4. At the end of this session; you able to:
- Define group and team
- List types of groups
- Define and discuss concept of group dynamics
- Importance of working in team
- List and describe stage of team development
- List and describe factors affecting group effectiveness
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5. Definition of group
A group is a collection of two or more people with common
interests or objectives.
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7. Formal groups
A well organized kind of
group
Characterized by:
Has purpose or goal
A set of membership
Recognized leaders
Have rules
Sense of belongingness
Longer activities
7
Informal groups
Not well organized
Characterized by:
No special purpose or goal
No special membership
No special leader within
the group
No special rule apply
Short term
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8. Group Team
Members work
independently
Members work
interdependently and work
towards both personal and team
goal
Members are not involved in the
planning of their group's
objectives (no buy-in, inward
focus
Members feel a sense of ownership
towards
their role because they committed
themselves to goals they helped create.
Members are given their tasks Members collaborate together and use
their talent and experience to achieve
goal
Members are very cautious about what
they say and are afraid to ask
questions. They may not fully
understand what is taking place in
their group
Open communication. Diverse
perspective are welcome
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9. Members may have a lot to contribute
but may not contribute ideas due to lack
of personal reward or negative
relationship with other members
Members are encouraged to offer their
skills and knowledge, and in turn each
member will contribute to team success.
Individual success ensured by team
success
Members are bothered by differing opinions
or disagreements because they consider it a
threat. No process for conflict resolution.
Members see conflict as a part of
creative problem solving.
Everybody wants to resolve problems
constructively.
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10. Groups/teams are needed to:
Learn more fully and with less effort
High motivation when actively involved
Learn in context
Pool the resource
Enhance performance
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12. A. Group size
Small group(Up to 12 members):
Advantage
Interact more with each other and easier to coordinate their efforts
More motivated, satisfied, and committed
Easier to share information
Better able to see the importance of their personal contributions
Disadvantage: Decreased perspectives and diminished creativity
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13. Large groups (More than 30 members).
◦ Advantage
More resources at their disposal to achieve group goals
Enables to obtain division of work
◦ Disadvantage
Problem of communication and coordination
Low level of motivation
Members might not think their efforts are really needed
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15. B. Norms
Group norms take time to develop, but are typically well understood by
group members.
They provide benchmarks by which group members evaluate one another.
E.g. Attendance policies, dress codes, and ethical standards are examples of
behavioral norms.
Leader should encourage members to develop norms that
contribute to group performance
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16. 16
Basic Group Concepts
Acceptable Standards
of Behavior Shared
by the Members
of a Group
Expected Patterns of
Behavior Based on a
Given Position in a
Social Unit
Group Roles Group Norms
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17. There are group-building and maintenance roles
The set of behaviors and tasks that a group member is expected to perform because
of his or her position in the group.
Group building roles- which contribute to building relationships and
cohesiveness among the membership ( psyche dimension).
E.g. Encourager, mediating ( harmonizing), standard setter, Following-going alone
with the group, Gate keeping
Group task roles- which help the group to do its work (the socio dimension).
E.g. initiator, contributor (supplier), information seeker and giver, elaborator…
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18. Encouraging-being friendly, warm, responsive to others, praising
others and their ideas, agreeing with and accepting the contribution of
others.
Mediating-harmonizing, conciliating difference in points of view,
making compromises
Gate keeping-trying to make it possible for another member to make
a contribution by saying, “We haven’t heard from Alemu yet,” or
suggesting limited talking time for everyone so that all will have a
chance to be heard.
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19. Standard setting-expressing standards for the group to
use in choosing its subject matter or procedures, rules of
conduct, ethical values.
Following-going alone with the group, somewhat
passively accepting the ideas of others, serving as an audience
during group discussion, being a good listener.
Relieving tension-draining off negative feeling by
jesting or throwing oil on troubled water, diverting attention
from unpleasant to pleasant matters.
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20. Initiating-suggesting new ideas or a changed way of looking at group
problem or goal, proposing new activities.
Information seeking-asking for relevant facts or authoritative
information.
Information giving-providing relevant facts or authoritative information
or relating personal experience pertinently to the group task.
Opinion giving-stating a pertinent belief or opinion about something the
group is considering.
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21. Clarifying-probing for meaning and understanding, restating
something the group is considering.
Elaborating-building on a previous comment, enlarging on it,
giving examples.
Co-coordinating-showing or clarifying the relationships among
various ideas, trying to pull ideas and suggestions together.
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22. Orienting-defining the progress of the discussion in terms of the
group’s goals, raising questions about the direction the discussion is
taking.
Testing-checking with the group to see if it is ready to make a
decision or to take some action.
Summarizing-reviewing the content of past discussion
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23. Blocking-interfering with the progress of the group by going of a
tangent, citing personal experiences unrelated to the group’s
problem, arguing too much on a point the rest of the group has
resolved, rejecting ideas without consideration, preventing a vote.
