Public Health Framework

About Prevention logo
Child maltreatment prevention encompasses a variety of types of efforts which share in the common goal of preventing initial or repeat occurrence of child abuse or neglect.[1] 

Prevention efforts are frequently categorized into different levels according to the attributes of the audience they target. There are two models common in the child maltreatment prevention field. They are often used interchangeably, though there are some distinctions. The earlier public health model focuses on the level of problematic behavior within the target group, classifying interventions as primary, secondary, and tertiary.

The more recent model also originated in the public health field, but was later adapted by the mental health and social science fields. This model focuses on the level of risk and benefit experienced by the targeted group, utilizing the terms universal, selective and indicated to distinguish between types of interventions.[2] Most recently, children's mental health professionals have added two additional levels to the latter hierarchy: Heath Promotion/ Positive Development Strategies and Treatment.[3]


Levels of Prevention

Original Public Health Model

Newer Public Health Model

Health Promotion/Positive Development Strategies target an entire population with the goal of enhancing strengths as a means to reduce the risk of negative outcomes and enhance positive development.
Primary Prevention focuses on reaching an entire population in order to prevent a first occurrence of child maltreatment.Universal Prevention is offered to the general public or an entire population regardless of their level of risk for child maltreatment.
Secondary Prevention consists of efforts to prevent occurrence of child maltreatment among those who are already showing signs of maltreating. (e.g. those with harsh parenting practices)Selective Prevention addresses those who are at risk of child maltreatment due to a personal, family, or community factor. (e.g. living in a high poverty area, teen parents, experiencing depression)
Tertiary Prevention addresses situations where maltreatment has already occurred in an effort to allay its negative effects and prevent reoccurrence.Indicated Prevention targets those who have displayed detectable signs or symptoms of child maltreatment behavior or are at very high risk for such behavior to alleviate the precursors before they become child maltreatment. (e.g. screened out families)
 Treatment consists of intervention designed to address those who are perpetrating child maltreatment to halt the behavior and those who are victims to advance their healing.


As interventions move from population focused to more targeted efforts, they increase in intensity and become more individualized.

While the programming that the Prevention Board supports falls primarily into the health promotion, universal prevention and selective prevention categories, approaches do not necessarily fit one discrete category. Some aspects of an approach may be promotive where other aspects may be preventative. Some efforts may be universal in one context and selective in another. Many of the Prevention Board strategies are chosen because they address multiple levels, facilitating a continuum of services to address the diverse needs of families.