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Theoretical Framework

This study was anchored in the Milios Framework for Prevention. In this model Milios

Framework of prevention a nurse and leader in public health policy and public health education

developed a framework for prevention that includes concepts of community-oriented,

population focused care.(1976,1981).

The basic treatise is that behavioral patterns of 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 behavioral choice is lack of knowledge.

Governmental and institutional policies, she said set the range of options for personal choice

making. It neglected the role of community health nursing, examining the determinants of

community health and attempting to influence those determinants through public policy.

Salmon Whites construct for public health nursing states that public health as an organized

societal effort to protect, promote and restore the health of people and public health nursing

as focused on achieving and maintaining public health.

He gave 3 practice priorities i.e.; prevention of disease and poor health, protection against

disease and external agents and promotion of health. For these 3 general categories of nursing

intervention have also been put forward, they are:

-education directed toward voluntary change in the attitude and behaviour of the subjects

-engineering directed at managing risk-related variables

-enforcement directed at mandatory regulation to achieve better health.

Scope of prevention spans individual, family, community and global care. Intervention target is

in 4 categories:


2. Environmental

3. Medical/technological/organizational

4. Social

Environmental theory focuses in altering the environment of the patient in order to affect

change in his or her health. The environmental factors that affect health, as identified in the

theory, are: fresh air, pure water, sufficient food supplies, efficient drainage, cleanliness of the

patient and environment, and light (particularly direct sunlight). If any of these areas is lacking,

the patient may experience diminished health. A nurse's role in a patient's recovery is to alter

the environment in order to gradually create the optimal conditions for the patient's body to

heal itself. In some cases, this would mean minimal noise and in other cases could mean a

specific diet. All of these areas can be manipulated to help the patient meet his or her health

goals and get healthy.

Allender J.N; Spradely B.W. Community Health Nursing Concepts and practice. (8th edn)
Stanhope M; Lancaster J. Community Health Nursing Promoting health of Aggregates, Families and
individuals.(4th edn) 2001.Mosby,265-80.