The epidemiologic

triad is the classic

model based on the
belief that health
status is determined
by the interaction of
the characteristics of
the host, agent and
environment, not by
any single factor.
 De- emphasizes the agent as the sole cause
of disease, whereas it emphasizes the
interplay of physical, biologic, and social
environments.

 Interaction between the host and

environment with or without an identifiable
agent, remains the major determinant of
health status in all epidemiological models.
 Many diseases, illnesses, and conditions have
multiple or no discernible agents, or the
agent may be a part of the environment.

 An alternate model is conceptualize as a

wheel, with a circle as the genetic core of the
host, surrounded by a larger, segmented
wheel representing the biological, physical
and social environments.
 Is an epidemiologic model that strongly
emphasizes the concept of multiple causation
while de-emphasizing the role of agents in
explaining illness.

 In this model, it is necessary to identify all

possible antecedent factors that could
influence the development or prevention of a
particular health condition.
 Each factor is perceived as a link in multiple
interrelated chains.
 The epidemiologic process and the nursing
process are both derived from the problem
solving process that provides a framework for
gathering data about health problems,
analyzing the information, generating
diagnoses or hypotheses, planning for
resolution, implementing plans of action, and
evaluating results.
 The focus of the nursing process is on
caring for the client within his or her
family, whereas the focus of the
epidemiologic process is on caring for
the population of the community as a
whole.
Nursing Process, Client Based Epidemiologic Process, Population Based

Assessment : Assessment :

- an individual client database is established - data are gathered from reliable sources
- data are interpreted - nature, extent and scope of problem are defined
- problem described by person, place, and time
Diagnosis Diagnosis

- health care needs and assets are identified - tentative hypothesis is formulated
- goals and objectives for care are established -data analyzed to test the hypothesis

Planning Planning

- processes for achieving goals are selected - plans are made for control and prevention of the
condition or event
Implementation Implementation

-actions initiated to achieve goals -actions are initiated to implement the plan

Evaluation Evaluation

- extent of goal achievement is determined -actions are evaluated and report is prepared
- further research is conducted if necessary
 Every phase of
public health
nursing involves
the provision of
health education
whenever the
opportunity arises.
Lifestyle patterns are
modifiable, and
Nurses can help make
the public aware of
the benefits of
preventive health
through use of the
media and meeting
with individuals and
community groups.
Following the landmark epidemiologic studies
of smoking and lung cancer in the 1950s, the
general public gradually recognized that
personal behaviors such as smoking were risk
factors for the leading conditions causing
morbidity and mortality in the United States
and other countries.
 In 1984, the CDC and the U.S. State Health
departments collaboratively established the
Behavioral Risk Factor Surveillance System
(BRFSS).

The goal of this surveillance system is to

collect, analyze, and interpret specific
behavioral risk factor data that can be used to
plan, implement, and monitor health
promotion and disease prevention programs.
The BRFSS gathers information about health
behaviors, such as lack of physical activity,
obesity, and safety belt use.

Dietary factors are associated with 4 out of the

10 leading causes of death: heart disease,
some types of cancer, stroke, and type
2diabetes.
 Obesity rates have
doubled in adults
and tripled in
children and
adolescents over
the last two
decades.
A thorough and accurate client database, whether
that of individuals, groups, or the community,
provides the evidence and rationale for your
interventions.

Use statistics to demonstrate the need for program

development and community interventions.

Early attempts at understanding the reasons for

disease were primarily a direct result of trial-and-
error observations of individual people.