Annual Research Review: Universal and targeted strategies for assigning interventions to achieve population impact.
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.
Duke Scholars
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Related Subject Headings
- Preventive Health Services
- Patient Selection
- Outcome and Process Assessment, Health Care
- Mental Disorders
- Humans
- Developmental & Child Psychology
- Cost-Benefit Analysis
- 5203 Clinical and health psychology
- 5201 Applied and developmental psychology
- 3202 Clinical sciences
Citation
Published In
DOI
EISSN
ISSN
Publication Date
Volume
Issue
Start / End Page
Related Subject Headings
- Preventive Health Services
- Patient Selection
- Outcome and Process Assessment, Health Care
- Mental Disorders
- Humans
- Developmental & Child Psychology
- Cost-Benefit Analysis
- 5203 Clinical and health psychology
- 5201 Applied and developmental psychology
- 3202 Clinical sciences