Precision Prevention and Public Health

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McGrath, Colleen
Palmarella, Graceann
Solomon, Sara
Dupuis, Roxanne

A new trend, “Precision Prevention,” is emerging in public health. This term is borrowed from “Precision Medicine,” a concept in medicine that allows for individualized treatments for patients. Precision prevention utilizes “biologic, behavioral, socioeconomic, and epidemiologic data to devise and implement strategies” tailored to specific individuals or populations. The goal of precision prevention is to target the “right intervention to the right population at the right time.” Much of precision prevention accounts for one’s social determinants of health, tailoring interventions based on a set of individual factors related to where we live, learn, work, and play that impact our health. Precision prevention works to move away from universal approaches to illness and injury prevention. Flaura Koplin Winston, MD, MPH, Chair of the Science and Medical Advisory Committee for Entrepreneurship and Innovation at The Children’s Hospital of Philadelphia (CHOP), applies a precision prevention framework, using a “tiered risk model” (see figure 1) for the Violence Prevention Initiative at CHOP. In the tiered risk model, there are three types of interventions focused around the needs of universal, selected, and indicated populations. At each level, interventions range from meeting the universal needs of the general population, to the select needs of populations at increased or different risk, and finally to interventions tailored for populations with adverse or indicated needs. For example, within the Violence Prevention Initiative, selected interventions that integrate appropriate community support services are tailored to children at greater risk for violence, and indicated interventions tailor the most intensive, direct support to child victims of violence.

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