Relevant initiatives are being implemented in low- and middle-income countries (LMICs) aimed at strengthening a culture of prevention. However, cumulative contextual factors constitute significant barriers for implementing rigorous prevention science in these contexts, as defined by guidelines from high-income countries (HICs). Specifically, disseminating a culture of prevention in LMICs can be impacted by political instability, limited health coverage, insecurity, limited rule of law, and scarcity of specialized professionals. This manuscript offers a contribution focused on strengthening a culture of prevention in LMICs. Specifically, four case studies are presented illustrating the gradual development of contrasting prevention initiatives in northern and central Mexico, Panamá, and Sub-Saharan Africa. The initiatives share the common goal of strengthening a culture of prevention in LMICs through the dissemination of efficacious parenting programs, aimed at reducing child maltreatment and improving parental and child mental health. Together, these initiatives illustrate the following: (a) the relevance of adopting a definition of culture of prevention characterized by national commitments with expected shared contributions by governments and civil society, (b) the need to carefully consider the impact of context when promoting prevention initiatives in LMICs, (c) the iterative, non-linear, and multi-faceted nature of promoting a culture of prevention in LMICs, and (d) the importance of committing to cultural competence and shared leadership with local communities for the advancement of prevention science in LMICs. Implications for expanding a culture of prevention in LMICs are discussed.
Keywords: Culture of prevention; International prevention science; Low- and middle-income countries.
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- K01 DA036747/DA/NIDA NIH HHS/United States
- 2009-2012, grant number 115150/Consejo Nacional de Ciencia y Tecnología (MX)--Fondo Sectorial de Investigacion en Salud y Seguridad Social
- PLP-2014-095/Leverhulme Trust
- R34MH087678/National Institute of Mental Health
- R34 MH087678/MH/NIMH NIH HHS/United States
- UL1 TR000448/TR/NCATS NIH HHS/United States
- R25MH08091607/National Institute of Mental Health
- K01DA036747/National Institute on Drug Abuse
- T141/79/Ilifa Labantwana Fund
- 103/757/John Fell Fund, University of Oxford
- FP7/2007-2013, grant agreement 313421/European Research Council/International
- 43137/The South African National Lottery Distribution Trust Fund
- UL1 TR000448/NCTAS
- UL1 TR002345/TR/NCATS NIH HHS/United States