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


Journal Article (Review)

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

Pubmed Central 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