Annual Research Review: Universal and targeted strategies for assigning interventions to achieve population impact.

Journal Article (Review;Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Dodge, KA

Published Date

  • March 2020

Published In

Volume / Issue

  • 61 / 3

Start / End Page

  • 255 - 267

PubMed ID

  • 31643089

Electronic International Standard Serial Number (EISSN)

  • 1469-7610

International Standard Serial Number (ISSN)

  • 0021-9630

Digital Object Identifier (DOI)

  • 10.1111/jcpp.13141


  • eng