As we look at the community, it may not be easy to “find” prevention services. Our work is often housed in a variety of locales and often masked as other types of interventions. These locales include schools, social services, family support organizations, religious institutions, hospitals, workplaces and law enforcement facilities. The services include educational counseling, family support, youth activities, workplace human services, and media campaigns to reach the public. Prevention professionals work in all of these settings to deliver prevention services to the community. But wherever these services reside, the prevention goals remain the same—to provide positive support to prevent problem behavior, like substance use, if possible; and if early onset of the behavior has occurred, to intervene before more serious problems have developed.
As we discussed in Prevention Nugget #4, prevention programming is designed to intervene in those points of the Etiology Model where people become vulnerable to negative outcomes through interactions with the micro- and macro-environments. It focuses on these interactions and provides support to the socialization agents in those settings, such as, parents in families, staff and peers in schools, and supervisors/colleagues in the workplace. At the macro-level, the targets are factors such as rules, regulations, and laws; social and cultural influences on beliefs and behaviors; and the physical environment that influences feelings of safety and social communications.
What are some of the programs and strategies made for these settings? At the micro-level, prevention programming includes for the family--management and parenting skills programs; in schools and the workplace--policies regarding substance use, social and physical climate, and manualized prevention curricula. At the macro-level, strategies include strengthening laws that limit the accessibility and availability of psychoactive substances for youth; limiting the number of alcohol outlets; improving neighborhood security through lighting and enhanced physical surroundings. The primary purpose is to prevent youth access to substances; and provide safe and healthy settings for community citizens.
Prevention professionals who work in these settings may train key socialization agents or act as agents themselves directly reaching the target audience. At the micro-level, for example, they might train parents on parenting or family management skills; or teachers on classroom climate and management; or they might directly train youth through a school curriculum, or other direct interaction. These are called behavioral interventions as they directly focus on behaviors, such as decision making in regard to their health and well-being.
Furthermore, at the macro-level, prevention professionals can create environments that also help to reinforce positive decision making and behaviors. Some of these involve changing policies or laws regulating access to substances, controlling their use in public places, raising taxes on purchasing and other environment-based actions. Recent work in regard to controlling advertising, packaging, and youth access to e-cigarettes has been implemented to stem recent increases in such use.
Prevention professionals often work with coalitions and groups across public and private organizations to develop a comprehensive community prevention system. They bring everyone to the table to maximize the effort, avoid duplication, and monitor community services and their affect on substance use. This type of effort has been found to be effective in not only in pulling these prevention services together but also on impacting substance use rates in communities.
What have been your experiences in working with youth or planning a macro-level intervention? What are recent examples you can share with others about your environments for prevention?