Prevention & Promotion:

Key Concepts
Class Outline: Prevention and Promotion – Key Concepts
 History
 What is prevention?
 Caplan's Model of Prevention
 Primary, Secondary, and
Tertiary
 IOM Preventative Measures
 Universal, Selective, and
Indicated
 Two Prevention Equations
 Risk & Resilience
History
 George Albee and Mental Health
• Mental Health Resources Strained

 Focus away from Treatment

The Broad Street Pump
 Cholera epidemic in London in 1854
 John Snow, a physician, plotted and investigated 578 cases
in the city.
 Found the commonality of Broad St. pump use
 Pump was disabled and epidemic subsided.
 Considered one of the founding events in the field of
Public Health.
John Snow's Map
Lessons from the Broad Street Pump
 Even if you do not know how to cure a problem, you may still be able
to prevent it.
 You do not need to know the cause of a problem to prevent it; you just
need to understand something about the mechanisms through which
the problem is transmitted or sustained.
 You can often prevent a problem through changing some aspect of
human behavior.
 While individual behavior change can contribute to prevention,
complete prevention of a problem often relies upon public action.
Two Approaches for Prevention
What is Prevention and Promotion?
 Prevention
 Latin for "to anticipate"
 Focus on preventing social ills
 Promotion
 Focusing on and enhancing strengths
• Taking a "strengths-based"
approach
 Similar to enhancing wellness & thriving
Caplan's Model of Prevention
 Primary Prevention
• Preventative efforts for an entire population

 Secondary Prevention
• Given to populations with signs of risk
 "at risk" populations

 Tertiary Prevention
• Given to populations with an ailment with the hopes of
reducing the intensity
 Hard to distinguish from treatment
Caplan's Model of Prevention
Preventative Measures: IOM
Reports
 Universal Preventative Measures
• Similar to primary prevention
 Selective Preventative Measures
• Targeted "at risk" populations
 Indicated Preventative Measures
• Targeted at "high risk" populations
Prevention Models
Prevention Equations:
Albee (1982)
Prevention Equations: Elias (1987)
Population Focus of Prevention
 Prevention programs focus on reducing the rate of disorders
within a population
• Programs need to measure their success

 Incidence: The rate of new cases of a disorder during a

given period (usually a year)

 Prevalence: The total number of cases in a population

• Prevention programs aim to lower the incidence of new cases, and
ultimately lower the prevalence in a population
Risk and Resiliency
 Risk: individual and contextual factors that contribute to
negative life outcomes.
 Cumulative-risk hypothesis
 Resiliency: ability of some individuals to overcome adverse
conditions and experience healthy development.
Risk & Resiliency
 Contributing Factors Across Ecological Levels
 Individual: cognitive abilities, temperament, etc.
 Micro: social support, parenting, etc.
 Locality/Organizational: schools, connections to
organizations, etc.
Recap: Prevention and Promotion Key Concepts
 How did prevention and promotion develop?
 What was the thinking at the time regarding
resources for treatment?
 What are the two models of prevention (Caplan & IOM)?
 How are they similar?
 How are they different?
 What are the differences between the Albee prevention
equation and the Elias equation?
 What is risk & resilience?