Prevention Strategy Discussion

Prevention Strategy Discussion

You have been working at the Wayne County probation office for approximately 6 months now. Your supervisor has given you your 6-month employment evaluation, which was excellent. As a result, your supervisor has informed you that he is to choose one of the probation officers on his staff of 45 to be appointed to a committee on alcohol use and abuse. This committee is being put together by the County Board of Supervisors. Your supervisor asks you to be part of this committee, which you excitedly agree to do.

At your first committee meeting, the committee chair divides the 30 individuals into smaller subcommittees to explore specific areas of alcohol use and abuse. You are assigned to the prevention and treatment committee along with eight other individuals. The committee is made up professionals from various disciplines, including probation, parole, corrections, addiction, substance/alcohol abuse, social work, psychology, psychiatry, and pharmacology. The board of supervisors has asked that your committee focus solely on prevention issues relating to minors (not adults).

Group Portion

As a group, you must choose 3 prevention strategies that are effective with minors (children under the age of 18). For each prevention strategy addressed, you must state/explain/discuss the following:

• The definition of the prevention strategy and where you learned of it
• How it is put into practice
• What environment this prevention strategy is used in
• The efficacy of the prevention strategy
• The cost of the prevention strategy
• The specific minor age group that it targets
• Citations for each sentence that contains information from any source

The natural history of a disease classifies into five stages: underlying, susceptible, subclinical, clinical, and recovery/disability/death. Corresponding preventive health measures have been grouped into similar stages to target the prevention of these stages of a disease. These preventive stages are primordial prevention, primary prevention, secondary prevention, and tertiary prevention. Combined, these strategies not only aim to prevent the onset of disease through risk reduction, but also downstream complications of a manifested disease.

Primordial Prevention:

In 1978, the most recent addition to preventive strategies, primordial prevention, was described. It consists of risk factor reduction targeted towards an entire population through a focus on social and environmental conditions. Such measures typically get promoted

through laws and national policy. Because primordial prevention is the earliest prevention modality, it is often aimed at children to decrease as much risk exposure as possible. Primordial prevention targets the underlying stage of natural disease by targeting the underlying social conditions that promote disease onset. An example includes improving access to an urban neighborhood to safe sidewalks to promote physical activity; this, in turn, decreases risk factors for obesity, cardiovascular disease, type 2 diabetes, etc.

Primary Prevention:

Primary prevention consists of measures aimed at a susceptible population or individual. The purpose of primary prevention is to prevent a disease from ever occurring. Thus, its target population is healthy individuals. It commonly institutes activities that limit risk exposure or increase the immunity of individuals at risk to prevent a disease from progressing in a susceptible individual to subclinical disease. For example, immunizations are a form of primary prevention.

Secondary Prevention:

Secondary prevention emphasizes early disease detection, and its target is healthy-appearing individuals with subclinical forms of the disease. The subclinical disease consists of pathologic changes, but no overt symptoms that are diagnosable in a doctor’s visit. Secondary prevention often occurs in the form of screenings. For example, a Papanicolaou (Pap) smear is a form of secondary prevention aimed to diagnose cervical cancer in its subclinical state before progression.

Tertiary Prevention:

Tertiary prevention targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease as well as of any associated sequelae. While secondary prevention seeks to prevent the onset of illness, tertiary prevention aims to reduce the effects of the disease once established in an individual. Forms of tertiary prevention are commonly rehabilitation efforts.

Quaternary Prevention:

According to the Wonca International Dictionary for General/Family Practice, Quaternary prevention is: “action taken to identify patients at risk of overmedicalization, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable.” Marc Jamoulle initially proposed this concept, and the targets were mainly patients with illness but without the disease. The definition has undergone recent modification as” ‘an action taken to protect individuals (persons/patients) from medical interventions that are likely to cause more harm than good.” [1]