The document discusses using evidence-based kernels and behavioral vaccines to promote population-level prevention. It provides examples of kernels including antecedent, reinforcement, physiological, and relational kernels. Behavioral vaccines are described as simple procedures using kernels that can reduce problems and increase well-being when used repeatedly. Examples are provided of successful population-level interventions using kernels, such as the Triple P parenting program. The potential benefits of applying kernels to address issues facing children are discussed.

1. tweet with #ADP2010con
and @drdennisembry
Saving America, Saving California, Saving Our Futures
Evidenced-Based Kernels for Population-Level Prevent Rapid Results
See
www.paxis.org
by Dennis D. Embry, Ph.D.
www.youtube.com
/drdennisembry PAXIS Institute
October 12, 2010
Copyright © 2010, PAXIS Institute, All rights reserved. May be shared in its entirety with notice and attribution.
Monday, October 18, 2010 1

2. Our hopes for our children,
our grandchildren or our
children of choice…
Text your hope to: 22333
“110310…your hope…”
Monday, October 18, 2010 2

3. What will you get to protect
this baby’s future when it
goes home from hospital?
Monday, October 18, 2010 3

4. What will you get
to protect your
child when they
get their first bike?
Monday, October 18, 2010 4

5. Monday, October 18, 2010 5

6. Preventing mental, emotional
and disorders in our children…
Monday, October 18, 2010 6

7. Protect your child from growing up to have a
major mental illness?
Monday, October 18, 2010 7

8. Protect your child from
growing up to have a
major addiction?
Monday, October 18, 2010 8

9. Mental, emotional and behavioral
disorders are preventable by our
own hands.
Monday, October 18, 2010 9

10. 2009:
Institute of Medicine Report
Disturbing, disruptive and aggressive
behaviors have been increasing in the
United States for more than 20 years.
The United States has more of these
problems than many other rich
countries.
Monday, October 18, 2010 10

11. Nearly 75 percent of the nation's 17- to 24-year-
olds are ineligible for service
• Medical/physical problems, 35
percent.
• Illegal drug use, 18 percent.
• Mental Category V (the lowest
10 percent of the population), 9
percent.
• Too many dependents under
age 18, 6 percent.
• Criminal record, 5 percent.
Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd
Monday, October 18, 2010 11

12. Nearly 75 percent of the nation's 17- to 24-year-
olds are ineligible for service
• Medical/physical problems, 35
percent.
• Illegal drug use, 18 percent.
• Mental Category V (the lowest
10 percent of the population), 9
percent.
• Too many dependents under
age 18, 6 percent.
• Criminal record, 5 percent.
Army Times, Nov 5, 2009 • www.missionreadiness.org/PAEE0609.pd
Monday, October 18, 2010 12

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FIGURE 2
Manufacturing, Employment in Enterprises with fewer than 20 Employees, 2006
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FIGURE 3
Manufacturing, Employment in Enterprises with fewer than 500 Employees, 2001
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Monday, October 18, 2010 14

15. Two to three times as many American children are
being prescribed psychiatric drugs…
Monday, October 18, 2010 15

16. American
children are
less healthy
than the
children in
21 other
rich
countries
Monday, October 18, 2010 16

17. Are America’s economy, safety and future secure when
our children are unhealthy in body, mind and behavior?
Monday, October 18, 2010 17

18. American children and youth will have a shorter
lifespan than current adults
Youthanasia
Monday, October 18, 2010 18

19. What can we do to change the
present & futures of our children?
Monday, October 18, 2010 19

20. Rapid
Monday, October 18, 2010 20

21. Monday, October 18, 2010 21

22. Monday, October 18, 2010 22

23. If we just hit the
problem harder…
Monday, October 18, 2010 23

24. Monday, October 18, 2010 24

25. 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
Monday, October 18, 2010 25

26. 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.
Monday, October 18, 2010 26

27. 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.
Monday, October 18, 2010 27

28. 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.
Monday, October 18, 2010 28

29. If kernels are so good…
Monday, October 18, 2010 29

30. Publication:
Prinz, Sanders, Shapiro, Lutzker & Whitaker (2009). Population-based prevention of child
maltreatment: The U.S. Triple P System Population Trial. Volume 10, March Issue, Prevention
Science.
http://www.springerlink.com/content/104965/
Funded by the US Centers for Disease Control, Grant # U17/CCU42231 to Dr. Ron Priinz, and Dr.Matt Sanders
Monday, October 18, 2010 30

31. Why not launch a marketing campaign to get
families to use Triple P when in two years…
Monday, October 18, 2010 31

32. Substantiated Child Maltreatment
16
Control Counties
Rates per 1,000 Children (0-8 Years)
15
13
Triple P Counties
12
10
Pre Post
Prinz et al., 2009, Prevention Science
Monday, October 18, 2010 32

