MODELS OF PREVENTIONOUTLINE

IntroductionClinical modelRole performance modelAdaptive modelAgent-Host-Environmental model:High Level Wellness ModelHolistic Health ModelNightingale’s Theory of EnvironmentMilio’s Framework for PreventionLevels of Prevention ModelThe Health Belief ModelTannahill Model of Health PromotionThe Social ModelThe Social-Ecological ModelMental Health Promotion ModelAIDS Risk Reduction Model

INTRODUCTION

A model is a theoretical way of understanding a concept or idea. Models represent different ways of

approaching complex issues. There are different models of health.

DEFINITION OF MODEL:-

A model is a theoretical way of understanding a concept or idea.

Represent different ways of approaching complex issues. Health beliefs are a person’s ideas,

convictions, and attitudes about health and illness. Because health beliefs usually influence health

behaviour, they can positively or negatively affect a client’s health.

‘Prevention of illnesses is a positive health behaviour.

Common positive health behaviours include immunizations, proper sleep patterns, adequate exercise,

and nutrition.

Preventing illness is one aspect of wellness care that focuses on detection or prevention of disease.

DEFINITION OF HEALTH:-

"Health is a state of complete physical, social and mental well-being, and not merely the absence of

disease or infirmity"- WHO (1948)

New philosophy of health

Health is:

Fundamental Right

Essence Of Productive Life

Intersectoral

Integral Part Of Development

Central To The Concept Of Quality Of Life

Involves Individual, State And International Responsibilities

Worldwide Social Goal

Major Social Investment

Millennium Development Goal

In the millennium declaration of September 2000, member states of the United Nations made a most

passionate commitment to address the crippling poverty and multiplying misery that grip many areas of

the world. Government sets a date of 2015 by which they would meet the millennium development

goals.

Goals

Eradicate extreme poverty and hunger

Achieve universal primary education

Promote gender equality and empower women

Reduce child mortality

Improve maternal health

Combat HIV/AIDS, malaria and other disease

Ensure environmental sustainability

Develop a global partnership for development

Concept of Prevention:-

"...Prevention is any activity which reduces the burden of mortality or morbidity from disease."

PRINCIPLES OF PREVENTION:-

The terms primary, secondary and tertiary prevention were first documented in the late 1940s by Hugh

Leavell and E. Guerney Clark from the Harvard and Columbia University Schools of Public Health,

respectively. Pioneers in Public Health thinking at that time, Leavell and Clark described the principles

of prevention within the context of the Public Health triad of Host, Agent and Environment commonly

referred to as the epidemiologic triangle model of Causation of diseases.

LEAVELL AND CLARK’S THREE LEVELS OF PREVENTION

Primary Prevention

Seeks to prevent a disease or condition at a pre-pathologic

state;

To stop something from ever happening, Health Promotion,

health education, marriage counselling, genetic screening,

good standard of nutrition, adjusted to developmental phase

of life, Specific, Protection, use of specific immunization,

attention to personal hygiene, use of environmental

sanitation, protection against occupational hazards, protection from accidents, use of specific

nutrients, protections from carcinogens, avoidance to allergens.

Secondary Prevention

Also known as “Health Maintenance”:

Seeks to identify specific illnesses or conditions at an early stage with, prompt intervention to

prevent or limit disability;

To prevent catastrophic effects that could occur if proper attention and treatment are not

provided,

Early Diagnosis and Prompt Treatment,

Case finding measures,

Individual and mass screening survey,

Prevent spread of communicable disease,

Prevent complication and squeal,

Shorten period of disability,

Disability Limitations,

Adequate treatment to arrest disease process and prevent further complication and squeal,

Provision of facilities to limit disability and prevent death.

Tertiary Prevention

Occurs after a disease or disability has occurred and the recovery process has begun; Intent is to halt the

disease or injury process and assist the person in obtaining an optimal health status. To establish a high-

level wellness. “To maximize use of remaining capacities’, Restoration and Rehabilitation, Work

therapy in hospital, Use of shelter colony

1. CLINICAL MODEL The clinical model views health as the absence of physiological disease or the absence of

disequilibrium. Persons with clinical symptoms of disease are not considered healthy from this

perspective. People are viewed as physiologic system with related functions and symptoms are disease

or injury.

