By Pennsylvania School Board regulations, beginning with the class of 2017, public school students must demonstrate successful completion of secondary level course work in Algebra I, Biology, and English Literature by passing the Keystone Exams.

Some of these targets are similar to those identified in primary prevention, but the purpose of the intervention differs; in secondary level work, the focus is on identified clients or their families, schools, doctors, employers, not on structures indirectly related to clients.

By Pennsylvania School Board regulations, for the graduating class of 2017, students must demonstrate successful completion of secondary level course work in Algebra I, Biology, English Composition, and Literature.