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24. Aggression-criticizing or blaming others, showing hostility toward
the group or some individual without relation to what has happened
in the group, attacking the motives of others, deflating the ego or
status of others.
Seeking recognition-attempting to call attention to one’s self by
excessive talking, extreme ideas, boasting, boisterousness.
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25. Special pleading-introducing or supporting ideas related to one’s
own pet concerns or philosophies beyond reason, attempting to speak
for “the grass roots,” “the housewife,” “the common man,” and so on.
Withdrawing-acting indifferent or passive, resorting to excessive
formality, doodling, whispering to others.
Dominating-trying to assert authority in manipulating the group or
certain members of it by “pulling rank,” giving directions
authoritatively, interrupting contributions of others.
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26. Authoritarian- led groups
produced a greater quantity of work over a short period of time
experienced more hostility, competition, and aggression-especially scapegoating,
more discontent beneath the surface, more dependence, and less originality.
Democratically led groups,
slower in getting into production,
strongly motivated, became increasingly productive with time and learning,
experienced more friendliness
teamwork, praised one another more friendliness and team work,
expressed greater satisfaction.
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27. Laissez-faire groups
They did less work and poorer work than either of the others
spent more time in horseplay,
talked more about what they should be doing
experienced more aggression than democratic groups but less then the
authoritarian
expressed a preference for democratic leadership.
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28. Lipitt and Seashore (1980) saw group cohesion as the ‘attractiveness of
the group to its members’ .
Cohesion involves the willingness of members to accept group
decisions and whether group activities are grounded on commitment
to a common goal or on likes and dislikes of persons for each other.
Cohesiveness is the degree to which members are attracted to the
group. Ideally, a group should work together while members maintain
their individuality (Lipitt & Seashore, 1980).
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29. The cohesiveness of a group is determined by the strength of attraction
of the group for its members
In the literature it is often referred to as the “we-feeling” of a group.
Symptoms of low cohesion include sub Rosa conversations between
pairs of members outside the main flow of the group’s discussion
◦ The emergence of cliques, fractions, and such sub groupings as the “old timers”
versus the “newcomers,” the “conservatives” versus the “liberals,” and so on.
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30. 30
Strong Increase
in Productivity
Moderate Increase
in Productivity
No Significant Effect
on Productivity
Decrease in
Productivity
Cohesiveness
Alignment
of
Group
and
Org.
Goals
High Low
Cohesiveness-Productivity Relationship
High
Low
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31. Group participants tend very soon to begin to identify certain
individuals that they like more than other members, and others that
they like less.
The sociometric patterns-have an important influence on the group’s
activities.
People tend to agree with people they like and to disagree with people
they dislike, even though both sides express the same ideas.
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32. Social Loafing: "Free Riding" When Working with Others
Additive tasks are those in which each person's contributions are added
together to another's. Unfortunately, as people work together, some in the
group may ride on the efforts of others. This is social loafing.
Some explain social loafing through social impact theory, that the impact
of any social force acting on a group is divided equally among its members.
As a result, each member feels less than fully responsible for the outcome
and puts in less effort.
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33. Definition: Group dynamics involve the study and
analysis of how people interact and communicate with
each other in face-to face small groups. The study of
group dynamics provides a vehicle to analyze group
communications with the intent of rendering the
groups more effective.
(Davies & Newstrom 1985; La Monica,1985)
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34. Group Dynamics: Is the interactions and relationships
that take place among group members as well as
between the group and the rest of society.
It tells us what is happening among the group members
or in the group itself.
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35. Members feelings, roles and contributions etc. (observe that
members feelings; anger, tiredness or boredom etc)
It includes interdependence of group members, collective
problem solving and decision making, and group conformity
(compliance/agreement).
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36. Group dynamics describes both:
Interpersonal processes in groups
The scientific study of groups and group processes (Kurt Lewin)
Level of Analysis
Individual level: focus on the individual (psychological)
Group level: focus on the group and social context (sociological)
Multilevel: adopts multiple perspectives on groups
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37. Person A
Person B
Person C
Convergence
Alone Group
Session 1
Group
Session 3
Group
Session 2
Average
distance
estimates
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38. Pooled
◦ Members make separate, independent contributions to group such that
group performance is the sum of each member’s contributions
◦ E.g. courses delivered by different individuals.
Sequential
◦ Members perform tasks in a sequential order making it difficult to
determine individual performance since one member depends on
another.
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39. Reciprocal (shared/common)
◦ Work performed by one group member is mutually
dependent on work done by other members.
◦ E.g. football teams: goal keepers-defenders-midfield….
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41. 41
Bruce Tuckman's Model
•Four stages of group development in 1965
•He refined and developed the model in 1977, Added
the 5th phase
The Stages of Group Development
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43. Forming: Orientation Stage
When the group members first see each other
Characterized by group awareness and relationship
building
Involves the practical and psychological start-up of
the team
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45. The challenge: is to create team identity (uniqueness) and
make the team important to the group members.