Health is identified as the absence of signs and symptoms of disease or disability as identified

by medical science. Many medical practitioners use the clinical model. The focus of many medical

practice is the relief of signs and symptoms of disease and the elimination of malfunction and pain when

the signs and symptoms of disease are no longer present in a person, the medical practitioner often

considers that the individual’s health is restored.

In the clinical model, the opposite end of continuum from health is disease. In this medical

health is motivated by the absence of diagnosable disease.

The absence of signs and symptoms of disease indicates health.

Illness would be the presence of conspicuous signs and symptoms of disease.

People who use this model of health to guide their use of healthcare services may not seek

preventive health services, or they may wait until they are very ill to seek care.

Clinical model is the conventional model of the discipline of medicine.

11. ROLE PERFORMANCE MODEL

This model adds social and psychological standards to the concept of health. Health is defined in terms

of the individual’s ability to fulfil societal roles, i.e., to perform work. This critical criterion of health is

the person’s ability to fulfil his roles in society with the maximum {e.g., best, highest) expected

performance. If a person is unable to perform his expected roles, it can mean illness even though an X-

Ray film of his lung indicates a tumour.

Parson (1972) views health in this light. Health also been defined as “the state of optimum capacity of

an individual for the effective performance of his roles and tasks. An emphasis in this definition is the

capacity of the individual rather than a commitment of roles and tasks.

The role performance model of health views health as the ability to perform social roles. Illness is

determined by the capacity to function and perform ones daily activities. It is assumed that sickness is

the inability to perform ones work. A problem of this model is the assumption that a person’s most

important role is the work role. People usually fulfil several roles. E.g., mother, father, daughter, son,

friend and certain individual may consider nonwork roles and paramount in their lives.

In this model health is motivated by being able to fulfil responsibilities at work, play, home, community.

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.

III. ADAPTIVE MODEL

The focus of the adaptive model is adaptation. Incorporating the clinical and role performance model is

the adaptive model. This model is derived from the writings of Dubos who views health as a creative

process. Individuals are actively and continually adapting to their environments.

Accordingly the individuals must have sufficient knowledge to make informed choices about their

health and also the income and resources to act on choices. They believe that complete wellbeing is

unobtainable.

Health is perceived as a condition in which the person can engage in effective interaction with the

physical and social environment. There is an indication of growth and change in this model. i.e., health

is a state of well-being in which the person is able to use purposeful, adaptive, responses and processes,

physically, mentally, emotionally, spiritually and socially in response to internal and external stimuli in

order to maintain relative stability and comfort and to strive for personal objectives and cultural goals.

The adaptive model of health defines health as the ability to interact effectively within the physical and

social environment. The disease state thus represents a failure in adaptation and ineffective coping with

environmental changes. The aim of treatment is to restore the ability of the person to adapt, i.e., to cope.

Ascending to this model extreme good health is flexible adaptation to the environment and interaction

with the environment to maximum advantage. The focus of this model is stability although there is also

an element of growth and change.

Siegel (1973) describes health as “an outcome of interplay between the internal environment and

external multi-environments. In the adaptive model health, the opposite end of the continuum from

health is illness.

Accordingly health is motivated by altering oneself for the risks in the environment as situations

changes (i.e., engaging in stress reduction, dietary or exercise programme, community recycling or

reducing exposure to environmental hazards.

The ability to adapt positively to social, mental, and physiological change is indicative of health.

Illness occurs when the person fails to adapt or becomes in adaptive toward these changes.

As the concept of adaptation has entered other aspects of culture, this model has become widely

accepted.

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

a. The agent-host-environment model of health and illness also called the ecologic model, originated in

the community health work of Leavell and Clark (1965) and has been expanded into a general theory of

the multiple causes of disease.

b. The model is used primarily in predicting illness rather than in promoting wellness, although

identification of risk factors that result from the interactions of agent, host and environment are helpful

in promoting and maintaining health.

c. The model has three dynamic interactive elements:

1. Agent:

Any environmental factor or stressor (biological, chemical, mechanical, physical or psycho-social) that

by its presence or absence (e.g. lack of essential nutrients) can lead to illness or disease.

