ects of the traditional individual-level OT intervention may include for health promotion activities, but there exists a significant possibility for the profession to broaden the scope of impact by directly influencing public health needs via the family, community, and societal levels (Scaffa, Reitz, & Pizzi, 2010).
In implementing population health strategies with the goal of reducing the incidence of any condition, Scaffa, Reitz and Pizzi (2010) articulate that this is to be achieved through the combination of two primary strategies: early detection and prevention. Additional strategies to impact population health include health services, health promotion, and health protection. The combination of these critical strategies represents the most comprehensive approach to effectively achieving community and population health outcomes. Table 2 elaborates on the definitions of these key terms.
Actions and interventions designed to identify risks, and reduce susceptibility or exposure to health threats prior to disease onset (primary prevention), detect and treat disease in early stages to prevent progress or recurrence (secondary prevention), and alleviate the effects of disease and injury (tertiary prevention).
Interventions typically provided by health-care medical professionals after symptoms are present or diagnosis is evident.
Interventions directed at lifestyle and involve any planned combination of educational, political, regulatory, environmental, and organization supports for actions and conditions of living conducive to the health of individuals, groups, or communities.
Any planned intervention or services designed to provide individuals and communities with resistance to health threats, often by modifying policy or the environment to decrease potentially harmful interactions.
(Scaffa, Reitz, & Pizzi, 2010)
Applying these strategies to positively impact the public health concern of postpartum depression requires the creation of effective community health promotion programs which integrate interventions that span educational, social, and environmental domains (Scaffa, Reitz, & Pizzi, 2010). Scaffa and colleagues (2010) articulate that effective use of occupational therapy models directed at community health outcomes requires careful consideration of intrinsic (person-specific) and extrinsic (environmental specific) factors that impact perceptions of wellbeing and quality of life. The authors reference Baum, Bass-Haugen, and Chrostiansen’s (2005) use of the term situational analysis which is defined as “a process that involves the collection of information and the analysis of factors intrinsic and extrinsic to the individual, the organization or the population to determine the occupational performance issues that will impact the ability to reach client-centered goals” (p. 372; as quoted by Scaffa, Reitz, & Pizzi, 2010, p. 216).
Table 3 represents the authors’ recommended components of a situational analysis for the purpose of designing community-health interventions, and how those apply to the goal of impacting the incidence of postpartum depression (Baum et al., 2005; as quoted by Scaffa, Reitz, & Pizzi, 2010, p. 216).
Situational Analysis Component and the Application to
Postpartum Depression (PPD):
A general description of the population, including health behaviors, disease, injury, and disability incidence and prevalence statistics.
Impacts postpartum women within one year of giving birth
Prevalent in 1:7 women nationally, how does this compare to community prevalence?
Implied adverse mental health outcomes for the childbearing woman
Positive correlates to adverse impact on neonatal/child development
An environmental scan to identify environmental enablers and barriers.
What percentage of the childbearing population has access to healthcare coverage? How is it being utilized?
What percentage of OBGYN or pediatric clinics are actively screening for PPD?
What is their correlated rate of referral for mental health services?
What programs exist in the community to support maternal role transitions?
What community bas