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Purpose: We estimate national health expenditures on prevention using precise definitions, a transparent methodology, and a subdivision of the estimates into components to aid researchers in applying their own concepts of prevention activities.

Methodology/Approach: We supplemented the National Health Expenditure Accounts (NHEA) with additional data to identify national spending on primary and secondary prevention for each year from 1996 to 2004 across eight spending categories.

Findings: We estimate that NHEA expenditures devoted to prevention grew from $83.2 billion in 1996 to $159.8 billion in 2004, in current dollars. As a share of NHEA, this represents an increase from 7.8 percent in 1996 to 8.6 percent in 2004. This share peaked at 9 percent in 2002 and then declined due to reductions in public health spending as a percent of NHEA between 2002 and 2004. Primary prevention represents about half the expenditures, consisting largely of public health expenditures – the largest prevention element.

Originality/Value of Paper: Our 2004 estimate that 8.6 percent of NHEA goes to prevention is nearly three times as large as the commonly cited figure of 3 percent, but depends on the definitions used: our estimate falls to 8.1 percent when the research component is excluded, 5.1 percent when consideration is limited to primary prevention plus screening, 4.2 percent for primary prevention alone, and 2.8 percent if we count only public health expenditures. These findings should contribute to a more informed discussion of our nation's allocation of health care resources to prevention.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.

African American student-athletes represent the largest racial minority group of athletes in the National Collegiate Athletic Association (NCAA) and the majority of male student-athletes in football and basketball. The NCAA has partnered with It’s On Us, an awareness campaign to help end sexual violence on college campuses. Intercollegiate athletics is a viable context, then, to consider transformative Black masculinity and sexual violence prevention. Transformative Black masculinity is when an African American or Black man intentionally employs his identity in the service of social justice and purposefully engages other Black males, as well as others, for that cause. This chapter considers transformative Black masculinity as a conceptual tool for the intentional engagement of Black male student-athletes within institutions of higher education for sexual violence prevention. Recommendations for policy, education and practice, and research are provided.

This chapter introduces a conceptual schema with which the authors chart the historical trajectory of four realms of feminist antiviolence efforts in the United States, describing strains and tensions between and within each realm, with a particular focus on the efficacy of violence prevention.

We draw on feminist theory and empirical studies of antiviolence efforts as well as our own interview and ethnographic research into violence prevention.

This chapter charts a four-part schema for understanding the trajectory of feminist engagements with violence against women. It theorizes that the segmentation of feminist antiviolence has given rise to a variety of tensions within realms that could be resolved or mitigated by reconnecting the realms.

In the face of growing objections to their handling of sexual assault and other forms of gender-based violence, the military, colleges, and other institutions have touted their violence prevention programs. While these programs serve as a testament to over forty years of feminist efforts to institutionalized antiviolence policies and practices, without a holistic feminist approach, violence prevention functions as little more than public relations.

The chapter is of use for scholars thinking about violence against women and gender-based violence, as well as institutions that set policy around issues of violence.

Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing factors to these disparities, proven and promising approaches through strengths-based methods, barriers to implementation of prevention and treatment efforts, and future recommendations for effective programs and research.

Approach – We have conducted a thorough literature review of relevant research studies, as well as a review of government, tribal, and community-based curricula and resources. This review of programs is not exhaustive but provides several examples of best practices in the field and suggestions for future directions.

Social implications – We strongly advocate that to accurately explore the true etiology of substance abuse and to respond to the concerns that AI/AN have prioritized, it is necessary to utilize a strengths-based approach and draw upon traditional AI/AN perspectives and values, and active community participation in the process. More specifically, prevention and treatment programs should use methods that incorporate elders or intergenerational approaches; foster individual and family skills-building; promote traditional healing methods to recognize and treat historical, cultural, and intergenerational and personal trauma; focus on early intervention; and tailor efforts to each Native nation or community.

Value – Ultimately, to reduce substance abuse disparities in AI/AN youth, we must find better ways to merge traditional Native practices with western behavioral health to ensure cultural competency, as well as to develop mechanisms to effect system- and policy-level changes that reduce barriers to care and promote the well-being of AI/AN youth, families, and communities.

This chapter on terrorism prevention provides the reader with an overview of the various terrorist prevention organizations within the United States at the federal, state, and local levels. It is divided into two different sections, the first providing a detailed description of various federal agencies involved in terrorism prevention and an overview of how state and local agencies fit within the federal framework. The second section of this chapter describes various efforts to integrate these disparate organizations into a cohesive effort to prevent terrorism activities. This chapter concludes with some suggestions for future consideration to help with the overall terrorism prevention effort.

Building a culture of safety in transportation is not dissimilar from building a culture of safety in health. Public health is widely known for protecting the public from diseases through milk pasteurization and chlorination of drinking water, and from injuries by implementing environmental and occupational safeguards and fostering behavioral change. Lifestyle and environmental changes that have contributed to the reductions in smoking and heart disease can also help change driving, walking and cycling behaviors, and environments. Stimulating a culture of safety on the road means providing safe and accessible transportation for all. The vision for a culture of traffic safety is to change the public’s attitude about the unacceptable toll from traffic injuries and to implement a systems approach to traffic injury prevention as a means for improving public health and public safety. Framing the motor vehicle injury problem in this way provides an opportunity for partnerships between highway safety and public health to improve the culture of safety.

Purpose: The study makes use of situational crime prevention framework for analyzing online community reactions to the banning of deepfake pornographic content from Reddit.

Methodology/approach: Qualitative text analysis of user comments posted to Reddit’s rule-change announcement (N = 582) was carried out. Analysis relied on the original 25 techniques of situational crime prevention that were adapted into a table of activities and mechanisms meant specifically for use with online platforms.

Findings: Analysis indicates that Reddit users voiced several shortcomings that are currently present in Reddit’s platform management approach. In particular, users emphasized issues related to the lack of a consistent and transparent approach to community rule enforcement, as users believed the rule changes to be sudden and poorly reasoned. The general reactionary nature of Reddit’s approach to moderating community-harming actions also was a point of emphasis, alongside the platform’s continued rigid stance on freedom of expression, even with regard to illegal and demeaning content. Regarding Reddit and the new rules on involuntary pornography and the sexualization of minors, enforcement of sitewide policy appears contingent on external influences, such as attention from mainstream media or financial matters, rather than stemming from an inherent stance on decreasing community-harming activities.

Research limitations: The study only pertains to a specific rule change by Reddit and subsequent reactions from the platform’s community. Future research is needed to test the applicability of the adapted table of 25 techniques of situational crime prevention in the context of other online platforms.

Originality/value: First, the study applies the situational crime prevention approach in the context of moderating online platforms. Second, results from the study shed light on current practices in online content moderation from the perspective of criminological theory, as well as inform specific actions that can be taken to decrease the presence of community-harming phenomena and improve the enforcement of sitewide policy rules in general. Finally, by adapting the original 25 techniques of situational crime prevention to online content moderation, the study suggests a tentative roadmap for similar research in the future.