WHAT IS PRIMARY PREVENTION?
Three Levels of Prevention
- Primary – Approaches that take place before domestic violence has occurred to prevent first time victimization or perpetration (before)
- Secondary – To intervene, respond and/or prevent violence from happening again and deal with short-term consequences (after, intermediate) -i.e. arrest, emergency shelter, medical attention
- Tertiary – To provide ongoing support to victims and ongoing accountability to abusers (after, long term) – i.e. Support Group and Batterer Accountability Programs through Probation.
Primary prevention is on a continuum with intervention (secondary or tertiary prevention). Primary prevention activities can be designed to compliment intervention strategies that are already in place in a community.
Models, Tools, & Approaches
The Public Health Model offers a four step approach for developing primary prevention strategies:
- Define problem or need
- Identify risk and protective factors
- Develop and evaluate prevention strategies
- Disseminate promising strategies
Social Ecological Model
Individual behavior development, change, and maintenance are influenced by each level of the social ecology. The four levels of the social ecology are: individual, relationship, community and society. (An organizational level can also be included and can be found in other versions of this nested model.)
Accordingly, each level of the social ecological model can be thought of as an avenue through which individual behavior development, change, and maintenance can be promoted. To prevent IPV from initially occurring, each level of the social ecology offers opportunities to develop and maintain individual behavior associated with non-violence and change behaviors associated with violence. When you are developing prevention strategies across the four levels of the social ecology, the key is to note which avenue you are using to influence individual behavior.
Each level is connected and reinforces the others, while representing separate, but complementary avenues through which to prevent domestic violence.
- Strategies can be directed at individuals to change their social/ cognitive skills/ behaviors
- These activities are designed to change the people in close interpersonal relationship with your targeted individuals
- Activities designed to change environments in communities – common social settings, groups or organizations, i.e. schools, may do so through changing the climate or conditions that allow domestic violence to exist by addressing policy, training and interpersonal skills of people in these settings
- Changing societal or cultural norms through media or legislative advocacy designed to effect broader, systemic social change, i.e. economic development, national or statewide social marketing campaigns.
Universal, Selected and Indicated Approaches
Prevention activities and strategies can be directed at an entire population (universal strategies,) at a group considered “at risk” (selected) or at a group already exposed to violence or has already perpetrated or has been victims (indicated). Stopping violence before it occurs, irrespective of who might be at risk for perpetration or vulnerable to being victimized, may be addressed by a prevention program that addresses the whole population (universal.) This involves moving beyond raising awareness and increasing knowledge to changing attitudes, behaviors and beliefs (KABB’s,) in order to change the conditions in a community that allow domestic and sexual violence to thrive. NYSCADV believes that employing an “action learning” approach increases the chance of prevention activities achieving successful outcomes. “Action learning” gives training participants opportunities to dialogue and engage in activities that help them practice the skills that the program is promoting.
Strategies for Developing Primary Prevention Messages
- Identify the social norms and “negative” messages/incentives and act to remove or change them
- Create and promote “positive” messages/incentives through established community systems and key individuals such as Public Opinion Leaders (POL’s.) Utilize a peer service learning model in schools.
- Saturate individuals in the chosen setting or community with multiple prevention messages over time. Research indicates that one-time events or activities are less effective in changing attitudes and behaviors due to the individuals limited exposure to the information. (Nation, et al, What Works in Prevention: Principles of Effective Prevention Programs. American Psychologist, 58, 449-456. (2003).
What Are We Trying to Change?
- Knowledge – For change in knowledge provide succinct and clear information; an increase in knowledge can occur in one-time brief (up to one hour) encounter.
- Attitudes – For change in attitude provide information and an appeal to emotions or personal impact; some practice is necessary; takes time and multiple encounters.
- Beliefs & Behavior – For change in behavior people need to demonstrate and practice new skills and communicate with others during the learning process; usually takes multiple events that include practicing the skills.
Social Change Framework
- Seek to uncover root or underlying causes of the behaviors at all levels – asking why Domestic Violence occurs/exists, what promotes it, what condones it, etc.
- Recognize the interconnectedness of oppression – racism, sexism, heterosexism, classism, adultism, ableism, etc. – challenging imbalances of power are key to creating a community which views all of its members as valuable and which views violence, including institutional violence, as intolerable.
Public Health Prevention Information Adapted from “Centers for Disease Control and Prevention. Sexual Violence Prevention: Beginning the Dialogue. Atlanta, GA: CDC, 2004.