Personal relations: depend on the leader…
Group member behavior: is questioning, why, how…
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46. Characterized by: resistance, negativity, and confusion within the
group, emotional status and conflict
Conflict over leadership structure, power, authority & procedures
members may isolate or even remove themselves from the group at
this stage.
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47. Groups require a high level of directive supervision, but also need
considerable support.
The leader must serve as mediator as well a teacher of group norms
and values.
needs to listen to group problems, manage conflicts, encourage
participation
Group members must focus on the commonalties of the group and
not the differences.
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48. Constructive, or Resolution Stage
Characterized: by cooperation and integration within the group.
The challenge is to channel the skills, energy, and independent spirit of
the team members into coordinated work.
Personal relations: are marked by unity, begin sharing ideas, feelings,
giving feedback to each other
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49. Production/Synergy Stage/Cohesiveness
Characterized by productivity, unity, and commitment within the group.
A collective, interdependent organism is the final outcome of the group
development process.
Leader’s Actions: provide resources, remove obstacles, reward high
performance
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50. IS closure of the group/team process
When the team project has been completed, turnover – due to elections
or new member recruitment
The group process will end and a new group/team building process will
begin
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51. Conflict is a problem that occurs at several levels: between
organizations; between groups; between members within groups;
within an individual and between the multiple roles of a person's
life.
conflict can be (inter organizational, intergroup, interpersonal;
intrapersonal and inter role).
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52. o Compromise - Split issues down the middle.
o Competition - high concern with one's own interests.
o Collaboration - high concern for one's own interest and those of
others.
o Accommodation - giving others what they want.
o Avoidance - low concern for oneself and others
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56. At the end of this chapter, the trainees will be able to:
Define communication and health communication
Discuss about communication models
Explore methods of communication
Explain stages of communication
Identify barriers to effective communication and how to
overcome them
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57. Communication and health communication
Models of communications
Methods of communications
Barriers and communication failure
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58. Definition of communication:
o Communication is the process of sharing of ideas, information,
knowledge, and experience among people to take action.
o Communication may take place between one person and another,
between an individual and a group or between two groups.
o Communication facilitates creation of awareness, acceptance and action
at individual, group and inter-group level. The process always involves a
sender and a receiver regardless of the number of people concerned.
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59. Communication refers to the transmission or exchange of information
and implies the sharing of meaning among those who are communicating.
So communication uses/helps to share information, give instruction, give
feed back and express feeling
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60. Encoding – The process of converting the message/ subject
matter into communication symbols.
Encoding process translates ideas, facts, feelings, opinions etc. into
symbols, signs, actions, pictures, audio-visuals etc.
Decoding – The receiver translates the words and symbols used in
the message into idea and interprets it to obtain its meaning.
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61. Health communication is the application of communication to
communicate health message based on communication
principles.
Health communication is the art and technique of informing,
influencing, and motivating individuals, institutions, and large
public audiences about important health issues based on sound
scientific and ethical consideration.
That means health communication can take place at a number of
different levels : The individual , Social networks (family) , The
organization , Communities and Society level
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62. What are models?
Models are a proven framework to guide practice
Model is a systematic representation of an object or event in idealized and abstract
form.
There are different models of communication ,these are
Aristotle model of communication
Hypodermic Needle Or Bullet model
Laswell model of communication
Shannon and Weaver model of communication
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63. One of the earliest recorded models is attributed to the ancient Greek philosopher
Aristotle.
Aristotle represented communication as might an orator who speaks to large
audiences. e.g. public meeting
His model incorporates few elements.
I. Speaker
II. Message
III. Listener
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65. The factors which played a role in determining persuasive effects
were the contents of the speech, its arrangement and the manner
in which the speech was delivered.
Persuasion is effected through the audience when they are
brought by speech in to a state of emotion.
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66. The Hypodermic Needle Model postulated that the mass Media had
direct, immediate and powerful effects on a mass audience. The media
were pictured as sending Forth messages to atomize Masses without any
intervention.
that means that the messages of the media are accepted by the people
without any hindrance just as the drug in the injection needle mixes with
the blood stream after an injection
This model had been primarily on intuitive theorizing and that it would
not be suitable to study the mass media effects
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68. Harold Laswell 1948, posed the question, “Who says what in which
channel with what effect?” .
This model includes considerations of a variety of factors being considered to
determine the impact of a communication.
To illustrate the significance of each element of the model, try visualizing
what effect some dynamic speaker would have if the medium were print, or
what would happen if the audience didn’t speak the same language.
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70. The model introduces three elements: a transmitter, a receiver, and
sources of noise.
Their example is telecommunications:
In telecommunication:
the transmitter and receiver : would be the hardware used by the
sender and receiver during the act of communication
Noise may come from static sources (like solar flares), unusual weather
conditions, or electron equipment that interferes with the signal.