2. Host:

Person(s) who may or may not be at risk of acquiring a disease.

Family history, age and lifestyle habits influence the host's reaction.

3. Environment:

All factors external to the host that may or may not predispose the person to the development of disease.

IV. HIGH LEVEL WELLNESS MODEL:

a. Dunn (1959) describes a health grid in which a health axis and an environmental axis intersect.

b. The health axis extends from peak wellness to death, and the environmental axis extends from very

favourable to very unfavourable.

c. The intersection of the two axes forms four quadrants of

health and wellness:

1. High-level wellness in a favourable environment.

2. Emergent high-level wellness in an unfavourable

environment

3. Protected poor health in favourable environment.

4. Poor health in an unfavourable environment.

V. 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) cannot 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.

VI. Nightingale’s Theory of Environment Florence Nightingale’s environmental theory focuses on

preventive care for populations.

She suggested that disease was more prevalent in poor

environments and that health could be promoted by

providing adequate ventilation, pure water, quiet, warmth,

light and cleanliness.

"Poor environmental conditions are bad for health and that

good environmental conditions reduce disease."

This is one way to measure a person’s level of health.

This model views health as a constantly changing state, with high level wellness and death being

on opposite ends of a graduated scale, or continuum.

This continuum illustrates the dynamic state of health, as a person adapts to changes in the

internal and external environments to maintain a state of well-being..

VII. 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.

VIII. 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.

IX. Tannahill Model of Health Promotion

1. Health Education: communication activity aimed at enhancing well-being and preventing ill-

health through favourably influencing the knowledge, beliefs, attitudes and behaviour of the

community

2. 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

3. Prevention: refers to both the initial occurrence of disease and also to the progress and

subsequently the final outcome

X. The Social Model A social health model is aimed at incorporating the

social and economic, as well as biophysical context

of health status,

It is based on knowledge of the experience, views

and practices of people with disabilities.

It locates the problem within society, rather than

within the individual with a disability

Rules are determined within a framework of choice

and independent living with strong support from

organized disability communities.

The biases of the social model include:

limiting the causes of disability either exclusively or mainly to social and environmental policies

and practices, or

Advancing perceptions of disability that emphasize individual rights rather than advancing

broader economic rights.

XI. The Social-Ecological Model: A Framework for Prevention The ultimate goal is to stop violence before it begins. Prevention requires understanding the

factors that influence violence. CDC uses a four-level social-ecological model to better understand

violence and the effect of potential prevention strategies (Dahlberg & Krug 2002). This model considers

the complex interplay between individual, relationship,

community, and societal factors. It allows us to address the factors that put people at risk for

experiencing or perpetrating violence.

Prevention strategies should include a continuum of activities that address multiple levels of the model.

These activities should be developmentally appropriate and conducted across the lifespan. This

approach is more likely to sustain prevention efforts over time than any single intervention.

Individual

The first level identifies biological and personal history factors that increase the likelihood of becoming

a victim or perpetrator of violence. Some of these factors are age, education, income, substance use, or

history of abuse. Prevention strategies at this level are often designed to promote attitudes, beliefs, and

behaviours that ultimately prevent violence. Specific approaches may include education and life skills

training.

Relationship

The second level examines close relationships that may increase the risk of experiencing violence as a

victim or perpetrator. A person's closest social circle-peers, partners and family members-influences

their behaviour and contributes to their range of experience. Prevention strategies at this level may

include mentoring and peer programs designed to reduce conflict, foster problem solving skills, and

promote healthy relationships.

Community

The third level explores the settings, such as schools, workplaces, and neighbourhoods, in which social

relationships occur and seeks to identify the characteristics of these settings that are associated with

becoming victims or perpetrators of violence. Prevention strategies at this level are typically designed to

impact the climate, processes, and policies in a given system. Social norm and social marketing

campaigns are often used to foster community climates that promote healthy relationships.

Societal

The fourth level looks at the broad societal factors that help create a climate in which violence is

encouraged or inhibited. These factors include social and cultural norms. Other large societal factors

include the health, economic, educational and social policies that help to maintain economic or social

inequalities between groups in society.

