Three useful models have been developed to explain both the causes and opportunities for intervention and prevention of social issues such as sexual and domestic violence. JDI draws heavily on all three models for analysis and planning. The orientation of each can be categorized as follows:WHO: The Public Health Model considers who we work with in relationship to the problem.
WHERE: The Ecological Model looks at what level in society we might address our prevention efforts.
HOW: The Spectrum of Prevention model addresses the public health efforts and opportunities that are needed to interrupt and prevent the cycle of violence for individuals, families, and communities.
The Public Health Model helps us to consider who we want to work with in relationship to the problem:
Universal Populations: (address the general population)
An approach aimed a general population regardless of each individual’s risk for perpetration or victimization are called universal interventions. Groups can be defined geographically (e.g. entire school or school district) or by characteristics (e.g. ethnicity, age, gender). Prevention aimed at universal populations is also reffered to as primary prevention as it aims to avoid a given public health problem. Primary Prevention measures include activities that help avoid the suffering, cost and burden associated with disease, it is typically considered the most cost-effective form of health care.
Selected Populations: (address those at risk)
An approach aimed at those who are thought to have a heightened risk for perpetration or victimization are referred to as selected interventions. Prevention aimed at selected populations is also reffered to as secondary prevention. These activities are focused on populations who are at significant risk for a negative outcome without treatment. Screening tests are examples of secondary prevention measures.
Indicated Populations: (address those affected)
An approach aimed at those who have already perpetrated or those who have been victimized are called indicated interventions. Prevention aimed at the affected individuals is also reffered to as tertiary prevention.
Tertiary prevention activities involve the care of established disease, with attempts made to restore to highest function, minimize the negative effects of disease, and prevent disease-related complications.
The Ecological Model (sometimes referred to as the Socio-Ecological Model) helps us to think about the level in society where we might address our prevention efforts.
Example problem influences include: attitudes and beliefs that support sexual violence; impulsive and antisocial behavior; childhood history of sexual abuse or witnessing violence; alcohol and drug use
Example problem influences include: association with sexually aggressive peers; family environment that is emotionally un-supportive, physically violent, or strongly patriarchal
Example problem influences include: general tolerance of sexual assault; lack of support from police or judicial system; poverty; lack of employment opportunities; weak community sanctions against perpetrators
Example problem influences include: inequalities based on gender, race, and sexual orientation, religious or cultural beliefs, economic and social policies
(Source: Dahlberg LL, Krug EG. Violence-a global public health problem. In: Krug E, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, eds. World Report on Violence and Health. Geneva, Switzerland: World Health Organization; 2002:1-56.)
This Spectrum of Prevention model addresses how public health efforts and opportunities can interrupt and prevent the cycle of violence for individuals, families and communities.
1. Strengthen Individual Knowledge and Skills. This strategy reaches out directly to specific individuals at risk of injury or disease, encouraging them to change their behavior.
2. Promoting Community Education. This strategy is designed to reach the greatest number of people possible, raising awareness about a particular issue or problem, with the goal of encouraging individuals in the community to change their behavior.
3. Educating Providers. This strategy reaches an influential group of individuals who have daily contact with large numbers of at-risk people.
4. Fostering Coalitions and Networks. Working together with other groups to foster coalitions and networks allows for successes that an individual program or activist cannot achieve alone.
5. Changing Organizational Practices. This strategy recognizes that an organization that can change its own policies can affect the health and safety of its members and serve to influence other organizations and the community as a whole.
6. Influencing Policy and Legislation. This strategy represents the possibility for the strongest and broadest changes to the environment,
(Source: The Spectrum of Prevention is based on the work of Dr. Marshal Swift and Larry Cohen MSW.)