AOD Thesaurus.  Annotated Hierarchy.  prevention. health care.  J - JF16.4
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Jprevention, treatment, and maintenance. health care   b-out   d-out   qh
HN Changed descriptor 2000; through 1999 use "prevention, intervention, and treatment. health care".
SN These areas are closely related. If a needed descriptor is not available in one area, a descriptor from another area can be used. Furthermore, descriptors from any other area, in particular from *+G health and disease* qh ah, *+HA screening and diagnostic method* qh ah, *+HJ treatment method* qh ah, and *+T demographic characteristics* qh ah can be used in combination with J descriptors as needed.
      Section *+JB prevention* qh ah concentrates on the prevention of disorders, with emphasis on education and information programs directed at groups. It also includes measures an individual can take to prevent development of a disorder and measures to prevent the negative consequences of a disorder (overlap with treatment) and AODR accidents. The term "intervention" was used in earlier editions of the Thesaurus with the specific meaning of intervening with an individual, couple, or family with the purpose of initiating measures to revert, stop, or slow the progress of a disorder in its nascent stage. Such measures are now subsumed under prevention. Intervention is generally used as a broad term referring to any kind of preventive or treatment intervention directed at individuals or groups. Thus, a prevention education program may be referred to as a preventive intervention in the community.
      Section *+JL treatment and patient care* qh ah deals with the overall process of providing treatment and post-treatment maintenance for an individual. The specific methods used in this treatment are covered in sections *+HA screening and diagnostic method* qh ah and *+HJ treatment method* qh ah.
      Section *+JS health care delivery and administration* qh ah deals with the overall organization of the health care system and other administrative aspects of health care. For purposes of this section, health care is conceived broadly to include prevention, intervention, and treatment.
      This introductory section includes a few descriptors that apply throughout prevention, intervention, and treatment.
      A target group can be specified by a descriptor from *+T demographic characteristics* qh ah, possibly combined with a descriptor from *+S field, discipline, or occupation* qh ah.
ST prevention, intervention, and treatment. health care
RT+HB AODU screening, identification, and diagnostic method    qh   ah
+JA4e health care in general    qh   ah
+JT8e health service or program by sponsor or setting    qh   ah
 MR2.4e target group    qh   ah


JAgeneral prevention, treatment, and maintenance concepts   d-out   qh
HN Introduced 2000.
RT+FR16.6e attitude towards illness or disability    qh   ah

JA2health services, prevention, and treatment research   qh
HN Introduced 2000.
NT JV6.6.4 health care research funding    qh   ah
JA2.2e.  health services research   qh
HN Introduced 1995.
SN Health services research studies the impact of organization, financing, and administration of health services on the multiple dimensions of service delivery: accessibility, cost, outcomes, quality, and other aspects of health services. It combines concepts and methods from economics, medicine, sociology, psychology, epidemiology, business administration, and a number of other disciplines. It does not focus on human biology or etiology, prevention, diagnosis, or treatment of disease.
      Health services research occurs at four levels: (1) the clinical level, which takes into account nonmedical factors that affect outcomes, such as setting and provider characteristics, and a broad range of outcome criteria, such as patient satisfaction and treatment costs; (2) the institutional level, which focuses on organizational and administrative features of service delivery, such as the impact of managed care on the quality of care and cost; (3) the systems level, which examines the interrelationships among various aspects of the health care system, such as how financing mechanisms, organization of health care services, health care demand, and health care expenditures are related; and (4) the environmental level, which examines the circumstances and events in the larger social, political, and economic contexts that shape the health services system and define its functions in relation to the overall social system.
      Health services research includes studies of resources for treatment and of the use and cost of these resources; estimates of the need or demand for treatment services in the population or in particular subpopulations; studies of the costs and cost-effectiveness of treatment or alternative treatments; and studies of the possible cost-offsets of treatment (e.g., cost of treatment versus cost of the untreated condition and social costs, such as reduced productivity, motor vehicle and other property damage, incarceration, family disruption, etc.).
ST health care delivery research
health care research
HSR
medical care research
research on treatment services
RT+GA general concepts of health and disease    qh   ah
+JA2.4e prevention research    qh   ah
+JA2.6e treatment research    qh   ah
+JU4e health care planning    qh   ah
 JV6.6.4 health care research funding    qh   ah
+LAe social psychology    qh   ah
+MAe sociology and anthropology    qh   ah
+MNe law    qh   ah
+MO law enforcement and the justice system    qh   ah
+MP18e public policy    qh   ah
+MT6 analytical method in economics    qh   ah
+MT10.2 macroeconomic cost-benefit analysis    qh   ah
+MVe human services    qh   ah
+PBe demography    qh   ah
+PDe epidemiology    qh   ah
+RB research organization and management    qh   ah
+RCe research and evaluation method    qh   ah
+Te demographic characteristics    qh   ah
JA2.2.4e.  .  organization of services in HSR   qh
HN Introduced 1995.
ST organization and management of services in HSR
BT+MQe administration and management    qh   ah
RT+JMe patient care management    qh   ah
 JP6.2 patient placement criteria    qh   ah
+JS health care delivery and administration    qh   ah
+JS2e health care delivery    qh   ah
+JS2.4e managed care    qh   ah
JA2.2.6e.  .  treatment outcome in HSR   qh
HN Introduced 1995.
