hesc 400 ch2
TRANSCRIPT
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Models for Program Planningin Health Promotion
PRECEDE-PROCEEDOther Models
Models provide structure &organization for the planning process
Many different models
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Common elements, but differentlabels
Must understand the Generalized
Model for Program Planning
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AssessingNeeds
e ngGoalsandObjectives
Deve op ngan
Intervention
Implementingthe
Intervention
the
Results
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No perfect model
Can be used in entirety, parts,
combinations
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Three Fs of program planning help usselect an appropriate model:
Fluidity - steps are sequential
Flexibility - adapt to needs of stakeholders
Functionality - useful in improving healthconditions
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PRECEDE predisposing, reinforcing, and enabling
The PRECEDE-PROCEED Planning Model is the mostwidely used planning model, and has been used for
MANY problems, populations, locations.
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constructs in educational/ecological diagnosis &evaluation(Green & Kreuter, 2005, p. 9)
Developed in the early 1970s
PROCEED policy, regulatory, and organizationalconstructs in educational & environmentaldevelopment(Green & Kreuter, 2005, p. 9)
Developed in the 1980s
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Created by:Lawrence W. Green &Marshall W. Kreuter
Best known, most oftenused model
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Theoretically grounded
Comprehensive
Found in manygovernment programs,eg, PATCH
PRECEDE
First 4 phases: Assessment
1) social assessment2) epidemiological, behavioral, environmental assessment3) educational & ecological assessment
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PROCEED
Last 4 phases: Implementation and Evaluation
5) implementation
6) process evaluation
7) impact evaluation
8) outcome evaluation
Underlying approach:
Begin by identifying the desired outcome
THEN determine what causes it
THEN design an intervention to reach the desired
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DO NOT START WITH:
Health problem
Desired program
DO START WITH:
Desired quality of life outcome
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Phase 1: Subjectively define QOL of thepriority population
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assessment of needs & aspirations
Assessment:Identify (list)Describe (explain)
Prioritize (rank)
ProblemsProblems
andand
PrioritiesPriorities
What are some examples of socialindicators of QOL?
Achievement
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Alienation
Comfort
Crime
Happiness
Self-esteem
Unemployment
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Phase 2: Use data to identify & rank health issuesthat contribute to problems identified in Phase 1
Data include:Vital Indicators
E morbidit mortalit & disabilit data
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. ., , ,
GeneticRelationship between genes and health and behavior
BehavioralRisky behaviors
Environmental
Things outside person that can be changed to impact health
Rank:
2 X 2 matrix
MoreImportant
LessImportant
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oreChangeable
LessChangeable
Phase 3: Identifies factors that have potential toinfluence behavior or change the environment
1. Predisposing factors
Antecedent; impact motivation
Eg: knowledge, attitudes, beliefs, perceptions, values
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2. Enabling factors
Antecedent; barriers & facilitators
Eg: skills, access, availability, rules, laws
3. Reinforcing factors
Subsequent; +/- feedback
Eg: social benefits like recognition, appreciation;incentives; disincentives
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Phase 4: Intervention Alignment
Matches appropriate strategies & interventions
with projected changes and outcomes
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Phase 4: Administration & Policy Assessment
Determine if capabilities & resources areavailable
Transition to PROCEED
Moving toward PROCEED, but not distinct break
Phase 5: Have resources, selectintervention
Strategies:
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Communication
Environmental change
Beginning of PROCEED
Program begins
Phase 6: Process EvaluationMeasurements of implementation to control,assure, or improve the quality of the program
Phase 7: Impact evaluationImmediate observable effects of ro ram
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Phase 8: Outcome evaluationLong-term effects of the program
Line up with PRECEDE
Depends on evaluation requirements ofprogram
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There are many other models besidesPRECEDE-PROCEED
MATCH (Multilevel Approach to CommunityHealth)
Developed in late 1980s
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. .
