Which of the following is considered a downstream intervention in the patient care delivery model?

• A. Providing gait training for a patient who has suffered a stroke.
• B. Screening for fall risk
• C. Coordinating a patient’s care
• D. Implementing a community-based health promotion campaign

Answer: (A)

Downstream interventions are actions taken after a health problem has occurred to treat it and restore function. Gait training for a patient who has suffered a stroke fits this because it is rehabilitation aimed at improving walking ability after the event, directly addressing the functional deficit left by the stroke. It focuses on restoring capability rather than preventing the problem in the first place. In contrast, screening for fall risk aims to identify risk factors before a problem happens, which is preventive (upstream). Coordinating a patient’s care is about organizing services across the care continuum, not a direct rehabilitation treatment. Implementing a community-based health promotion campaign targets population-level prevention and health promotion, another upstream activity.