Group interventions and the limits of behavioral medicine

A wide range of interventions has been devised to address health hazards in the social and physical environment. The authors propose a 2-dimensional m atrix to organize these interventions. The timing of interventions is divid ed into 4 stages: preventing exposure to hazard (proactive primary preventi on), preventing symptoms from appearing (reactive primary prevention), prev enting early symptoms from becoming chronic or leading to disease (secondar y prevention), and managing the disease (tertiary prevention). The level at which the intervention is targeted is divided into 2 categories: micro (in dividual or family) and macro (more aggregate social level). Large-scale in terventions such as media campaigns can target either individual health beh aviors (microlevel) or the environment (macrolevel). This typology is illus trated with interventions designed to prevent or ameliorate the health cons equences of adverse employment changes such as job loss. The analysis concl udes that behavioral medicine and public health approaches are differential ly suited to different intervention types.