simple as changing one risk factor, but will require interventions on multiple determinants at various levels.

Only 1 to 2 percent of the U.S. health care budget is spent on prevention, and a like imbalance exists between funding for basic biomedical research and for population-based prevention research (Scrimshaw et al., 2001). As a consequence, although the scientific literature includes an enormous amount of information about physical and biological risk factors for disease and disability, as well as more limited information about social and behavioral determinants of health, little of this knowledge has been translated into forms that are accessible or useful to local public health practitioners or to the community.

Although many scholars agree on the importance of prevention research, exact definitions of the term vary. According to Scrimshaw and colleagues (2001), this “lack of a consistent definition for prevention research decreases the conceptual clarity of the term and impedes the development of a clear understanding of prevention research.” Brownson and Simoes (1999) assert that prevention research focuses on determining the underlying causes of death, injury, and disability; research discoveries are then applied at the community level. CDC defines prevention research as research directly applicable to public health practice (Doll et al., 2001). Sattin (2001) states that prevention research is a multidisciplinary approach to discovering new ways to prolong the health, well-being, and self-sufficiency of all Americans; it focuses on preventing disease, injury, and disability. Scrimshaw and colleagues (2001) describe how prevention is frequently defined in terms of the self-interest of the person giving the definition.

Prevention is frequently categorized into three levels: primary, secondary, and tertiary. Primary prevention in public health is aimed at preventing an illness or disability from occurring. Secondary prevention efforts include interventions in illness to prevent continued illness or disability, whereas tertiary prevention activities attempt to limit further progression of illness or disability or to postpone death. Clinical preventive services are generally considered secondary or tertiary preventions. To increase the clarity of its discussion, the committee has chosen to define population-based prevention research using a modified version of the definition developed by the Association of Schools of Public Health (Spencer, 2000) for population-based prevention research, which

  • Addresses health problems that affect large numbers of people;

  • Involves a definable population and operates at the level of the whole person;

  • Evaluates the application and impacts of new discoveries on the actual health of the population; and



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