Prevention, as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) s “interventions are intended to prevent or reduce the risk of developing a behavioral health problem, such as underage alcohol use, prescription drug misuse and abuse, and illicit drug use.” There are three levels of prevention – primary, secondary, and tertiary. The Centers for Disease Control (CDC) defines them as follows
The Decisions at Every Turn Coalition employs a primary prevention model, seeking to implement programs and strategies that educate Ashland as a whole and youth in particular on the risks of using substances.
In addition to directly educating youth and families in Ashland, the Coalition also employs environmental strategies to prevent youth substance use. Environmental strategies do not necessarily involve altering the physical environment in any way – rather, an environmental strategy is any prevention strategy that targets not individuals, but physical structures, social and cultural norms, policy, and other outside factors that can influence the choices an individual community member makes. This might include advocating for laws that restrict alcohol and nicotine product access to youth, zoning that reduces the number of stores that are permitted to sell tobacco and alcohol, and media campaigns that seek to alter incorrect assumptions about substance use in a community.
The bottom two segments of this pyramid indicate where environmental strategies lie on the coninuum of public health intervention model types (Frieden, T. A framework for public health action: The health impact pyramid. Am J Public Health. 2010 April; 100(4): 590–595. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836340/)
Through these strategies, coalitions around the country hope to change the culture and policy of substances in the long term to create a healthier environment for youth and adults.