|
Precaution Adaption Processes Model (PAPM)
|
-Dichotomous model, practical for decision-making
|
-“Decision not to treat” may be viewed as unacceptable
|
|
-Incorporates a distinct unawareness stage (versus unaware OR unengaged) with opportunity for education
|
-Emphasis on reading materials/pamphlets may need to be locally modified to literacy rates
|
|
-Challenge of measuring family’s exact stage of placement
|
|
Transtheoretical Model (TTM)
|
-Removes assumptions about immediate readiness for behavior
|
-Danger of evolving into a self-help model without adequate support for change when the external forces of poverty and conflicting priorities are the reason for delay
|
|
-Recognizes different families will be in different stages
|
|
-Encourages inclusive, appropriately timed motivational readiness interventions
|
-Does not always recognize broader social and physical context
|
|
-May unintentionally imply blame on a family, whereas much of the impetus is a fractured system of care delivery
|
|
-Supports families between decisional stages toward acceptance
|
|
-Common phrases such as “self” efficacy and “self” realization may not be relevant in settings where health behaviors and outcomes are communally based
|
|
Decision to not utilize stage- based model
|
-Potentially streamlined decision-making
|
-Population characteristics, needs, and values may be overlooked when community engagement is not prioritized (available and accessible does not equal acceptable, appropriate, or equitable)
|
|
-Time and resources centralized to making treatment available and accessible
|
|
-With limited funding sources, focuses resources on specific, measurable biological outcomes such as diagnostic accuracy and disease response
|
|
-Risk imposition of an external “evidence based approach” which is not taking local evidence and local experience into consideration to facilitate service or intervention adoption and sustainability
|
| | |
-Risk suboptimal allocation and mis-prioritization of resources toward well-intentioned empiric efforts that are however poorly aligned with target populations’ current stages of readiness for change
|
