MODELS OF PREVENTION

There are several theories and models that support the practice of health promotion
and disease prevention. Theories and models are used in program planning to
understand and explain health behavior and to guide the identification,
development, and implementation of interventions.
When identifying a theory or model to guide health promotion or disease
prevention programs, it is important to consider a range of factors, such as the
specific health problem being addressed, the population(s) being served, and the
contexts within which the program is being implemented. Health promotion and
disease prevention programs typically draw from one or more theories or models.

The Health Belief Model

The Health Belief Model is a theoretical model that can be used to guide health
promotion and disease prevention programs. It is used to explain and predict
individual changes in health behaviors. It is one of the most widely used models
for understanding health behaviors.
Key elements of the Health Belief Model focus on individual beliefs about health
conditions, which predict individual health-related behaviors. The model defines
the key factors that influence health behaviors as an individual's perceived threat to
sickness or disease (perceived susceptibility), belief of consequence (perceived
severity), potential positive benefits of action (perceived benefits), perceived
barriers to action, exposure to factors that prompt action (cues to action), and
confidence in ability to succeed (self-efficacy).

HOLISTIC HEALTH CARE MODEL:

In the `80s, the reductionist method made famous by F.W. Taylor caused
manufacturing industry to lose perspective of their overall factory. The
approach, which focuses principally on analyzing individual components, fails to
accurately account for their interactions. This narrow view was further
compounded by the academic community which thrived on using reductionism for
analyzing complex systems, ever the while increasing the gap between their
research and actual practice. Throughout the `90s and still today,
manufacturing is increasingly focusing on the entire supply chain. In healthcare
this evolution is lagging.

Holistic Health Model by Edelman and Mandle, 2002

 Holism represents the interaction of a person’s mind, body and spirit within
the environment.
 Holism is based on the belief that people (or their parts) can not be fully
understood if examined solely in pieces apart from their environment.
 Holism sees people as ever charging systems of energy.
 In this model, nurses consider clients the ultimate experts regarding their
own health and respect client’s subjective experience as relevant in
maintaining  health or assisting in healing.
 In holistic model of health, clients are involved in their healing process,
thereby assuming some responsibility for health maintenance.
 Agent-Host-Environmental model

Agent-Host-Environmental model: by Leavell and Clark(1965)

 This model is useful for examining causes of disease in an individual.

 The agent, host and environment interact in ways that create risk factors, and
understanding these is important for the promotion and maintenance of
health.
 An agent is an environmental factor or stressor that must be present or
absent for an illness to occur.
 A host is a living organism capable of being infected or affected by an agent.
 The host reaction is influenced by family history, age, and health habits
 Levels of Prevention Model

 This model, advocated by Leavell and Clark in 1975, has influenced both
public health practice and ambulatory care delivery worldwide.
 This model suggests that the natural history of any disease exists on a
continuum, with health at one end and advanced disease at the other.
 The model delineates three levels of the application of preventive measures
that can be used to promote health and arrest the disease process at different
points along the continuum.
 The goal is to maintain a healthy state and to prevent disease or injury.

It has been defined in terms of four levels:

 Primordial prevention
 Primary prevention
 Secondary prevention
 Tertiary  prevention
Primordial prevention

 Prevention of the emergence or development of risk factors in population or

countries in which they have not yet appeared.
 Efforts are directed towards discouraging children from adopting harmful
lifestyles.

Primary prevention

 An action taken prior to the onset of disease, which removes the possibility
that the disease will ever occur.
 It includes the concept of positive health, that encourages the achievement
and maintenance of an “acceptable level of health that will enable every
individual to lead  a socially and economically productive life.

Secondary prevention

 Action which halts the progress of a disease at its incipient stage and
prevents complications.
 The domain of clinical medicine.
 An imperfect tool in the transmission of disease.
 More expensive and less effective than primary prevention.

Tertiary prevention

 All measures available to reduce or limit impairment and disabilities,

minimize suffering caused by existing departures from good health and to
promote the patient's adjustment to irremediable conditions.
 High Level Wellness Model

High Level Wellness Model  by Dunn(1961):

 This model recognizes health as an ongoing process toward a person’s

highest potential of functioning.
 This process involves the person, family and the community.
 He describes high-level wellness as “the experience of a person alive with
the glow of good health, alive to the tips of their fingers with energy to burn,
tingling with vitality – at times like this the world is a glorious place”.
 The wellness- illness continuum (Travis and Ryan 1988) is a visual
comparison of high-level wellness and traditional medicine’s view of
wellness.
 High level wellness according to Ardell(1977) is a lifestyle focused
approach which you design for the purpose of pursuing the highest level of
health within your capability.
 Milio’s Framework for Prevention

Milio’s Framework for Prevention

 Nancy Milio developed a framework for prevention that includes concepts

of community – oriented, population- focused care.
 Milio stated that behavioural patterns of the populations-and individuals
who make up populations – are a result of habitual selection from limited
choices.
 She challenged the common notion that a main determinant for unhealthful 
behavioural choice is lack of knowledge.
 Milio’s framework described a sometimes neglected role of community
health nursing to examine the determinants of a community’s health and
attempt to influence those determinants through public policy.
 Role performance model

 Health is indicated by the ability to perform social roles.

 Role performance includes work, family and social roles, with performance
based on societal expectations.
 Illness would be the future to perform a person’s roles at the level of others
in society.
 This model is basis for work and school physical examination and physician
–excused absences.
 The sick role, in which people can be excused from performing their social
roles while they are ill, is a vital component of the role performance model.
 Tannahill Model of Health Promotion

 Health Education: communication activity aimed at enhancing well-being

and preventing ill-health through favorably influencing the knowledge,
beliefs, attitudes and behavior of the community
 Health Protection: refers to the policies and codes of practice aimed at
preventing ill-health or positively enhancing well-being, for example, no
smoking in public places. Health Protection is responsible for the
development and implementation of legislation, policies and programs in the
areas of Environmental Health Protection, Community Care Facilities, and
Emergency Preparedness
 Prevention: refers to both the initial occurrence of disease and also to the
progress and subsequently the final outcome

BASIC HUMAN NEEDS MODEL:

The Human Needs Model of Nursing adapts Maslow's concept of human needs to
create such a conceptual framework for practice. It places equal emphasis on those
patient problems which arise as the result of unmet needs at higher levels as well as
those at lower levels, thereby acknowledging the holistic and dynamic nature of
man.

CONCLUSION:
Nursing must expand its efforts to design and implement interventions
which support promotion of health and prevention of disease/illness and disability.
Preventing illness and staying well involve complex, multidimensional activities
focused not only on the individual, but also on families, groups and populations.
Approaches to prevention should be comprehensive, encompass primary,
secondary and tertiary levels of prevention and involve consumers in their
formulation. Prevention strategies are more likely to be adopted by citizens who
participate in influencing and developing such strategies. Nurses have developed
many health models to understand the client’s attitudes and values about health and
illness so that effective health care can be provided. These nursing models allow
nurses to understand and predict client’s health behaviour, including how they use
health services and adhere to recommended therapy.