PHN 652 Intervention Wheel Analysis
PHN 652 Intervention Wheel Analysis
The Intervention Wheel is a population-based practice model comprising three levels of practice: individual/family, community, and systems; and 17 public health interventions. Every practice level and intervention plays a part in improving population health. It is a diagrammatic demonstration of population-based public health practice. It illustrates how public health enhances population health via interventions with the individuals, families, and communities and the systems that affect the health of communities (Glavin et al., 2019). The purpose of this paper is to examine the intervention wheel and compare it with another public health model.
Strengths and Weaknesses of the Intervention Wheel
One of the strengths of the intervention wheel is that it does not limit population-based interventions only to people who seek the services or who are poor or vulnerable but focuses on the entire population facing related health concerns or characteristics. Thus, population-based planning using the intervention wheel typically starts with identifying every person in the population at risk or population of interest (Minnesota Department of Health [MDH], 2019). Besides, its population-based approach analyzes all elements that promote or prevent health. The wheel focuses on all the factors influencing health instead of only individual health risks or disease.
Interventions implemented at each of the three levels of practice in the intervention wheel enhance population health status. Therefore, public health professionals establish the most suitable level of practice as per the community’s needs and the availability of efficient measures and resources (MDH, 2019). Besides, the intervention wheel considers no one level of practice to be more important than another. As a matter of fact, population health issues are dealt with at all three levels concurrently. Nevertheless, the intervention wheel has some limitations based on its concepts. This includes emphasizing prevention more than treatment (Schaffer et al., 2022). Although it is a notable concept, treatment should sometimes be a priority for individuals requiring treatment rather than giving them measures to prevent the disease.
Example of When the Intervention Wheel Has Been Used In Public Health
The intervention wheel has been applied by public health nurses (PHNs) in preventing and managing falls in the community in Ireland and Norway. Most falls occur in the community and are a severe public health issue. The interventions applied by the PHNs include screening, health education, case management, case finding, collaboration, consultation, referral and follow-up, delegating functions, counseling, and surveillance (Leahy-Warren et al., 2018). These interventions served as a starting point in examining the range of PHN measures possible with regard to falls prevention and management with older adults.
The intervention wheel provided an understanding of the potential scope of public health nursing in preventing falls and conveying PHN practice in the community. The study demonstrated how the intervention wheel could be applied by PHNs as a model to support a public health approach on falls prevention and management (Leahy-Warren et al., 2018). The application and use of the intervention wheel for falls prevention provided a universal language for practice.
The Health Belief Model
The Health Belief Model (HBM) is one of the public health models typically used in health promotion and disease
prevention. It explains and predicts changes in health behaviors among individuals. Besides, it is commonly used to understand health behaviors in public health practice. The key elements of the HBM center on personal beliefs about diseases, which speculate health-related behaviors among individuals (Wu et al., 2020). HBM explains the primary factors that determine health behaviors as: A person’s perceived threat to a disease or illness (perceived susceptibility); Belief in consequences or the severity of the disease (perceived severity); Belief about the potential positive benefits of action (perceived benefits); Opinion on factors that may prevent one from adopting the new behavior (perceived barriers to action); Factors that prompt behavior change (cues to action); Personal belief in the ability to succeed (self-efficacy) (Houlden et al., 2021).
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Individuals will likely initiate action when they experience a personal threat or risk, but only when the benefits of implementing the action outweigh the actual or perceived barriers. Besides, being able to implement the action is crucial. This means that a person’s course of action will often be based on their perceptions of the benefits and barriers associated with the health behavior (Wu et al., 2020). However, even though the person believes that adopting healthier behaviors will have considerable benefits, they are not likely to modify their current behaviors if they question whether they can overcome the barriers to change.
