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Annual Research Review: Universal and targeted strategies for assigning interventions to achieve population impact
Author(s) -
Dodge Kenneth A.
Publication year - 2020
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.13141
Subject(s) - psychological intervention , intervention (counseling) , population , identification (biology) , psychology , heuristic , spillover effect , risk analysis (engineering) , affect (linguistics) , computer science , medicine , psychiatry , artificial intelligence , economics , environmental health , microeconomics , botany , communication , biology
This article proposes that universal and targeted preventive interventions should be compared and evaluated in terms of their benefit–cost ratio in achieving population‐wide impact on mental disorders and related outcomes. Universal approaches attempt to affect every individual in a population, whereas targeted approaches select candidates for intervention based on screening of demographic or behavioral characteristics. Unique assets and challenges of each approach in achieving population impact in a cost‐efficient way are discussed, along with spillover effects, sensitivity and specificity, developmental processes, timing of intervention, and the relation between severity of risk and plasticity. A general targeted‐efficiency framework is proposed as a heuristic to evaluate the collective merits of universal and targeted approaches in specific cases. A tiered approach that combines universal and targeted identification strategies is proposed, and examples are described. Issues for high‐priority research are identified.