Optimal Health

The Optimal Health Model

The mission of the Office of Population Affairs (OPA) is to promote health across the reproductive lifespan through innovative, evidence-based adolescent health and family planning programs, services, strategic partnerships, evaluation, and research. A fundamental aspect of achieving this mission involves the integration of the concept of optimal health into OPA projects and initiatives.

What is optimal health?

Optimal health is a dynamic balance of physical, emotional, social, spiritual, and intellectual health…Lifestyle change can be facilitated through a combination of learning experiences that enhance awareness, increase motivation, and build skills and, most important, through the creation of opportunities that open access to environments that make positive health practices the easiest choice. 1

Optimal Health Model

The optimal health model prioritizes prevention through policies following these steps:

  • Identify the health concern.
  • Identify the risk factors that influence that health concern.
  • Respond with an intervention that promotes the best possible health outcome for the population.
  • Encourage individuals to make appropriate changes that will lead them towards a position of increasingly lower risk.

The model is adaptable to a range of risk behaviors and diseases, and measures success by the degree of movement away from risk. This aspirational public health model can help transform the health conversation and promote optimal health for all.

Action Steps for Optimal Health

Optimal health is a holistic focus with the aim of attaining the best possible health outcomes by promoting healthier behaviors and not merely the absence of disease:

  • State the population message of primary prevention/risk avoidance.
  • Adopt the optimal health framework as an intentional lens for individualizing care for every person, regardless of current health status.
  • Look for ways to promote the balance of physical, emotional, social, spiritual, and intellectual health.
  • Focus on inspiring individuals towards optimal health with changes that are specific to their individual situation, but always measuring success by the degree of movement away from risk.
  • Highlight the importance of cultivating healthy relationships.
  • Recognize the important role of parents/supportive adults, values, and traditions to influence adolescents’ decisions.

How do we apply an optimal health model approach to high risk behaviors?

We talk about population health as applying universal strategies to prevent illness and/or behaviors before they are initiated. Public health strategies typically fall into three categories: primary prevention or risk avoidance, secondary intervention or risk reduction, and treatment.  Avoiding risk is optimal or preferred to reducing risk, and primary prevention can lead to health outcomes that are generally improved when behavioral risks are avoided. Public health advocates should encourage the development of the skills necessary to make healthy choices and avoid risky behaviors, or if currently engaged in those behaviors, to change the behaviors and avoid them in the future.  These healthy choices help move them towards optimal health across the reproductive lifespan. In general, and for any health topic, the aspirational aim would be to catalyze movement as much as possible from high risk to low risk to no risk, while providing reinforcement to those at no risk to maintain that status.

Optimal Sexual Health

The most reliable way to avoid sexual risk is to delay the onset of sexual activity and to be in a long-term, mutually monogamous relationship with an uninfected partner.2 The population approach to sexual health should be a risk avoidance message. Optimal sexual health messages should be family-and community-centered, age appropriate, and culturally informed. The messages should be provided in a context that increases opportunities for individuals to thrive and empowers them to avoid sexual risk.  While optimal physical health remains a primary focus, it is important for all public health models to promote the balance of physical, emotional, social, spiritual, and intellectual health.

An Individual Approach

The optimal health model is a public health population approach, but it also provides a meaningful lens for adaptation as a highly individualized element of individual-centered care. Those who are not yet sexually active can be encouraged to delay the onset of sexual activity. Additionally, those who have been sexually active can be encouraged not to immediately engage in sexual activity when starting a new romantic relationship. Those who are sexually experienced can reduce their risk by decreasing their number of lifetime sexual partners and by choosing both consistent and correct condom use as well as an acceptable and effective family planning method. Making risk-free choices in the future is always the aspirational goal. The practical application sensitizes healthcare providers and others to identify each individual’s forward path towards better health, even if it is not possible for them to attain a risk-free status. In this way, the optimal health model aims to move each individual progressively in a healthier direction.

Regardless of an individual’s current state of health, the goal of the optimal health model is to encourage behaviors that lead to a healthier life.

Introducing the Optimal Health Model - PDF (434 KB) [download this print-friendly version]

An Introduction to the Optimal Health Model for Family Planning Clinicians

Listen to a podcast describing the optimal health model in the context of family planning for reducing risks in both achieving and preventing pregnancy.

Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century

At the request of the HHS Office of the Assistant Secretary, the National Academies of Sciences, Engineering, and Medicine convened an ad hoc Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth. The committee reviewed key questions related to the effective implementation of the Teen Pregnancy Prevention (TPP) program using an optimal health lens. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century - PDF (1.6 MB) presents an examination of the optimal health framework to (1) identify core components of risk behavior prevention programs that can be used to improve a variety of adolescent health outcomes, and (2) develop evidence-based recommendations for research and the effective implementation of federal programming initiatives focused on adolescent health.

Learn about Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth, a study to identify key components of youth-serving programs that have proved successful in improving health outcomes related to adolescent behavior.

Formative Evaluation Project to Promote Optimal Health In Youth

During Fall 2019, the Office of the Assistant Secretary for Health sponsored a formative evaluation project of programs to promote optimal health in youth. These four papers present lessons learned resulting from this project, and are intended to inform the fields of youth development and teen pregnancy prevention.

  • Difficult Community Conversations discusses situations that a community-based organization may encounter when undertaking an independent program evaluation, and provides practical tips for having conversations with partners that are learning about program evaluation.
  • Program Documentation and Checklists provides a concise description of “What to Track and Why” during internal and independent program evaluations.
  • RACI Diagram Tool provides details on how to keep project staff and stakeholders Responsible, Accountable, Consulted, and Informed.
  • Warm Handoff describes the importance of streamlining interactions between stakeholders during program evaluation.

1 O’Donnell, M. P. (2009). Definition of Health Promotion 2.0: Embracing Passion, Enhancing Motivation, Recognizing Dynamic Balance, and Creating Opportunities. American Journal of Health Promotion, 24(1), iv-iv. doi:10.4278/ajhp.24.1.iv