Types of Prevention: Primary, Secondary, Tertiary
According to the Prevention Institute, prevention is “a systematic process that promotes healthy environments and behaviors and reduces the likelihood or frequency of violence against women occurring.” Primary prevention strategies, “are carried out before the sexual violence initially occurs, and these strategies focus on stopping conditions that support sexual violence, focus on promoting conditions that inhibit sexual violence, and promote positive behaviors and develop skills that we want others to adopt in order to prevent sexual violence” (North Carolina Coalition Against Sexual Violence).
Primary prevention is often classified as an “upstream” approach. A common explanation of need for primary prevention is the “River Story” highlighting the need to “go upstream” to prevent future problems.
The Centers for Disease Control and Prevention (2004) recognizes that there are several ways to classify sexual violence prevention and intervention activities. The most common and useful way, from a public health perspective, is to adapt the Commission on Chronic Illness’ (1957) disease prevention classification scheme in a way that identifies activities according to when they occur in relation to the violence:
Primary Prevention: Activities that take place before sexual violence has occurred to prevent initial perpetration or victimization. Primary Prevention efforts are guided by theory, strategy, and evaluation.
- Secondary Prevention: Immediate responses after the sexual violence has occurred to deal with the short-term consequences of violence.
- Tertiary Prevention: Long-term responses after sexual violence have occurred to deal with the lasting consequences of violence and sex offender treatment interventions.
- When all three types (primary, secondary, and tertiary) are used together, they create a comprehensive response to sexual violence.
Over the last thirty years, most efforts in response to violence against women could be classified as secondary or tertiary forms of prevention. Activities to promote awareness of the problem of violence against women are a crucial effort, though they are generally not recognized as primary prevention. Similarly, identifying resources for those who have been abused, activities intended to identify those who have been abused are not primary prevention activities.
To address violence against women prevention in a truly comprehensive manner, strategies to prevent its initial perpetration and victimization (primary prevention) must reach the same level of efficacy and adoption as programs that respond to its consequences.
On the Center for Disease Control and Prevention’s Veto Violence web site, they have created several online eLearning courses about basic public health prevention concepts such as the social ecological model and primary, secondary and tertiary prevention. These online courses, called Principles of Prevention, will be very helpful as part of the basic training to introduce people to prevention concepts.
- Banyard, V. L., Plante, E. G., & Moynihan, M. M. (2004). Bystander education: Bringing a broader community perspective to sexual violence prevention. Journal of Community Psychology, 32(1), 61.
- Centers for Disease Control and Prevention. (2004). Sexual Violence Prevention: Beginning the Dialogue. Atlanta, GA: U.S. Centers for Disease Control and Prevention.
- Clinton-Sherrod, M., Gibbs, D., Vincus, A., Squire, S., Cignetti, C., Pettibone, K., et al. (2003). Report Describing Projects Designed to Prevent First-Time Male Perpetration of Sexual Violence. Research Triangle Park, NC: RTI International.
- Commission on Chronic Illness. (1957). Chronic Illness in the United States (Vol. 1). Cambridge, MA: Harvard University Press.
- Gordon, R. S. (1983). An operational classification of disease prevention. Public Health Reports, 98(2), 107-109.
- Rozee, P.D., & Koss, M. P. (2001). Rape: A century of resistance, Psychology of Women Quarterly, 25, 295-311.