To combat occurrences of child maltreatment, prevention programs typically focus on methods or activities that seek to reduce or deter specific or predictable problems, protect the current state of well-being, or promote desired outcomes or behaviors (adapted from Bloom, 1996). Prevention programs are categorized into three levels of services and include:*

Primary Prevention: Primary prevention programs are directed at the general population to prevent all parents from abusing or neglecting their children. The aim of primary prevention programs is to “inoculate” the total population.

Secondary Prevention: Secondary prevention programs serve individuals or families in which maltreatment is more likely to occur such as children or families exhibiting acknowledged risk factors. The aim of secondary prevention programs is to attenuate the effects of risk.

Tertiary Prevention: Tertiary prevention programs serve families in which maltreatment has already occurred such as among families in which maltreatment has been publicly documented. The aim of tertiary prevention programs is to remediate the adverse consequences of maltreatment.

While many of us believe in social safety nets that aim at primary prevention (universal access to public health home visits, child care and family support centers, for example), current policies and funding tend to support secondary and tertiary prevention efforts. The level of prevention your program aims to provide will determine in part the populations you serve, and the types and intensity of services you include in your program.

How should programs begin to determine the types and intensities of services they provide? While innovation and individualization to fit your families and communities are encouraged and commended, you need not start at zero. There exists a body of research to guide our practice. We should chose those strategies in our programs that have the most and best evidence that they produce positive changes for children and families. Roberts and Yeager (+) in their book on evidence- and practice-based research urge practitioners to use “scientifically validated assessment, intervention and evaluation procedures, and…use critical thinking when making practice decisions”.

These standards require that we articulate clear outcomes and indicators based on previously documented evidence of what has worked in the past; that we ask ourselves – and those we serve – tough questions about how and whether our services are currently working; and that we intentionally and systematically revise our practices when it appears that we are not reaching desired outcomes.

* “Emerging Practices in the Prevention of Child Abuse and Neglect” pg.7, National Clearinghouse on Child Abuse and Neglect, http://www.childwelfare.gov/preventing/programs/whatworks/report/index.cfm

+ “Evidence-Based Practice Manual” (p.5), A.R. Roberts and K.R. Yeager (Eds.). Oxford University Press, (2004).