Kernels for-life-manitoba-2010

Kernels for Life:
from what we know about prevention science
and human development to what we do for
children and youth for our futures…

Twitter hashtag: #HCMMB
Slides and publications
http://www.slideshare.net/drdennisembry

Copyright © 2010, PAXIS Institute, All rights reserved. May be reproduced in whole without charge, provided copyright notice included.

Thursday, November 18, 2010 1

We must move in the right
direction, with all due speed for
the next decade—not just for
the children of Manitoba, but
also as the Inukshuk for the
Western Hemisphere.


FREE DOWNLOAD

Embry, D. D., & Biglan, A. (2008).
Evidence-Based Kernels:
Fundamental Units of Behavioral
Inﬂuence. Clinical Child & Family
Psychology Review, 39.

Download at:

www.pubmed.gov
Described in the 2009 IOM Report, p. 210


Relational
Antecedent Reinforcement Physiological
Frame
Kernel Kernel Kernel
Kernel

Changes Creates verbal
Happens BEFORE Happens AFTER the
biochemistry of relations for the
the behavior behavior
behavior behavior

Embry, D. D., & Biglan, A.
(2008). Evidence-Based

Four Types of Kernels
Kernels: Fundamental Units
of Behavioral Inﬂuence.
Clinical Child & Family
Psychology Review, 39.


What is a kernel?
Is the smallest unit of scientiﬁcally proven behavioral
inﬂuence.

• Is indivisible; that is, removing any part makes it inactive.

Produces quick easily measured change that can grow
much bigger change over time.

Can be be used alone OR combined with other kernels
to create new programs, strategies or policies.
• Are the active ingredients of evidence-based programs
• Can be spread by word-of-mouth, by modeling, by non
professionals.
• Can address historic disparities without stigma, in part
because they are also found in cultural wisdom.


Rapid


Community Prenatal Ages 0-2 Ages 3-5
Text Text Text Text

Primary Intermediate Early Teens Later Teens


Your take away task for communities and families…
List five ideas you can take back to your
community or even your own family
Explain the benefits of how these five things
Ask others to try one or more of these thing
Ask them use their social and electronic
networks to spread these ideas
For the benefit of all children and families in
Manitoba


Epigensis revisited Fraser
Mustard’s talk


Obesity
Conduct
Disorders

Homicide &
Suicide

Early Sex

Early
Pregnancy
Addictions

Aggression
Disease

School
failure

Epigensis results in a risky path or a healthy path

Redness, rubor, a response of body tissues to
injury or irritation; characterized by pain and
swelling and redness and heat.
Excitation, excitement, fervor, fervour the state of
being emotionally aroused and worked up
Inflaming arousal to violent emotion
Firing, ignition, kindling, lighting
the act of setting on fire or catching fire

Hypothesis: Evolutionary “inflammatory” processes


Threat from parasites, Threat from humans
bacteria, and viruses who might kill or steal


Human Infectious/Biological Threats Human Predatory Threats

Evolutionary Adaptive Responses Evolutionary Adaptive Responses
(Simplified) (Simplified)
Neuro-Hormones

Mood
Modulators

Reward Delay Intra-Group Threat Attributional
Generalized Localized Modulators
Affiliation Bias (Inflammatory)
Inflammatory Inflammatory (Anti-Inflammatory)
Out-Group
Response Response Stress
Modulators
Aggress. (Inflammatory)
Intra-Group
Cooperation Tit-for-Tat Beh. Bias
Anti-Inflammatory Regulators Puberty/Sex (Anti-Inflammatory)
Modulators (Inflammatory)


Substance Work Obesity,
Early Mental Illness Violence Cancer School
Abuse Problems etc
Sex Failure

Mood Reward Executive Behavioral
Attention
Stability Delay Function Competencies

Immune-
STD’s Motor Healing Special
Skills Multi-Inﬂammatory Threat Reaction Functions Ed

Major Ecologic Causes of the Dual Inﬂammatory Threats to Children & Youth

Physiological Antecedents Reinforcement Verbal Relations


K R
Path Path

Evolutionary Path
of a Child’s Life

Probability of short-life and doubtful
Probability of long-life and reproductive success
reproductive success


Obesity
Conduct
Disorders

Homicide &
Suicide

Early Sex

Early
Pregnancy
Addictions

Aggression
Disease

School
Disabilities
failure

R PATH = Risky behaviors or health

Physically and Successful in
emotionally life-long
healthy learning

Safe and Socially engaged
secure Healthy Child and responsible
Manitoba


Community Prenatal Ages 0-2 Ages 3-5
Text Text Text Text

Primary Intermediate Early Teens Later Teens


Coaster and Poster case study for women


Do these effect
epigensis?


