Health and Wellness

public health

critical functions of state and local health departments such as preventing infectious disease outbreaks, containing environmental hazards, and encouraging health behaviors

vision 2025

occupational therapy maximizes health, wellbeing, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living

OT Models and Theories that can inform OT and public health practice

1. MOHO

2. Wilcock’s Doing, Being, Belonging, Becoming

3 Major Components of MOHO

1. performance capacity

2. habituation

3. volition

Performance Capacity

• interplay of the client’s physical, physiological, and cognitive capacities

• primary function: produce the actions required to accomplish occupation

habituation

• internalized readiness to exhibit consistent patterns of behavior guided by habits and roles and fit to the client’s environment

• habits and internalized roles provide humans with a sense of order and predictability

volition

• motivation of the individual, community, or population to engage in behaviors

• trajectory of change

• adaptive cycle

• maladaptive cycle

Doing

• synonym for occupation

• humans have innate need

• cultural experiences and community structures

Being

• one’s awareness and capacity

• how people feel about what they do

• bidirectional influence of consciousness and occupational choices

Belonging

• Importance of relationships to physical, mental, and social health

• shared sense of community, identity, and interconnectedness

Becoming

• ongoing nature of growth, change, and transformation

• future oriented self-potential

• grounded in doing, being, and belonging

• facilitates wellbeing

4 different levels of occupation-based health promotion

• individual wellbeing

• group or community wellbeing

• multidimensional wellbeing - environment

• social determinants of health

Diffusion of Innovation Model

Explains how new ideas, practices, or technologies spread within a society or group overtime.

• Innovation = new idea, practice, or product

• Communication Channels = how people hear about the innovation

• Time = adoption happens gradually over time

• social system = group or community

• adopters = minimal unit of analysis

Health Belief Model

Psychological model that explains why people choose to engage or not engage in health-related behaviors. Focusing on their beliefs and perceptions.

• perceived susceptibility = does the person believe they’re at risk for a health problem?

• perceived severity = does the person believe the health problem is serious?

• perceived benefits = does the person believe the action will reduce risk or severity?

• perceived barriers = what are the obstacles to taking action?

• cues to action = what triggers the decision to act?

• self-efficacy = does the person believe they can successfully take the action

Precede Proceed

Planning framework used to design, implement, and evaluate health programs

Precede = predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation

• social assessment = identify quality of life issues and community concerns

• epidemiological assessment = identify health issues and behaviors contributing to the problem

• behavioral and environmental assessment = identify specific behaviors or environmental factors

• educational and ecological assessment = identify influence factors; predisposing knowledge or beliefs, enabling skills or resources, reinforcing via social support

• administrative and policy assessment = identify resources, policies, and barriers to implementation

Proceed = policy, regulatory, and organizational constructions in educational and environmental development

• implementation = intervention into action

• process evaluation = assess whether the program is being delivered as intended

• impact evaluation = measure immediate effects

• outcome evaluation = measure long term outcomes

social ecological model

How a person’s development and behavior are influenced by multiple layers of their environment

• Individual = knowledge, attitudes, behavior, self-efficacy, gender, etc.

• Interpersonal = formal and informal social networks; family, friends, peers, coworkers, religious networks, customs, traditions

• Community = relationships among organizations, institutions, and informational networks within defined boundaries; parks, businesses

• Organization = organizations or social institutions with rules for operations

• Policy/Enabling Environment = local, state, national, and international laws and policies

Transtheoretical Model or Stages of Change Model

Explains how people change health-related behaviors over time. Behavior change is a process, not a one-time event

• pre-contemplation = doesn’t see a problem

• contemplation = considers change

• preparation = plans to act soon

• action = modifies behavior or environment

• maintenance = sustains new behavior

• relapse = returns to old behavior

Social Cogntiive Theory

Explains how people learn and change behaviors by watching others, thinking about outcomes, and believing in their own abilities

• reciprocal determinism = behavior, personal factors, and the environment all influence each other

• observational learning/modeling = people learn by watching others and seeing the outcomes

• self-efficacy = belief in one’s own ability to succeed in specific tasks

• outcome expectations = beliefs about what will happen if a behavior is performed

• reinforcements = responses to a behavior that affect whether it will happen again

Public Health Principles

• health promotion

• wellness

• community health

• prevention

• occupational justice

Healthy People 2030

Vision = all people can achieve their full potential for health and wellbeing across the lifespan

Mission = to promote, strengthen, and evaluate the nation’s efforts to improve the health and wellbeing of all people

Foundational Principles:

• health and wellbeing of all people and communities are essential

• promoting health and wellbeing and preventing disease are linked efforts that encompass physical, mental, and social health dimensions

• investing to achieve the full potential for health and wellbeing for all provides valuable benefits to society

• achieving health and wellbeing requires eliminating health disparities, achieving health equity, and attaining health literacy

• healthy physical, social, and economic environments strengthen the potential to achieve health and wellbeing

• promoting and achieving the nation’s health and wellbeing is a shared responsibility that’s distributed across the national, state, tribal, and community levels. Including the public, private, and non profit sectors.

• working to attain the full potential for health and wellbeing of the population is a component of decision-making and policy formation across all sectors

Healthy People 2030 Overarching Goals

1. attain healthy, thriving lives and wellbeing free of preventable disease, disability, injury, and premature death

2. eliminate health disparities, achieve health equity, and attain health literacy

3. create social, physical, and economic environments that promote attaining full potential, health, and wellbeing

4. promote healthy development, healthy behaviors, and wellbeing across all life stages

5. engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve health and wellbeing

Healthy People 2030 Plan of Action

1. set national goals and measurable objectives

2. provide data that’s accurate, timely, and accessible

3. foster impact through public and private efforts

4. provide tools for the public, programs, policy makers, and others to evaluate progress toward improving health and wellbeing

5. share and support the implementation of evidence-based programs and policies

6. report biennially on progress throughout the decade from 2020 to 2030

7. stimulate research and innovation toward meeting goals

8. facilitate development and availability of affordable means of health promotion, disease prevention, and treatment

What is population health?

• the health of all people living in a given place

• refers to the differences in health across groups

• product of many causes operating at many levels “from cells to society”

Population Health

provides an opportunity for healthcare systems, agencies, and organizations to work together in order to improve the health outcomes of the communities they serve

public health

works to protect and improve the health of communities through policy recommendations, health education and outreach, and research for disease detection and injury prevention

What is epidemiology?

the study of the distribution frequencies, and determinants of disease, injury, and disability in human populations