Conceptual models for population-focused public health nursing interventions and outcomes: the state of the art.

The conceptual basis of public health nursing (PHN) has evolved particularly over the past three decades. In October 2010, a national research agenda setting conference was held with grant support from the Agency for Healthcare Research and Quality. From the conference, public health nursing intervention models emerged as one of four top priorities. The need for a stronger theoretic base that can guide population-focused nursing practice and research was strongly emphasized. The purpose of this review, in concert with this priority, is to analyze the current status of PHN conceptual models. Based on the review, a set of recommendations is presented related to future conceptual development and testing, with an emphasis on PHN interventions and outcomes. A key recommendation is the refinement of the existing conceptual models with perhaps some consolidation of models, thereby establishing strong grand, middle-range and practice theories that include explicit PHN intervention and outcome components. Another recommendation calls for rigorous comparative analysis and testing. Professional support from the PHN community along with funding agencies will be needed to implement the recommendations related to PHN theory development and testing.