What is Primary Prevention

By Chris Linder, center director

As we work to address relationship and sexual violence on college campuses and beyond, we often end up focusing on responding to violence after it happens, rather than working to prevent it from happening in the first place. Although some responses to relationship and sexual violence might also contribute to preventing it from happening in the future, the reality is that someone was harmed already in the process.

Primary prevention strategies focus on stopping violence from happening in the first place. Although most of us say we are working toward violence prevention, the reality is that we’re actually usually doing secondary or tertiary prevention.

Many scholars and practitioners credit the Centers for Disease Control (CDC) for developing a prevention framework that highlights the differences between primary, secondary, and tertiary prevention of violence, including relationship and sexual violence.

Primary prevention focuses on stopping the violence before it happens at all—some might say, going "upstream" to intervene with people at highest risk for causing or experiencing harm. For example, one might engage in discussions with children about healthy relationships and appropriate boundaries for themselves and others, teaching them both to respect others’ boundaries and to feel comfortable setting their own.

Another example of primary prevention is to design educational programs to examine the roots of relationship and sexual violence, including power and oppression, and model ways to engage in more egalitarian relationships with each other. Finally, another example of primary prevention is to intervene with people who show high likelihood for committing relationship and sexual violence by educating them about how their behaviors might cause harm to another person.

WHAT IS SECONDARY PREVENTION?

Secondary prevention focuses on intervening after violence occurs to prevent it from happening again. Because research indicates that many people experience victimization more than once in their lifetimes, one example of secondary prevention might be to train police officers on lethality assessment—when a person calls to report relationship and sexual violence, officers are trained to ask specific questions to assess the danger of the situation.

By asking specific questions, officers may be able to identify particularly high-risk situations to prevent a victim or survivor from experiencing more harm or more lethal harm. Because one of the risk factors for victimization is previous victimization, another example of secondary prevention is to provide education to survivors of relationship and sexual violence to better understand and identify red flags associated with perpetrators of violence. Further, some programs may provide intervention for people who have committed interpersonal violence after they engaged in it. The goal with secondary prevention is to address specific instances of violence to prevent it from happening again.

WHAT IS TERTIARY PREVENTION?

Tertiary prevention refers to actions that focus on addressing the long-term consequences of violence occurring in the first place. Tertiary programs include supporting survivors of childhood violence. Because exposure to or experiences with relationship and sexual violence in childhood is a risk factor for both experiencing and perpetrating violence as an adult, supporting people who experienced harm as a child through healing programs may reduce one of the long-term effects of relationship and sexual violence.

All of these forms of prevention are important and necessary for ending relationship and sexual violence; however, as a culture, we have spent most of our time, money and additional resources focusing on secondary and tertiary prevention. In our efforts to be “victim-centered” in all of our work around relationship and sexual violence, we often interpret (and sometimes the reality is) that when we spend resources intervening with perpetrators and potential perpetrators we are somehow taking away from services for victims. Imagine, though, if we intervened early enough with potential perpetrators, we would not have victims that needed support and services!

Additionally, we frequently do not engage in primary prevention work because we do not have good models for it. Relationship and sexual violence is rooted in power and oppression, meaning that people with some level of power frequently engage in violence to maintain the power they have over another person. Although they may not experience power in all aspects of their lives, they do have access to formal and informal power in at least one aspect of their life that they seek to maintain. This may be a conscious or unconscious strategy.

For example, many men are unaware of the ways they utilize their limited power to exert power over women. Examples of using power to maintain dominance include some partners in relationships being solely responsible for managing finances and dictating how the couple or the family spends its money. Other examples might be using coercion (often masked as persuasion) to engage a partner in sexual activity. Some people may use power to maintain dominance by creating an environment in which their partner is always walking on eggshells, trying to guess what the next thing is that will “set them off,” resulting in the non-dominant partner doing everything in their power to maintain peace.

OUR FOCUS

With this in mind, we conceptualized the Interpersonal Violence Prevention and Education Collective (IPV-PEC) at the U to focus on primary prevention of relationship and sexual violence. Many programs and services on campus focus on addressing relationship and sexual violence from a secondary and tertiary perspective, and fewer resources are dedicated to engaging true primary prevention—ending violence before it starts.

The IPV-PEC is not designed to take over or eliminate programs dedicated to secondary and tertiary prevention, but rather to add to the work being done at the U to address interpersonal violence and to provide an outlet for people to dedicate energy to explicitly focus on primary prevention. Our hope is that by collectively focusing on all three levels of prevention, we might make a dent in the rates of interpersonal violence experienced by and committed by people affiliated with our campus and the surrounding community.