September 24, 2016

From Mandy Davis, LCSW, PhD, Co-Director, Trauma Informed Oregon

What Do We Mean When We Say “Prevention”?

We have focused this newsletter on prevention strategies and resources. As I started to think about prevention activities in Oregon, it got me thinking about how we define prevention—so I asked some folks (age 6 and up), “What does prevention mean to you?” Here are some of the answers:

  • Keeping something from happening.
  • Stopping something from happening.
  • Blocking.
  • Keeping bad stuff from happening.
  • Empowerment.
  • Keeping something from getting worse.
  • Helping.
  • Awareness and education.
  • The magazine on my parent’s coffee table.

These answers, all of them, make up the definition of prevention. When I ask students if their practice is a primary, secondary, or tertiary prevention strategy, I often get confused looks. Some of you, like me, have even debated (for probably too long) if an activity is primary or secondary and questioning if we even need to determine the level. I find defining prevention in these different levels is helpful because often times when we say “prevention” folks will automatically think, “keeping something from ever happening” and this does not fully reflect all of our work.

Levels of Prevention

Here is a quick description of what the levels of prevention mean:

Primary Prevention: “Promotes health and protects against exposure to risk factors.”

Example: promote positive social support, social-emotional learning

Secondary Prevention: Focuses on, “stopping or slowing the progression of disease.”

Example: assess suicide risk, screen for interpersonal violence, crisis services

Tertiary Prevention: “Improves the quality of life” of someone with a diagnosed condition.

Example: therapy animals, safe housing

Thinking Outside the Box of Prevention

In trauma work we often think prevention activities as services we provide to individuals, families, and communities. In Trauma Informed Care work I encourage us to also think about how we are applying preventions activities for our workforce such as workforce wellness programs, vicarious trauma prevention plans, on-sight health screenings, flexible scheduling, and workers’ compensation. It is important to remember that activities that connect and engage communities by providing support to one another are also activities that prevent adversity.

All of these efforts are necessary, primary to tertiary and individual to societal, as we work to build resilient organizations, schools, and communities. There are so many great things happening in Oregon—the ACE Intervention Learning Collaborative, for example. I hope you will share what you are doing or have experienced. I also want to share this resource I received recently that nicely combines prevention (health promotion and education) and trauma informed care.