Similarity between the Intervention Wheel and HBM
The Intervention wheel and HBM models share some similarities in their concepts. Firstly, both models emphasize conducting a needs assessment to identify the health needs of the target population, which guide the interventions that public health professionals should implement. In the intervention wheel model, the public health interventions begin with assessing the population’s health status, which is determined by a community health assessment process (Glavin et al., 2019). The public health professionals analyze health status within populations, including risk factors, problems, assets, and protective factors. In HBM, public health professionals gather information after carrying out health needs assessments to establish individuals at risk and the populations that should be targeted in health promotion and disease prevention programs.
The two models examine factors that promote health among the target population. In the wheel model, public health interventions consider the broad determinants of health and center on the wide range of factors that influence health, including socioeconomic status, race and ethnicity, nutrition, housing, employment and working conditions, culture, and social support networks (MDH, 2019). Similarly, HBM examines the factors that influence behavior change, particularly barriers that hinder behavior change (Houlden et al., 2021). This includes barriers like inadequate financial resources, lack of transportation options, psychological factors, and childcare needs.
Differences between Intervention Wheel and HBM
Despite the similarities, the intervention wheel and HBM models have apparent differences in their concepts. The intervention wheel model is population-based and focuses on entire populations with similar characteristics and health concerns (Schaffer et al., 2022). On the other hand, the HBM is individual-based and focuses on a specific individual’s characteristics and factors that limit or may enable them to change their health behavior (Houlden et al., 2021). When conducting a needs assessment, the intervention wheel model involves a community health assessment to evaluate the health status of populations. Besides, public health agencies assess populations’ health status for public health programs to respond fittingly to the new and emerging problems, concerns, and opportunities in the community (MDH, 2019). On the other hand, the needs assessment in HBM focuses on specific individuals rather than the entire population. It seeks to identify persons at risk of disease and the population that should be focused on.
The wheel model focuses on all three levels of practice individual/family-focused, community-focused, and systems-focused. Thus, interventions are directed at the whole population within a community, the systems that impact the health of those populations, and the individuals and families within the populations identified as at risk (Schaffer et al., 2022). Conversely, HBM is individual-focused and emphasizes changing individuals’ or families’ knowledge, beliefs, attitudes, practices, and behaviors (Houlden et al., 2021). Furthermore, the intervention wheel model has outlined 17 public health interventions, while the HBM has no defined interventions.
The intervention wheel model is a graphic representation of population-based public health practice and comprises three levels of practice and 17 public health nursing interventions. Its interventions are directed toward the entire population facing similar health concerns or characteristics, and it examines all factors that promote or prevent health. The wheel and HBM models are similar since they focus more on primary prevention through behavior change and improving population health. However, the wheel stresses all three levels of practice, while HBM only focuses on the individual/family level.
Glavin, K., Schaffer, M. A., & Kvarme, L. G. (2019). The Public Health Intervention Wheel in Norway. Public Health Nursing. doi:10.1111/phn.12657
Houlden, S., Hodson, J., Veletsianos, G., Reid, D., & Thompson-Wagner, C. (2021). The health belief model: How public health can address the misinformation crisis beyond COVID-19. Public health in practice (Oxford, England), 2, 100151. https://doi.org/10.1016/j.puhip.2021.100151
Leahy-Warren, P., Day, M. R., Philpott, L., Glavin, K., Gjevjon, E. R., Steffenak, A. K. M., … Mulcahy, H. (2018). A falls case summary: Application of the public health nursing intervention wheel. Public Health Nursing, 35(4), 307–316. doi:10.1111/phn.12408
Minnesota Department of Health. (2019). Public health interventions: Applications for public health nursing practice (2nd ed.).
Schaffer, M. A., Strohschein, S., & Glavin, K. (2022). Twenty years with the public health intervention wheel: Evidence for practice. Public health nursing (Boston, Mass.), 39(1), 195–201. https://doi.org/10.1111/phn.12941
Wu, S., Feng, X., & Sun, X. (2020). Development and evaluation of the health belief model scale for exercise. International journal of nursing sciences, 7(Suppl 1), S23–S30. https://doi.org/10.1016/j.ijnss.2020.07.006