A useful analogy for teaching secondary prevention concept

Jennifer Christian MD

A lot of people with whom you need to collaborate in RETAIN may not be familiar with (or buy into) the concept of secondary prevention of work disability  – or said another way, the techniques that prevent adverse secondary consequences of injuries/illnesses.  This is the generic “active ingredient” of Washington’s COHE, Early RTW, and early Voc Rehab programs, so is a really important for everyone involved to understand. 

I thought of a way you might be able to make the concept of secondary prevention come alive for others – by analogy to our country’s efforts to fight building fires.   The fire departments in every community use primary, secondary and tertiary prevention techniques to manage the threat of fire in structures.  The techniques vary in WHEN they are deployed, in WHO does them, and in the LEVEL OF EXPERTISE/EXPENSE involved:  

    • PRIMARY PREVENTION approaches are DEPLOYED AHEAD OF TIME.  They include a variety of activities carried out by many different types of professionals:   education on the importance of not smoking in bed, teaching children to “stop drop and roll,” assuring that all electrical wiring is up to code, requiring the use of fire resistant construction materials, etc.
    • SECONDARY PREVENTION APPROACHES are put in place by homeowners ahead of time in anticipation of possible fires -- but are DEPLOYED AT THE FIRST SIGN OF TROUBLE:   smoke alarms in every house go off the instant they detect a problem, sprinkler systems and/or hand-held fire extinguishers douse little fires before they can turn into roaring conflagrations. 

    • TERTIARY PREVENTION APPROACHES are DEPLOYED TO DO DAMAGE CONTROL in response to a conflagration:  a full array of complicated, dangerous (and expensive) fire-fighting professionals, equipment, procedures and techniques to save lives, prevent complete destruction of the building or spread to other structures.

Is this helpful? 

Jennifer Christian, MD, MPH
Moderator, RETAINers List-Serv and Website on Groups.io
(a volunteer activity – not an officially sponsored group)
Chair, 60 Summits Project
(non-profit organization founded in 2006 and mothballed since 2010)


David Duden

This is helpful and as I think about the nudge theory, it would appear that there is a role for how education, directional messaging and loss minimization messages are designed and delivered.....think of the directional floor lighting in air planes on the floor....helping folks get to safety, and also to stay low....