"Wait...Which Level of Prevention is This Again?" Understanding the Three Levels of Prevention

I received an email this weekend from one of my students preparing for ANCC's PMH Board Certification exam, saying that she was struggling with getting clear on the three levels of prevention.

I told her, "You're not alone.  Of all the topics for this exam, this one is among the most obscure to me...." I explained that part of the reason most of us have trouble sorting it out is that there are actually two prevention paradigms out there...and ANCC won't tell us which paradigm they test us on.

The good news is that over time, I have not heard of any reports that ANCC is using the less popular, newer paradigm of Universal, Selective, and Indicated.  I still teach it in my online exam prep course, but it seems that I may be able to drop that part and just stick with the simpler one---primary, secondary, and tertiary.  

The easiest way to understand these three levels of prevention is this:

• Primary Prevention = BEFORE illness develops:  “How do we reduce the chance this disorder ever starts?”  (e.g., mental and physical health education, etc.)

• Secondary Prevention = EARLY illness detection/intervention :“How do we catch this early before it has the chance to worsen?”  (e.g., screenings, etc.)

• Tertiary Prevention = AFTER illness is established:  “How do we minimize long-term impairment and help this person live as fully as possible?”  (e.g., case management, medication education, etc.)

If you focus on those six key words--before illness, early illness, and after illness--you should be able to answer any ANCC questions on the subject correctly.

Hope that helps! And as always, keep studying!