Applied when behavioral & environmental risk& protective factors for disease / injury areknown & general priorities determined
Includes ecological planning: levels ofinfluence
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Phase 1 Health Goals Section
Select goals - consider prevalence, importance,changeability
Select target population
Identify behaviors associated with health status
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Identify environmental factors (barriers & facilitators)
Phase 2 - Intervention Planning
Select intervention objectives
Identify targets of intervention (TIAs)
Select intervention approaches (ecological levels):governments, organizations, communities, individuals
Phase 3 DevelopmentCreate program units or componentsCreate plans
Phase 4 ImplementationAdoption
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ImplementationMaintenance
Phase 5 EvaluationConduct process evaluationMeasure impact
Monitor outcome
Decisions based on consumer input andinterests
Based on concepts from:Health Communication strategies to
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decisions (NCI, 2002)
Social Marketing application of commercialmarketing technologies to the analysis, planning,execution, and evaluation of programs designed toinfluence the voluntary behavior of target[priority] audiences in order to improve theirpersonal welfare and that of their society(Andreasen, 1995, p. 7)
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Developed by the Office ofCommunication at CDC in 1997
First issued in 1998
Developed for CDC public health
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health communication
Now available to public
Developed for healthcommunication, but can be used
with all health promotion planningAvailable on CD-ROM
P 2: Analyze
Problem (causes,
P 3: Plan Intervention(Is communicationdominant orsupportive?)
P 4: Develop
Intervention
P 5: Plan
Evaluation
P 6:
Implement
Plan
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P 1: Describe
Problem
(identify &
define)
,
strategies
There is also a supplemental resources CD for CDCynergy 3.0
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Plans to make CDCynergy web-based
Several versions & more to come
http://www.cdc.gov/communication/cdcynergy.htm
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SMART (Social Marketing Assessment &Response Tool)
Social marketing planning framework created byNeiger & Thackeray (1998)
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Provides an excellent overview of social marketing
Seven phases
Heart of the model is Phases 2, 3, & 4; usually
performed simultaneously
P 1: PreliminaryPlanning [problem, name in terms of
behavior, develop goals, project costs]
P 2:
Consumer Analysis [segmentpriority population, determine
P 3:
Market Analysis
P 4:Channel Analysis
[interpersonal, small group,
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needs, wants, & preferences]; alsosecondary & tertiary audiences
[4Ps, competitors,& partners]
organizational, community,mass media]
P 5: Developing Interventions, Materials, & Pretesting
P 6: Implementation
P 7: Evaluation
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Healthy People 2010
(A systematicA roach to Health
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Promotion)
Components:Goals
Objectives
Determinants of health
Health status
MAPP (Mobilizing for Action through Planning& Partnerships)
Relatively new; created by NACCHO for use bylocal public health agencies
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Phases:Organizing for Success & Partnership Development
Visioning
Four MAPP Assessments
Identify Strategic Issues
Formulate Goals & StrategiesThe Action Cycle (Implement & Evaluate)
MAPP:
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APEX-PH (Assessment Protocol for Excellencein Public Health)
Components: Organizational capacity, CommunityProcess, Completing the Cycle
Developed by NACCHO for local health depts.
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PACE-EH (Protocol for Assessing CommunityExcellence in Environmental Health)
SWOT Analysis (Strengths, Weaknesses,Opportunities, Threats)
Minimizes planning time
S W
O
T
The Communication Model
NCI, 2002
Healthy Communities
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(Healthy Cities) (USDHHS)
Components: MobilizeAssess Plan for Action Implement Track Progress & Outcomes
Healthy Plan-IT (CDC)
Components:
Priority Setting
Establishin Goals
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Outcome Objectives
Strategy
Evaluation
Budget
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Intervention Mapping
Relatively new 1998
Plans programs that are based on theory &evidence
Draws on PRECEDEPROCEED and MATCH
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models
Steps:1) Needs assessment2) Matrices of Change Objectives
3) Theory-based methods and practical strategies4) Program5) Adoption and Implementation6) Evaluation Planning
Comprehensive Health Education Model (Sullivan, 1973)
Model for Health Education Planning (Ross & Mico, 1980)
Model for Health Education Planning & ResourceDevelopment (Bates & Winder, 1984)
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Planned Approach to Community Health (CDC, nd)
Generic Health/Fitness Delivery System (Patton et al.,1986)
The Planning, Program Development, and Evaluation
Model (Timmreck, 2003)
LOTS of models!
All based on same generalized model
PRECEDE-PROCEDE most commonCan mix and match
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Which models are especially good for:Communication?
Social Marketing?
Partnerships?
Environment issues?
Multiple levels?