Health and Function The ICF Model Amy Houtrow, MD, PhD, MPH

IOM’s definition of children’s health: Develop and realize their potential Satisfy their needs Develop the capacities that allow them to interact successfully with their biological, physical, and social environments

Disability is an umbrella term for impairments at the level of the body part, activity limitations at level of person, and participation restrictions at the level of the person in society Disability is viewed as the outcome of the interaction between health conditions and contextual factors

Body Functions & Structure Activities Participation Health Condition (disorder or disease) Body Functions & Structure Activities Participation Environmental Factors Personal Factors Contextual Factors

ICF Classification The ICF contains two parts to classify and delineate health and health-related states. Functioning and disability with components of body function and structure, activities and participation. Contextual factors, both environmental (external) and personal (internal). http://www.who.int/classifications/icf/

Can versus Do Capacity: ability to do task in a controlled environment Capability: ability to do task in their environment Performance: doing the task in their environment

What you can do What you do do

Capacity/Capability Versus Performance

Framework for Health Care Guidelines Consider the ICF area of the recommendation Consider the impact of the recommendation on “downstream” aspects of functioning Consider facilitators and barriers Improve performance, build capacity and build capacity to improve performance

Questions?