ST treatment effectiveness and outcome in HSR
treatment outcome research
BT+JA2.6e treatment research    qh   ah
+JP14e treatment outcome    qh   ah
RT+FV22e evaluation    qh   ah
+HB AODU screening, identification, and diagnostic method    qh   ah
+HKe AODU treatment method    qh   ah
+JL treatment and patient care    qh   ah
 JP6.2 patient placement criteria    qh   ah
 JP12.16e treatment cost    qh   ah
+JS2e health care delivery    qh   ah
 MQ8.10e program evaluation    qh   ah
 MQ12.4.4e cost-effectiveness    qh   ah
JA2.2.8e.  .  utilization and cost in HSR   qh
HN Introduced 1995.
BT+JU6 health care capacity and utilization    qh   ah
+JV4.4e health care costs    qh   ah
RT JP12.16e treatment cost    qh   ah
 JU10.2 health care utilization review    qh   ah
+JV health care economics    qh   ah
 MQ12.4.4e cost-effectiveness    qh   ah
+MTe economics    qh   ah
+MT2.14.2.2 social and economic cost of AOD    qh   ah
JA2.2.10e.  .  financing and reimbursement in HSR   qh
HN Introduced 1995.
BT+JV6e health care financing    qh   ah
RT+JV health care economics    qh   ah
+JV4.4e health care costs    qh   ah
+MTe economics    qh   ah
JA2.4e.  prevention research   qh
SN Studies (1) the physiological, moral, cultural, social, and legal risk and protective factors that influence an individual's susceptibility to disease and disability as the basis for designing interventions to prevent the occurrence of disease or disability or the progression of asymptomatic disease and (2) the effects of such preventive interventions in populations (prevention trials).
      (1) includes basic psychological research to study the development of disorders such as alcohol abuse, drug abuse, mental illness, and adult criminal behavior and to understand the precursors of maladaptive behaviors (e.g., unsafe sexual activity, dropping out of school) whose consequences can alter one's potential to become a healthy adult, with a focus on the identification of early signs of difficulties and the emergence of developmental sequences, or stages, of disorders and maladaptive behaviors.
      (2) includes the conduct of clinical and community trials and demonstrations to assess preventive interventions and to encourage their adoption and the refinement of methodological and statistical procedures for quantitatively assessing risk and measuring the effects of preventive interventions.
      If applicable, combine with a more specific descriptor from *+JB prevention* qh ah and from *+R research method and research organization* qh ah. This descriptor may not retrieve all documents on specific prevention research studies. (IOM)
BT+JBe prevention    qh   ah
RT+FV22e evaluation    qh   ah
+JA2.2e health services research    qh   ah
+R research method and research organization    qh   ah
+RA general topics in research    qh   ah
+RB research organization and management    qh   ah
JA2.4.2.  .  prevention-related research   qh
HN Introduced 2000.
SN U.S. Public Health Service definition. Research that has a high probability of yielding results which will likely be applicable to the prevention of disease or disability. Included are studies aimed at elucidating the chain of causation (i.e., the etiology and mechanisms) of acute and chronic disease. Such basic research efforts generate the fundamental knowledge which contributes to the development of future preventive interventions.
JA2.6e.  treatment research   qh
SN Treatment research deals with all aspects of treatment: the medical and psychosocial methods of treatment, their biological or psychological mechanisms of action, their effectiveness, and the organizational, social, and economic conditions of treatment. In the latter area it overlaps with *+JA2.2 health services research* qh ah.
NT JA2.2.6e treatment outcome in HSR    qh   ah
BT+JL treatment and patient care    qh   ah
RT+R research method and research organization    qh   ah

JA4ehealth care in general   qh
SN Documents that broadly address multiple topics in *+J prevention, treatment, and maintenance. health care* qh ah.
ST health care
RT+GA general concepts of health and disease    qh   ah
 MP18.6e public policy on health    qh   ah
+MVe human services    qh   ah
+PDe epidemiology    qh   ah
+SJ4 health care (field)    qh   ah
JA4.2e.  continuum of care   qh
SN A continuum of activities and strategies that address the resolution of diseases, disorders, disability, and other instances of harm to individuals. Includes prevention, treatment, and maintenance (including aftercare and rehabilitation). The boundaries between these stages are blurred.
ST continuum of service
intervention spectrum
spectrum of interventions for disorders
JA4.4.  prevention and treatment goals   qh
HN Introduced 2000.
SN The goals of prevention and treatment overlap. Goals listed under *+JB4 prevention goals* qh ah may also be goals of treatment and vice versa.
SN Combine with other descriptors to represent a specific health care goal.
ST health care goal
health priorities
NT+JB4e prevention goals    qh   ah
+JL2e treatment goals    qh   ah
RT MN36.2 goal of punishment    qh   ah
JA4.6.  recipient-intervention matching   qh
HN Introduced 2000.
SN Choosing the intervention approach that will best address the recipients' problems, considering their background and state of health, and matching the intensity of the intervention with the severity and chronicity of the problem.
