Public Health Framework

About Prevention logoChild maltreatment prevention encompasses a spectrum of approaches which seek to mitigate conditions that increase the likelihood of maltreatment, address precursors, and, ultimately, prevent initial or repeat occurrence of child abuse or neglect.

Public health models utilize a population-based approach to prevention and provide a framework for designing and categorizing prevention strategies. One model classifies prevention efforts as primary, secondary or tertiary, according to their timing in relationship to the prevalence of risk and occurrence of harm [1].

A second model categorizes prevention approaches according to their targeted population. Universal prevention is offered to an entire population, regardless of risk. Selective and indicated approaches are designed for populations possessing specified risks. They differ according to the prevalence and intensity of those risks [2].

Further upstream from prevention are health promotion and positive development strategies which focus on enhancing the ability to withstand challenges rather than seeking to decrease the impact of risk. On the opposite end of the continuum, treatment approaches are designed to address the actual disorder, rather than the risks or symptoms.


      Classification Systems of Public Health Models


    Targeted Population

Health Promotion/Positive Development Strategies target an entire population with the goal of enhancing strengths support health, increase resiliency 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. experiencing depression, teen parents, living in a high poverty area).
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.
  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 approaches to address the diverse needs of families.