COMMUNITY HEALTH NURSING 2

MI L I O ' S
Framework of Prevention
BSN III - HALL (GROUP TWO)
 RE P OR T ER S

Adiel Aiah Valerie

Johanna Christian
 LEARNIN G
objectives
At the end of this report, BSN III Hall students are
expected to:

Explain the
Understand Understand it's
connection between
Milio's application in the
framework for the individual’s state
of health and that of community
prevention

the community health setting

 Nancy Milio, PhD, RN, was a
public health nurse who
formulated a framework for
prevention, which aimed to
explain the connection between
the individual’s state of health
and that of the community.

She proposed that an

individual’s health and lifestyle
choices are influenced by

Nancy Milio
resources, availability, cost,
and convenience more than
knowledge obtained from
education.
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. Nancy Milio
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
Nancy Milio
public policy.
 FRAMEWORK OF PREVENTION
The framework provides that the health status existing in the
population occurs due to too little or excess critical health
sustaining resources whereby people who are have enough
and safe food, shelter, water and environment are
vulnerable to infectious diseases which too much food will
lead to obesity.

Population behavior patterns also affect health since

knowledge and perception is influenced by informal and
formal learning and also by experience. Health is also
influenced by organizational behavior which includes policy
makers since they provide options available to thus
influencing selections made by individuals.
Milio's Propositions

Population health
results from
deprivation
and/excess of critical
health resources.
Milio's Propositions

Behaviors of populations
result from selection from
limited choices; these arise
from actual and perceived
options available as well as
beliefs and expectations
resulting from socialization,
education and experience.
Milio's Propositions

Organizational
decisions and policies
dictate many of the
options available to
individuals and
populations and
influence choices.
Milio's Propositions

Individual choices
related to health-
promoting or health-
damaging behaviors is
influenced by efforts to
maximize valued
resources.
Milio's Propositions

Alteration in patterns
of behavior resulting
from decision making
of significant number
of people in a
population can result
in social change.
Milio's Propositions

Without concurrent
availability of alternative
health-promoting options
for investment of personal
resources, health
education will be largely
ineffective in changing
behavior patterns.
 MI L I O ' S
Framework of Prevention
primordial
level
Consists of actions & measures
that inhibit the emergence of risk
factors in the form of
environmental, economic, social,
and behavioral conditions &
cultural patterns of living etc.

Includes environmental control of

disease vectors and eliminating
predisposing factors.

Prevention of the emergence or

development of risk factors in
countries or population groups in
which they have not yet appeared.
Addresses determinants at the
systemic level rather than
modifying personal risk factors
Efforts in this level are directed
towards discouraging children
from adopting harmful lifestyles.

Main Intervention
INDIVIDUAL AND
MASS EDUCATION
 E XAMP L E S
Promoting a healthy lifestyle in
childhood through prenatal
Outlawing alcohol in
nutrition programs and
certain countries
supporting early childhood
development programs

Maintaining appropriate weight,

Improving sanitation and
blood pressure, glucose level and
establishing healthy
lipids level; not smoking; having
communities
a healthy diet
primary
level
 Primary prevention aims to prevent
disease or injury before it ever occurs.
This is done by preventing exposures to
hazards that cause disease or injury.
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
level
 WHAT IS SECONDARY PREVENTION?
Secondary prevention is the early detection of disease
or its precursors before symptoms appear, with the
aim of preventing or curing it.
 E XAMP L E S
regular exams and
screening tests to Colonoscopy -
detect disease in its
earliest stages (e.g.
early detection
mammograms to of colon cancer
detect breast cancer)

daily, low-dose Pap smear -

aspirins and/or diet early
and exercise
programs to prevent detection of
further heart attacks cervical
or strokes
cancer
 E XAMP L E S

Blood pressure (BP)

control - Testing BP
and medications to
lower blood pressure
to prevent future
heart disease or
stroke
tertiary
level
Tertiary prevention aims to soften
the impact of an ongoing illness or
injury that has lasting effects.

done by helping people manage

long-term, often-complex health
problems and injuries

to improve as much as possible

their ability to function, their
quality of life and their life
expectancy.
 E XAMP L E S
cardiac or stroke rehabilitation
programs, chronic disease
management programs (e.g.
for diabetes, arthritis,
depression, etc.)

support groups that allow

members to share strategies for
living well
THANK YOU!