Violence Prevention Spectrum

The Public Health Approach to Violence Prevention

The public health approach to violence prevention provides a comprehensive approach to understanding how people, organizations, communities, and systems can prevent violence. Veto Violence through the Centers for Disease Control and Prevention (CDC) has established four steps for the public health approach to violence prevention.

1. Define the Problem
   • The first step consists of collecting data to determine the “who”, “what”, “where”, “when”, and “how” of violence occurring. Data collection in this step should come from a variety of sources such as population surveys, child welfare records, census data, medical reports, and more.
2. Identify Risk and Protective Factors
   • Once the problem has been defined, it is important to explore why some individuals or communities may experience violence at higher rates than others. Based on collected data, identify characteristics that appear to increase or decrease the likelihood of violence. Examples of protective factors may include: positive parental relationships, emotional regulation skills, strong social network, positive school environment, or safe and stable housing. Examples of risk factors may include: exposure to substances, poverty, risky peer behavior, bullying, or unmet childcare needs.
3. Develop and Test Prevention Strategies
   • Once information on the problem has been gathered, it is time to develop pilot prevention strategies and rigorously evaluate to see if they are preventing violence by increasing protective factors and decreasing risk factors.
4. Assure Widespread Adoption
   • If evaluation proves the prevention strategy to be effective, pilot programs should be implemented widely for greater impact. Continued evaluation is necessary to ensure that all components of the strategy are effective within various settings. Every community is different and one strategy may work well in one area and fail in another. This emphasizes the importance of the ability to tailor presentation to individual and community needs while maintaining the core strategy of the desired prevention outcome.

The Socioecological Model for Understanding the Problem

When attempting to define the problem, it is important to understand its depth. The CDC utilizes the socioecological model to illustrate the complexity and interwoven nature of risk factors that lead to violence and protective factors that may prevent violence. The overlapping model showcases how each level (individual, relationship, community, and societal) influences the others and exacerbates these factors. The model suggests that achieving the largest impact requires simultaneous prevention efforts across all levels.

• Individual Level: Biological factors or personal history that increase the likelihood of being a perpetrator or victim of violence (age, income level, substance use, prior history of abuse, education, etc.)
  • Prevention strategies: life skills training, conflict resolution, substance use programming.
• Relationship Level: A close circle of friends, family members, and partners who influence behavior.
  • Prevention strategies: mentoring, healthy relationship programming, family-focused programming.
• Community Level: Settings where individuals spend time making relationships (schools, work, neighborhood, doctor’s offices)
  • Prevention strategies: economic and housing opportunities, improving policies and procedures in workplaces and schools, community building.
• Societal Level: The cultural climate that either encourages or inhibits violence (policies, economic systems, cultural norms, media)
  • Prevention strategies: state and federal policies that offer economic supports to families, policies supporting early childhood education, mass marketing campaigns targeted at challenging social norms, media that decreases harmful stereotypes and promotion of violence.

The Prevention Spectrum

Comprehensive prevention strategies exist on a spectrum that includes both “upstream” and “downstream” efforts. Similar to the socioecological model approach, efforts in all areas of prevention are needed to address immediate and long term impacts of violence as well as working to prevent violence before it occurs.

The U.S. Department of Health and Human Services released an issue brief in 2023 on “Advancing Primary Prevention in Human Services: Convening Findings.” The below graphic has been adapted from their models to explain the difference levels of prevention.