Primary Prevention involves strategies used to prevent the initial onset of a disease or condition. Therefore, strategic interventions are used for individuals and populations that do not present with the health-related conditions for which the strategy is used to address. The purpose of these strategies is to limit the exposure of harmful stimuli or decreased risk factors associated with a specific disease or condition. Primary prevention activities can be further divided into two main categories: passive and active. Passive strategies involve protective measures and are defined as those that do not require the active engagement or involvement of an individual. On the other hand, active strategies involve health promotion measures and are defined as those that require the active participation of an individual. While passive strategies are implemented to “protect” an individual’s health, active strategies are used to enhance an individual’s health. Examples of passive and active primary prevention strategies are listed below:

 

Passive Primary Prevention Strategies:

• Re-mineralizing bread/milk products

• Immunizations (and prophylactic medications)

• Utilization of personal protective equipment

• Community water fluoridation

 

Active Primary Prevention Strategies:

• Health education and promotion

• Health diets and nutritional strategies

• Regular physical activity and exercise adherence

 

Secondary Prevention strategies utilizes screening and assessment measures to identify precursors of a disease or condition prior to the initial onset of symptoms. The purpose of these intervention strategies is to identify preliminary factors during the asymptomatic stage in order to prevent the progression, spreading of a condition or disease and limit the potential of future disability. Identification of precursors allows for prompt intervention, improved health outcomes, individualized care plans, and provides additional care options.

 

Secondary Prevention Strategies:

• Various screening/assessment measures

• Periodic health examinations

• Activity modifications

• Nutrition and exercises strategies to prevent further disease progression

 

Tertiary Prevention strategies are used to decrease the impact of adverse health conditions due to an ongoing disease or condition. The purpose of these strategies is to aid individuals presenting with long-term injuries/illnesses to reduce the presence of disability, limit the progression of complications, and improve function and quality of life.

 

Tertiary Prevention Strategies:

• Lifestyle changes (nutrition, exercise, sleep hygiene)

• Regular/periodic medical check-ups

• Therapeutic rehabilitation

• Pain management strategies

 

Quaternary Prevention consists of strategies used to avoid or prevent the occurrence of a condition or disease due to unnecessary, excessive, or harmful medical interventions. While similar in concept to primary prevention (encompassing both the protection and enhancement of health), quaternary prevention differs in that it 1) focuses on protecting rather than directly enhancing the health of patient populations, and 2) is related directly to the care provide by health care professionals. These strategies are necessary to reduce the psychological, physical, and financial burdens placed on patients due to overmedicalization.

 

Quaternary Prevention Strategies:

• Avoiding unnecessary diagnostic testing and interventions

• Utilizing patient education and shared decision-making

• Adhering to ethical practice guidelines (and scope of practice)

• Consistent patient monitoring (ex. remote patient/therapeutic monitoring)

 

All four of these prevention classifications are defined by the purpose for which it is applied. A single strategy or intervention does not necessarily belong solely to one category/classification of prevention. Rather, the aim or purpose for which the intervention is utilized determines the classification of prevention being used. An example of this can be seen with health-related lifestyle changes (i.e., nutritional strategies). While dietary changes can be used as a primary prevention strategy to prevent the initial onset of a condition, it can also be used as a secondary prevention strategy to prevent the progression of disease precursors identified during early screening measures. Another example can be seen with regular medical check-ups or follow-up appointments, which are strategies that can be seen (depending on its purpose) on the secondary, tertiary, and even quaternary levels.