Levels of Prevention Model

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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:

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Primordial prevention Primary prevention Secondary prevention Tertiary prevention

Primordial prevention
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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
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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. A holistic approach

Secondary prevention
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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
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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.

Modes of intervention
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Health promotion

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Specific protection Early diagnosis and treatment Disability limitation rehabilitation

Health promotion The process of enabling people to in areas to control over and to improve health
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Health education Environmental modifications Nutritional interventions Lifestyle and behavioral changes

Specific protection
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Immunization Specific nutrients Chemoprophylaxis Protection against occupational hazards Protection from carcinogens Avoidance of allergens

Early diagnosis and treatment Rehabilitation

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The combined and coordinated use of medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability. Examples-schools for blind, reconstructive surgery in leprosy, provision of aids for the crippled

Intervention approaches
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Individual-focused (personal health) Community-focused (population or subgroup) System-focused (procedures, rules, regulations, policy and law)

The Health Belief Model

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This model is based on the premise that for a behavioral change to succeed, individuals must have the incentive to change, feel threatened by their current behaviour, and feel that a change will be beneficial and be at acceptable cost. They must also feel competent to implement that change . The purpose of the model is to explain and predict preventive health behavior.

Milios Framework for Prevention

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Nancy Milio developed a framework for prevention that includes concepts of community oriented, population- focused care. Milios basic treatise was 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. Milios framework described a sometimes neglected role of community health nursing to examine the determinants of a communitys health and attempt to influence those determinants through public policy.

Holistic Health Model by Edelman and Mandle, 2002

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Holism represents the interaction of a persons mind, body and spirit within the environment. Holism is an antidote to the atomistic approach of contemporary science. 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 using the nursing process consider clients the ultimate experts regarding their own health and respect clients 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. Application of this model in nrsing music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, non-pharmacological complements to traditional medical care.