Journal Issue: Domestic Violence and Children Volume 9 Number 3 Winter 1999
Innovative Primary and Secondary Prevention Efforts
Existing primary prevention efforts are often directed toward particular population groups, and secondary efforts toward identified individuals within those groups. Programs for children typically target specific age groups and utilize, in their design, what is known about child development at that particular age. As a result, programs for very young children are markedly different from programs for adolescents, for example.
Unfortunately, there is no information currently available regarding the total number of primary and secondary prevention programs that address domestic violence. The programs described below are highlighted because they illustrate the points being discussed, not because they necessarily represent the most successful programs. Comprehensive, evaluative information with regard to domestic violence prevention programs is also very limited but is presented when available.Infants and Preschool-Age Children (0 to 5 Years)
Primary and secondary prevention strategies for infants and preschool children focus on ensuring that children receive a healthy start, including freedom from emotional, physical, and sexual abuse, and from the trauma of witnessing domestic violence. Development of such strategies begins by defining the principles of a healthy child-rearing environment. Though there are differing opinions about the details of such a healthy environment,22 all experts agree that in order for very young children to thrive and grow to be nonviolent, productive adults, they must be cared for by supportive and nurturing adults, have opportunities for socialization, and have the freedom within protective boundaries to explore their world.23
Prevention programs targeting infants and preschool children have developed from the public health and nursing fields. They involve efforts to provide support for new parents through home visiting programs.24 (For more information on home visiting programs, see the spring/summer 1999 issue of The Future of Children.) Home visiting support and assistance can be delivered on a universal basis whereby all new parents receive basic in-home services for a specified time period. However, no programs with a universal approach currently exist in North America.25 Alternatively, home visiting services can be delivered to selected groups, such as families or neighborhoods, that are at greater risk for domestic violence. There are home visiting programs that currently target families identified as being at risk for child abuse,26 and include efforts to improve parenting skills27 and to prevent social isolation.28 Hawaii's Healthy Start Program is a well-known example of a prevention effort, with home visits provided to infants born to high-risk families to help prevent the incidence of child abuse and to promote other aspects of healthy child development. (See Box 1.)
To date, home visitation programs have not focused on domestic violence prevention. Yet, such programs hold promise in this area because of their emphasis on creating a healthy environment for children and because many of the families served who are at risk for child abuse are also at risk for domestic violence. Moreover, families at risk for domestic violence may be more receptive to home visitation, with its focus on healthy relationships and family strengths, than to more directive or punitive approaches through child welfare services or law enforcement.20 However, there are potential problems with the use of home visiting programs to address domestic violence. These include concern for the safety of the home visitor and the victim, and the possibility that any trust between the home visitor and the family will be breached if domestic violence is discussed.29School-Age Children (6 to 12 Years)
Schools are ideal places in which to introduce primary prevention programs to wide ranges of children, because most children attend school. In addition, much of children's social learning takes place in schools, and research has shown that social learning can play a role in the development of behaviors and attitudes that support domestic violence. Teachers, who typically represent the second most important influence in the lives of children, are in an ideal position to motivate students to consider new ways of thinking and behaving.30
In a 1998 comprehensive review of model programs for battered mothers and their children, several community agencies reported the development of primary prevention efforts in collaboration with schools.31 One of the key values inherent in all of these primary prevention programs is the belief that every student needs to be aware of domestic violence and related forms of abuse. Even if students never become victims or perpetrators of domestic violence, they may have opportunities in the future, as community members, to help others in preventing or stopping it.32 Because these programs consider domestic violence a community and societal problem, many of them also involve parents and other members of the broader community.
One of the first programs to document efforts to prevent domestic violence by working with children in the schools was implemented by the Minnesota Coalition for Battered Women.33 (See Box 2.) The ideas and successes of this early program have spawned similar efforts across North America.34 Preliminary evaluations of these newer programs are promising and indicate that key elements of successful school-based programs include: identifying relationship violence as a form of societal violence; acknowledging that domestic violence is an abuse of power and control; creating a high enough level of trust so that children can disclose exposure to domestic violence and teachers can make appropriate referrals; teaching safety skills about what to do when domestic violence occurs; and encouraging the development of social skills such as anger management and conflict resolution as alternatives to violence.35Adolescents (13 to 18 Years)
Adolescence is a time of important cognitive and social development. Teens learn to think more rationally and become capable of thinking hypothetically. They also develop a greater understanding of the possible risks and consequences of their behaviors and learn to balance their own interests with those of their peers and family members. Conformity to parental opinions gradually decreases throughout adolescence, while peers become increasingly influential until late adolescence.36 Romantic relationships become more important by mid-adolescence.37 Thus, early- and mid-adolescence offer unique windows of opportunity for primary prevention efforts that make teens aware of the ways in which violence in relationships can occur, and that teach healthy ways to form intimate relationships.38 When offered opportunities to explore the richness and rewards of relationships, youths become eager to learn about choices and responsibilities. Clear messages about personal responsibility and boundaries, delivered in a blame-free manner, are generally acceptable to this age group, whereas lectures and warnings are less helpful.39
Primary prevention programs delivered universally through high schools often involve activities aimed at increasing awareness and dispelling myths about relationship violence. Such activities might include school auditorium presentations involving videotapes, plays, professional theater groups, or speeches from domestic violence or teen dating violence survivors; classroom discussions facilitated by teachers or domestic violence services professionals; programs and curricula that encourage students to examine attitudes and behaviors that promote or tolerate violence; and peer support groups. Some school-based programs have resulted in youth-initiated prevention activities such as theatrical presentations to younger children, and marches and other social protests against domestic violence.40
Preliminary data from evaluations of six school-based dating violence prevention programs report increases in knowledge about dating violence issues, positive changes in attitudes about dating violence, and self-reported decreases in the perpetration of dating violence. Though preliminary, these data indicate that adolescents are receptive to school-based prevention programs.41
In addition to school-based programs for adolescents, there are also community-based programs with primary prevention goals similar to those of the school-based programs. Many of the community-based programs also provide secondary prevention services to teens who have displayed early signs of violence. (See Box 3.)Adults
Public-awareness campaigns such as public service announcements and advertisements are common approaches to primary prevention of domestic violence by adults. These campaigns typically provide information regarding the warning signs of domestic violence as well as community resources for victims and perpetrators. One comprehensive public education campaign, developed by the Family Violence Prevention Fund (FVPF) in collaboration with the Advertising Council, included television advertisements delivering the message that there is no excuse for domestic violence, and making referrals to local domestic violence services.42
The evaluation of the campaign included collecting public-opinion data through telephone surveys in 1994 and again in 1996. These data showed decreases over the two years in the number of people who said they: (1) did not know what to do about domestic violence; (2) did not believe it was necessary to report incidences of domestic violence; (3) felt that it was no one else's business when a husband beats his wife; and (4) believed that the media exaggerated the problem of domestic violence. Though these results indicate that, in general, Americans increasingly view domestic violence as an important social issue, the data also revealed differences by ethnic group and gender. For example, men were more likely than women to believe that women provoke men into physically abusing them, and more likely to feel that the media exaggerated the prevalence and harms of domestic violence. These variations imply a need for public education campaigns tailored to particular segments of the population.43