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72. Physical:
Occurrences in the physical surroundings or in the media that can distort a message
Physiological:
Physical discomfort in the body of either the sender or the receiver
Psychological:
Negative feelings in the mind of either the sender or the receiver
Perceptual
- Incorrect perceptions of the message and the receiver by the sender, and vice-versa
Semantic
Misinterpretation of words and sentences by the sender or receiver
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73. Assumptions of Shannon-Weaver
Communication breakdown is caused by ‘noise’
The model is developed to separate noise from information-carrying signals
For example, in any face-to-face situation, there may be environmental or
other sources of noise that interfere with the communication.
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74. One contribution Schramm made was to consider the fields of
experience of the sender and receiver.
The sender encodes the message, based upon the sender’s field of
experience. The user’s field of experience guides decoding.
If there is no commonality in the sender’s and receiver’s field of
experience, then communication does not take place.
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75. The extent to which the signal is correctly decoded depends on the
extent of the overlap of the two fields of experience.
For instance, a lecture on neurophysiology delivered to an
audience of sixth graders may result in little or no
communication.
Because, no overlap in the field of experience of the lecturer and
the receivers (students)
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76. The extent to which the signal is correctly decoded depends on the
extent of the overlap of the two fields of experience.
For instance, a lecture on neurophysiology delivered to an audience of
sixth graders may result in little or no communication.
Because, no overlap in the field of experience of the lecturer and the
receivers (students)
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78. Schramm’s models introduced the idea of feedback from the receiver to the
sender.
Communication becomes a continuous process of messages and feedback. It
allows for interaction.
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80. Berlo (1960) took a different approach to constructing a communication model.
Rather than attempting to identify elements of interest, and relationships between
those elements, he created what he called “a model of the ingredients of
communication”.
This model identifies four elements of communication: Source, Message, Channel,
and Receiver.
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82. A) Linear (one –way) model
The flow of information from the sender (source) to the receiver is one-way or
unidirectional.
The communication is dominated by the “sender’s knowledge”. “Information is
poured out”.
This model does not consider feedback and interaction with the sender.
A familiar example is the lecture method in class rooms.
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83. Advantages Disadvantages
-Faster - Little audience participation
-Orderly - Learning is authoritative
-No feed back
-Does not influence behavior
S R
M
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84. B) Systems (Two –way) model
Information flows from the source to the receiver & back from receiver
to the source.
This is reciprocal in which the communicant (audience) becomes the
communicator (sender) & the communicator (sender) in turn becomes
a communicant (audience).
Roles are interchanged.
It is more appropriate in problem solving situations.
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85. Advantages Disadvantages
-More audience - Slower (time taking)
participation - Not orderly
-Learning is more democratic
- Open for feed back
- Influence behavior change
S R
M
F
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89. Use Oral Communication when;
1. The receiver is not particularly interested in receiving the message.
2. It is important to get feedback.
3. The receiver is too busy or preoccupied to read.
4. The sender wants to persuade or convince.
5. When discussion is needed.
7. When criticism of the receiver is involved.
8. When the receiver prefers one-to-one contact
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92. Non-verbal communication refer to using a non spoken symbol to
communicate a specific message
Nonverbal messages can;
support verbal messages (clarify)
contradict verbal messages (mixed messages)
replace verbal messages (secrets)
It is easy to lie with word much more difficult with non-verbal
communication
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94. It involves the exchange of facts, ideas, and opinions through a written
instrument /materials.
Successful written communication requires careful thought and clear
planning.
A plain writing style should be used for easy understand and reduces the
chances of misunderstanding and ambiguity.
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95. A useful tool in improving your writing skills is writing
Start writing in simple, plain English, then move on from some thing
concrete to something abstract and expressive.
In written communication, there are four common errors which
should be avoided, Judith (1993)
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97. 1. use a plain language approach to communications
2. Know the purpose of your written communication
3. only include important and directly relevant information
use simple language
5. keep sentences and paragraphs short
6. make it personal
7. use the active voice
8. use easy-to-read design techniques
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98. Advantages of Written
communication
1.Highly technical topics
can be presented using
words and diagrams.
2. Written material
provides a permanent
record that can be referred
to from time to time or
passed on to others.
3. Written material can be
duplicated in large
quantities
4. It is fairly easy to
distribute written material
Disadvantages of Written
communication
1. People seldom take the time and
effort to read technical materials.
2. The preparation of written
communication is time-consuming.
3. Once prepared in large quantities,
printed documents are difficult to
change.
4. Written material provides little
feedback for the sender.
5. Technical materials are often too
long and complex for the majority of
readers.
6. A portion of the population may not
be able to read written material.
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99. In order to say communication process is complete, the following
elements should exist:
source, encoding, audience, message, decoding, feed back
and effect.