ST client-intervention matching
NT+JP6e patient-treatment matching    qh   ah
RT+NA8.4e audience-message matching    qh   ah
 RK2.4 assignment of study subjects to conditions    qh   ah
JA4.8.  recipient-intervenor matching   qh
HN Introduced 2000.
SN The matching of the recipients of a preventive intervention with appropriate intervenors or the matching of patients with doctors, nurses, counselors, or mentors. May match the intervenor's skills with the skills required by the recipient and criteria such as age, gender, ethnicity, and other demographic characteristics. Intervenors include spokespersons in media campaigns.
ST assignment of intervenors to participants
RT+NA8.4.2 audience-messenger matching    qh   ah
JA4.10.  intervenor-recipient relations   qh
HN Introduced 2000.
NT+JP10.8e treatment-provider-patient relations    qh   ah
JA4.12.  prevention or treatment protocol   qh
HN Introduced 2000.
ST control of prevention or treatment delivery
control of prevention or treatment execution
intervention protocol
prevention or treatment implementation fidelity
variation and control of intervention and components
NT JP10.2.10e patient compliance    qh   ah
RT+JU10e health care quality control    qh   ah
+RK2e study design    qh   ah
JA4.12.2.  .  manual-based prevention or treatment   qh
HN Introduced 2000.
SN Prevention or treatment intervention carried out strictly according to a manual that lays out all steps in detail.
ST controlled prevention or treatment execution
JA4.12.4.  .  adaptive prevention or treatment   qh
HN Introduced 2000.
SN Prevention or treatment intervention carried out with more freedom or variation from strict prescription, thus offering the possibility of adaptation to special circumstances but also losing a measure of control.
ST uncontrolled prevention or treatment execution
JA4.12.8.  .  prevention or treatment approval   qh
HN Introduced 2000.
SN Approval by a person or committee, other than the health care professional directly in charge.
NT JV6.4.2e prevention or treatment preapproval    qh   ah
JA4.12.8.2.  .  .  prevention or treatment approval by medical-ethical committee   qh
HN Introduced 2000.
RT MY2.14.4e medical ethics    qh   ah
JA4.12.10e.  .  patient supervision   qh
HN Introduced 2000.

JA6risk and protective factors   qh
HN Changed descriptor 2000; through 1999 use "risk factors and protective factors."
SN Factors that increase or decrease the probability that a person will contract a disorder. Many disorders, especially AOD use and mental disorders, are generally not caused or counteracted by a single factor; they are more likely a function of a number of risk and protective factors encountered by an individual. The causal relationship between these risk and protective factors and the disorder is often unclear. Often correlations can be established but causation cannot be proven. A correlate of later disorder may be merely an indicator rather than a causative factor.
      A multiplicity of risk factors or paucity of countervailing protective factors increases the probability that a person will develop the disorder.
      Risk factors and protective factors often come in pairs; for example, poor relations to school constitute a risk factor while good relations to school constitute a protective factor. Some protective factors counteract the effects of one or more risk factors.
      Some risk and protective factors are inherent in the individual; others are inherent in the individual's physical, cultural, social, political, and economic environments.
      Classification and rules for indexing and searching. Risk and protective factors are classified in two ways, representing two facets: (1) *+JA6.6 risk factors* qh ah versus *+JA6.8 protective factors* qh ah and (2) by area/domain, such as *+JA6.12.6 biological risk and protective factors* qh ah or *+JA6.14.6 environmental risk and protective factors* qh ah. Often two descriptors, one from each facet, will be needed; for example, for biological risk factors, index *+JA6.6 risk factors* qh ah and *+JA6.12.6 biological risk and protective factors* qh ah.
      If a document focuses on a factor, such as low birth weight, as a risk factor, three descriptors must be used: *GJ2.12 low birth weight* qh ah, *+JA6.6 risk factors* qh ah, and the applicable descriptor from facet 2, in the example *+JA6.12.6 biological risk and protective factors* qh ah. Under the concepts in facet 2, many factors that could act as AOD related risk factors and/or protective factors are listed as Related Terms without claim to completeness. In a very complete search for, say, *JA6.12.8 psychological risk and protective factors* qh ah, it is advisable to search for all the factors listed as Related Terms (and perhaps additional factors the searcher can think of).
ST influence factors
risk and resiliency characteristics
RT+EE14.4.4e beneficial vs adverse drug effect    qh   ah
+GA10.8e disease factor    qh   ah
+HA2.2.2 screening and diagnostic method for potential disorder    qh   ah
 HB4.2e screening and diagnostic method for potential AODD    qh   ah
 JG26.2.2.6 assessment for AODU susceptibility    qh   ah
+LB16 social attachment vs detachment    qh   ah
+LG14.4.4 child-rearing practice    qh   ah
 LG16.4.2e parental tolerance of adolescent AOD use    qh   ah
 LG16.6e parental monitoring    qh   ah
+LM context    qh   ah
 TZ2.2e high-risk youth    qh   ah
JA6.2.  risk and protective factors by number of domains   qh
HN Introduced 2000.
SN A risk factor can occur in one or more of the following domains: home, school, peer group, neighborhood, or workplace. When a risk factor occurs in multiple domains, interventions are required in all of them.
