It is difficult to quantify current funding for either prevention research or prevention services, due to the many agencies involved, varied definitions and tracking systems used by agencies, and the multiple levels of service funding and delivery. In some cases, prevention is a piece of a larger program or an eligible activity under a block grant, but there is no specific accounting of the proportion targeted to prevention. Similarly, programs that fund services aimed at addressing factors that contribute to prevention of mental, emotional, and behavioral (MEB) disorders clearly have an important role to play in prevention, but they cannot fairly be claimed as prevention programs in their entirety—for example, child abuse prevention programs. In addition, there is no national network or organization that coordinates all preventive efforts, either for research or services, from which funding estimates can be generated. While more states and counties have been investing in prevention activities, the scope of that investment has not been monitored systematically.
Multiple components of the U.S. Department of Health and Human Services (HHS), including the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality (AHRQ), the Maternal and Child Health Bureau (MCHB), the Centers for Disease Control and Prevention (CDC), and the Administration for Children and Families (ACF) fund prevention research involving young people. The research arms of the U.S. Department of Education (ED) and the U.S. Department of Justice and private foundations also fund relevant research. Published randomized controlled trials (see Figure 1-1) tend to be funded primarily by HHS. Of those with an identified funding source,1 almost three-quarters (74 percent) received some funding from HHS; more than half (57 percent) received all of their funding from HHS. Given that NIH is the largest source of research funding in HHS, particularly for randomized controlled trials, it is reasonable to assume that they are the primary source of this funding. Only one in four published randomized controlled trials received all of its funding from a non-U.S. government source, such as foundations or foreign governments.