Primary Prevention—Promoting the best for all of us.

By Maria Doyle, Family Support Specialist for FRC-Q

April was Child Abuse Prevention Month – our annual chance to focus on what everyone can do to help ensure that every child has the great childhood they deserve. When we say “child abuse prevention” our minds often turn to children who experience maltreatment at the hands of their parents, who, when faced with situations where stressors exceeded resources, harmed their children. But this of course is not a picture of child abuse prevention – it’s what happens when we fail to prevent it.

All parents experience some level of stress – the great news is that we know what specific resources have been shown to be most effective in mitigating that stress, so it does not lead to parental neglect or maltreatment of a child. In the field of child abuse prevention, we have begun to state what we are seeking rather than what we are trying to avoid – because then we can turn our attention to achieving it. The simplest way to say it is that every child deserves a great childhood. The CDC, who recognize this as a public health issue, says it like this: “Safe, stable, nurturing relationships and environments are essential to preventing child abuse and neglect.” When we identify creating safe, stable, and nurturing relationships and environments for kids as a public health issue we are saying that there are strategies we can put in place that reach everyone – not just those who might be judged at risk. When strategies are implemented for everyone this is primary prevention. To borrow an example from the brain injury prevention field – bike helmets are recommended for all. This is a primary prevention strategy!

There are some very specific primary prevention strategies that are known to promote families being best able to provide safe, nurturing relationships and environments [1]. They include:

1. Strengthening economic supports for families through policies like paid family leave, flexible employee policies and the federal earned income tax credit

2. Change attitudes and norms about parenting – like making it more acceptable to seek help when you need it and creating more connections between members of communities. Family Resource Centers provide play groups, information about parenting, and opportunities for parents to connect with each other. Sometimes people may be reticent to seek out their local family resource center because they think they are supposed to do it all on their own. Our ideas about privacy and families might also prevent us from connecting with our neighbors. Changing attitudes can strengthen families!

3. Provide quality care and education early in life. We know that brains are built not born. Focusing on improving the quality of early care and education as well as enhancing primary health care to better support families.

4. Enhance parenting skills to promote healthy child development. We know that family resource centers and home visiting can provide important information and supports to families that strengthen them in their knowledge of parenting and child development. Information is power to fuel parents to be their best, and families to be their strongest.

Detailed above is what we can do on the society and organizational level to create the context for those safe, stable, and nurturing relationships and environments for children. Let’s focus for a moment on the family characteristics that we know strong families possess. Research tells us that when certain family characteristics are present and robust in families three things result: families are strong, children develop optimally, and there is a reduced risk of child abuse and neglect. These characteristics are called protective factors because they help families be their best in the face of challenges. They are described in the Strengthening Families Protective Factors Framework (TM) developed by the Center for the Study of Social Policy [2]. The Framework identifies five protective factors and actions that anyone who wishes to support families can take to promote them. They are:

Parental Resilience: The capacity to recover from, and perhaps be transformed by life’s challenges.

Knowledge of Parenting and Child Development: Knowing what to expect from children at different ages and stages and how to respond.

Social Connections: Having friends, family and neighbors to turn to in times of joy and challenge

Concrete Support in Times of Need: Knowing where to turn and receiving help when you need it.

Social and Emotional Competence of Children: Supporting children to experience their feelings, resolve conflict and have positive relationships.

When we have neighbors, communities, and governments working in ways that support families to develop these protective factors, families can then create those relationships and environments that are safe and nurturing for their children – that’s primary prevention.

If we each did one thing during April to help a family be their best – we would be on our way to realizing NH Children’s Trust vision of a New Hampshire free of child abuse and neglect.

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1. National Center for Injury Control and Prevention, Center for Disease Control and Prevention, . (2018). Essentials for Childhood: Creating Safe Stable Nurturing Relationships and Environments for All Children. Retrieved April 1, 2020, from cdc.gov: https://www.cdc.gov/violenceprevention/pdf/essentials-for-childhood-framework508.pdf

2. Center for the Study of Social Policy. (n.d.). Strengthening Families Framework. Retrieved from Center for the Study of Social Policy: https://cssp.org/our-work/project/strengthening-families