The model depicts a population-based approach to public health nursing.

Smiling nurse at workstation

The circle, composed of colorful wedges, is reminiscent of a board game spinner. But this circle is no toy. It’s the Minnesota Intervention Wheel, a tool that illustrates what public health nurses do to improve health outcomes.

“The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health,” Linda Keller, Susan Strohschein, Betty Lia-Hoagberg, and Marjorie Schaffer explain in an article for Public Health Nursing.1

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The Minnesota Department of Health (MDH) introduced the color-coded graphic illustration, once known as the Public Health Intervention Model, in 1998.1 Today, you may hear it called the Intervention Wheel, or simply, the Wheel.

“In these times of change, the public health system is constantly challenged to keep focused on the health of populations. The Intervention Wheel is a conceptual framework that has proven to be a useful model in defining population-based practice and explaining how it contributes to improving population health,” Keller, Strohschein, and Laurel Briske write in the chapter “Population-Based Public Health Nursing Practice: The Intervention Wheel” in Public Health Nursing: Population Centered Health Care in the Community.2

Here’s a closer look at its three key elements:

It’s Population-Based

“Population-based public health practice focuses on entire populations that possess similar health concerns or characteristics,” Keller, Strohschein, Lia-Hoagberg, and Schaffer explain. “This includes everyone in a population who is actually or potentially affected by a health concern. … For example, a population of adolescents includes all adolescents in the community, not just those who are referred to a health department.”1

There Are Three Levels of Practice

Three concentric circles inside the wheel name the levels of practice. They are identified, from the outer ring to the inner ring: Systems-focused, community-focused, and individual-focused. Public Health Interventions: Applications for Public Health Nursing Practice, featured on the MDH website, explains the levels:3

  • Systems-focused: Changes organizations, policies, laws, and power structures. The focus is not directly on individuals and communities but on the systems that impact health. Changing systems often impacts population health in a more effective and lasting way than requiring change from every individual in a community.
  • Community-focused: Changes community norms, attitudes, awareness, practices, and behaviors. This practice level is directed at entire populations within the community or occasionally toward target groups within those populations. Community-focused practice is measured in terms of what proportion of the population actually changes.
  • Individual/family-focused: Changes knowledge, attitudes, beliefs, practices, and behaviors of individuals and families. This practice level is directed at individuals, alone or as part of a family, class, or group. Individuals receive services because they are identified as belonging to a population at risk.

Interventions Are Actions

The interventions comprising the wheel’s outer ring are grouped by color. Keller, Strohschein, and Briske explain the color groupings:2

  • Red: The five interventions in the red wedge are frequently implemented in conjunction with one another. Surveillance is often paired with disease and health event investigation, even though either can be implemented independently. Screening frequently follows either surveillance or disease and health event investigation and is often preceded by outreach activities in order to maximize the number of those at risk who actually get screened. Most often, screening leads to case finding, but this intervention can also be carried out independently.
  • Green: The green wedge consists of referral and follow-up, case management, and delegated functions—three interventions that, in practice, are often implemented together.
  • Blue: Similarly, health teaching, counseling, and consultation—the blue wedge—are more similar than they are different; health teaching and counseling are especially often paired.
  • Orange: The interventions in the orange wedge—collaboration, coalition building, and community organizing—while distinct, are grouped together because they are all types of collective action and are most often carried out at systems or community levels of practice.
  • Yellow: Similarly, advocacy, social marketing, and policy development and enforcement—the yellow wedge—are often interrelated when implemented. In fact, advocacy is often viewed as a precursor to policy development; social marketing is seen by some as a method of carrying out advocacy.

Choosing a Public Health Career

“The Intervention Wheel answers the question, ‘What do public health nurses do?’ and delineates public health nursing as a specialty practice of nursing,” the MDH says.4 If this specialty practice appeals to you, then a Master of Science in Nursing (MSN) degree with a Public Health Nursing specialization can prepare you for this rewarding work.

Online nursing schools let you earn a degree while still engaged in your nursing career. Walden University’s MSN program with a Public Health Nursing specialization, one of a few of its kind offered fully online, allows you to collaborate with nurses from around the United States in an interactive online environment. You’ll learn from expert teaching faculty, 100% of whom hold doctoral degrees. You’ll translate knowledge into practice by designing, developing, and implementing a public health project in a professional healthcare setting. Throughout this immersive experience, you’ll gain knowledge you need to lead change in the healthcare environment of your choosing.

Let Walden’s life-changing online MSN program help you become a public health professional who inspires others while making communities healthier.

Walden University is an accredited institution offering a Master of Science in Nursing (MSN) degree program with a Public Health Nursing specialization. Expand your career options and earn a degree online in a convenient, flexible format that fits your busy life.

1Source: https://sites.up.edu/wp-content/uploads/sites/131/2013/03/Keller-et-al.-Part-I.pdf
2Source: https://pdfs.semanticscholar.org/14eb/808ffbe7382fa698bfa88f30da2c7477e728.pdf
3Source: www.health.state.mn.us/communities/practice/research/phncouncil/docs/PHInterventionsHandout.pdf
4Source: www.health.state.mn.us/communities/practice/research/phncouncil/wheel.html

Walden University is accredited by The Higher Learning Commission, www.hlcommission.org.

The MSN nurse practitioner specializations are designed to prepare graduates to qualify to sit for national nurse practitioner certification exams and to prepare graduates who possess an active registered nurse (RN) license to practice as nurse practitioners. However, each state Board of Nursing has its own academic and certification requirements and issues its own credential for an RN to be permitted to practice as a nurse practitioner in that state. Walden enrollment advisors can provide information relating to national certification exams and guidance relating to the state-by-state requirements for practice as a nurse practitioner; however, it remains the individual’s responsibility to understand, evaluate, and comply with all requirements relating to national certification exams for the state in which he or she intends to practice as requirements vary widely. Walden makes no representations or guarantee that completion of Walden coursework or programs will permit an individual to obtain national certification or to obtain state licensure, authorization, endorsement, or other state credential.

Walden University is accredited by The Higher Learning Commission, www.hlcommission.org.

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