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Randomised controlled trials (RCTs) are acknowledged to provide the most reliable estimate of programme effectiveness, yet relatively few are undertaken in children's services. Consequently, there are few models with a demonstrated impact on child well‐being, leading to a concern not only that services may frequently be ineffective but also that some may be harmful. This article considers how this state of affairs has come into being and discusses potential remedies for improving both the knowledge base and the quality of interventions. It focuses on ‘operating systems’ that link prevention science and community engagement and so help communities, agencies and local authorities to choose effective prevention, early intervention and treatment models. Specifically, it describes an attempt in Ireland to implement a robust programme of research into children's health and development, to rigorously design new services, evaluate their impact to the highest standard (using RCTs)and integrate the results into the policy process. Based on the authors' extensive first‐hand experience of supporting the work, and the advice of international experts, the article reflects critically on the unforeseen challenges and offers lessons for others starting a similar enterprise.

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.

Despite the importance of increasing engagement and minimising attrition and drop‐out in parenting interventions, there is a paucity of empirical evidence examining factors related to engagement and participation. The range of factors examined in relation to engagement is generally limited in scope and variety, focusing on variables of convenience rather than utilising a theoretically‐driven approach.The aim of this article is to review the factors related to parental engagement with interventions and to describe strategies and implications for improving engagement with parenting interventions. Several policy and practice implications are identified: (1) Poor parental engagement may threaten or compromise the capacity of parenting programmes to deliver valued outcomes. Viable engagement strategies need to be a core part of prevention and early intervention parenting programmes; (2) Agencies delivering parenting services need a proactive engagement strategy, which includes strategies to prevent drop‐out, as well as strategies to actively respond to parental disengagement; (3) Research is needed to test the efficacy and robustness of different engagement enhancement strategies. Empirical tests are needed to test the effectiveness of different engagement strategies in order to ensure that the most efficient, cost‐effective and efficacious approach is used in order to engage parents. Investment of research effort to improve parental engagement is likely to have a high yield in terms of programme efficiency, utility and cost effectiveness. We conclude that research examining how to improve engagement and decrease non‐completion is needed to strengthen the population level value of parenting programmes as preventive interventions.

Students with emotional and behavioral disorders are at great risk for long-term negative outcomes. Researchers and practitioners alike acknowledge the need for evidence-based, preventive, and early intervention strategies. Accordingly, in this chapter an expanded view of prevention is presented as a series of data driven decisions to guide provision of supports that lessen the impact of emotional/behavioral disorders (EBD). Universal screening, use of a multitiered framework, delivery of increasingly intensive support prior to chronic and persistent patterns of behavior, and continuity of service across school, home, and community settings are discussed. Specific techniques for data decision-making, use of a school-based team approach, and recommendations for future research are also provided.

Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing factors to these disparities, proven and promising approaches through strengths-based methods, barriers to implementation of prevention and treatment efforts, and future recommendations for effective programs and research.

Approach – We have conducted a thorough literature review of relevant research studies, as well as a review of government, tribal, and community-based curricula and resources. This review of programs is not exhaustive but provides several examples of best practices in the field and suggestions for future directions.

Social implications – We strongly advocate that to accurately explore the true etiology of substance abuse and to respond to the concerns that AI/AN have prioritized, it is necessary to utilize a strengths-based approach and draw upon traditional AI/AN perspectives and values, and active community participation in the process. More specifically, prevention and treatment programs should use methods that incorporate elders or intergenerational approaches; foster individual and family skills-building; promote traditional healing methods to recognize and treat historical, cultural, and intergenerational and personal trauma; focus on early intervention; and tailor efforts to each Native nation or community.

Value – Ultimately, to reduce substance abuse disparities in AI/AN youth, we must find better ways to merge traditional Native practices with western behavioral health to ensure cultural competency, as well as to develop mechanisms to effect system- and policy-level changes that reduce barriers to care and promote the well-being of AI/AN youth, families, and communities.

