their community” (p. 427). In the context of youth development, Pittman argued for an increased focus on promotion nearly two decades ago, saying the field needs to move “from thinking that youth problems are merely the principal barriers to youth development to thinking that youth development serves as the most effective strategy for the prevention of youth problems” (Pittman and Fleming, 1991).

In practice there is already considerable overlap between prevention and promotion. Meta-analytic and qualitative reviews of preventive intervention studies demonstrate that many psychosocial prevention programs involve the promotion of child competencies or the healthy functioning of families, schools, or communities (Durlak and Wells, 1997, 1998; Greenberg, Domitrovich, and Bumbarger, 2001). For example, a review of programs that aim to prevent chronic delinquency through early interventions for education and family support found that effective programs have common features of promoting children’s cognitive competence and achievement and promoting secure parent-child attachment, positive parenting, and improved educational status for parents (Yoshikawa, 1994). Similarly, reviews of mental health promotion programs for children and young people cite many programs that have been demonstrated both to reduce problems and to increase positive aspects of development (e.g., National Research Council and Institute of Medicine, 2002; Catalano, Berglund, et al., 2002, 2004). Catalano, Berglund, and colleagues (2002, 2004), for example, concluded that several youth development programs that were effective in building positive development in such areas as social, emotional, and cognitive competence as well as self-determination and efficacy were also effective in reducing a range of problem behaviors, such as alcohol and drug use, violence, and aggression. Such findings are compatible with theoretical models in which competence and problem outcomes influence each other over time (see Chapter 4).

Furthermore, the committee’s inclusion of mental health promotion in the purview of the mental health field is also consistent with the recognition that health promotion is an important component of public health that goes beyond prevention of disease (Breslow, 1999). Indeed, health has been defined not simply as the absence of disease, but in a positive way as “a resource for everyday life … a positive concept emphasizing social and personal resources as well as physical capabilities” (World Health Organization, 1986). Building on this perspective, a 2004 report of the National Research Council (NRC) and the IOM proposed a new definition specifically for children’s health: “the extent to which individual children or groups of children are able or enabled to (a) develop and realize their potential, (b) satisfy their needs, and (c) develop the capacities that allow them to interact successfully with their biological, physical, and social environments” (National Research Council and Institute of Medicine, 2004a, p. 33). This



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