Each component will be discussed below.
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100. person who thinks of all idea to be communicated,
decides why it should be communicated and also decides
on the intended impact.
The sender is the originator of the messages.
The source can be from an individual or groups, an
institution or organization.
People most likely to accept a communication from a
person or organization that they trust i.e. has high source
credibility.
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101. source credibility can come from:
A person’s natural position in the family, community, e.g. head,
village chief or elder;
Through their personal qualities or actions, e.g. a health worker
who always comes out to help people even at night;
Qualifications and training;
The extent to which the source shares characteristics such as age,
sex, education, religion, experiences with the receiver.
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102. A person from a similar back ground to the community is more likely to
share the same language, ideas and motivations and thus be a more
effective communicator.
One of the main reasons for communication failure is when the source
comes from a different background from the receiver and uses
inappropriate message content and appeals.
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103. The first step in planning any communication is to consider the intended audience.
Audience is the person or the group for whom the communication is intended or
the person who receive the message through channels.
Who is our audience? Do we have a primary and a secondary audience? What
information do they need to take action on our work? Understanding audiences is
fundamental.
There may be several different “types,” each with their own likes, needs and
abilities.
Therefore, the communicator always has to consider all aspects of the audience by
doing audience analysis.
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104. Audience analysis is “the process of examining information about the
listeners whom you expect to hear your speech.”
Determining the important characteristics of an audience in order to choose
the best style, format and information for communication
Audience Segmentation
The process of categorizing audiences into logical groups to enhance a
better fit among: Audiences, Messages, Media and Services or products
the audience segmentation can be as the primary, secondary, and
influencing audiences.
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105. Message is a piece of information, ideas, facts, opinion, feeling,
attitude or a course of action that passed from the sender to the
receiver with the intention to change their understanding or health
related behavior .
The content of the message could be organized in different ways so
that it can persuade or convince people. These are called appeals.
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106. 1. Fear arousal appeal
The message is conveyed to frighten people into action by emphasizing
the serious outcome from not taking action.
Symbols such as dying persons, coffins, grave stones, skulls may be used.
2. Humour
The message is conveyed in a funny way such as cartoon.
Humour is very good way of attracting interest & attention.
It is good to create a lasting memory but hard to change beliefs and
attitudes.
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107. 3. Logical / Factual appeal
The message is conveyed to convince people by giving facts, figures and information.
For example facts related to HIV/AIDS; its causes, route of transmission, prevention
methods, Telling people the percentage of people living with HIV virus etc...
It carries weight with a person of high educational level.
4. Emotional appeal
The message is conveying to convince people by arousing emotions, images & feelings rather
than giving facts & figures,
Example by showing smiling babies, wealthy families with latrine etc, and associating with FP
education.
A Person with less education will often be more convinced by simple emotional appeals from
people they trust.
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108. 5. One sided message
Only presents the advantages of taking action & does not mention any possible
disadvantages. E.g. educating the mothers only about benefits of oral contraceptive
pill.
One sided compared with two sided messages Presenting only one side of an
argument may be effective:
6. Two sided message
Presents both the advantages & disadvantages (pros’ & cons’) of taking action.
Appropriate if:
The audiences are exposed to different views.
The audiences are literates.
We are in face to face with individuals or groups: it is easy to present both sides and
make sure that the audience understands the issues.
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109. 7. Positive appeals
Communications that ask people to do something, e.g. breast feed your child,
use a latrine.
8. Negative appeals
Communications that ask people not to do something, e.g. do not bottle feed
your child, do not defecate in the bush.
Positive compared with negative appeals. Negative appeals use terms
such as “avoid” or “don’t” to discourage people from performing harmful
behaviors. But most health educators agree that it is better to be positive &
promote beneficial behavior.
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110. A channel is the physical bridge or the media by which the message
travels from a source to a receiver.
The channel used to communicate influences what information can be
conveyed and how.
The commonest types of channel are face to face, audio, visual, printed
materials or combined audio visual & printed materials.
Your choice of channel will depend on what you are trying to achieve,
the nature of your audience and what resources are at your disposal.
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111. 1. Interpersonal channels –
E.g. home visits, group discussions, and counselling
2. Broadcast example, Radio and television
3. Print channels - such as pamphlets, flyers, and posters- are generally considered
best for providing a timely reminder of key communication messages.
The impact to be achieved
Reach Vs Frequency? What determines this decision?
Reach- The number or proportion of the intended audience to receive the message.
Frequency- The number of times the message reaches the intended audience.
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112. Proposed media mix
Do we need to use a mix of media? Why? Which media to mix?
Media Mix/ Multi media approach is the use of two or more channels for a single
communication program.
Advantages of Media Mix-
Compensates for messages not received by another channel
Addresses the media behaviour or media habits of different audience segments
Potentiates frequency of messages
Increases reach
Promotes Trust/credibility of the message
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113. Effect: is the change in the receiver’s knowledge, attitude & practice or behavior.