JA6.2.2.  .  single-domain risk and protective factors   qh
HN Introduced 2000.
JA6.2.4.  .  multiple-domain risk and protective factors   qh
HN Introduced 2000.
JA6.4.  cross-generation risk factors   qh
HN Introduced 2000.
SN Risk factors can occur across generations in the same family, such as problematic behaviors of mothers affecting their children.
RT JG18 multi-generation prevention    qh   ah
JA6.6e.  risk factors   qh
SN Attributes of individuals or environments that increase the chances of developing a disorder. They may also lead to greater severity or longer duration of the disorder. Risk factors may be genetic, biological, psychological, social, or environmental in origin.
ST disease risk
disorder predictors
models of vulnerability
risk characteristics
risk indicators
risk precursors
vulnerability factors
NT AM8e AOD induced risk    qh   ah
 JD4e risk factor model    qh   ah
 NF22.2.6 academic failure    qh   ah
+TP4e school dropout    qh   ah
BT+RM14e predictive factor    qh   ah
RT AE8e AOD use susceptibility    qh   ah
 AJ2.2 vulnerability model of AODU disorder    qh   ah
+AKe causes of AODU    qh   ah
+EA18.2e stressor    qh   ah
+GA10e etiology    qh   ah
+GA10.8.2e disease susceptibility    qh   ah
 JG26.2.2.6 assessment for AODU susceptibility    qh   ah
+JKe prevention barriers    qh   ah
 LC2.12e social isolation    qh   ah
+MT10.4 risk    qh   ah
+PDe epidemiology    qh   ah
JA6.8e.  protective factors   qh
SN Protective factors increase resiliency or inhibit the development of disorders, such as AODU problems. They are generally viewed as the opposite of risk factors.
      Protective factors decrease the risk of disorders or maladaptive behavior in several ways. They may reduce exposure to risk factors, disrupt important processes involved in the development of the disorder, interact with a risk factor to reduce its effects, or directly reduce dysfunction.
ST protective characteristics
resiliency factors
NT EE14.4.4.2.2e protective drug effect    qh   ah
RT AK8 resistance to AODD    qh   ah
 EA20 stress moderator    qh   ah
+FE10e skills    qh   ah
+GA10.8.4 resistance to disease    qh   ah
+NF20e affective and interpersonal education    qh   ah
+NF20.4e skills building    qh   ah
JA6.10.  modifiability of risk or protective factors   qh
HN Introduced 2000.
JA6.12.  internal risk and protective factors   qh
HN Introduced 2000.
ST individual risk factors
RT+AH12e age of AODU onset    qh   ah
 RM10.2 individual-level variable    qh   ah
JA6.12.6.  .  biological risk and protective factors   qh
HN Introduced 2000.
ST medical risk and protective factors
NT+HF26e biological markers    qh   ah
RT AM8e AOD induced risk    qh   ah
 ED4.14.2.2e premature birth    qh   ah
+EE20.6.4e prenatal AOD exposure    qh   ah
 GJ2.12e low birth weight    qh   ah
+GZe behavioral and mental disorder    qh   ah
+HB4.6.2e AODR biological markers    qh   ah
+JA6 risk and protective factors    qh   ah
JA6.12.6.6.  .  .  genetic risk and protective factors   qh
HN Introduced 2000.
RT+HB4.6.2.4e AODR genetic markers    qh   ah
JA6.12.8.  .  psychological risk and protective factors   qh
HN Introduced 2000.
ST psychiatric risk and protective factors
BT+JA6.16 behavioral risk and protective factors    qh   ah
RT+FE10e skills    qh   ah
+FP14.10.6e anxiety    qh   ah
+FQe psychological stress    qh   ah
+FR16.8.2.2e self-esteem    qh   ah
+GZe behavioral and mental disorder    qh   ah
+JA6 risk and protective factors    qh   ah
+LB14e social deviance    qh   ah
JA6.14.  external risk and protective factors   qh
HN Introduced 2000.
RT RM10.4 group-level variable    qh   ah
JA6.14.2.  .  interpersonal risk and protective factors   qh
HN Introduced 2000.
ST social risk and protective factors
BT+JA6.16 behavioral risk and protective factors    qh   ah
RT LC2.14.4e peer pressure    qh   ah
JA6.14.2.2.  .  .  family risk and protective factors   qh
HN Introduced 2000.
RT+LE intimacy and family    qh   ah
+LKe life event    qh   ah
JA6.14.2.4.  .  .  peer risk and protective factors   qh
HN Introduced 2000.
JA6.14.4.  .  life circumstance risk and protective factors   qh
HN Introduced 2000.
ST life event risk and protective factors
RT+LH4 life circumstances    qh   ah
+LKe life event    qh   ah
+MT14.8e standard of living    qh   ah
JA6.14.6.  .  environmental risk and protective factors   qh
HN Introduced 2000.
RT+JA6 risk and protective factors    qh   ah
JA6.14.6.6.  .  .  medical environmental risk and protective factors   qh
HN Introduced 2000.
JA6.14.6.8.  .  .  social environmental risk and protective factors   qh
HN Introduced 2000.
RT+MT2.10e AOD availability    qh   ah
JA6.14.6.8.6.  .  .  .  school risk and protective factors   qh
HN Introduced 2000.
