Theoretical Frameworks for Community-Based Practice

Model of Human Occupation (MOHO)

• explains how the human system selects and performs occupations

  • influenced through continual interaction with the environment, as well as the dynamic and reciprocal interaction between the environment and the three other elements of the model…. volition, habituation, and performance capacity

What is performance capacity?

the interplay of physical, physiological, and cognitive capacities, observable and objectively measured with client’s subjectice experiences and perspectives

What is habituation?

internalized, consistent patterns of behaviors; sense of order and predictability

What is volition?

describes what motivates an individual, community, or population to engage in behaviors

MOHO constructs: how a system changes…

• trajectory of change: the self-transformation of the system over time

• adaptive cycle: supports the individual in satisfying internal demands as well as the demands of the environment

• maladaptive cycle: not meeting one or both of the interntal or environmental demands

Transactional Perspective of Occupation (TPO)

Occupations are part of the transaction of persons and environments; relationships not just an individual

Concepts:

• problematic situations

• functional coordination

• creativity

• growth

TPO for community practice:

Community occupation influenced by…

• history

• sociocultural context

• various stakeholders

• physical setting

• goals and visions for the future

• community norms and values

Occupational ecosustainable community development approach

restore balance with the natural environment

Occupation justice approach

people are occupational in nature engagement is critical to well-being; people have a right to occupational engagement and participation in their environments of choice

Occupation-focused prevention of illness and disability approach

occupation as a contributing factor to illness and recovery

Occupation-focused health promotion approach

health education and preventive medicine and emphasizes achieving well-being

Health Belief Model

• Perceived susceptibility: person’s subjective impression of the risk of a disease, illness, trauma, or negative health experience/health condition

• Perceived severity: convictions a person holds regarding the degree of seriousness of a given health problem

• Perceived benefits: beliefs a person has regarding the availability and effectiveness of a variety of possible actions in reducing the threat of an illness, trauma, or negative health experience/condition

• Perceived barriers: costs or negative aspects associated with engaging in a specific health or preventative behavior

• Cues to action: instigating events that stimulate the intitiation of a behavior

Transtheoretical Model of Health Behavior Change

The stages of behavior change:

Precontemplation: build awareness for my need to change

Contemplation: increase my pros for change and decrease my cons

Preparation: commit and plan

Action: implement and revise my plan

Maintenance: integrate change into my lifestyle

Precede-Proceed Planning Model

Phases:

1. social assessment

2. epidemiological assessment

3. behavioral and environmental assessment

4. educational and ecological assessment

5. administrative and policy assessment

6. implementation

7. process evaluation

8. impact evaluation

9. outcome evaluation

Diffusions of Innovations Model

How to most effectively communicate the availability of the intervention (i.e. diffusion) and the adoption of new behaviors (i.e. innovation)

• Relative advantage, compatibility, complexity, triability, observability

Laggards, late majority, early majority, early adopters, innovators

Ex. think stanleys or owalas