PREVENTION SCIENCE IS NOT SEXY
Sharlene Johnson, BSW, CPS
Time and time again I see the familiar eyes glazed over expression as I launch into my discussion of addressing substance abuse risk and protective factors in a community. I struggle with how to engage my audience in this discussion. Once after a town hall forum I was told I needed to “give the redneck version” or “make it sexy”. I am a passionate prevention specialist deeply entrenched in prevention sciences, but let me tell you, even I don’t think risk and protective factors are “sexy”. But, just maybe I can make it understandable. So with a little help from the University of Kansas Community Toolbox here is the sexiest description I can muster.
Have you ever wondered why some people in our communities have better outcomes than others? Why some children do well in school while other kids - equally intelligent - do not? Why different people in the same community have unequal health status? Have you wanted to change these outcomes?
There are many different and interrelated causes of problems and desired outcomes. If your community can understand these causes, it can focus its intervention to better contribute to community improvement. This allows you to transform your community into the community you envision.
So, where do you begin in trying to make these changes? One very good way to go about it is to consider the
risk and protective factors
that may be partially responsible for a particular problem or desired outcome.
What are risk and protective factors? They are the aspects of a person (or group) and environment or personal experience that make it more likely (
risk factors
) or less likely (
protective factors
) that people will experience a given problem or achieve a desired outcome. If a person smokes, that is a risk factor for having a heart attack. If he walks two miles a day, that's a protective factor against that same heart attack.
Risk and protective factors are key to figuring out how to address community health and development issues. It's a matter of taking a step back from the problem, looking at the behaviors and conditions that originally caused it, and then figuring out how to change those conditions.
For example, in an effort to prevent substance abuse, an approach that uses risk and protective factors to direct interventions might give young people healthy activities in which to participate, positive role models, and the assertiveness training
to be able
to "Just say no!" when they are offered alcohol or other drugs.
Often, risk and protective factors can be considered flip sides of the same coin. A family history of alcoholism is considered a risk factor for becoming an alcoholic. On the other hand, growing up in a family in which parents talked frankly with their children about alcohol (and didn't abuse it themselves) may be considered a protective factor. The greater the number of risk factors, the greater the chances of adverse outcomes on health, education, and development.
We generally group both risk and protective factors into two categories—personal and environmental.
Personal factors
are things that are unique to each individual/group. They include an individual's knowledge, skills, experience, history, and genetic makeup.
Environmental factors
are factors that affect a specific group of people in each community; they are not specific to each person. The environment refers to the conditions in which each individual lives - their household, their neighborhood or town, and the larger community. These may include aspects of the
social environment
, including the norms and behaviors of their families, friends, and others in their community. It also involves aspects of the
physical environment,
including access to resources, exposure to hazards, and overall living conditions.
Many risk and protective factors are related to multiple community outcomes. That is, they are important factors in almost all community health and development concerns. As such, they can give you a good place to start in developing your own lists of risk and protective factors. Poverty is a risk factor for teen pregnancy, substance abuse, and inadequate access to health care. On the other hand, a child having a strong relationship with a caring adult is a protective factor against substance abuse, dropping out of school, committing criminal actions, and so on.
Not all risk and protective factors are created equal. Some risk and protective factors are much more influential than others. Having friends who use drugs has been shown to be a very significant risk factor for a teen to start using drugs. It's a much stronger risk factor than simply having the substances available in the community. It's important to consider the relative importance of each risk and protective factor because this will help you prioritize your actions later on.
The more risk factors a person has, the greater the likelihood they will engage in a given unhealthy behavior. And conversely,
the more protective factors or assets they have
in their corner, the
less likely
they are to engage in that behavior. If you smoke heavily, eat a diet high in cholesterol, don't exercise, and have high blood pressure, it's much more likely that you will have a heart attack than if your only risk factor is a poor diet.
Having a solid understanding of risk and protective factors and your community dynamics gives you an excellent base from which to develop prevention strategies. By reducing risk factors and enhancing the protective factors surrounding a given community issue, your community can work effectively to address the issues.
