Implementing a Public Health Approach to Relational Health Will Require Changes at the Provider, Practice, and Community Levels, as Well as Horizontal Integration Across Sectors
| Types of Prevention . | Approaches to Relational Health . | Examples at the Provider Level . | Examples at the Practice Level . | Examples at the Community Level . | |
|---|---|---|---|---|---|
| Tertiary | Repair strained or compromised relationships | Build the therapeutic alliance; employ a common-factors approach; explain behavioral responses to stress; endorse referral resources. | Colocate counseling services (warm handoffs); facilitate, track, and follow-up on referrals offered. | Embrace restorative justice and social inclusion (over punitive measures and exclusion). | |
| Secondary | Identify and address potential barriers to SSNRs | Build the therapeutic alliance; surveil for possible barriers to SSNRs; champion screening at practice level; endorse referral resources. | Universal screening for prevalent barriers seen in that practice; facilitate, track, and follow-up on referrals offered. | Identify and address sources of inequity, isolation, and social discord (poverty and racism). | |
| Primary | Promote SSNRs by building 2-generational relational skills | Build the therapeutic alliance; promote positive parenting; encourage developmentally appropriate play. | Provide or support positive parenting classes; participate in ROR, VIP, and other programs that support the dyad. | Implement home visiting; support extended family medical leave. | |
| Types of Prevention . | Approaches to Relational Health . | Examples at the Provider Level . | Examples at the Practice Level . | Examples at the Community Level . | |
|---|---|---|---|---|---|
| Tertiary | Repair strained or compromised relationships | Build the therapeutic alliance; employ a common-factors approach; explain behavioral responses to stress; endorse referral resources. | Colocate counseling services (warm handoffs); facilitate, track, and follow-up on referrals offered. | Embrace restorative justice and social inclusion (over punitive measures and exclusion). | |
| Secondary | Identify and address potential barriers to SSNRs | Build the therapeutic alliance; surveil for possible barriers to SSNRs; champion screening at practice level; endorse referral resources. | Universal screening for prevalent barriers seen in that practice; facilitate, track, and follow-up on referrals offered. | Identify and address sources of inequity, isolation, and social discord (poverty and racism). | |
| Primary | Promote SSNRs by building 2-generational relational skills | Build the therapeutic alliance; promote positive parenting; encourage developmentally appropriate play. | Provide or support positive parenting classes; participate in ROR, VIP, and other programs that support the dyad. | Implement home visiting; support extended family medical leave. | |
See the Appendix for full descriptions of the abbreviations.