The ultimate goal of prevention is to stop something from ever happening - period. Before choosing ad hoc strategies that may have limited impact, effective prevention of child abuse requires an understanding of the factors that influence abuse and neglect. This socio-ecological model of prevention assists us in reaching this understanding.
The 90by30 socio-ecological model of prevention is drawn from the original concept from theC enters for Disease Control and Prevention (CDC) and the one adapted by the Oregon Attorney General’s Sexual Assault Task Force in its 2006 Sexual Violence Prevention Plan (Barkhurst 2006). The CDC developed the original social-ecological model to better understand abuse and the effect of potential prevention strategies (Dahlberg & Krug 2002).
This model depicts the complex interplay between individual, relationship, community, institutional, and societal factors that relate to child abuse and neglect. It allows us to zero in on and address the factors that put people at risk for experiencing or perpetrating abuse or neglect. It's an approach more likely to sustain prevention efforts over time than any single intervention.
The levels of factors are:
The first level identifies biological and personal history factors that increase the likelihood of becoming a victim or perpetrator of child abuse or neglect. These factors include age, education, stress level, substance use, rigid belief systems, or family history. For example, age is an individual characteristic that places very young children at higher risk for abuse and neglect. Prevention strategies at this level are often designed to promote changes in attitudes, beliefs, and behaviors that ultimately prevent abuse and neglect. They operate at an individual level, giving parents or providers particular resources to combat abuse. Specific approaches may include child abuse and neglect awareness and skills training for pediatricians, child care center staff, and elementary school teachers; counseling; and life skills training.
The second level examines close relationships that may increase the risk of experiencing child abuse and neglect - or the risk of being abusive or neglecting a child. Each person’s closest social circle – peers, partners, family members – greatly influences their behavior and contributes to their range of experience. Prevention strategies at this level include mentoring and peer programs designed to reduce isolation, foster problem solving skills, and promote healthy parenting.
The third level explores the settings, such as schools, workplaces, and neighborhoods, in which social relationships occur. It seeks to identify the characteristics of these settings that are associated with becoming victims or perpetrators of abuse or neglect. Prevention strategies at this level are typically designed to impact the climate in a given system. After-school programs, family fun nights, and youth recreation activities are some examples of community-level strategies used to foster positive community climates that promote healthy families, safe schools and safe neighborhoods.
The fourth level explores the roles that institutions play in prevention. Prevention strategies fall into the realm of public policy, laws, and/or resource allocation relating to supporting prevention efforts. Examples of institutional strategies include school district-wide anti-bullying programs, laws that require supervised parenting time under certain conditions, or the Vatican’s new policy for Catholic Churches on reporting incidents of child sexual abuse.
The fifth level looks at the broad societal factors that help create a climate in which abuse or neglect is either encouraged or inhibited. These factors are closely related to social and cultural norms. Other large societal factors include the health, economic, educational and social policies that help to maintain economic or social inequalities between groups in society. Strategy examples include social media or social norms campaigns designed to shift the way we think so that most members of a society make different choices when faced with certain conditions.
The Mothers Against Drunk Driving (MADD) Story
The MADD campaign is one of the most successful examples of what can happen when we applying the Socio-Ecological Model to significant social problems. Starting with one mother whose daughter was killed by a drunk driver, MADD sparked a movement that included activities across the entire model – and changed the behavior of a nation.
MADD strategies across the model included:
- Targeting individuals with the messages of the harm caused by driving drunk and the task of not letting friends drive drunk.
- Targeting relationships by focusing on peer-related messages so that it became acceptable to intervene with another person who was intoxicated and wanted to drive.
- Forming community-based chapters of MADD to reinforce both the activities and the messages at the local level.
- Working with major institutions, including Congress and the legislatures in 50 states to pass tough criminal laws relating to driving under the influence.
- Using media and social norm campaigns to reinforce the messages of the harm and trauma caused by drunk driving – and the solutions. Over 25 years, these societal campaigns shifted the entire country from public acceptance and winking at drunk driving to a no-tolerance attitude and a set of new norms (such as naming a "designated driver") that offer very practical alternatives to drinking and driving.
In 25 years, we hope child abuse will have been subject to the same shifts in social norms and changes at every level of the socio-ecological model as drunk driving.