Positive effect: when desired change in knowledge, attitude, practice occurs;
Negative effect: when desired change in knowledge, attitude & practice does not
occurs.
Feedback: - is the mechanism of assessing what has happened on the receivers
after the communication has occurred by sender.
A communication is said to have feedback when the receiver of the message gives
his/her responses to the sender of the message.
It completes the process of communication.
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114. In health education and health promotion we communicate for special
purpose:–To promote improvement/change in health through the
modification of the human, social and political factors that influence
behavior.
To achieve these objectives, a successful communication must pass
through several stages.
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115. Sender receiver
Reaches senses
Gains attention
Message understood
Acceptance /change
Behavior change
Change in health
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116. Communication can not be effective unless it is Seen or heard by its
intended audience.
A common cause of failure in this stage is preaching the
converted, e.g. posters placed at the clinic or talks given at antenatal
clinics.
These only reach to the people who are already motivated & attended
the service.
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117. Any communication must attract attention so that people will make the effort to listen
and read it.
Attention: is the process by which a person selects part of the message to focus on
while ignoring others for the time being.
Examples of failure at this stage are:
Walking past the poster with out bothering to look at it;
Not paying attention to the health talk or demonstration at the clinic;
Turning off the radio programs or switching over.
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118. Once the person pays attention to a message he/she then tries to
understand it. Another name for this stage is perception.
Perception is a highly subjective process.
For example, two people may hear the same radio program or see
the same poster and interpret the message quite differentially from
each other and from the meaning intended by the sender.
A person’s interpretation of a communication will depend on many
things.
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119. Examples of failures at this stage can take place when:
Complex language & unfamiliar technical words are used;
Pictures containing complicated diagrams and distracting details
Pictures containing unfamiliar/strange subjects.
Too much information is presented and people can not absorb it at all.
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120. A communication should not only be received and understood – it
should be believed & accepted.
It is usually easier to promote a change when its effects can be easily
demonstrated.
For example:
ventilated improved pit latrines do not smell.
if people become green in color when they get HIV/AIDS it is easier to promote
change.
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121. A communication may result in a change in beliefs and attitudes but
still not influence behavior/action.
This can happen when the communication has not been aimed at the
belief that has most influence on the person’s behavior.
e.g. A person may have favorable attitude & want to carry out the
action e.g. using FP but the people around may prevent from doing it
or no means (enabling factor) such as money, skill and availability of
the service to do as a result there will be no behavior change.
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122. Improvement in health will only take place if the behaviors have
been carefully selected so that they really influence health.
If your messages are based on outdated & incorrect ideas, people
could follow your advice but their health would not improve.
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123. 1. Physical
Difficulties in hearing, seeing
In appropriate physical facilities
2. Intellectual
The natural ability, home background, schooling affects the perception/
understanding of the receiver for what he sees & hears.
The ability of the facilitator/ education/ instructor.
3. Emotional
Readiness, willingness or eagerness of the receiver
Emotional status of the educator
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124. 4. Environmental
Noise, invisibility, congestion
Noise is a major distraction during communication.
a. Physical noise – avoidable
b. Internal noise - any physiological or psychological state that could undermine a
person’s ability to communicate effectively:
Being ill
Overworked
Beset by personal problems.
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125. 5. Cultural
Customs he beliefs, religion, attitudes, economic and social class differences,
language/vocabulary variation.