RT+NF22.2e academic performance    qh   ah
+TP4e school dropout    qh   ah
JA6.14.6.8.8.  .  .  .  sociocultural risk and protective factors   qh
HN Introduced 2000.
RT HB4.6.6e AODR sociocultural markers    qh   ah
+MCe sociocultural aspects of AOD use    qh   ah
JA6.16.  behavioral risk and protective factors   qh
HN Introduced 2000.
NT JA6.12.8 psychological risk and protective factors    qh   ah
+JA6.14.2 interpersonal risk and protective factors    qh   ah
RT+FS specific attitude and behavior    qh   ah
 HB4.6.4e AODR behavioral markers    qh   ah
+LB16 social attachment vs detachment    qh   ah
JA6.18.  demographic risk and protective factors   qh
HN Introduced 2000.
SN Risk and protective factors that are easily observable demographic variables. They can be internal or external. Determination of recipient groups for selective prevention is generally based on demographic risk factors.
RT JC4.4.2e selective prevention    qh   ah

JA8risk and needs assessment   qh
HN Introduced 1995.
RT+RF purpose of study    qh   ah
JA8.2e.  risk assessment   qh
SN Studies attempting to identify at-risk groups or assess the predisposition of society towards a particular problem, such as drug use, based on a set of predictive risk factors. This also includes identifying the risks posed by that problem. For tobacco, this could be identifying the risks posed by secondhand smoke.
NT JA8.6.2e community risk assessment    qh   ah
+JG26.2.2e health risk assessment    qh   ah
BT+FV24.6 assessment    qh   ah
+MT10.4 risk    qh   ah
RT HB4.2e screening and diagnostic method for potential AODD    qh   ah
 JD4e risk factor model    qh   ah
JA8.4e.  needs assessment   qh
SN Process by which a geographic area, community, or organization is examined for its needs for a particular service. Much of the AOD literature pertaining to needs assessment discusses how to assess the needs for services or programs, such as treatment programs, employee assistance programs, or prevention programs. The term also applies to assessing the needs of a specific group of people, such as the treatment needs of women or intravenous drug users in a particular community.
NT JA8.6.4e community needs assessment    qh   ah
 JN6e individual needs assessment    qh   ah
BT+FV24.6 assessment    qh   ah
RT+JN patient assessment and diagnosis    qh   ah
+MQ8.2e program planning    qh   ah
+RCe research and evaluation method    qh   ah
JA8.6.  community risk and needs assessment   qh
HN Introduced 1995.
ST societal risk and needs assessment
BT+MQ8 program planning, implementation, and evaluation    qh   ah
RT+RCe research and evaluation method    qh   ah
JA8.6.2e.  .  community risk assessment   qh
HN Introduced 1995. ETOH descriptor 2000.
SN Assessment of the predisposition of a community or group towards drug use based on a set of predictive risk and protective factors, prevalence studies, etc. Such an assessment can be conducted on the local, state or national level as well as in a school or organization; it can involve the total population or special population subgroups. Also includes the assessment of health risks posed by AOD use for users or non-users (the health risks of secondhand smoke). More broadly, used for assessment of the risks of any type of health problem within a community or group.
BT+JA8.2e risk assessment    qh   ah
JA8.6.4e.  .  community needs assessment   qh
HN Introduced 1995. ETOH descriptor 2000.
SN Assessment of the needs for prevention, treatment, and maintenance programs and services within a community or group, usually based on risk assessment. Such an assessment can be conducted on the local, state, or national level as well as in a school or organization; it can involve the total population or special population subgroups.
BT+JA8.4e needs assessment    qh   ah
JA8.6.6e.  .  community monitoring   qh
HN Introduced 1995.
SN Collecting data over time on the incidence and prevalence of AOD use and abuse and risk and protective factors in a given community to justify, plan, and evaluate AOD programs.
RT+MLe community action    qh   ah


JBeprevention   d-out   qh
SN Social, economic, legal, educational, psychological, or medical measures aimed (1) at removing the causes or preventing the development of disorders or (2) at avoiding or ameliorating the harmful effects and consequences of an established disorder (overlap with treatment). AOD prevention strives at minimizing the use of potentially addictive substances or lowering the dependence risk in susceptible individuals. The prevention section of the Thesaurus covers strategies aimed at preventing disorders, including education and information programs directed at groups and preventive interventions directed at families and individuals. It also includes measures an individual can take to prevent development of a disorder, as well as prevention of AODR accidents. Use a more specific descriptor when applicable.
      "To prevent" literally means "to keep something from happening." Different notions of what that something is constitute a source of confusion in the prevention field. For example, do measures to prevent sequelae of a disorder constitute prevention or a part of treatment? (IOM)
      A prevention target group can be specified by a descriptor from *+T demographic characteristics* qh ah, possibly combined with a descriptor from *+S field, discipline, or occupation* qh ah.
      Classification: The descriptors under prevention are subdivided into three major facets; a prevention effort can be characterized by combination, choosing the appropriate descriptor from each facet. The three facets are:
      *+JE prevention strategy, program, or service* qh ah is a rather formal facet that allows one to specify to which of these categories a prevention effort belongs.
