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Empirically Based Mean Effect Size Distributions for Universal Prevention Programs Targeting School-Aged Youth: A Review of Meta-Analyses


This review of reviews presents an empirically based set of mean effect size distributions for judging the relative impact of the effects of universal mental health promotion and prevention programs for school-age youth (ages 5 through 18) across a range of program targets and types of outcomes. Mean effect size distributions were established by examining the findings from 74 meta-analyses of universal prevention and promotion programs that included more than 1100 controlled outcome studies involving over 490,000 school-age youth. The distributions of mean effect sizes from these meta-analyses indicated considerable variability across program targets and outcomes that differed substantially from Cohen’s (1988, Statistical power analysis for the behavioral sciences (2nd ed.)) widely used set of conventions for assessing if effects are small, medium, or large. These updated mean effect size distributions will provide researchers, practitioners, and funders with more appropriate evidence-based standards for judging the relative effects of universal prevention programs for youth. Limitations in current data and directions for future work are also discussed.

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Fig. 1


  1. 1.

    Namely, a meta-analysis might have synthesized findings from universal prevention programs reporting substance use outcomes, regardless of the primary target of the intervention. In this instance, results from a delinquency prevention trial reporting substance use outcomes might have been included in the meta-analysis. In our coding, this meta-analysis would have been categorized as a “substance use program,” unless the meta-analysis authors reported additional subgroup results by actual program target.

  2. 2.

    We conducted sensitivity analyses (shown in the online Appendix) to assess how the inclusion of dependent mean effect sizes within-meta-analyses influenced the results. Those sensitivity analyses included one mean effect size estimate from each meta-analysis, where we selected the mean effect size based on the largest number of primary studies. Results from those sensitivity analyses are substantively similar to those reported in Table 2.

  3. 3.

    As shown in the follow-up mean effect size distributions in Appendix B, there was consistent evidence that follow-up mean effects were smaller than immediate posttest mean effects. These findings should be interpreted cautiously, however, given that only 25 of the 74 included meta-analyses reported follow-up effect sizes.


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Correspondence to Emily E. Tanner-Smith.

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Conflict of Interest

The authors declare that they have no conflicts of interest. JAD acknowledges that he is an author of several meta-analyses included in this review, but he was not involved in extracting any data from those meta-analyses for the purposes of this review.

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This article does not contain any studies with human participants performed by any of the authors.

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Tanner-Smith, E.E., Durlak, J.A. & Marx, R.A. Empirically Based Mean Effect Size Distributions for Universal Prevention Programs Targeting School-Aged Youth: A Review of Meta-Analyses. Prev Sci 19, 1091–1101 (2018).

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  • Effect sizes
  • Meta-analysis
  • Universal prevention
  • Youth