THE FRAMEWORK

Allows codification of complex information, over 1400 codes Bio-psycho-social view of the determinants of health Health status in terms of Functionality (d.codes-”Activities - Participation”) Biomedical condition as Capacity (b and s codes-”Body Functions – Structures”) Context as barriers or facilitators for Performance (e codes- “Environmental Factors”)

ICF model: not helpful to guide enquiry and action, a “change model” is needed

Proposed modification of causal relationships Environmental Factors (e codes) Social PERFORMANCE? Participation (d codes) Activities Overlap FUNCTIONING? CAPACITY? Individual Body Functions and Structures (b and s codes)

Proposed unit of analysis: “Activity Setting” (O’Donnell) Components of an activity setting Joint productive activity Cultural values and group goals Scripts for conduct and self-expression Tasks/behavior/experience outcomes Motives that persons have Inter-subjectivity Persons

Activity Settings allowed us to use people’s stories of events as INPUTS: Cultural values and group goals Where? When? Scripts for conduct and self-expression (norms) How? Why? What? Tasks/behavior/experience Motives that persons have Persons

And social and individual change as OUTPUTS: Societal patterns of production and consumption Current activity setting Cultural values and group goals Scripts for conduct and self-expression (norms) Joint productive activity New activity setting Tasks/behavior/experience Inter-subjectivity Motives that persons have Persons Individual pathways of embodiment (Krieger) Time

MAPPING TO THE ICF CODES Outcomes of Activity Settings……..to ICF Functionality e. Environmental Factors Culture/values PERFORMANCE Scripts for conduct FUNCTIONALITY ? d. Activities and Participation JOINT PRODUCTIVE ACTIVITY/ INTERSUBJECTIVITY? CAPACITY Motives of participants b. Body Functions and Structures Persons

BY MODIFIYNG THE ICF FRAMEWORK, A dynamic ecological model is proposed Convergence on multidisciplinary ideas is achieved The core of relations in the model is intuitively accessible to diverse populations