What is primary prevention?

Primary prevention aims to prevent substance use before it happens. The Prevention Alliance of Tennessee focuses mainly on primary prevention— but secondary and tertiary prevention are also needed to reduce behavioral health problems like substance abuse. Primary prevention is a public health approach to help communities avoid substance abuse and many related behavioral health problems such as depression, violence, and teen pregnancy. It includes evidence-based programs, policies, and strategies that address contextual factors, such as community and family connectedness, school participation, and social skills. Those factors are known as risk and protective factors. Reducing risk factors and strengthening protective factors can reduce behavioral health problems like substance abuse. Primary prevention happens before a substance use disorder diagnosis. So, many initiatives reach children and youth prior to any substance use. For example, one goal of primary prevention is to delay the age at which a young person tries alcohol, marijuana, tobacco, or other substances. Prevention efforts might include school-based programs to help youth improve their resiliency skills, as well as local alcohol tax increases to discourage drinking. Primary prevention differs from secondary and tertiary prevention, which include harm reduction strategies and referral to treatment. These interventions aim to reduce the consequences and prevalence of substance abuse — meaning the total number of people experiencing it. Because substance use disorder is a chronic illness, there are opportunities for prevention, harm reduction, treatment and recovery services across the continuum of care.

 

What is the strategic prevention framework?

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Strategic Prevention Framework (SPF) is a prevention planning process that promotes data-driven decision making that focuses on population-level, rather than individual-level change. The SPF model is a particularly good fit for coalitions and is designed to help them be successful in their efforts.

The SPF process consists of five steps.

  1. Assess prevention needs based on current local data;
  2. Build prevention capacity;
  3. Develop a strategic plan;
  4. Implement evidence-based community prevention programs, policies and practices; and
  5. Evaluate efforts for outcomes

Cultural competence and sustainability are incorporated throughout each step of the SPF.

SPF diagram

Why are coalitions important?

The work of prevention is greatly advanced when it is coordinated by a locally-developed coalition. By bringing together stakeholders from all sectors to collect and analyze local data to determine the strengths and the needs of their community, coalitions become perfectly positioned for the successful implementation of evidence-based programs that can address the risks faced by Tennesseans. Coalitions utilize a trusted process known as the Strategic Prevention Framework, beginning with a comprehensive community assessment, making data-driven decisions to build capacity around changing and emerging issues. Coalitions are equipped to address problems from the onset and can identify early trends based on comprehensive data assessments. To effectively address local problems, coalitions collaborate to develop and implement customized strategic solutions.

 

What does it take to be an Effective Prevention Coalition?

Research suggests that effective prevention coalitions impact community-wide changes in targeted health behaviors. There are specific criteria for effectiveness that have been identified as crucial to achieving these community-level impacts.

  • Adopts the public health approach
  • Builds capacity around specific issues
  • Has long-range, strategic focus on population-level change
  • Coordinates data collection and analysis
  • Uses data to determine priorities
  • Involves diverse community partners, reflective of the community
  • Selects evidence-based programs, policies, & practices
  • Has long-range, strategic focus on population-level change
  • Sets goals and tracks outcomes over time

How can I support coalitions?

Be a champion for prevention coalitions that are proactive solutions to achieving positive community outcomes. Establish a long-range plan for investing in effective community coalition practices that includes funding and other resource allocations for:

  • Experienced, skilled personnel
  • Expert technical assistance, training, and research
  • Evidence-based programming, policies, & practices
  • Administration of passive consent youth surveys to learn more about the risk and protective factors & anti-social behaviors experienced by our youth.

Who Should Receive Prevention?

Universal, Selective, and Indicated Prevention Strategies

Prevention programs target populations by how “at risk” they are for a behavioral health problem, such as substance use. Programs can be universal, selective or indicated, depending on their intended populations. Universal programs are available to everyone, such as all students in a school. Selective programs are aimed at people exposed to specific risk factors, like children of parents with substance abuse disorders. Indicated programs are tailored for those who have shown signs of problem behaviors, like youth who are experimenting with binge drinking.

 

What are environmental strategies?

Environmental strategies are prevention efforts aimed at changing or influencing community standards, institutions, structures or attitudes that shape individuals’ behaviors. While individual approaches focus on helping people develop the knowledge, attitudes, and skills they need to change their behavior, environmental approaches focus on creating an environment that makes it easier for people to act in healthy ways.

Who should participate in prevention?

Everyone has a role in prevention. Parents can raise children to reduce their risk of misusing substances. Educators can teach their students the coping skills and strategies they need to promote their own mental health. Young people can lead their peers to make healthy choices. Prevention specialists can provide evidence-based services to support the communities they serve. Policymakers can ensure that prevention is at the forefront of discussions and policies impacting behavioral health. If all of us work together, we can build a comprehensive system of prevention that includes education-based prevention services, community-based collaboration, and youth-led services.

Why spend public funds on prevention? 

Because the benefits of prevention outweigh the costs. By stopping substance use before it starts, or before it becomes substance misuse or abuse, prevention also works to save Tennessee tax dollars.

For every $1 invested in primary prevention, Tennessee can save between $4 and $17.

The positive outcomes from successful substance abuse prevention include:

  • Fewer drug abuse-related emergency room visits,
  • Increased productivity,
  • Improved job stability,
  • Fewer unemployment episodes,
  • Lower rates of violent crime,
  • Prevention of DUI injuries to others
  • Better family interaction,
  • Reduced juvenile delinquency,
  • Fewer incidents of family violence,
  • Improved school attendance and academic achievement, and
  • Better health outcomes.

When Should Prevention Happen?

Primary, Secondary, and Tertiary Prevention Strategies

Primary prevention aims to prevent substance use before it happens. The Prevention Alliance of Tennessee focuses mainly on primary prevention— but secondary and tertiary prevention are also needed to reduce behavioral health problems like substance abuse. Primary prevention is a public health approach to help communities avoid substance abuse and many related behavioral health problems such as depression, violence, and teen pregnancy. It includes evidence-based programs, policies, and strategies that address contextual factors, such as community and family connectedness, school participation, and social skills. Those factors are known as risk and protective factors. Reducing risk factors and strengthening protective factors can reduce behavioral health problems like substance abuse. Primary prevention happens before a substance use disorder diagnosis. So, many initiatives reach children and youth prior to any substance use. For example, one goal of primary prevention is to delay the age at which a young person tries alcohol, marijuana, tobacco, or other substances. Prevention efforts might include school-based programs to help youth improve their resiliency skills, as well as local alcohol tax increases to discourage drinking. Primary prevention differs from secondary and tertiary prevention, which include harm reduction strategies and referral to treatment. These interventions aim to reduce the consequences and prevalence of substance abuse — meaning the total number of people experiencing it. Because substance use disorder is a chronic illness, there are opportunities for prevention, harm reduction, treatment and recovery services across the continuum of care.

 

How can I find a coalition?

Visit our contacts page here: https://tncoalitions.org/alliance-members/

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