XII. MENTAL HEALTH PROMOTION MODEL

Mental health is sometimes thought of as simply the absence of a mental illness but it is actually much

broader. Mental health is a state of successful mental functioning, resulting in productive activities,

fulfilling relationships, and the ability to adapt to change and cope with adversity. Mental health is

indispensable to personal wellbeing, family and interpersonal

relationships, and one's contribution to society

Medical Prevention Model:

The medical prevention model focuses on biological and

brain research to discover the specific causes of mental

illness, with primary prevention activities focused on the

prevention of illness in the individual patient. This

model consists of the following steps:

Identify a disease that warrants the development of a preventive intervention program. Develop

reliable methods for its diagnosis so that people can divided series of epidemiological and

laboratory studies, identify the likely cause of the disease.

Launch and into groups according to whether they do or do not have the disease.

By a revaluate and experimental preventive intervention program based on the results of those

studies.

Nursing Prevention Model:

The nursing prevention model stresses the importance of promoting mental health and

preventing mental illness by focusing on risk factors, protective factors, vulnerability, and

human responses.

In the nursing prevention model, the "patient" may be and individual, family, or

community.

It is based on the understanding that mental disorders are the result of many causes, requiring

that mental illness prevention be thought of in a more behavioral way as the promotion of

adaptive coping responses and the prevention of maladaptive responses to life stressors.

Stressors can include single-episode events, such as a divorce, or long-standing conditions, such

as marital conflict. They can reflect either an acute health problem or a chronic health problem.

The nursing prevention model thus assumes that problems are multicausal, that everyone

is vulnerable to stressful life events, and that any disability or problem may arise as a

consequence.

For example: four vulnerable people can face a stressful life event, such as the ending of a

marriage or the loss of a job.

One person may become severely depressed, the second may be involved in an automobile

accident, the third may begin to drink heavily, and the fourth may develop coronary artery

disease.

The nursing prevention model does not search for a cause of each problem. Rather, I involves the

following steps:

1. Identifying a stressor that appears to result in a maladaptive coping response in a significant

portion of the population. Develop procedures for reliably identifying people who are at risk for

the stressor and maladaptive response.

2. By epidemiological and laboratory methods, study the consequences of that stressor and develop

hypotheses related to how its negative consequences might be reduced or eliminated.

3. Launch and evaluate an experimental preventive intervention program based on these hypotheses

Purpose of mental health promotion for people with mental illness is to ensure that individuals

with mental illness have power, choice, and control over their lives and mental health, and that

their communities have the strength and capacity to support individual empowerment and

recovery.

The person with mental illness is the central focus: participating in her/his community, involved

in decision-making about mental health services, and choosing which supports are most

appropriate.

There are four key resources which should be available to the person to support their mental

health:

1. mental health services

2. family and friends

3. consumer groups and organizations

4. Generic community services and groups.

XIII. AIDS Risk Reduction Model

It believes change is a process. Individuals must go through with different factors affecting

movement.

This model proposes that the further an intervention helps clients to progress on the stage

continuum, the more likely they are to exhibit change.

Individuals must pass through three stages;

A) Labelling - one must label their actions as risky for contracting HIV (i.e. problematic). Three

elements are necessary

Knowledge about how HIV is transmitted and prevented,

Perceiving themselves as susceptible for HIV and

Believing HIV is undesirable

B) Commitment – this decision-making stage may result in one of several outcomes

Making a firm commitment to deal with the problem

Remaining undecided,

Waiting for the problem to solve itself, or

Resigning to the problem: Weigh cost and benefits- giving up pleasure (high risk) for less

pleasure (low risk)

C) Enactment – This includes three stages:

Seeking information,

Obtaining remedies, and

Enacting solutions.

XIV. Travis's illness-wellness continuum The Illness-Wellness Continuum is a graphic illustration of

a wellbeing concept first proposed by John W. Travis in

1972.

