The Downside to Primary Prevention’s Popularity: A Question

As a primary prevention practitioner and promoter (a PPPP, of course), I have enthusiastically watched it gain support and popularity over the past few years.  Today, more people than ever before believe that prevention works.  They value primary prevention strategies and their support continues to grow.  Recently, however, I’ve noticed an unintended consequence of the push towards primary prevention.  It seems that most folks want to call what they are doing primary prevention…whether or not it actually is.  I’ve lately joked with colleagues that you can put the label on anything and, VOILA!, it’s primary prevention.  Primary prevention victim therapy?  Sure!  Primary prevention offender management?  You got it!  Heck, a primary prevention jail – why not?

Seriously, there is no end to the strategies that I have seen labeled primary prevention.  But these aren’t primary prevention.  While important, necessary efforts, they take place after the behavior we’re trying to prevent occurred.  We have a name for that and it’s not primary prevention.

So what is one to do when faced with people emphatically exclaiming that their therapy program is primary prevention?  This is my dilemma.  Given the unfortunate history of prevention folks sometimes framing their work as “better than response,” how do I point out that a strategy isn’t primary prevention without seeming like a jerk?  True, some people simply need education about the types of prevention, but I’m not really talking about them.  I’m talking about the folks who want to do primary prevention and who get very angry at the suggestion that they might not actually be doing it.  How do we approach those people?  Aside from acknowledging the value of the work they are currently doing and gently suggesting ways to build on it with primary prevention strategies, my 6pm-after-a-long-day-at-work mind is at a loss.

And before you say it, I know that ultimately the semantics don’t matter.  I don’t care if you call it “primary prevention” or “the sh*t we do,” as long as it aims to create a culture in which the bad stuff doesn’t happen in the first place.

So fellow PPPP’s, do you have an answer?

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3 thoughts on “The Downside to Primary Prevention’s Popularity: A Question

  1. YES! I just ranted (to you, actually) about this in an e-mail. There are so few of us who are tasked only with prevention. So, how do I respond when a program (who slips in some school presentations after serving survivors in court) says, “I’m doing Prevention with incarcerated survivors.” To her credit, she did say, “I know it’s not primary…” but still, we sound like jerks to constantly correct folks to say, “primary” but are we doing a disservice by not correcting them? I don’t know the answer to this. You can only say, “Tell me how you see this preventing violence from happening in the first place…” so many ways. ramble ramble ramble…

  2. This is the outcome of over ten years of emphasis on primary prevention. If only primary prevention work is funded, then everyone will call their work primary prevention. It isn’t a question of semantics, it is a question of necessity. Acknowledging that non-primary work is good or valuable work is not the same a cutting a check for someone to do that work. People who do work with survivors or sex offenders know that they are doing valuable work, and they want the opportunity to do that work. If they have to call it “prevention”, “primary prevention”, or “egg drop soup” to do it, they will.

  3. I know you posted this a little while ago, but I just came across it and enjoyed reading it. Our state seems to be trying to sort out what primary prevention is, and we’re finding that people are doing the work and not realizing it, in addition to the other way around that you speak to in this post. As for the people insisting what they’re doing is primary prevention when you don’t believe it is, I would suggest a little MORE education. Sometimes people hear the message, get it on the surface, but don’t really understand it. But with great PPPPs like you out there (nice term, btw) I feel hopeful!

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