or other trauma), indicated prevention (for children identified as having aggression, peer problems, prodromal signs of depression, etc.), or treatment are rare. The fragmented nature of the models created by curriculum developers and researchers as well as the often fragmented planning between schools, government agencies, and the private sector of human services contribute to this problem.

Social settings that have not been often targeted to house preventive interventions include important microsystems and exosystems (systems that affect the child but do not directly include the child, such as a parent’s workplace) of human development (Bronfenbrenner and Morris, 1998). Workforce development organizations, for example, have the potential to influence parental employment, which in turn is related to early childhood development. Community-based organizations (aside from child care and preschool programs) have also been underutilized. They may be settings that families trust (e.g., organizations serving immigrant populations) and that therefore may be productive settings for child- or family-focused programs. The primary health care system has also generally been overlooked as a setting for preventive interventions. Finally, the bulk of child care–based interventions have occurred in center-based settings, with family day care settings rarely targeted for quality improvement or implementation of specific preventive curricula.

Other service systems also have potentially much to gain from prevention. Communities have to invest significant resources to handle delinquent youth through the juvenile justice system, to counter ineffective or unsafe parenting through the foster care system, and to counter difficulties in learning or behavior through special education. The missions of all these programs are clear: to provide services to those who are in serious need. However, these systems usually do not embrace the mission of preventing these problems from arising in the first place. Unless prevention can find ways to integrate its work into the central missions of these and other community institutions (Kellam, 2000), the prevention focus will continue to be lacking.

Two reports of the Institute of Medicine call for an increase in bidirectional communication between researchers and organizations and social service settings in which prevention can be housed (Institute of Medicine, 1994, 1998). It seems sensible that research efforts should be directed toward understanding and facilitating such communications, although little research has been conducted in this area. One study, surveying both researchers and practitioners who attended the same bereavement conference on modes of communication, found relatively modest overlap (Bridging Work Group, 2005).



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