Concept:-

Travis believes that the standard approach to medicine,

which assumes a person is well when there are no signs or

symptoms of disease, was insufficient. This led to his

development of the Continuum. The right side of the Continuum reflects degrees of wellness, while the

left indicates degrees of illness. The Illness-Wellness Continuum has been used to highlight how, even

in the absence of physical disease, an individual can suffer from depression, anxiety or other conditions

— indicating a lack of wellness.

While standard medicine (see "Treatment Paradigm"), typically treats injuries, disabilities, and

symptoms, to bring the individual to a "neutral point" where no illness is present, the Wellness Paradigm

seeks to move the individual’s state of wellbeing further along the continuum towards optimal emotional

and mental states. The concept is premised on the idea that wellbeing is a dynamic rather than a static

process. In this, the Illness-Wellness Continuum reflects the view of the World Health Organization,

which has defined health as "a state of complete physical, mental and social well-being and not merely

the absence of disease or infirmity."

The Illness-Wellness Continuum proposes that individuals can move further to the right, towards health

and wellbeing, through awareness, education, and growth.  Conversely, worsening states of health are

reflected by signs, symptoms, and disability. In addition, a person's outlook plays a major role moving

along the Continuum in either direction. A positive outlook will enhance the individual’s health and

wellbeing, while a negative outlook will hinder it, independent of present health status. For example, a

person who demonstrates no symptoms of disease, but is constantly complaining, would be facing the

left side of the Continuum, toward an early death.

However, a person having a disability, but still maintaining a positive outlook, will be facing to the

right, toward a high level of wellness. It is less important where a person is on the continuum than which

direction they are facing.

The Illness-Wellness Continuum has been praised for promoting preventive treatment—improving

wellbeing before an individual presents with signs or symptoms of illness, as well as educating people to

be aware of, and consequently avoiding risk factors, protecting against pathology and an early death.

a. The illness- wellness continuum developed by travis ranges from high-level wellness to premature

death.

b. The model illustrates two arrows pointing in opposite directions and joined at a neutral point.

c. This is achieved in three steps:

1. Awareness

2. Education

3. Growth

XV. HEALTH BELIEFS MODELS The Health Belief Model is a psychological model that attempts to explain and predict health

behaviours. This is done by focusing on the attitudes and beliefs of individuals. The HBM was first

developed in the 1950s by social psychologists of Hochbaum, Rosenstock and Kegels working in the

U.S. Public Health Services. This model is an intrapersonal (within the individual, knowledge and

beliefs) theory used in health promotion to design intervention and prevention programs. It was

designed in the 1950s and continues to be one of the most popular and widely used theories in

intervention science. The focus of the HBM is to assess health behaviour of individuals through

examination of perceptions and attitudes someone may have towards disease and negative outcomes of

certain actions. The HBM assumes that behaviour change occurs with the existence of three ideas at the

same time:

An individual recognizes that there is

enough reason to make a health concern

relevant (perceived susceptibility and

severity)

That person understands he or she may be

vulnerable to a disease or negative health

outcome.(perceived threat)

Lastly the individual must realize that behaviour change can be beneficial and the benefits of that

change will outweigh any costs of doing so. (Perceived benefits and barriers).

Health Belief Model: Major Concepts

HBM is based on six key concepts. The following table, excerpted with minor modifications from "Theory at a Glance: A Guide for Health Promotion Practice" (1997), presents definitions and applications for each of the six key concepts. Examples of the concepts as they apply to sexuality education are presented after this table.

Concept Definition Application

1. Perceived Susceptibility

One's belief of the chances of getting a condition

Define population(s) at risk and their risk levels

Personalize risk based on a person's

traits or behaviours

Heighten perceived susceptibility if too low

2. Perceived Severity

One's belief of how serious a condition and its consequences are

Specify and describe consequences of the risk and the condition

3. Perceived Benefits

One's belief in the efficacy of the advised action to reduce risk or seriousness of impact

Define action to take — how, where, when

Clarify the positive effects to expected

Describe evidence of effectiveness

4. Perceived Barriers

One's belief in the tangible and psychological costs of the advised behaviour

Identify and reduce barriers through reassurance, incentives, and assistance

5. Cues to Action

Strategies to activate "readiness" Provide how-to information

Promote awareness

Provide reminders

6. Self-Efficacy

Confidence in one's ability to take action

Provide training, guidance, and positive reinforcement

1. Health locus of control model

2. Rosen stock's and Becker's health belief models, include

Individual Perceptions

Individual perceptions speak directly to the knowledge and beliefs that a person has about his behaviors

and the outcomes they could have. This section of the paper includes two main sections; Perceived

Susceptibility and Perceived Severity.

