Since the ultimate goal of prevention is to stop violence before it begins, prevention requires understanding the factors that influence the problem. Prevention paradigms, originally designed to reduce health problems arising from infectious diseases, have been successfully grafted to prevent social and behavioral problems. We briefly outline of three models. To be effective in different communities, these models almost require plasticity, so that unique contextual factors can shape original strategies, and the models can absorb and thrive on change.
From the Institute of Medicine (IOM)
Universal programs address the entire population with messages and programs aimed at preventing or delaying problem behaviors. The entire community benefits from it.
Selective/Targeted programs select subsets of the total population that are assessed as at risk for problem behaviors by virtue of their membership to a particular population segment. The goal is to prevent the development of serious problems.
Indicated programs identify individuals who are exhibiting early signs of problem behavior(s) and aim special programs at them to prevent further onset of difficulties.
The public health model
Primary prevention aims to avoid problems before they appear, and includes activities, programs, and practices designed for everyone in the general population to alter the set of opportunities, risks, and expectations surrounding them.
Secondary prevention identifies persons in the early stages of problem behaviors and attempts to reduce negative consequences by changing problem behavior through counseling or treatment. It is often referred to as early intervention.
Tertiary prevention strives to end problem behavior and/or to ameliorate its harmful effects through treatment and rehabilitation. This is most often referred to as treatment but also includes rehabilitation and relapse prevention.
From the CDC, this model considers the complex interplay between 4 levels - individual, relationship, community, and societal factors – that increase the likelihood of becoming a victim or perpetrator of violence.
Individual Level Identifies biological and personal history factors such as age, education, income, or abuse history. Prevention is designed to promote changes in attitudes, beliefs, and behaviors.
Relationship Level Examines close relationships -peers, partners, family members- that may increase victimization or perpetration risk. Prevention programs reduce conflict, foster problem-solving skills, and promote healthy relationships.
Community Level Explores settings, such as schools, workplaces, and neighborhoods, in which social relationships occur. Prevention strategies aim to impact the climate, and policies and procedures in systems, e.g., social norm and social marketing campaigns to promote healthy relationships.
Societal Level Looks at broad societal factors that encourage or inhibit violence; such as social and cultural norms, health, economic, educational and social policies that lead to inequalities.
In the closing section, several future research priorities are outlined and a number of key conclusions drawn.
This is a short, not comprehensive, list of national prevention work.
Community engagement approaches to prevention in Asian and Pacific Islander programs are in the Community Organizing section. New Visions is an exemplary leader in the field of community-based-organizations doing prevention work.
Persons depicted are models and are used for illustrative purposes only.
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