Demonstrating the efficacy and effectiveness of prevention programmes in rigorous randomised trials is only the beginning of a process that may lead to better public health outcomes. Although a growing number of programmes have been shown to be effective at reducing drug use and delinquency among young people under carefully controlled conditions, we are now faced with a new set of obstacles. First, these evidence‐based programmes are still under‐utilised compared to prevention strategies with no empirical support. Second, when effective programmes are used the evidence suggests they are not being implemented with quality and fidelity. Third, effective programmes are often initiated with short‐term grant funding, creating a challenge for sustainability beyond seed funding. We discuss each of these challenges, and present lessons learned from a large‐scale dissemination effort involving over 140 evidence‐based programme replications in one state in the US.

Both the government and local service providers in the UK are becoming increasingly aware of the possibility of improving child outcomes through the delivery of parenting programmes. Government initiatives, such as Sure Start, Pathfinders and Flying Start are a positive step forward, yet programmes sometimes fail to work in service settings. This article describes the components necessary to deliver effective interventions, exploring the need to choose an evidence‐based parent programme, implement it with fidelity and evaluate the outcome. It describes the steps taken in North and Mid Wales to do this and reports briefly on the successful outcomes achieved by delivering the Incredible Years Basic Parenting Programme to the parents of high‐risk children in Sure Start areas.

The purpose of this paper was to examine the transformation of fire prevention processes via improved targeting of fire prevention interventions over a four-year period.

A four-year case study of the transformation of fire prevention processes involving a UK fire and rescue service, local council, National Health Service primary care trust and a police force was undertaken.

Understanding the socio-economic causal factors underlying unintentional dwelling fires, and the need to work in collaborative partnerships to achieve change in such factors can support more targeted and effective fire prevention activities.

Analysis of underlying causal factors and their relationships, together with population segmentation and working in coordinated collaborative partnerships, can support enhanced fire risk assessment and community safety. This supported more pro-active early intervention fire risk management.

Analysis of socio-economic causal factors and socio-economic groups associated with unintentional dwelling fires can assist in targeting fire prevention activities in a more effective and efficient manner. This enabled the fire and rescue service to target fire prevention to social groups most at risk of dwelling fires and the types of fires (for example, kitchen fires) relevant to the different social groups.

Collaborative public sector partnerships can achieve change in the socio-economic circumstances of at-risk individuals to support fire prevention. This enables the social- and health-related factors underlying fire risk to be addressed by the relevant partner health or social services agencies.

The detailed analysis of the transformation of fire prevention activities that led to an implemented approach to enhance community safety. In particular, the analysis and evaluation of the move to collaborative multi-agency partnerships to support and improve fire prevention activities.

Although many educators feel insecure about reporting suspected child maltreatment, educators are in a unique position to identify and, subsequently, intervene in such cases. This is particularly true for those working in early childhood education settings, as the youngest children – those most vulnerable to the effects of maltreatment – are at the greatest risk for being victims of most types of maltreatment. Thus, early childhood educators should be familiar with child maltreatment and be prepared to act in these cases. The purpose of this chapter is to provide a general overview of child maltreatment. Definitions and prevalent issues will be discussed, and the potential effects of child maltreatment across a variety of domains, including cognitive, academic, social, and behavioral functioning, will be highlighted. Finally, the authors explore various responsibilities, such as mandated reporting and intervention and prevention activities, of early childhood educators.

This article reports on three pragmatic randomised controlled trials (RCTs) to help children at risk of conduct disorder (CD): two involved the Incredible Years (IY) BASIC parent programme and the other concerned the IY teacher programme. All three interventions took place in regular service settings in North‐ and Mid‐Wales. In all three studies, staff from the provider agency delivered the programme and participated in RCT evaluations in which participants were randomly allocated to intervention or waitinglist control conditions. After a brief introduction to research into the prevention or treatment of CD, and the issues to be considered by services in selecting and delivering interventions, this article summarises the structure, content and evidence base of the IY programmes. The three Welsh studies are briefly described before exploring what factors contributed to service participation in the trials and the benefits and lessons learned in undertaking them.