Antecedent
Kernel

Happens BEFORE
the behavior


Addictions intervention or treatment kernels


Antecedent
Kernel

“Wait for the Timer” for addictions and other issues


Reinforcement
Kernel

“Prize Bowl” for change, recovery & addictions


Reward & Reminder case study on tobacco


Reward &
Reminder:
Logic
model


Baseline After Reward and Reminder
60%
Wyoming

Percentage of Illegal or Non-Compliant Tobacco Sales to Minors
50%

40%

Reward & 30%

Reminder Impact
20%

10%

on Access 0%
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
60%
Wisconsin
50%

40%

30%

20%

10%

0%
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Data Source: Synar Report, SAMSA


Reward &
Reminder:
Impact on
prevalence

Source: Youth Risk Behavior Survey (YRBS), Centers for Disease Control


The Lancet case study on ﬁsh consumption


Apparent consumption o inoleic acid (% of dietary energy) among
Australia, Canada, UK and USA for the years 1961–2000

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“Risky” Beh.
Evolution Neonates Breast Milk
& Mismatch
In the Rife Valley, the Successful human American infants have
human brain evolution neonates born with been getting steadily Theory
the result of eating 60-day supply of less omega-3 (n3) and Almost all adolescent
fish high in omega-3 omega-3 in more pro-inflammatory risky behaviors have
omega-6 (n6) in breast now been documented
not savannah animals subcutaneous fat from
milk to be related to low n3
mother’s diet
and high n6 in US diet
See Broadhurst, Cunnane, &
Crawford (1998). Rift Valley lake fish
See HIbbeln et al. (2007).Maternal
seafood consumption in pregnancy and
See Ailhaud et al. (2006).Temporal change in last 50 years
changes in dietary fats: Role of n6
and shellfish provided brain-specific neurodevelopmental outcomes in Hibbeln et al. (2006). Healthy intakes of
polyunsaturated fatty acids in excessive
nutrition for childhood (ALSPAC study): an adipose tissue n-3 and n-6 fatty acids: estimations
early Homo observational cohort study considering worldwide diversity.
development and relationship to obesity


Low maternal omega-3 consumption from
seafood and
34

Physiological 32

Kernel
30
Percentage of children with
low verbal IQ, WISC-III , 8y

28 Hibbeln et al, Lancet 2007: 369: 578-585
UK

26
r = 0.97
24 r2 = 0.95
F=27.2
22 p<0.02.

20
Changes 18

biochemistry of 16

behavior 14

0 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 0.55 0.60

-
Estimated omega 3 fatty acids from seafood (en %)
Mother at 32 wk gestation


Physiological Mother
Mother

concordant

Kernel
concordant

exceeds

Changes
biochemistry of
behavior
Mother
concordant
Mother
concordant

exceeds
exceeds


Omega-3 for all pregnant mothers, nursing
mothers and weaned infants and toddlers


The cost? About $40 per year


Why not help our serious at-
risk children with omega-3?
30%
Percentage with Psychosis at 12 months

27.5%
24%

18%

12%

6%
4.9%
0%
Omega-3 Placeo
Psychosis

Amminger, G. P., M. R. Schafer, et al. (2010). "Long-Chain {omega}-3 Fatty Acids for Indicated
Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." Arch Gen
Psychiatry 67(2): 146-154.

Before Omega 3

Omega-3 can improve school
grades and success
Omega 3 Placebo
7
These were gains in
6
After Omega 3 academics after 3
5
months of
4
exposure to ﬁsh oil.
3
2
1
0
-1
-2
Reading Spelling See www.durhamtrial.org/


The British and Netherlands Prison Studies


Reduce Omega 3 and
Micronutrient Brain Deﬁciency


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0.25 Placebo

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Before supplementation During supplementation

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Why not reproduce the rapid
results in Manitoba to get a
37% reduction in jail violence?
It cost the Brits 19¢ per day or $69.35 per year.


Safe Playing Case Study


A environmental policy
case study in reducing
early rebelliousness, risk
taking and sensation
seeking
This risk factor can be easily measured in early-childhood, and it
predicts lifetime injuries, delinquency, alcohol/drug abuse abuse,
and school difﬁculties.


Contextual example of such risk


Oh,prior prevention efforts in Sweden had resulted
in more fatalities…


A book about “me” being a Safe Player


Adults deﬁning boundaries of safe play


Adults setting timer to watch safe play in child


Parent praising safe play with stickers


Study 1 showed preschool intervention alone had short-
term beneﬁts

Study 2 showed preschool plus parenting intervention had
long-term beneﬁts

Study 3 showed strategy could be implemented in 35 Head
Starts nationally

Study 4 showed parents could change child’s behavior from
special story workbook

Study 5 showed behavior change for over 100 preschoolers,
with no adverse effect.