      *+JF prevention by sponsor or setting* qh ah allows one to specify who sponsors the prevention effort and/or where the prevention effort takes place, two aspects that are usually tightly intertwined.
      *+JG prevention approach* qh ah, the longest facet, deals with the methods used, the specific approaches and measures that are taken to accomplish prevention.
NT+JA2.4e prevention research    qh   ah
+JC basic prevention categories    qh   ah
+JDe prevention model    qh   ah
+JE prevention strategy, program, or service    qh   ah
+JF prevention by sponsor or setting    qh   ah
+JGe prevention approach    qh   ah
+JH health-related prevention    qh   ah
+JJe intervention (persuasion to treatment)    qh   ah
+JKe prevention barriers    qh   ah
 PN4.4e history of AOD prevention    qh   ah
RT+HB AODU screening, identification, and diagnostic method    qh   ah
+J prevention, treatment, and maintenance. health care    qh   ah
+JA2.4e prevention research    qh   ah
+JG26e identification and screening    qh   ah
+JUe health care administration    qh   ah
+MP18.2e public policy on AOD    qh   ah
+N communication, information, and education    qh   ah
+NFe education and training    qh   ah

JB2eAOD prevention   qh
SN Removing the causes or preventing the development of AOD disorders, accidents, or the harmful effects and consequences of drinking or use of other drugs. Use this descriptor or a more specific one under it in combination with one or more descriptors for the prevention goal(s) and approaches.
NT PN4.4e history of AOD prevention    qh   ah
JB2.2e.  prevention of problematic AODU   qh
HN ETOH descriptor 2000.
NT+HK2.6e cessation of AODU    qh   ah
BT+JB4.4e prevention of disorder    qh   ah
RT+AA2.4e problematic AOD use    qh   ah
JB2.4.  AODU harm reduction   qh
HN Introduced 2000.
ST AOD control in the phase of consequences
prevention of harm from AODU
NT+JG24 AODR traffic safety measures    qh   ah
 JG24.2.2e ride program    qh   ah
 JH10.6.4e needle distribution and exchange    qh   ah
BT+JB4.6.2e harm reduction    qh   ah
+JC2.4e secondary prevention    qh   ah
RT+JB4.6 prevention of disorder consequences    qh   ah
+JPe treatment and maintenance    qh   ah
 MM8.4 violence prevention    qh   ah
JB2.4.2.  .  prevention of AOD effects and consequences   qh
HN Introduced 1995.
SN Prevention of the harmful effects and consequences resulting from AOD use, abuse, and dependence.
BT+JB4.6 prevention of disorder consequences    qh   ah
RT+AMe AOD effects and consequences    qh   ah
JB2.4.2.2e.  .  .  prevention of AODE   qh
HN ETOH descriptor 2000.
SN Prevention of the medical or psychological effects of AODU.
BT+AM2e AODE    qh   ah
JB2.4.2.4e.  .  .  prevention of AOD associated consequences   qh
HN Introduced 1995. Through 1995 also use "prevention of AODU consequences."
JB2.4.2.4.2e.  .  .  .  AODR injury prevention   qh
SN Includes the prevention of any injuries as a result of AODR crashes or incidents.
ST AODR accident prevention
NT JG10.4.6.8 drinking and driving education    qh   ah
 MO6.6.4.2e roadside sobriety check    qh   ah
+OB10e AODR accident prevention technology    qh   ah
BT+AM4.2e AODR injury    qh   ah
+GH6.2e injury    qh   ah
+OR4.2e accident prevention    qh   ah
RT+MN32.2.2e DWI laws    qh   ah
 MO6.6.12.2.2e DWI arrest    qh   ah
+OBe AOD use detection technology    qh   ah
JB2.4.4e.  .  prevention of AODR problems   qh
SN Prevention of AOD related problems, such as drinking and driving or drug trafficking.
BT+ANe AODR interpersonal and societal problems    qh   ah
RT JF12.2e server intervention    qh   ah
+OR safety and accidents    qh   ah

JB4eprevention goals   qh
SN In the prevention of AODU, goals depend on the type of drug. For alcohol, the goal varies considerably, depending on the age of the user, the extent of use, and the settings in which the use takes place.
BT+JA4.4 prevention and treatment goals    qh   ah
RT+ADe AOD use behavior    qh   ah
 JB6e prevention outcome    qh   ah
+JC basic prevention categories    qh   ah
+JGe prevention approach    qh   ah
+JL2e treatment goals    qh   ah
 MP18.2.8.8e demand reduction policy    qh   ah
JB4.2.  intermediate prevention goals   qh
HN Introduced 2000.
SN Effecting changes in the causes and circumstances that affect the development or severity of a disorder or its consequences. Effecting changes in risk and protective factors. Creating preconditions under which preventive interventions can be successful. These are intermediate steps towards any of the final prevention goals listed below.
ST prevent risk condition that may lead to a disorder
proximal prevention targets
RT JB12e prevention readiness    qh   ah
+JGe prevention approach    qh   ah
JB4.4e.  prevention of disorder   qh
HN ETOH descriptor 2000.
SN Removing the causes or preventing the development of disorders.
