A public health nurse is planning strategies to address substance use for clients in the community. Which of the following strategies are part of primary health promotion and prevention?

A. Providing a needle exchange program is considered secondary prevention, as it reduces complications in those already using substances rather than preventing initial use. B. Teaching fifth graders about the risks of substance use is primary prevention, because it aims to stop substance use before it begins. C. Giving a list of outpatient support services to clients leaving inpatient treatment is tertiary prevention, since it helps prevent relapse in those already affected. D. Educating pregnant clients who are already in a sober living community is also not primary prevention, because they have a history of substance use; this falls under secondary/tertiary prevention.