Public Health professionals define three levels of prevention: primary, secondary, and tertiary.
Historically, the sexual assault movement was in reaction mode responding to the crisis, supporting survivors who had already been sexually assaulted, and raising awareness of available resources. Over the last decade or so, the movement has shifted toward focusing more on primary prevention intervening “up-stream”, or addressing the root causes of violence in order to prevent it from happening in the first place.
- Primary Prevention: Approaches that are employed before any sexual violence has occurred to prevent initial perpetration and victimization. Primary prevention includes building an environment that encourages well-being and healthy choices. This could include approaches such as public dissemination of information and resources. Primary Prevention can be directed toward either at “Universal” or “Selected” audiences. Universal reflects strategies aimed at everyone in the population of interest, independent of risk. Selected denotes strategies directed toward those in the population at increased risk for sexual violence perpetration or victimization.
- Secondary Prevention: An immediate response after sexual violence has been perpetrated. Secondary prevention deals with the short-term consequences of violence; it attempts to reduce the harm to the victims in the immediate aftermath of the violence (e.g. separating the victim and the perpetrator; providing immediate crisis counseling for the victim), and to locate, contain, and address the perpetrators. Secondary and Tertiary prevention can be directed towards “Indicated” audiences, reflecting strategies aimed at individuals who have perpetrated sexual violence or those who have been victimized.
- Tertiary Prevention: A long-term response after sexual violence perpetration. Tertiary prevention addresses the lasting consequences of victimization (e.g. by providing ongoing counseling for victims) and the provision of specialized sex offender treatment and management to the perpetrators of sexual violence to minimize the possibility of re-offense. Tertiary prevention also includes intervention in family violence to prevent reoccurrence of the situations and behaviors that cause harm.
What would it take to raise a generation of boys and girls who grow up without violence as their model for how to behave? Those boys and girls need to receive positive, violence-free messages from their peers, the adults in their lives, and the pop culture that surrounds them. In the movement, we refer to this as the Socio-Ecological Model:
Individual behavioral choices are affected by one’s own individual identity and belief systems as they relate to messages, beliefs, boundaries, and expectations expressed by significant others and other family members, parents, peer groups, school or other social community, and the culture at large. [For more information, see the CDC publication “Sexual Violence Prevention: Beginning the Dialogue”]
From an institutional perspective, another way of thinking about this is to use the “spectrum of prevention” model:
Spectrum of Prevention Model
||Influencing Policy and Legislation
||Developing strategies to change laws and policies to influence outcomes
||Changing Organizational Practices
||Adopting regulations and shaping norms to improve health and safety
||Fostering Coalitions and Networks
||Convening groups and individuals for broader goals and greater impact
||Informing providers who will transmit skills and knowledge to others
||Promoting Community Education
||Reaching groups of people with information and resources to promote health and safety
||Strengthening Individual Knowledge and Skills
||Enhancing an individual’s capability of preventing injury or illness and promoting safety
The “9 Principles of Effective Prevention Programming”
The prevention of violence can take many forms; as the field has grown, practitioners have begun to identify best practices in terms of those things that make programming most effective. The CDC has identified “9 Principles of Primary Prevention”, concepts borrowed from other prevention efforts (substance abuse, risky sexual behavior, school failure, juvenile delinquency & violence) which have proven successful in shifting people’s behavior over time. To be successful, when planning prevention programming your organization should consider the following:
To learn more about each of these principles, read the paper Applying the Principles of Prevention: What Do Prevention Practitioners Need to Know About What Works? [PDF]
You can also view the CDC’s Veto Violence project – Principles of Prevention online course (flash based content).
Risk and Protective Factors
Individual Risk Factors
- Alcohol and drug use
- Empathic deficits
- General aggressiveness and acceptance of violence
- Early sexual initiation
- Coercive sexual fantasies
- Preference for impersonal sex and sexual-risk taking
- Exposure to sexually explicit media
- Hostility towards women
- Adherence to traditional gender role norms
- Suicidal behavior
- Prior sexual victimization or perpetration
- Family environment characterized by physical violence and conflict
- Childhood history of physical, sexual, or emotional abuse
- Emotionally unsupportive family environment
- Poor parent-child relationships, particularly with fathers
- Association with sexually aggressive, hyper masculine, and delinquent peers
- Involvement in a violent or abusive intimate relationship
- Lack of employment opportunities
- Lack of institutional support from police and judicial system
- General tolerance of sexual violence within the community
- Weak community sanctions against sexual violence perpetrators
- Societal norms that support sexual violence
- Societal norms that support male superiority and sexual entitlement
- Societal norms that maintain women’s inferiority and sexual submissiveness
- Weak laws and policies related to sexual violence and gender equity
- High levels of crime and other forms of violence
Protective Factors for Perpetration
Protective factors may lessen the likelihood of sexual violence victimization or perpetration by buffering against risk. These factors can exist at individual, relational, community, and societal levels. The few protective factors identified by researchers to date are listed below. Research in this area is ongoing.
- Parental use of reasoning to resolve family conflict
- Emotional health and connectedness
- Academic achievement
- Empathy and concern for how one’s actions affect others