6. Status of the source
Status of the source either too high or too low as compared to the audience also
affects effectives
7. Inconsistencies between verbal & non- verbal communication
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128. Define the acronym PRECEDE and PROCEED
List the steps of PRECEDE and PROCEED
Discuss the application of PRECEDE and PROCEED for
health care intervention
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129. It provides future direction
It create efficient use of resources
It helps to adjust change environment
It also facilitates a base for team work
Remember that 80% of the programs and projects fail due to
poor objectives and misleading or insufficient assumptions, not
b/c of poor implementation
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130. Problem Identification and needs assessment
Prioritization
Formulation of goals and objectives; as well as
indicators
Three types of objectives should be realized
Health objective/s,
Behavioral objective/s, and
Communication objective/s
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131. Developing program components
Identification of appropriate communication methods and
approaches
Evaluation and Monitoring indicators and plan
Completing the action plan (write up)
Implementation preparation
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132. The Emphasis here is about planning the health education and
health promotion program
Widely used models in HE and HP program design are:
PRECEED-PROCEDE Model of the PRECEED part
PERT (Program Evaluation and Review Technique)
PATCH (Planned Approach to Community Health)
MATCH (Multilevel Approaches to Community Health)
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133. The general planning framework includes the following steps
1. Identifying the needs (problems or exemplary experiences/
2. Prioritizing or ranking them
3. Setting goals, objectives
4. Designing strategies
5. Tracing barriers/obstacles
6. Identifying activities/tasks and responsibilities
7. Identifying resources and allocate them
8. Write up and communicating the plan
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134. Health
Promotion
Phase 4:
Educational &
Environmental
Diagnosis
Predisposing
factors
Reinforcing
factors
Health
Education
Phase 9:
Outcome Evaluation
Phase 8:
Impact Evaluation
Phase 6:
Implementation
Policy
&
Regulation
Health
Lifestyle/
behavioral
Causes
Environmental
Causes
Enabling
factors
Phase 7:
Process Evaluation
Quality of
Life
Phase 2:
Epidemiologic
al Diagnosis
Phase 1:
Social
Diagnosis
Phase 3:
Behavioral
& environmental
diagnosis
Phase 5:
administrative &
Policy
Diagnosis
134
Phase 4:
Educational &
Organization
Diagnosis
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135. The PRECEED-PROCEDE MODEL is one of the ecological
model is one of the planning, implementation, monitoring
and evaluation ecological model
The first five phases of the model serves a planning phases
Its acronym PRECEED stands for
Predisposing, Reinforcing, Enabling Constructs for
Educational and Environmental/or Ecological Diagnosis
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136. The PRECEED part of the PRECEED-PROCEDE model has five
phases, such as:
1. Social Assessment /diagnosis/
2. Epidemiological assessment /diagnosis/
3. Behavioral/lifestyle and environmental assessment /diagnosis/
4. Educational and organizational assessment /diagnosis/
5. Administrative and policy assessment /diagnosis/
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137. The first phase is about quality of life
Quality of life is a manifestation of ultimate values of health
It is defined as the “perception of individuals or groups that their needs are
being satisfied and that they are not being denied opportunities to pursue
happiness and fulfillment”
The Ferrans and Powers Quality of index is such a scale which measures four
quality of life domains:
◦ Health and functioning, Psychological and spiritual, Social and economic, and Family;
and it has been effectively applied cross culturally.
Some of the Indicators,
Unemployment, Crime, Rape, Violence (women and children), Absenteeism
,Decreased productivity, Job insecurity
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138. FGD
Key informant in-depth interview
Nominal group process
The Delphi Methods
Survey
Public Service data/information
Participatory rural appraisal (PRA)
Participatory learning and appraisal (PLA)
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139. Through literature reviews or survey identify the major health and health
related problems with in the community (example ten top diseases or
rates of health service utilization )
This includes mortality and morbidity data obtained from either
documented secondary data or results from the interview of respondents
Some indicators, for epidemiological Dx are,
-disease prevalence
-death prevalence
-injuries
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140. During this phase, assess & analyze behavioral/life styles and
environmental factors influencing the priority health problem,
(usually individual behavioral models may be used for studying
the lifestyle and behavioral factors at this phase)-
Usually behavioral survey may be needed at this level
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141. Specific behavior or practices:
Risk sexual behaviors/unsafe sex
Inappropriate/no use of PPD
Lack of Medical checkup/food handlers
Factors related to environment:
The institution doesn’t have health policy
There is no personal hygienic measures
Lack of STI/HIVs prevention and control policy
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142. Categorize as Predisposing, Reinforcing and Enabling (PRE) Factors what
you have been identified so far starting from Phase 1 to phase 3
At this stage you are also expected to develop behavioral and non behavioral
goals, objectives, strategies, indicators, and identify potential resources and
stakeholders and /or collaborators for the would be program effecting
While sorting the PRE you should see both the negative and positive factors
as follows
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143. Negative Predisposing Factors
1. Perceived personal risk is low (15%)
believe that they are at high risk at
present
2. (90%) of freshman students
identified living with one partner is
considered to be safer sex than using
condoms persistently
3. Perceived condom response efficacy
is low (only20%) believes highly
likely
4. Multiple and unsafe sexual contacts
are rampant (20% of the study
subjects have had sexual contacts at
least once without using condom
during the last 6 months
143
Positive Predisposing
Factors
1. Educated group of the
community
2. Knowledge on
HIV/AIDS is relatively
high (100% and 90% of
them identified three &
four modes of HIV
transmission respectively
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144. 144
•There is rewards
when a graduate
female student
keeps her virginity
until graduation
•There is no strict
regulation to punish
students who found to
be guilty of sexual
abuse
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145. Negative Enabling Factors
1. 55% of complains that
senior students influence
freshman students to
have multiple sexual
practices
2. 98% of the students
responded that freshman
orientation did not
include HIV/AIDS issue
145
Positive Enabling
Factors
1. 40% of Peer
groups of the same
year discuss their
problems together
2. 16% of the
students have
experience in peer
to peer education
and counseling in
their previous times
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146. Negative Enabling Factors
1. The policy and regulation is not
fully implemented and no
responsible person to monitor and
evaluate its progress
2. Low involvement of male students
3. messages transmitted through the
community radio of JU ever
touches HIV/AIDS issue of the
campus and is not tailored
4. No Entertaining Education
Programs yet designed and
implemented
5. The anti AIDS Clubs are not
functioning regularly
146
Positive Enabling
Factors
1. Policy/ Regulations of
JU about HIV/AIDS
prevention & control
exists
2. Women’s Affairs
office working on life
skills training of
students
3. JU Community Radio
started broadcasting
4. campus contains
many students
5. AIDS Clubs are
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147. Rating behavioral or environmental factors in terms of importance
(magnitude Vs strength of cause-effect relationship)
Incidence or frequency of behavior or the environmental factor
The strength of their association with the disease (HIV/AIDS)
Rating behavior or environmental factor in terms of changeability
(susceptibility Vs time needed)
How susceptible to change?