Study 6 showed effort could be successful in a 3-city
multiple baseline in New Zealand

Study 7 is national campaign, adopted by 50% of New
Zealand families

Study 8 replicates city results in US


Kernels and 4-P’s used in multi-city/national
Safe Playing campaign
Proclamations in cities and nationally
Endorsements/Sponsorships by prestige organizations AND businesses
Media models of adoption by high-status people
Media models showing rapid results/beneﬁts
Public posting of rates of adoption/use
Competitions between cities on adoptions

Placement in supermarket or other easy venues
Price free after ﬁlling out Safe Playing Promise (with address, etc.)
Promotion for every family who wants their child to be safe
Product promises child will be safer in two weeks when steps followed


Why not distribute specially
constructed books for
parents with young children…
Reduce dangerous,
impulsive, disturbing
behavior quickly?
Increase social-
competence quickly?
Improve school
readiness quickly?

Embry, D. D. and L. Peters (1985). A three-city evaluation of the diffusion of a pedestrian-safety
injury control intervention. R. S. Division, New Zealand Ministry of Transport, Wellington, NZ.

Good Behavior Game Case Study


Why not turn about the lives of high risk primary
grade children using a teacher invented procedure?

Muriel Saunders,
the teacher


Her invention immediately increases time to learn


Why not turn about the lives of high risk primary
grade children using a teacher invented procedure?


Community reinforcement case study


PeaceBuilders School-Community Reinforcement Study

Positive Peer-to-Peer Social
Home Notes Notes Competence Violence


Injury Prevention Study Using Positive Reinforcement
60%

50% Change in
40%
Nurses’ Ofﬁce
Visits from Year to
30%
Year
20%

10%

0%

-10%

-20%
All Visits Injury Viists Non-Injuries Fighting Injuries Non-Fighting Injuries

Control/Wait List Intervention

Krug, E. G., N. D. Brener, et al. (1997). "The impact of an elementary school-based violence prevention program on
visits to the school nurse." American Journal of Preventive Medicine 13(6): 459-463.

Prevention Store

Prevention Science Meets
Retail Consumers
Dennis D. Embry, Ph.D., Society for Prevention Research, Denver, June, 2010


If kernels are so good…


How have kernels evolved?
The ﬁrst (almost certainly antecedents) were selected by
consequence for immediate reinforcement of food, protection, etc.
Early tools come to mind as examples.
The second (physiological) probably also arouse by selection by
consequences by providing relief from physical or emotional
distress.
The third (relational frames) arouse with invention of oral and
written language, selected by consequences to protect against
danger from other humans or natural harm.
The forth (contingent reinforcement) arouse with invention of oral
and written language, selected by consequences for social
advantage within groups and survival advantage of kin.


Using kernels to build
population-level change…
Problem
Kernel
#1 Observed
Proximal
Observed Effect
Kernel
Proximal Kernel
#2
Effect

Kernel Big
Kernel
#3 Change
Effect
Observed
Proximal
Effect
t


Rule #1 of big change
A big population-level change requires
myriads of reliable, measurable small
behavioral changes in at least 20% to 25% of
the the total population.
Blame is not a kernel. A diagnoses is not a kernel.
“Shoulds” are not a kernel. Blame, diagnoses, and
“shoulds” are personal or group ways of
experiential avoidance for dealing with failure of the
methods to create desired change.


Always maximize the dignity and self-sufficiency of the
persons whose behavior you wish to influence.
If you fail this step, you will be meet resistance,
counter-control and sabotage of the group of persons
to maintain their dignity and self-sufficiency. This is a
basic feature of human social interactions from which
our species has evolved. Dead, disposed or failed
chiefs and leaders liter human history who failed to
observe the key universal feature of human societies.


Pay attention to variations in behavior for improvement.

Small differences—when done by many people—
can make the difference between night and day.
These small differences are the the variation in
quality control that great car companies like
Toyota or Honda to make incremental
improvements. Look for innovations as well as
problems.


Rule # 4 Big Change with a
kernel requires other kernels
A kernel that you want to promote to affect a
speciﬁc behavior will require other kernels to make
the speciﬁc action happen. This because other
behaviors or people will be required before and
after or in other settings for cooperation to happen.


Why not use a new word to convey our support
every child being healthy in Manitoba


Spreading healthy children in Manitoba like dandelions


is the gift of our futures


Contact: Dr. Dennis D. Embry, PAXIS Institute, PO Box 31205, Tucson, AZ USA
dde@paxis.org • www.paxis.org • www.slideshare.net/drdennisembry


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