roles and interactions among multiple genetic and epigenetic influences on brain development may lead to strategies to tailor preventive interventions to specific individuals or groups of individuals at greatest risk.

  • Economic analyses. The challenges of conducting economic analyses and the relative novelty of this type of analysis in the prevention field suggest the need for guidelines for conducting economic analyses (cost-effectiveness and cost-benefit analyses) as well as provision of incentives to encourage their inclusion in study designs. Evidence of the economic benefits of preventive interventions will make them more valuable to communities as they decide about the distribution of limited resources.

  • Competencies. Competencies related to age-appropriate developmental tasks in the family, school, peer group, and community play an important role in mental health. The etiology and development of competencies need to be better understood. Methods to assess the relative value and effects of different types of competencies on development of and protection from disorders require attention.

  • Use of technology. The Internet, mass media, and other current technologies (e.g., CD-ROMs) represent potential mechanisms to reach large segments of the population. Research in this area should be conducted to determine whether such media can be used effectively to promote mental health or to prevent disorders.

  • Other research gaps. Despite dramatic increases in prevention research, significant gaps remain regarding populations and settings to be targeted.

Given the modest effect sizes of some interventions, research funders are encouraged to support research to improve the breadth of the application and effectiveness of current evidence-based interventions and to develop new, more effective interventions. They should also direct researchers to measure outcomes over time, ideally across developmental periods, analyze multiple outcomes (including the effects on multiple disorders), and assess iatrogenic effects. Researchers in turn are encouraged to design interventions and evaluations that respond to these concerns (see Box S-5).

Finally, the gap is substantial between what is known and what is actually being done. The nation is now well positioned to equip young people with the skills, interests, assets, and health habits needed to live healthy, happy, and productive lives in caring relationships that strengthen the social fabric. This can be achieved by refining the science and by developing the infrastructure and large-scale collaborative systems that allow the equitable delivery of population-based preventive approaches. We call on the nation to build on the extensive research now available by implement-



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