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IOM Classifications

Institute of Medicine (IOM) Prevention Classifications


Categories which identify the population that an intervention’s strategy will reach

Four classifications:

  1. Universal direct
  2. Universal indirect
  3. Selective
  4. Indicated




An intervention is universal if it is designed to prevent a problem from ever occurring and before any preliminary risk factors are developed; everyone in the population is included in the program regardless of risk


Population may include individuals with higher risk and/or who have already developed the problem, but others who are low-risk and do not have the problem are included as well with no distinction or adaptations for different groups


Universal Direct

Serve the population through interaction

Examples: program implemented in every health class at a junior high, open community parenting group for anyone raising kids

Universal Indirect

Serve the population through behind-the-scenes work

Examples: coalition activities, policy changes, advocacy


An intervention is selective if the participants have been identified as having higher risk for the problem than the general population; individuals may or may not already have the problem

Examples: homeless youth, low-income single mothers


An intervention is indicated if the participants involved are showing early signs of the problem; these types of programs may focus on harm reduction and decreasing risk factors

Examples: students who have been caught smoking cigarettes, adults arrested for their first DUI