Primary prevention as health and social competence promotion.

Primary prevention continues to be shackled by an implicit "magic bullet" perspective and an inoculationist mentality. The proliferation of short-term, uncoordinated programs co-exists with data showing that large segments of our teenage-and-younger population are exposed to conditions that are likely to harm their psychosocial growth. The status of primary prevention in the schools is shown pictorially as a jumbled confusion. An argument is made that coordination of interventions, centered around the goal of promotion of health and social competence, is necessary to achieve more successful primary prevention. Skills comprising social competence as life skills for adaptation to diverse environments are outlined. A representation of schools with programming organized by a shared prevention/promotion skills/set of strategies is provided. Primary prevention is discussed as emergent from the promotion of health and social competence; the latter are ends in themselves, reflecting children's inalienable, developmental "rights". Persons concerned with primary prevention-and therefore with the education and the socialization of children-are called upon to examine their efforts and determine the extent to which they are addressing focal skills and doing so in a coherent, developmental, and cross-culturally sensitive manner, accompanied by the commitment of resources, time, and focused professional development activity guided by the tenets of knowledge in the primary prevention field.