33. Child Abuse Hospital Injuries
1.80
Rates per 1,000 Children (0-8 Years)
1.68 Control Counties
1.55
1.43 Triple P Counties
1.30
Pre Post
Prinz et al., 2009, Prevention Science
Monday, October 18, 2010 33

34. Child Out-of-Home Placements
Control Counties
4.50
Rates per 1,000 Children (0-8 Years)
4.13
Triple P Counties
3.75
3.38
3.00
Pre Post
Prinz et al., 2009, Prevention Science
Monday, October 18, 2010 34

35. Monday, October 18, 2010 35

36. Monday, October 18, 2010 36

37. Monday, October 18, 2010 37

38. Triple P: Global dissemination from 1996 onwards…
Watch
this
Australia
Germany space......
New
Zealand
The
Netherlands
Canada Belgium Chile
Ireland Switzerland
France
Scotland Sweden
Singapore Portugal
England
Wales Japan Turkey
Iran Hong
Kong
Qatar
Curacao Austria
Romania
Monday, October 18, 2010 38

39. Why not turn about the lives of high risk primary
grade children using a teacher kernel recipe?
Muriel Saunders,
the teacher
Monday, October 18, 2010 39

40. Group Alerts/
Beat the Soft Team Response Mystery
Timer Competition Cost Motivator
Antecedent Antecedent Reinforcement Reinforcement
kernel
Antecedent kernel kernel kernel
Kernel
Monday, October 18, 2010 40

41. Her invention immediately increases time to learn
Monday, October 18, 2010 41

42. Why not turn about the lives of high risk primary
grade children using a teacher invented procedure?
Monday, October 18, 2010 42

43. Long-term GBG outcomes from
inoculation in just first grade
Increase in high-school entry
Increase in college entry
Reduced special education service needs
Lifetime reduction of tobacco use by 25% to
50%
Lifetime reduction of psychiatric diagnoses
Lifetime reduction of antisocial behavior and
arrests
Lifetime reduction in all serious addictions
Lifetime reduction in suicidal actions
Monday, October 18, 2010 43

44. 5 out 9,000 schools = 0.05% of California schools
Monday, October 18, 2010 44

45. Inukshuk points the right way…
Physiological
Kernel
Monday, October 18, 2010 45

46. Physiological
Kernel
Monday, October 18, 2010 46

47. Monday, October 18, 2010 47

48. Reduce Omega 3 Brain Deficiency
Monday, October 18, 2010 48

49. 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
Monday, October 18, 2010 49

50. Why not reproduce the rapid
results in America and
California to get a 37%
reduction in jail violence?
It cost the Brits 19¢ per day or $69.35 per year.
Monday, October 18, 2010 50

51. 1.0
Inpatient
Discharge
0.8
0.6
Survival
Probability
0.4
High
DHA
(n=16)
Low
DHA
(n=17)
0.2 (median
split
of
plasma
phospholipid
%
faIy
acids)
0
0 200 400 600 800
Time
to
First
Suicide
AIempt
(days)
Suble>e,
Hibbeln
et
al
Am
J
Psychiatry
2006;163:
1100-­‐1102
Monday, October 18, 2010 51

52. Why not help our high 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.
Monday, October 18, 2010 52

53. Why not have invite families
Relational
Frame to promise clear rules about
Kernel
alcohol, tobacco & drugs if…
It produces a 23% reduction binge drinking and
27% reduction delinquency rates among 7th
graders in 2 years and this has been adopted
nationally by Sweden and being adopted by the
State of Tennessee and Manitoba?
PS. Effect sizes were 0.35 for drunkenness
and 0.38 for delinquency.
Koutakis, N., H. Stattin, et al. (2008). "Reducing youth alcohol drinking through a parent-targeted intervention:
the Orebro Prevention Program." Addiction 103(10): 1629-1637.
Monday, October 18, 2010 53

54. “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
The story of the Broad
Street water pump during a respectful non-stigmatizing way”—
the cholera epidemic in
London.
(IOM, page 387).
Monday, October 18, 2010 54

55. A public health model versus rationing model of
prevention…
Monday, October 18, 2010 55

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Monday, October 18, 2010 1?K;=L(*& 56

57. Monday, October 18, 2010 57

58. Who will stand with me for saving all
the children of California and America
for all our futures?
Thank you…
Dennis D. Embry, Ph.D.
520-299-6770
dde@paxis.org
www.paxis.org • simplegifts.com
slides show & documents at
www.slideshare.net/drdennnisembry
Monday, October 18, 2010 58