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This bulletin describes state-of-the-art universal and selective prevention programs designed to promote parent and teacher competencies and to prevent conduct problems. In addition, it describes indicated interventions designed for children who already have been diagnosed with oppositional defiant disorder and/or conduct disorder. Emphasis is placed on empirically supported programs that have identified key malleable risk factors in children, families, and schools, which have been shown in longitudinal research to be related to later development of substance abuse, delinquency, and violence. We have targeted preschool and primary grade children, ages 0-8 years, in this review because research suggests that the most effective interventions can nip in the bud risk behaviors in the early years, before antisocial behaviors become crystallized. Guidelines for selecting effective interventions are provided.

Increases in computer ownership and Internet use patterns provide a potential avenue for dissemination of evidence-based prevention and treatment interventions. This paper describes the use of a hybrid delivery model combining computer and web-based delivery of content with assistance of a coach through phone calls, electronic messages and home visits, to deliver a psychoeducational intervention (the Incredible Years parenting program) designed to promote behavioral change in parents and children. The model attempted to simulate many of the parent training methods shown to be successful in the original program. The intervention was implemented with 90 Head Start families who reported elevated levels of child behavior problems. Of the 45 families offered the intervention in the final year of the project, using procedures refined in light of the initial year's experience, 82% completed at least half the program and 76% completed the entire intervention. These participants reported high achievement of their self-determined goals and were highly satisfied with the intervention. The combination of technology with professional coaching represents a potential model for adapting and disseminating evidence-based interventions.

With the increasing focus on service accountability, there is an urgent need to identify empirically supported treatments (ESTs) and disseminate their use in the daily practice of mental health organizations. This article describes the authors' experiences of implementing an EST at a children's mental health center by involving the collaboration of clinicians, administrators, and innovator(s). Initially, a small group of clinicians voluntarily commit to pilot test the EST, with the intention of evaluating the adoption and integration of the treatment model into the organization's full-service delivery system. Using E. M. Rogers's (1995) work on the diffusion of innovations, the current case study example suggests that ESTs can be flexibly and successfully implemented with integrity.

BackgroundChildren with type 1 diabetes and their parents face rigorous procedures for blood glucose monitoring and regulation. Mobile telecommunication systems show potential as an aid for families’ self-management of diabetes.ObjectiveA prototype designed to automatically transfer readings from a child’s blood glucose monitor to their parent’s mobile phone was tested. In this formative stage of development, we sought insights into the appropriateness of the concept, feasibility of use, and ideas for further development and research.MethodsDuring four months, a self-selected sample of 15 children (aged 9 to 15 years) with type 1 diabetes and their parents (n = 30) used the prototype approximately three times daily. Parent and child experiences were collected through questionnaires and through interviews with 9 of the parents.ResultsSystem use was easily integrated into everyday life, and parents valued the sense of reassurance offered by the system. Parents’ ongoing struggle to balance control of their children with allowing independence was evident. For children who measured regularly, use appeared to reduce parental intrusions. For those who measured irregularly, however, parental reminders (eg, “nagging”) appeared to increase. Although increased reminders could be considered a positive outcome, they can potentially increase parent-child conflict and thus also undermine proper metabolic control. Parents felt that system appropriateness tapered off with the onset of adolescence, partly due to a potential sense of surveillance from the child’s perspective that could fuel oppositional behavior. Parental suggestions for further developments included similar alerts of irregular insulin dosages and automatically generated dietary and insulin dosage advice.ConclusionsUser enthusiasm suggests that such systems might find a consumer market regardless of whether or not they ultimately improve health outcomes. Thus, more rigorous studies are warranted to inform guidelines for appropriate use. Potentially fruitful approaches include integrating such systems with theory-based parenting interventions and approaches that can aid in interpreting and responding to experiences of surveillance, virtual presence, and balances of power in e-mediated relationships.