010 as part of the larger 3rd European Public Health Association (EUPHA) Conference.
The meeting brought together leading researchers and practitioners from across Europe to discuss the need for the EUSPR, the landscape in which it would operate and the practical next steps that will be taken to establish the society.
A large part of the focus for the first half day was spent looking at the role of prevention in tackling health inequalities.
The first presentation was from Walter Ricciardi (EUPHA President), who argued that we are currently experiencing the third revolution in health interventions. The first revolution was the development of public health initiatives – providing clean drinking water, improving sanitation etc. The second revolution was in the development of medical technology and drugs. And now we are seeing a revolution that is being developed as access to information and the networks that carry it are democratised.
As with a number of the presentations there was a clear feeling that too often research was locked up in journals, and one of the aims of the EUSPR should be to unlock the knowledge developed by prevention researchers so that it has widespread public application.
The second presentation was from Joan Benach (John Hopkins University, USA), who took us through the findings from the WHO report, ‘Closing the Gap in a generation’, which he argued had been criticised by neo-liberals for arguing that economic inequality creates health inequality, and by radicals for not taking the argument further.
He reminded us that the causes of lifestyle-related ill health can help us to explain the persistence of poor health, and there were two ways that we could conceptualise prevention; one where we target those at significant risk of ill-health, the other by providing universal approaches which provide health promotion for all. It was, however, pointed out that interventions could have three effects (where by the health behaviour could improve, stay the same, or get worse) and the challenge is to get interventions that make things better for the target group while not making things worse for everyone else.
The presentation finished with a conclusion that included a call for sustained interventions that allow researchers and policy makers to draw long term conclusions about their benefits. A focus on solutions over problems, and a discourse on the mechanisms that we’re going to use to prevent ill health.
The next speaker was Professor Mike Kelly, who heads up the Public Health Excellence Centre for the UK’s National Institute for Health and Clinical Excellence. His presentation looked at the complex interactions between factors that affect health. He argued that while understanding risks associated with belonging to particular groups in society was important it was also important to recognise that often this isn’t exactly how life is lived. He suggested that we have much more complicated lives than understanding of risk factors often allow, and we have little understanding of how these factors interract. He suggested we need to think much more about what he called lifeworlds, how our lives interact with others and how we think about the moment as well as actions in the future.
He also pointed to the research that NICE have done on changing behaviour, and reminded us that doing so was complex. For example, where X is our desire to reduce heart attacks by increasing the amount of exercise (Y) done by an individual:
For every step between a piece of advice given to the individual (X) and him or her going for that first trip to the gym (Y) there are a lot of things that can get in the way. They might not believe the advice, they might get tempted back to their bad behaviour by friends, they might not buy a pair of trainers, or sign up to the gym.
The third presentation was from Finn Rasmussen (Karolinska Institute, Sweden) who talked about research into preventing obesity in children. He suggested a process for developing interventions which is applicable across all types of prevention research:
1. Choose the aim of the intervention.
2. Choose a theoretical model that it will conform to.
3. Develop the programme.
4. Develop the documentation and training for delivery.
5. Design your evaluation.
Our final speaker was Anthony Biglan from the Oregon Research Institute (USA). His talk was wide ranging, taking in specific approaches – e.g. the Good Behaviour Game and ACT – to community development models, and a theoretical model of prevention from prenatal to young adulthood. He suggested that there had been an explosion over the last few decades in research in the USA that had used randomised control trials. This, he reported, had given him a sense of what prevention was able to achieve and a confidence in its effectiveness when done correctly. He did admit how difficult it was sometimes to get policy makers to show empathy with some of the communities that evidence many of the vulnerabilities that prevention is trying to address, whether that was substance misuse, obesity or mental health issues.
Zili Sloboda, JBS International Director of Research and previous president of the Society for Prevention Research (SPR) spoke about the origins of the SPR in the USA, which was launched in 1991, with 19 researchers who wanted to build better ways of understanding and promoting prevention research and science. There are now over 700 members. She explained that funding comes from National Institute for Health ($181,000) and others; in 2008 they had a budget of $520,621, of which $282,821 was spent on conferences. The SPR has task groups who take forward activity between meetings using conference calls and email. Task groups’ work is developed in order to have sessions at the conference.
The SPR’s journal, Prevention Science, is published by Springer, who pays for an editor and some expenses for the board.
She explained that the SPR have defined what they want to be doing for the next period:
Define the field of prevention – so as to ensure that scientists and researchers get to decide what prevention looks like rather than funders.
Partner with practitioners to advocate for prevention
Develop a research agenda
Establish an infrastructure to support quality prevention services
The next speaker was Farida Allaghi, Director of Mentor Arabia and trustee of Mentor International. She spoke about the history and role of Mentor as an international drug prevention charity, and how it could help support the EUSPR.
Finally, Rosaria Galanti drew the conference to a close by discussing the future of the EUSPR.
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