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A Low-Tech Approach to Primary Prevention

Robert Chamberlin MD, MPH '82

Robert ChamberlinThe most important thing I learned as a pediatrician getting my MPH at the Johns Hopkins School of Hygiene and Public Health (1982) was the power of primary prevention approaches for reducing the frequency of community-wide problems such as out-of-wedlock teenage births, child abuse and neglect, school failure and welfare dependency.

The next 15 years were spent trying to implement this kind of approach in various U.S. cultural settings where the dominant mode was to wait until things get really bad and then try and do something about them (tertiary prevention). The problem with this, of course, is you never deal with the root causes so you never catch up. More successful approaches that were being used in several places were home visits by nurses to single, low-income teen mothers having their first babies and the development of drop-in, community-based resource centers for families with young children. My efforts to implement these kinds of programs in New Hampshire communities over a number of years were initially thwarted by lack of time away from running clinics and not enough state money to fund community programs.

However, I was able to build a statewide group of advocates through community forums, talks to professional groups and developing a newsletter that described what local communities were doing in New Hampshire, Vermont and other states. With help from the New Hampshire Children’s Trust Fund, a number of family resource centers came together to form Network New Hampshire and provided technical assistance to other communities wanting to start programs. A nurse in the State Health Department developed a home visiting program for mothers on Medicaid. Several legislators got interested and helped find funds for programs, as did the New Hampshire Children’s Trust Fund.

I found out you can still do a lot without high-tech technology.

Robert Chamberlin is retired and lives with his wife in Ft. Myers Fl. He volunteers with Healthy Start of SW Florida and a United Way House in Ft. Myers.

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