engleski

Study of effectiveness of prevention programs

There is an increasing focus on the effectiveness of mental health promotion and prevention interventions worldwide. Many studies have shown that mental health promotion and prevention interventions can be effective in reducing mental, emotional and behavioural problems (Botvin et al., 2006 ; Hawkins et al., 2005 ; Hosman et al., 2004 ; Tobler and Stratton, 1997). This doctoral study was conducted with the intention to provide deeper understanding of mental health promotion and prevention programs’ effectiveness in Croatian context. A study was a part of a project “Preffi – Quality Assurance in the County of Istria” initiated by the University of Zagreb, Faculty of Education and Rehabilitation Sciences and the Department of Health and Social Services in County of Istria. Main assumption of the project was that the incorporation of evidence-based principles is crucial in improving the quality and effectiveness of mental health promotion and prevention practice. The study included 24 mental health promotion and prevention programs proposed by NGO's and other institutions from Istria and financed by the Department. All programs were assessed with the quality assessment instrument - Preffi 2.0. Programs were divided into two groups, experimental and control. Program’s managers and deliverers from the experimental group were involved into the Training for Prevention intervention. In order to assess if the Training had an impact on programs’ effectiveness, the outcome evaluation of programs from both conditions was conducted. The results of the study on metric characteristic of Preffi 2.0 shown that the instrument has a high content validity and that it is reliable in assessing the quality of programs’ proposals. Concerning the predictive validity of Preffi 2.0, the results of a correlation analysis have shown that there is no significant correlation between total scores on Preffi 2.0 and the effect sizes of programs. However, it was found that there is a moderate, positive linear relationship between two Preffi clusters and effects of programs. A method of meta-analysis has shown that programs whose managers and deliverers were involved in the Training didn't achieve significantly higher scores on effectiveness comparing to those programs which were not involved in the Training. However, the analysis has shown that the Training for prevention influence on the programs’ effect sizes is marginally significant at the level of 10% (p=.11). Programs' managers and deliverers who were involved in the Training achieve significantly higher scores on three Preffi clusters after the Training in comparison with programs which were not involved in the Training. Assessment of written programs’ proposals with the Preffi 2.0 instrument has offered an insight into each program’s quality level and into the average quality level of 24 programs from the County of Istria. The results suggest that the general quality level of the assessed programs’ proposals from the County of Istria is rather low. Existing strengths and weaknesses of assessed programs are detected and described. Based on the study results, recommendations for Preffi 2.0 and Training for Prevention improvement and future studies are given. Perspectives of the Preffi 2.0 and Training for Prevention in improving prevention capacities in Croatia are also elaborated in this doctoral dissertation.

mental health promotion; prevention; effect predictors; effectiveness; quality assessment; quality assurance

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