A. Perceived Susceptibility

Within the health field susceptibility refers to the risk a person has to a particular disease or health

outcome. Within the context of the HBM, perceived susceptibility examines the individual’s opinions

about how likely the behaviours they partake in are going to lead to a negative health outcome. For

example, look at an individual who smokes. Smoking is known to have many complications such as

lung cancer, bladder cancer, etc. If a smoker does not feel that he is at risk of developing any of these

diseases, he has no reason in his mind to make a behaviour change. One of the Goals of the HBM is to

change perceptions of susceptibility in order to move towards behaviour change.

B. Perceived Severity

Most people are familiar with the word severity as how serious a situation or action can be. In the HBM

perceived severity addresses how serious the diseases that a person is susceptible to can be. In the case

of a smoker, lung cancer is one of the leading causes of death among the American population. A

smoker may not understand how difficult lung cancer can be to detect and how difficult it can be to

treat. They also may not know how painful and long lasting a disease it can be later in life. The HBM

seeks to increase awareness of how serious the outcomes of behaviours can be in order increase the

quality of one’s life.

Now that there is an understanding of Individual Perceptions it is important to understand how

Modifying Factors can affect some ones decision to change.

Modifying Factors

While Individual Perceptions were internalized, In the Health Belief Model Modifying Factors step

outside the body to examine and use outside influences to affect the how threatened a person feels by the

outcomes of continuing the same behaviours that put him at risk. As seen by the arrows in the diagram,

perceived susceptibility and severity do have their own impact on threat as well.

A. Perceived Threat

Susceptibility as stated before displayed how someone acknowledged that their behavior could lead to a

specific disease. Threat takes the idea one step further by examining just how likely it is that the disease

could be developed. To use lung cancer again, someone who has been smoking for a year may not feel

threatened by potential disease because they have not been doing it very long and if they quit their body

can recover. On the other hand, a smoker who has been doing so for 25 years may feel very threatened

by lung cancer if he has developed a strong cough. The cough could be a symptom that increases his

level of threat and triggers his decision to quit.

B. Environmental Factors

Environmental factors can add to the threat of disease. Demographic background can cause one to be

more at risk such as race, ethnicity, and socioeconomic status. Someone living in poverty would be

more threatened by a disease if they could not afford health care. Also Peers and other influential people

can have an influence. If an entire group of friends smoke together, it is going to be more difficult for

one person to quit.

C. Cues to Action

Lastly cues to action are reasons why an individual realizes he could be threatened by serious disease.

These could be media or concerned loved ones. Cues to action are anything that triggers a decision to

change behaviour. The previous two categories have built on each other and lead to Likelihood of

Action.

Likelihood of Action

After becoming aware of the potential for developing a disease if behaviour does not change, it is

important to weigh out the benefits and the barriers to taking action and determine if it is worth it.

A. Perceived Benefits

What are the benefits to change? In the HBM the goal is greater quality of life for an individual both

mentally and physically. Clearly a benefit to change would be increased health but there could be other

factors that exist on an individual level.

B. Perceived Barriers

What are the reasons that I cannot change my behaviour? Barriers could be anything from losing friends

to not having enough money or even self-efficacy problems such as not believing in one’s self. For

change to take place the benefits must be stronger than the barriers.

Summary

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.

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currentnursing.com/nursing theory/models_prevention.html

WEBSITE:-

www.iccwa.org.au/.../the_ health _ belief _ model . pdf evan_burke. pdf

www.utwente.nl › Home › ... › Health Communication

currentnursing.com/nursing theory/health_belief_model.html

recapp.etr.org/recapp/index.cfm?fuseaction=pages.theoriesdetail...

basanvathappa, community health nursng

en.wikipedia.org/wiki/Illness-Wellness_Continuum