How much time does the program/ interventions have to show change?
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148. The Predisposing, Reinforcing, and Enabling factors categorization for
health education/promotion are meant to sort the casual factors into
three classes of targets for subsequent intervention according to the
three broad classes of intervention strategy:
1. Direct communication to change the predisposing factors
2. Indirect communication (through family, peers, teacher, employers,
health care providers) to change the reinforcing factors or enabling
factors, and
3. Organizational or training strategies to change the enabling factors
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150. By the end of phase 4 (educational and organizational assessment) the
following steps are accomplished:
1. Identification of program/intervention objectives (the desired,
behavioral, environmental, and health objectives)
2. Identification of the target audience (primary, secondary, tertiary)
3. Identification of important indicators for monitoring and evaluation
4. Identification of appropriate approaches/methods and tools to attain the
desired behaviors
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151. Health Objective:
1. To reduce HIV/AIDS Prevalence from the current 12.1% to 5% by
the end of the next 5 years
How can it be possible since it meant a dramatic change?
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152. Behavioral Objectives
1. To increase the personal HIV/AIDS susceptibility (perceived risks) from 15%
to 60% by the end of the next two years.
2. To increase the perceived response efficacy of consistent condom use from
20% to 80% by the end of the next two years.
3. To reduce freshman students complaint of senior students’ influence from the
current 55% to 10% by the end of the next two years.
Environmental Objective
1. To build sustainable HIV/AIDS Prevention and Control program run by the
students' organization by the end of the next five years.
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153. To disseminate focused HIV/AIDS messages through JU Community Radio at least once
every week starting the next six months of the program’s life
To strengthen & train Anti-Aids Club of the University students starting with in four
months of the program’s life
To have at least two entertainment HIV/AIDS education sessions per month starting 5
months of the program’s life (drama, songs, sports, and competitions are used)
To train 500 peer to peer trainers of trainees (TOT) up to 8 months of the program’s life
To have students’ HIV/AIDS conference at least once every six months starting six months
of the program’s life
To include HIV/AIDS issue in every freshman orientation sessions
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154. The next questions to be addressed are:
Who is responsible for what (tasks/activities sharing)
How the responsible bodies share & accomplished their activities
and tasks (strategies and roles)
What will be the evidences & how we ascertain whether the shared
responsibilities or tasks or activities are carried out accordingly?
Indicators of quality and coverage for monitoring and evaluation
plans
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155. By the end of Phase 5 (policy and regulation assessment)
Identification and selection of strategies such as the methods,
approaches, and tools are refined & strengthened
Identification and appraisal of resources (human, money,
material, time, space, technology, policy, existing supportive
regulations, stakeholders etc.) are completed.
Still what assumed in phase four is further distilled here
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156. Includes the following components:
Organization’s vision, mission, mandate, values, overall goal,
Background of the program intervention area and if need be stakeholders
backgrounds
Aim of developing the present program (or the significance of the
program)
Goals & objectives of the program,
Program’s strategies, procedures to be followed
Program’s tasks/activities, roles & responsibilities shared.
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157. indicators for all steps (quality and quantity indicators of input-
process-output-outcome-impact of the program)
Monitoring & evaluation as well as program Mx and
implementation plans-including Gantt chart (activities versus time
of accomplishment)
Resources break-down for every tasks or activities including the
sources, amount, kind, and time to be secured
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158. Several overlapping factors are incriminated.
They include:
1. Insufficient understanding of the problem and associated
factors leading to wrong behavior objective
2. Choosing inappropriate behavioral constructs for change
3. Over emphasis on behavior change without considering all
other factors (social, economic and physical environments)
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159. 4. Failure to appreciate existing resources, including knowledge in
the target groups
5. Directing health education at specific group without taking into
account the influence at family, community and government levels
6. Failure to ensure community participation in each level of the
program
7. Failure of timely communicating and networking
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160. Define acronym PRECEDE and PROCEED
List steps of planning using general frame work of planning
list steps of planning using PRECEDE and PROCEED model
Assume you are formulating objective for HIV prevention ,so
write
Health objective
Behavioral objective
Learning objective
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