STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based


What are its bases?

This model (approach) is based on the conceptual framework of Public Health, and it incorporates social and community processes that can encourage individuals and the population to take control over the variables and policies that affect their health. This model (approach), adopted by the World Health Organization, considers that the lifestyles of the various population groups can improve if the appropriate conditions are created or encouraged to give people more control over the factors that influence and affect their health. From the individual perspective, Health Promotion is a process that enables people to develop the skills required to take more control over their health. From the community perspective, it advocates the creation of health-promoting environments.

This model (approach) defines five priority areas of action: 1) To establish and promote healthy public policy, addressing the factors that affect the health of the general population. 2) To create environments that facilitate and promote health, by political action and modification of the basic causes of poor health and disability. This involves combining legislative, informative and educational measures, and measures to improve the physical and environmental setting. 3) To strengthen community action so that the community itself can move towards achieving optimal levels of health. 4) To promote personal skills to adopt healthy lifestyles, through information, awareness and education in life skills and decision-making. 5) To reorientate health services based on the needs in each region.

Which determinants can be addressed?

Personal and contextual: personal determinants refer to cognitive factors, such as knowledge, beliefs, attitudes, values and life skills. Contextual determinants are aimed at increasing the availability and accessibility of health-related resources and creating healthier societies, for example, with regulations on substance use, limiting their accessibility, and even empowering communities in health management.

Practical implications

This model (approach) suggests that complex problems, such as those related to drug use, cannot be overcome with simplistic measures, but that each of the factors associated with problems must be addressed with a multidimensional, multisectoral and multidisciplinary approach, which requires participation and coordination between public administrations and social agents representing organised civil society.



Ottawa Charter (1986). World Health Organization.

Green LW et al. (1986). What changes can health promotion achieve and how long do these changes last? The tradeoffs between expediency and durability. Preventive Medicine. 15:508-21

Kickbusch I. (2003). Models for population health. The contribution of the World Health Organization to a New Public Health and Health promotion. American Journal of Public Health., 93(3):383-388.

WHO (1996). The School Health Working Group. The WHO Expert Committee on Comprehensive School Health Education and Promotion. Research to Improve Implementation and Effectiveness of School Health Programmes. Geneva: World Health Organization.