What Works in Prevention Principles of Effective Prevention Programs Maury Nation Vanderbilt University Cindy Crusto Yale University School of Medicine Abraham Wandersman University of South Carolina Karol L. Kumpfer University of Utah Diana Seybolt University of Maryland, Baltimore Erin Morrissey-Kane and Katrina Davino University of South Carolina The high prevalence of drug abuse, delinquency, youth violence, and other youth problems creates a need to identify and disseminate effective prevention strategies. General principles gleaned from effective interventions may help prevention practitioners select, modify, or create more effective programs. Using a review-of-reviews ap- proach across 4 areas (substance abuse, risky sexual be- havior, school failure, and juvenile delinquency and vio- lence), the authors identified 9 characteristics that were consistently associated with effective prevention programs: Programs were comprehensive, included varied teaching methods, provided sufficient dosage, were theory driven, provided opportunities for positive relationships, were ap- propriately timed, were socioculturally relevant, included outcome evaluation, and involved well-trained staff. This synthesis can inform the planning and implementation of problem-specific prevention interventions, provide a ratio- nale for multiproblem prevention programs, and serve as a basis for further research. R ecent analyses concerning the status of American youth and families have concluded that the United States is a nation at risk in regard to many social indicators such as substance abuse, adolescent pregnancy, youth violence, and school dropouts (Bronfenbrenner, Mc- Clelland, Wethington, Moen, & Ceci, 1996; Weissberg, Walberg, O’Brien, & Kuster, 2003). In addition to the obvious public health concerns, the cost of the social, therapeutic, and rehabilitative services needed to address these problems has made the search for effective preven- tion programs essential. Our work with community coalitions indicates that community-based preventionists and mental health practi- tioners are seeking to provide effective prevention pro- grams. The science-based research and evaluation literature has consistently shown that a number of prevention pro- grams are beneficial in helping youth to avoid numerous problems (Albee & Gullotta, 1997; Durlak & Wells, 1997; Price, Cowen, Lorion, & Ramos-McKay, 1989; Weissberg & Greenberg, 1998). However, the difficulty in replicating expensive, science-based prevention models or proprietary commercial products has resulted in many local agencies creating or adapting their own prevention programs with marginal effects. Consequently, there is a gap between the science-based prevention programs and what is provided by practitioners to families and children in the United States (Morrissey et al., 1997). As private and public funders require greater accountability, practitioners are asking the question: What practical information does pre- vention research have to offer to improve the effectiveness of prevention practice? Furthermore, granting agencies and practitioners ask questions such as, What are the evidence- based programs that work? What is the essence of good prevention programs? and Whom should these programs target? Reviews of prevention programs have provided some answers to these questions. Some reviews provide case studies of effective programs (Albee & Gullotta, 1997) or summarize the research within a particular content area such as substance abuse (Center for Substance Abuse Pre- vention [CSAP], 2001; Tobler & Stratton, 1997), teen pregnancy (Kirby, 1997), and HIV/AIDS (Choi & Coates, 1994). An advantage of these reviews is that they can bring prevention theory within a content area to bear in drawing conclusions about the effectiveness of programs. These reviews suggest that there are some principles that tran- Editor’s note. This special issue was developed by Roger P. Weissberg and Karol L. Kumpfer as a result of the work of the APA Task Force on Prevention: Promoting Strength, Resilience, and Health in Young People. Author’s note. Maury Nation, Department of Human and Organizational Development, Vanderbilt University; Cindy Crusto, Department of Psy- chiatry, Yale University School of Medicine; Abraham Wandersman, Erin Morrissey-Kane, and Katrina Davino, Department of Psychology, Uni- versity of South Carolina; Karol L. Kumpfer, Department of Health Promotion and Education, University of Utah; Diana Seybolt, School of Medicine, University of Maryland, Baltimore. Some of the supporting documentation and references were omitted because of space limitations. We thank the following people for recommending reviews and providing feedback on earlier drafts of this article: Joy Dryfoos, Joseph Durlak, Anthony Biglan, and Maurice Elias. Correspondence concerning this article should be addressed to Maury Nation, Department of Human and Organizational Development, Vanderbilt University, Peabody College, #90, Nashville, TN 37203. E-mail: maury.nation@vanderbilt.edu 449 June/July 2003 ● American Psychologist Copyright 2003 by the American Psychological Association, Inc. 0003-066X/03/$12.00 Vol. 58, No. 6/7, 449 – 456 DOI: 10.1037/0003-066X.58.6-7.449