Prevention: Defining Terms

Scientists and researchers are always looking for new and better ways to prevent disease, injury, and harm — both to avert human suffering and to control the tremendous economic costs that are a result of trauma, physical injury, or of ill health. But when researchers and health experts talk about “prevention,” what do they mean?

In general, prevention includes a wide range of activities - known as “interventions” or “strategies” aimed at reducing risks or threats to our health and well-being. In the public health approach to prevention, efforts are usually defined by the three categories of: Primary Prevention (first-tier), Secondary Prevention (second-tier) and Tertiary Prevention (third- tier).

Primary Prevention

Primary prevention refers to approaches that seek to eliminate the root causes of child neglect and abuse with the purpose of ensuring that child abuse and neglect never occur. The goal of primary prevention, or the first tier approach, is to stop something from ever happening. This means the Titanic never sank, no one contracts polio, and the roof did not fall in.

Eradicating polio, while a monumental global effort, had a simple solution: vaccinate everyone. Child abuse is clearly a more complex problem, needing more complex solutions. But the idea is the same – focus the attention and the efforts on the causes – not the effect. This is primary prevention. Primary prevention uses Universal interventions – meaning ones that applies to all people within a society.

Secondary Prevention

Secondary prevention, or the second tier approach, are strategies designed to decrease risks for those identified as more likely to become victims or more likely to neglect or abuse children.

Secondary prevention strategies focus on those families or groups of people that research tells us will benefit the most from the intervention. Secondary prevention efforts are a way to focus limited resources to do the most good.

Most agencies working to address child abuse and neglect focus their resources on children and families identified in some way as at-risk for abuse or neglect.

  • Child welfare and child protective service strategies are designed to intervene at once when a report of neglect or abuse is made with the goal of ensuring that the child who has been harmed is not harmed again. This secondary prevention effort is to prevent this particular child from further abuse or neglect, but this individual strategy will not prevent abuse or neglect of all children.
  • Other secondary strategies focus on children who research shows are at a higher risk for abuse or neglect because of poverty, addicted parents, no access to early learning and other factors.

Secondary prevention means using Selective interventions – ones where groups of families are chosen for certain strategies because they are more at-risk than the general population.

Tertiary Prevention

Tertiary prevention, or the third tier approach, are efforts to reduce further harm to children and families who have already experienced child neglect or abuse and to stop those who have caused harm through abuse or neglect from doing so again.

Strategies are designed to help ease the harm from abuse and neglect, as much as possible, in order to support the healing and health of children as they face the challenges and long-term impact of child abuse and neglect throughout their lives.

Peer support groups, mental health interventions, legal prosecutions, medical advocacy efforts, and family support programs are also examples of tertiary prevention activities.

Tertiary prevention means using Indicated interventions that focus efforts on children and families already impacted by child abuse or neglect.