NT+JB2.2e prevention of problematic AODU    qh   ah
JB4.4.2.  .  prevention of new cases of disorder   qh
HN Introduced 2000.
ST reduction of new cases
RT PD6.2e incidence    qh   ah
JB4.4.2.2.  .  .  prevention of first incidence of a disorder   qh
HN Introduced 2000.
ST preventing initiation
JB4.4.2.2.2.  .  .  .  prevent the start of etiologic sequence   qh
HN Introduced 2000.
SN Prevent the start of a sequence that will lead to a disorder.
ST prevention of onset
RT JC2.2e primary prevention    qh   ah
JB4.4.2.2.4.  .  .  .  halt the progression of an etiologic sequence   qh
HN Introduced 2000.
SN Reduce the length of time that early symptoms continue and halt the progression of severity so that the individual does not even come close to meeting full diagnostic criteria.
RT+JC2.4e secondary prevention    qh   ah
JB4.4.2.4.  .  .  prevention of later incidences of a disorder   qh
HN Introduced 2000.
ST prevention of recurrence
RT JP22.6e relapse prevention    qh   ah
JB4.4.2.6.  .  .  delay the onset of disorder   qh
HN Introduced 2000.
JB4.4.4.  .  reduce existing cases of disorder   qh
HN Introduced 2000.
RT PD6.4e prevalence    qh   ah
JB4.4.6.  .  reduce duration or severity of disorder   qh
HN Introduced 2000.
SN If preventive interventions are not successful in forestalling the onset of a disorder, they may still have an effect by reducing the duration and/or severity of the disorder.
JB4.4.6.2.  .  .  reduce the duration of disorder   qh
HN Introduced 2000.
JB4.4.6.4.  .  .  reduce the severity of disorder   qh
HN Introduced 2000.
BT+GA12.4.10e disease severity    qh   ah
JB4.4.8.  .  comorbidity prevention   qh
HN Introduced 2000.
JB4.6.  prevention of disorder consequences   qh
SN Strives to avoid or ameliorate the harmful effects and consequences of an established disorder rather than cure it. This can be achieved by measures taken before the onset of the disorder or during the course of the disorder.
ST prevent disability associated with a disorder
NT+JB2.4.2 prevention of AOD effects and consequences    qh   ah
RT+JB2.4 AODU harm reduction    qh   ah
+JP22.4e long-term care    qh   ah
 JP22.6e relapse prevention    qh   ah
+JP24e rehabilitation    qh   ah
JB4.6.2e.  .  harm reduction   qh
HN ETOH descriptor 2000.
ST harm avoidance
harm minimization
NT+JB2.4 AODU harm reduction    qh   ah
 MP18.2.8.16e harm reduction policy    qh   ah
BT+JC2.4e secondary prevention    qh   ah
RT+ANe AODR interpersonal and societal problems    qh   ah
+HK2.10.2e chemical maintenance method    qh   ah
+JPe treatment and maintenance    qh   ah
 LR6.4.6 safe spaces for drug users    qh   ah
+MM8 safety from crime and violence    qh   ah
 MM8.4 violence prevention    qh   ah

JB6eprevention outcome   qh
HN Introduced 2000.
ST prevention effectiveness
RT+JB4e prevention goals    qh   ah
 JB12e prevention readiness    qh   ah

JB8prevention side effects   qh
HN Introduced 2000.
ST prevention adverse effects
prevention harmful effects
RT+JP12.12 treatment side effects    qh   ah

JB10eattitude toward prevention   qh
HN Introduced 1995. ETOH descriptor 2000.
SN Attitudes toward prevention and prevention programs generally.
BT+FR16 attitude    qh   ah
RT JP10.2.2e patient attitude toward treatment    qh   ah
 JP10.6e provider attitude toward treatment    qh   ah

JB12eprevention readiness   qh
HN Introduced 2000.
SN Applies both to individuals and groups/communities/institutions. For individuals, includes such elements as perception of susceptibility to the disorder, perception of the severity of the disorder for which the person is at risk, perception of the benefits of action, and perception of barriers to action. For groups/communities/institutions includes such elements as group norms regarding prevention, political conditions, and organizational culture.
ST prevention-related perceptions of self
readiness for intervention
resistance to engage in preventive activities
RT FD18.20e readiness to change    qh   ah
+FR16.8.2e attitude toward self    qh   ah
 JB4.2 intermediate prevention goals    qh   ah
 JB6e prevention outcome    qh   ah
+JJe intervention (persuasion to treatment)    qh   ah
+JP10.2 patient treatment factors    qh   ah

JB14eprevention paradox   qh
HN Introduced 2000.
SN The following phenomenon is known as the prevention paradox. A preventive measure that brings much benefit to the population but offers little benefit to each participating individual; conversely, many measures that are of great benefit to an individual offer a negligible benefit to the population. For example, seat belt use offers only a tiny marginal decrease in risk of death or injury to any one individual, despite its significant contribution to reducing the total accident toll; heart surgery, the epitome of the medical battle against individual mortality, has little or no impact on the public's health. In a calculation of short-term personal gain, the most effective health measures for the population pale in importance against the saving of identifiable lives.

JCbasic prevention categories   d-out   qh
HN Introduced 2000.
