Primary Secondary Tertiary Interventions

Primary, Secondary and Tertiary Prevention

Kerry A. Cook

Southern New Hampshire University

The three- tiered prevention model involving primary, secondary and tertiary prevention strategies has been developed to help with issues regarding risk or behavior in fields such as mental health, health, education, domestic violence, and more. It can be used at a community level, societal level, school or facility level.

The primary prevention level is meant to address a risk or problem before it becomes a tangible issue. It is geared towards a large population or community, such as teenagers, or males, or young children.  For example, this level of prevention can include taking steps to educate teens about the risk of STDs and how to prevent them, the dangers of drunk driving and how to handle the designated driver situation, or developing laws about helmets and protective gear during athletic activities (Park, Bell, & Baker, 2008).

The secondary level targets a more specific population or groups to keep already present risk factors or early behaviors from becoming bigger problems. This level of prevention may, for example, target males who are at risk for domestic violence due to such risk factors as head injuries or childhood exposure to violence (Wolfe and Jaffe, 2013).   It may be accomplished by getting a handle on learning disabilities through the implementation of Early Intervention and screenings. It could also be done by assessing people with mild traumatic brain injuries in order to help prevent secondary injury, or problems related to inadequate treatment, inflammation, or further injury (Park, Bell, & Baker, 2008).

The tertiary level of prevention is one which aims to mitigate, address or reduce the effects of an issue which has already presented itself. This level addresses specific individuals who are the “victims” of a behavior, injury, or medical issue, or who have a condition or disability that could have been treated or addressed earlier. This tertiary level of prevention could be used to counsel and protect victims of domestic violence so that the victim is not revictimized or at further risk (Wolfe and Jaffe, 2013).  It could be used to treat further complications or further instances of medical issues such as heart attacks or strokes.

Due to budget constraints and lack of resources, it appears as if problems are often addressed at the tertiary level, however this is the equivalent of closing the barn door after the horses are let out. This tertiary level often uses a maximum of dollars to address a minimum number of people who are already affected and suffering. Those dollars could be better spent at the primary level, aimed at a larger group of people who may be at risk but who are not yet affected. One example of this is diabetes. Type II Diabetes is becoming a major health epidemic that impacts not only the people affected by it, but society in that it affects health care costs and resources, employment issues such as time off for illness and health care costs, and more. It is a major cause of blindness, kidney failure, amputations, stroke and heart attack (Bowman, Gregg, Williams, Engelgau & Jack , 2003). Prevention of diabetes at the primary level is largely possible through proper nutrition, exercise, weight management and preventative medical care and whatever, the costs, can help to alleviate suffering and financial strain from many angles.

Another example of how primary prevention is preferable to tertiary prevention is with mental health issue sand eating disorders related to body image. It is well known that daily exposure to magazines and photoshopped models in society, sometimes hundreds of times a day, leads to these issues, primarily in adolescent females. Steps such as eliminating photoshopping and using realistic models in ads and magazines, addressing self -esteem and self -love issues at a young age, and recognizing the signs of eating disorders or poor body image early can affect millions of adolescent females in a positive way and prevent mental health issues and eating disorders. Some countries have recently made laws that models cannot be below a certain size or weight without a medical note stating that this is their natural and healthy body composition in an effort to keep models form starving themselves to reach an impossible and unhealthy ideal set by the fashion industry. More recently, we have seen campaigns to show “real” women with flaws, stretch marks, extra weight and no photoshopping. There are now emerging “plus size models” in magazines such as Sports Illustrated swimsuit edition, and in clothing store ads - while these models are far from plus size by society’s standards, they are far above the traditional size 0 that is generally seen in the fashion world.