Journal Issue: Domestic Violence and Children Volume 9 Number 3 Winter 1999
Types of Prevention Strategies
Another public health model that can inform the development of domestic violence prevention strategies divides prevention efforts into three categories: primary, secondary, and tertiary.18 Primary prevention involves efforts to reduce the incidence of a problem in a population before it occurs. The goal of secondary prevention is to target individuals to decrease the prevalence of a problem by minimizing or reducing its severity and the continuation of its early signs. Tertiary prevention involves attempts to minimize the course of a problem once it is already clearly evident and causing harm.
Primary prevention strategies can introduce to particular population groups new values, thinking processes, and relationship skills that are incompatible with violence and that promote healthy, nonviolent relationships. For example, resources can be used to focus on respect, trust, and supportive growth in relationships.19 These efforts can be targeted at populations that may be at risk for violence in their intimate relationships but who have not yet shown symptoms of concern, or they can be directed universally at broad population groups, such as school-age children or members of a particular community.
In contrast to a population-based focus, secondary prevention efforts in domestic violence address identified individuals who have exhibited particular behaviors associated with domestic violence. An example of secondary prevention is a clear protocol for the way teachers can assist students who have discussed witnessing domestic violence in their homes but who do not show serious signs of harm.20
Tertiary prevention efforts are the most common and emphasize the identification of domestic violence and its perpetrators and victims, control of the behavior and its harms, punishment and/or treatment for the perpetrators, and support for the victims. Intensive collaboration and coordinated services across agencies may be vital in tertiary prevention efforts to address chronic domestic violence and to help prevent future generations of batterers and victims. However, tertiary efforts can be very expensive and often show only limited success in stopping domestic violence, addressing long-term harms, and preventing future acts of violence.21
Table 1 uses the primary, secondary, and tertiary prevention paradigm to categorize a broad range of domestic violence prevention strategies. Several of the strategies mentioned in the table are described in greater detail in the following section, which discusses innovative primary and secondary prevention strategies currently being tried in the United States and Canada. (For information regarding tertiary prevention efforts for children exposed to domestic violence, see the articles by Lemon, by Findlater and Kelly, by Saathoff and Stoffel, by Culross, and by Groves in this journal issue.)