Introduction to Prevention:
by Stephen Small
University of Wisconsin-Madison
February 2000

History

This model grows out of the public health field and epidemiological approaches to disease prevention. The aim of prevention approaches is to prevent the occurrence of, or minimize the damage from, human problems. The prevention framework dominates both the scientific study of human psychosocial problems and science-based interventions directed at ameliorating these problems. For example, this approach serves as the foundation for the American Psychological Association-endorsed prevention research model, the Institute of Medicine's recommendations for reducing mental disorders and the federal Office of Juvenile Justice and Delinquency Prevention funding guidelines.

Key Concepts

The concept of risk and protective factors are at the core of the model. Risk factors are defined as individual or environmental markers that are related to the increased likelihood that a negative outcome will occur.

Protective factors are defined as individual or environmental safeguards that enhance a person's ability to resist stressful life events, risks or hazards and promote adaptation and competence. An important but often overlooked aspect of protective process is that they only operate when a risk factor is present.

Risk and protective factors can exist both within individuals and across various levels of the environment in which they live. Diverse problems can share common risk factors.

Risk factors often co-occur, and when they do, they appear to carry additive and sometimes exponential risks. It is often the accumulation of multiple risks rather than the presence of any single risk factor that leads to negative outcomes.

Strengths & Weaknesses

Strengths:

• Provides an initiative, logical framework for thinking about and identifying conditions and processes that may lead to detrimental outcomes and factors that may protect against such outcomes
• Researchers have found a number of common risk and protective factors that are related to a range of problematic youth behaviors such as school failure, pregnancy, poor physical health and drug use.

Weaknesses:

• This approach emphasizes problematic outcomes and calls attention to what is wrong with youth, rather than what is right. "Problem-free youth are not necessarily fully prepared youth."
• This model tells us little about how to promote normal development.
• Risk factors are typically viewed as being of equal importance, which is rarely the case.
• Risk factors are often only correlates or markers of some unidentified or underlying process. However, they are often incorrectly interpreted as being casually related to the problematic outcome of interest. Much less is actually known about the casual processes underlying many risk factors.
• Because the definition of a risk factor is so general, there is often confusion about its meaning. For example, protective factors are sometimes incorrectly operationalized as the absence of a risk factor.

References

Hawkins, J., Catalano, R. & Associates (1992). Communities that Care. San Francisco: Jossey-Bass.

Hawkins, J., Catalano, R. & Miller, J. (1992) Risk and Preventive factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64-105.

Institute of Medicine. (1994). Reducing risks for mental disorder: Frontiers for preventive intervention research. Washington, DC: National Academy Press.

Pellegrini, D. (1990). Psychological risk and protective factors in childhood. Developmental and behavioral Pediatrics, 11, 201 201-209.

Small, S & Luster, T. (1994). An ecological, risk factor approach to adolescent sexual activity. Journal of Marriage and the Family, 56, 181-192.