Partners In Prevention

What do we mean by prevention? Prevention is an active process of creating conditions and fostering personal attributes that promote the well-being of others.

To truly understand prevention requires a knowledge of the difference between “primary prevention” and “secondary prevention.” Primary prevention is the work we do to prevent problems before they occur. Secondary prevention, on the other hand, is a reactive, corrective effort to bring about change where there is a recognized problem. The tools, methods, and approaches of secondary prevention will not produce culture change; they work at the level of improving the behavior of individual students, one at a time.

Both types of prevention are equally important. Successful efforts in a community should contain both primary and secondary prevention strategies. However, if we are looking to truly prevent a problem – before it happens – it is critical to start with primary prevention. There are three important components to primary prevention:

• Reaching an Entire Population
• Developing a comprehensive program
• Implementing science-based prevention strategies

A combination of these three components will help define a successful prevention program.

Preventing problems on an individual level is important but to have a sustainable impact requires affecting an entire population – to decrease the effects of peer pressure, to remove stigma and/or to develop formal or informal support networks. By reaching out to an entire population, you can leverage social networks of students to produce significant improvement in perception and behavior, while inspiring social and cultural change. When implemented correctly, such a method changes not only an individual but a whole culture. In order for this method to achieve its potential, high levels of participation within a population are critical.

Why does it work? When all members of a social network – like an entire grade or even school – are exposed to a similar experience, they develop a common bond, whether or not that experience is perceived as positive or negative. The network’s members receive a common language that facilitates dialogue about cultural values and change. Most importantly, the group is large enough to create a critical mass of individuals leading to a “tipping point” toward change. And the “viral” dialogue that ensues improves the chances that the prevention messaging will “stick”.

The second critical piece of effective prevention programming is developing a comprehensive program. We must all remember: there is no silver bullet in any prevention programming. And none of us should be satisfied with “plugging a hole” or implementing an ineffective tool just to say we have addressed our prevention goals. Prevention programming involves careful planning of a comprehensive program that links multiple prevention efforts. That comprehensive plan may vary but it could include:

• Information and community awareness
• Education and skill development
• Alternative activities
• Community development, capacity building and institutional change
• Social policy
• Early intervention strategies

A comprehensive prevention effort would use many, if not all, of the prevention strategies above targeted at multiple domains within the population. For instance, a prevention effort within a school system would use multiple strategies targeted to not just students, but faculty, staff, coaches, parents and community members as well.

It is also important to remember that prevention is a work in progress, not a one-time effort. Behavior change rarely happens all at once, or immediately. As James Prochaska’s “stages of change” theory suggests, people go through a process of change that requires several steps or stages. Your comprehensive plan must recognize that even after going through the same prevention program, a group of students will lie along a spectrum in these stages of change, some ready to change, some thinking about changing and some not prepared to take any steps. And, when working at the primary prevention level, some may not even need to change.

Ensuring that the strategies on which we rely for our prevention efforts are science-based is the third important component in a successful prevention plan. Science-based refers to a process in which experts:

• Use commonly agreed upon terms and concepts
• Use commonly agreed upon criteria for rating research interventions
• Come to a consensus that evaluation research findings are credible and can be substantiated

From this process, a set of effective principles, strategies, and model programs can be derived to guide prevention efforts. It is also important to recognize that many prevention “best practices” have already been established. We can leverage those to ensure success with our own plans. Some of those best practices include incorporating research and a conceptual framework; measuring the accuracy, efficacy and credibility of the approach; developing measurable goals and objectives; having a long-term commitment; integrating overall health promotion; evaluating the process and outcome; providing a comprehensive approach; garnering community involvement and ownership; and ensuring replicability.

Ultimately, we must recognize that there are a number of stumbling blocks lying ahead of our children. Our job as educators, prevention experts and community citizens is to:

• Provide a safe environment for our youth to live, work and play.
• Offer them resources and alternatives for emotionally and physically healthy living.
• Prepare them to make appropriate choices in their lives.
• Have youth practice making appropriate choices as often as possible.

We encourage you to think about where your community needs the most help and to begin developing a prevention plan today.

If the Partners in Prevention can be of any assistance to you, please feel free to contact the MIAA at 508-541-7997 or contact the Massachusetts Substance Abuse Information and Education Hotline at 1-800-327-5050.

Approved unanimously at the MIAA Partners in Prevention Meeting on 6/6/05