Introduction to Primary Prevention
At ICADV we reject the notion that domestic violence is inevitable. We believe that domestic violence is a choice and we are committed to getting in front of the problem to change the social conditions that tolerate or encourage these forms of abuse. We believe that because some people (largely male) choose to perpetrate domestic violence, that it is possible for them to choose not to perpetrate. The processes around decision making for any individual are complex and result from a variety of influences from their personal experience and their social environment, but the choice to perpetrate domestic violence begins with the existence of the option to be abusive within our relationships. The option to abuse is expressed in our social environments in many different ways. Preventing violence involves not only working with individuals who perpetrate to make different decisions, but primarily focuses on creating change at the cultural level to make the option of domestic violence less likely or (ultimately) not possible.
What are we preventing?
Domestic violence programs have used the Duluth power and control wheel to educate about the comprehensive system of behaviors that abusers use to establish control in intimate relationships for three decades. In spite of this, many community interventions around domestic violence are only set up to be responsive to acts of physical violence. We believe that any prevention strategy that addresses physical acts of violence but leaves the victim vulnerable to emotional, economic, psychological or sexual abuse is incomplete. In framing our prevention work, we seek to address the entire range of abusive behaviors that abusers use to gain and maintain power and control.
What is Primary Prevention?
The Prevention Institute defines prevention as a systematic process that promotes safe and healthy environments and behaviors, reducing the likelihood or frequency of an incident, injury or condition occurring (2007). Primary prevention is the terminology that the public health community uses to describe interventions designed to prevent first time perpetration or victimization. Primary prevention strategy focuses on reducing factors that put an individual at risk for perpetration and by promoting factors that protect an individual from victimization.
Because the application of primary prevention strategy to intimate partner violence is fairly new nationally, there is not yet a significant research base describing best practices in this work. However, principles of effective prevention have been identified in other public health initiatives. Successful prevention initiatives incorporate as many of these strategies as they reasonably can. The Virginia Sexual and Domestic Violence Action Alliance (2009) has adapted this list for intimate partner and sexual violence:
- Develop prevention strategies that promote protective factors.
- Develop prevention strategies that strive to be comprehensive.
- Develop prevention strategies that are concentrated, and can be sustained and expanded over time.
- Develop prevention strategies that use varied teaching methods to address multiple learning processes.
- Develop prevention programs based on purposeful, logical rationale.
- Develop prevention strategies that are developmentally appropriate.
- Develop prevention strategies in collaboration with a representative cross-section of community members to incorporate diverse cultural beliefs, practices, and community norms.
- Develop prevention strategies that include a systematic method to determine program effectiveness and promote continuous quality improvement.
To be effective, prevention efforts must be as comprehensive as the elements of culture that support domestic violence. For more information about determining prevention strategy, see the Texas Association Against Sexual Assault’s strategy selection workbook at: http://www.taasa.org/prevention/pdfs/StrategySelectionWorkbook.pdf
How is this different from the prevention work that we have done in the past?
Past prevention efforts have mostly focused on raising awareness among the general public about domestic violence and providing potential victims with information about how they might reduce their risk of being victimized. Traditionally, prevention efforts have been delivered to targeted groups within the broader population; programs have been designed for those groups perceived as vulnerable to perpetration or victimization. In addition, programs have been implemented to try to intervene early with perpetrators to prevent repeat episodes of abusive behavior.
All of these prevention strategies take place in a context where perpetration is present. Better described as risk reduction, these strategies are designed to teach individuals how to avoid or manage their experience of violence and abuse. If displayed on a timeline, primary prevention would take place earlier than the customary prevention strategies described above.
Primary prevention includes initiatives that precede perpetration or victimization that seek to enhance protective factors and modify or eliminate risk factors.
“In the Thick”
Secondary prevention includes initiatives designed to intervene in the context of violence. E.g., shelter, arrest, medical care.
Tertiary prevention includes services designed to provide therapeutic support for survivors or rehabilitation for perpetrators: Batter intervention programs, probation, counseling programs and support groups.
Rather than trying to help individuals navigate a context of perpetration, primary prevention strategies give us the opportunity to truly get in front of the problem by changing the social conditions that enable domestic violence.
Why enhance strategy?
Current strategies for responding to domestic violence are insufficient to change the problem.
Though providing supportive services for victims and mandating rehabilitative interventions for perpetrators are essential components of a community’s response to domestic violence, these strategies have not resulted in a reduction of rates of domestic violence in the United States over the past thirty years.
Risk reduction strategies may or may not be effective in protecting an individual, but they do not prevent abusers from using violence, thus potentially relocating, but not preventing violence.
Awareness raising activities alone have not been shown to change abusive behaviors.
Advocacy for broader social change is where the movement began.
Domestic violence programs have served communities in Indiana since the late 1970s. The goal of these programs has been to provide excellent supportive services to victims while working to render those services unnecessary by eliminating domestic violence. Insufficient funding for domestic violence work has necessarily narrowed the scope of that work over time to a focus on services for victims. In a context where shelter staffs work at capacity just to keep the doors open and meet the needs of victims, the social change goal was pushed to the margins of the movement. The Delta project administered by the Centers for Disease Control and Prevention seeks to restore balance to the mission by providing funding for prevention without compromising support for the healing interventions that programs provide for survivors.
Who should be involved in Primary Prevention?
Everyone. Primary prevention seeks to promote healthy relationships with a universal audience. In the past, awareness raising campaigns were targeted at individuals thought to be at increased risk for perpetration or victimization. Because we live in a culture where differences based on sex, race, class, orientation, ability and other traits traditionally used as a basis for discrimination, inequality between groups supports the privilege of some and the marginalization of others. This does not mean that all of those in traditionally privileged groups will perpetrate violence or that all of those in marginalized groups will be victims of violence. What it does mean is that domestic violence is a problem for all of us, and each of us has opportunities to work for prevention. Communicating effectively with diverse groups and communities will require a range of messages and messengers, but we should seek to engage all of us in the conversation.