COMMUNITY HEALTH

NURSING VOL. 2
Christian Parabuac
Bachelor of Sciene in Nursing
Level 3.
Prof. Cherry ann Durante
Nancy Rosalie Milio, Ph.D., FAPHA, FAAN
Framework For Prevention
◦ Nancy Rosalie Milio, Ph.D., FAPHA, FAAN, is
Professor Emeritus of Nursing and Professor Emeritus
of Health Policy and Administration, School of Public
Health, University of North Carolina at Chapel Hill.
Dr. Milio's career was given its foundation during her
high school years in Denby High School, Detroit,
Michigan.
◦ She earned her Bachelor of Science degree (B.S.,
Nursing, 1960) and master's degree (M.A.,
Sociology, 1965) at Wayne State University, Detroit,
and her PhD at Yale University.
◦ She is a leader in public health policy and
education who originated the notion of healthy
public policy which addresses the effects of all
areas of public policy on health and has been
adopted internationally, including by the World
Health Organization.
 Milio’s
Framework for
Prevention_
Leya S. Thaobunyuen BSN3
DEFINITION

Nancy Milio developed a framework for prevention

that includes concepts of community – oriented,
population- focused care
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DEFINITION

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.
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DEFINITION

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.
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Milio’s Set of
Propositions
By Victoria Perey
1. The health status of
populations is the result of
deprivation and / or excess
of critical health –
sustaining resources.
Health – sustaining resources include the
seminal ones or the synergistic ones.
In any population those subgroups which
are deprived of sufficient and safe food, water,
shelter, and environment have great
vulnerability to acute, infectious disease
processes.
The poor third and fourth world countries are the most
stark examples.
The population subgroups which are affluent have disease
resulting from too much food of the highest cost varieties,
alcoholic, caffeinated and other drinks, and other dangerous
relaxants; to rapid transportation and communication, often
resulting in accidents and in stressful work overloads dealt
with in sedentary posture.
Excessive environmental pollution arises from arises
from the production – consumption patterns of this
affluent way of life.
Somewhere between the very poor and the affluent
are the population subgroups, having low – income but
living in a relatively affluent or advanced society.
The cigarettes, cars, pollutants, and tensions are
readily available to the poor, while at the same time they
are deprived of the level of protection afforded by the
quality of food, shelter, and environment which sustain
the more affluent.
Milio’s 2nd

Proposition
by Eyy Martinez
2. Behavior patterns of populations are a result of
habitual selection from limited choices, and these
habits of choice are related to: (a) actual and
perceived options available; (b) beliefs and
expectations developed and refined over time by
socialization, formal learning, and immediate
experience.
(a) actual and
perceived options
available.
These choices have been
limited by what is actually
available to groups of
people and what they
perceive to be available or
possible.
(b) beliefs and
expectations developed
and refined over time by
socialization, formal
learning, and immediate
experience.
Their knowledge of the
possible and their
perceptions are influenced
by what they have learned
in the past, informally and
non-verbally as well as
formally, and by what they
experience.
Applied to consumers, this is a point at
which new health information and
knowledge may influence individual
choice-making under certain
conditions.
Propositions
no. 4
by Jahmil Vergara
Definition:
The choice-making of individuals at a
given point in damaging time concerning
potentially health-promoting or health
selections is affected by their effort to
maximize valued resources.
 Choice is therefore related to the type and amount:

(a)their personal resources: b) societal (community and

their awareness, knowledge, family, national) resources:
available money and time, The availability of health-
transportation, the urgency of other sustaining services and
priorities resources in terms of cost,
location, program outreach
● Choices and behaviors of
individuals are strongly
influenced by desires,
values and beliefs.
● For example, the use of
barrier protection during
sex by adolescents often
dependent on peer
pressure and need for
acceptance, love and
belonging.
Thank you, next!
Is the total budget for the campaign
 5. Social change may be thought of as
changes in patterns of behavior resulting
from shifts in the choice-making of
significant numbers of people within a
population.

by Honey Molina
In order then for life-style patterns to alter among
individuals in numbers sufficient to affect the incidence
of major diseases, new, health-promoting options must
be available, and more readily so than health-
damaging options, i.e., in such a way as to be less
costly in dollar and other costs. People also must be
aware of the new options and of what they can gain
from selecting them relative to their former choices.
Some behaviors such as tobacco use
have become difficult to maintain in many
settings or situations in response to
organizational and public policy
mandates.
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Milio's Proposition
for Prevention
by Angelica Evangelista
 Milio's Sixth
Proposition
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Without concurrent availability of

alternative health-promoting
options for investment of personal
resources, health education will be
largely ineffective in changing
behaviour pattern.
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Addressing persistent health problems

Community
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is hindered because most people are very

aware of what causes the problem, but
are reluctant to makke reluctant lifestyle
changes to prevent or reverse the
condition. often “new” information an
assist in attracting attention and directing
positive behaviour changes.
 knowledge
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 Health education, as the process of

about
teaching and learning health supporting
information can have little significantly
extensive impact on the behaviour pattern,
that is, on personal choice and decision
making of groups of people, without the
easy availability of new, or newly-
perceived alternative health-promoting
options for investing personal resources.
Information
dissemination

Implicit in the

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Steps
Motivation

Change-making in the
living environment
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THANK YOU FOR

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about
LISTENING!

PREPARED BY : Angelica B. Evangelista

IMPLICATIONS
Milio’s Framework
for Prevention

ABESAMIS, JAMAECA J.
BSN 3
 IMPLICATIONS

• To broaden the range of options

available to people and to make
health-promoting choices easier
and/or to diminish health-damaging
options by making them more difficult
to choose.
 IMPLICATIONS

• For the most widespread

impact, the focus might be on
national-level policy-making
which would in turn change the
range of options for the largest
number of people.
 IMPLICATIONS

• Selected populations, those

vulnerable to ill health because of the
limited healthful options available to
them, might also receive special
attention.
 IMPLICATIONS

• This frame of references can

also help assess or project the
relative effectiveness of
various efforts at behavior
change.
IMPLICATIONS
Milio’s Framework for Prevention
Guillen, Jasper Andre P.
 The question may be raised that this
perspective suggests a manipulation
of behavior, a constraint on freedom.
- Quite the contrary, since as this
discussion shows, current policy and
allocative decisions clearly constrain
personal choice making, even if not so
perceived by many people.
 This framework suggests strategies which
will enhance the freedom to choose,
making it readily possible for individuals
and groups who now have difficult options
to create healthful lifestyles.
 Those who wish to pursue health
damaging patterns would still be able to
do so.
 Passage of an adequate National
Health Education and Promotion Act
will make possible the development
and testing of such models in order to
help health professionals and
consumers focus effectively on the
prevention of disease rather than on its
repair or containment.
THANK YOU!
 Milio’s Framework for Prevention
• Who is Milio? – Reported by Christian Parabuac
• Definition of Milio’s Framework for Prevention – Reported by Leya Thaobunyuen
Set of Propristions:
#1 - Reported by Victoria Perey
#2 - Reported by Eyy Martinez
#3 - Reported by Andrea Caguia
#4 - Reported by Jahmil Vergara
#5 - Reported by Honey Molina
#6 - Reported by Angelica Evangelista
• Implications – Reported by Jamaeca Abesamis & Andre Guillen