SN There are two schemes of basic prevention categories. One is based on the time of intervention and distinguishes between *JC2.2 primary prevention* qh ah (preventing a disorder before its onset), *+JC2.4 secondary prevention* qh ah (stopping a disorder in its early stages and/or limiting its harm), and *JC2.6 tertiary prevention* qh ah (to end an established disorder and/or to avoid or ameliorate its harmful effects and consequences through treatment and rehabilitation). The other scheme is based on the scope of the recipient group and the cost-benefit analysis of preventive interventions as it relates to universal or limited recipient groups. It distinguishes between *JC4.2 universal prevention* qh ah (directed at the entire population and thus warrants only low costs per individual), *JC4.4.2 selective prevention* qh ah (directed at demographically defined subsets of the total population whose members are deemed at particular risk and thus warrant higher cost per individual), and *JC4.4.4 indicated prevention* qh ah (directed at subjects who have been individually identified as being at risk, based on risk indicators or early warning signs, and who thus warrant still higher cost per individual).
      Although in practice there might be great overlap between categories from the two schemes in terms of time, target selection, and prevention approaches, logically, these two sets of categories are clearly distinct and should not be confused. As an Institute of Medicine report (1994) observed, "Unfortunately, over time there has been a simplistic blending of these two classification systems, and erroneous integration of terms that has added to the confusion."
      "The definitions of these categories, and the delineation between prevention and treatment is difficult for mental and substance abuse disorders, because it is often more difficult to document that a 'case' of mental disorder exists than it is to document a physical health problem. Symptoms and dysfunctions associated with a disorder may exist even though all criteria of a DSM diagnosis are not present. Even more difficult is the application of such categories to the prevention of problematic AOD use that does not rise to the level of a disorder." (From the same IOM report)
      The time-based scheme was the prevalent scheme until at least the mid-1980s, based on its adoption by the Public Health Service. Since then, the target-based scheme has risen to prominence based on its adoption by the Institute of Medicine and other institutions, such as NIDA. The AOD Thesaurus must reflect the literature and the thinking of all quarters in the field, and therefore includes both schemes.
      Furthermore, the time-based categories are closely aligned with specific *+JB4 prevention goals* qh ah. Indexers will assign only the descriptor that best corresponds to the perspective of a document. To achieve complete retrieval, searchers are advised to search for all applicable descriptors from *+JB4 prevention goals* qh ah and from *+JC basic prevention categories* qh ah, combined with OR.
BT+JBe prevention    qh   ah
JC2.  prevention by timing of the intervention   qh
HN Introduced 2000.
SN The traditional public health model distinguishes categories of prevention by the timing of the preventive intervention with respect to the development of a disorder: before its onset or after its onset but before full-blown clinical manifestation. This scheme works best for disorders that follow a simple mechanistic and linear process from onset to clinical manifestation. For disorders with multiple interacting causes and a more complex pathogenic sequence, the determination of "onset" is difficult and this scheme is less applicable.
JC2.2e.  .  primary prevention   qh
HN ETOH descriptor 2000.
SN The goal of primary prevention is to reduce prevalence of a disorder by preventing its onset (i.e., by reducing the incidence of new cases in a population).
RT JB4.4.2.2.2 prevent the start of etiologic sequence    qh   ah
+JC basic prevention categories    qh   ah
+JC4 prevention by scope of recipient group    qh   ah
JC2.4e.  .  secondary prevention   qh
HN ETOH descriptor 2000.
SN The goal of secondary prevention is to reduce the prevalence of a disorder by identifying the disorder at an early stage, before it has caused suffering or visibility and when it still can be reverted or arrested. By its nature, secondary prevention requires interventions with an individual, couple, or family and includes the detection of individuals who need such interventions, through screening, referral, or other methods. Secondary prevention is sometimes also known as "intervention" (with this term being used in a very specific meaning). The boundary between secondary prevention and treatment is blurred; the specific term "intervention" sometimes is used with a connotation that would push the boundary into treatment further than "secondary prevention" would connote.
NT+JB2.4 AODU harm reduction    qh   ah
+JB4.6.2e harm reduction    qh   ah
 JJ2 early intervention (early in a disease)    qh   ah
RT+HA screening and diagnostic method    qh   ah
+HB AODU screening, identification, and diagnostic method    qh   ah
 JB4.4.2.2.4 halt the progression of an etiologic sequence    qh   ah
+JC basic prevention categories    qh   ah
+JC4 prevention by scope of recipient group    qh   ah
JC2.6e.  .  tertiary prevention   qh
HN Introduced 1995. ETOH descriptor 2000.
SN The goal of tertiary prevention is to end an established disorder and/or to avoid or ameliorate its harmful effects and consequences through treatment and rehabilitation. Overlaps with or is an aspect of treatment, rehabilitation, and relapse prevention. Only index with this descriptor if it is mentioned in the document; otherwise index with *+JP treatment and maintenance* qh ah or one of the related terms listed below.
BT+JPe treatment and maintenance    qh   ah
RT+JC basic prevention categories    qh   ah
+JC4 prevention by scope of recipient group    qh   ah
+JP22e aftercare    qh   ah
 JP22.6e relapse prevention    qh   ah
+JP24e rehabilitation