This presentation will provide detail explanarion about health education theory

1. PRECEDE-PROCEED MODEL

2. OBJECTIVES
Define what PRECEDE-PROCEED model.
Identify phases of the model
List the assumptions
Generalize the core concepts of the model

3. OUTLINES
PRECEDE-PROCEED MODEL
Introduction
Phases
Assumptions
Precede model
Proceed model
Summary
References

4. PRECEDE-PROCEED
What is PRECEDE/PROCEED?
PRECEDE/PROCEED is a community-oriented,
participatory model for creating successful
community health promotion interventions.
Originators
Lawrence W . Green
Marshall W. Krueter

5. PRECEDE has five phases:
Phase 1: Social diagnosis
Phase 2: Epidemiological diagnosis
Phase 3: Behavioral and environmental
diagnosis
Phase 4: Educational and organizational
diagnosis
Phase 5: Administrative and policy diagnosis

6. PROCEED has four phases:
Phase 6: Implementation
Phase 7: Process evaluation
Phase 8: Impact evaluation
Phase 9: Outcome evaluation

7. Assumptions behind PRECEDE/PROCEED:
• Behavior change is voluntary
• Health promotion is more likely to be effective if
it’s participatory.
• Health and other issues must be looked at in the
context of the community.
• Health and other issues are essentially quality-of-
life issues.
• Health is itself a constellation of factors that add up
to a healthy life for individuals and communities.

8. Why use PRECEDE-PROCEED?
• A logic model provides:
=> A procedural structure for constructing an
intervention.
=> A framework for critical analysis.
=> An assurance for community involvement.
=> A chance to constantly monitor and adjust an
evaluation since it incorporates a multi-level evaluation.
=> An adaptation of the content and methods of
the intervention to a particular need and circumstance.

9. PRECEDE model
Phase 1 -Social Assessment
Assessment means...
 Identify
 Describe
 Prioritize
Phase 1 -seeks to subjectively define the QOL
(problems & priorities) of priority population
-Self-assessment of needs & aspirations

10. Methods for social diagnosis
• Community Forums
• Nominal Groups
• Focus Groups
• Surveys
• Interviews : key personnel , leaders…
• Literature Review –secondary information

11. Phase 2 –Epidemiological Assessment
• Epidemiology -study of the distribution & determinants of
disease
• Based on epidemiological Data
Epidemiological Data:
-Mortality
-Morbidity
-Disability
-Fertility
-Incidence rates
-Prevalence rates

12. Phase 3: Behavioral Diagnosis
• Focuses on behavioral and non-behavioral causes
(personal and environmental factors) which seem to be
linked to health problems defined in Phase 2.
A. Behavior of Interest (factors) Maybe…
 Behavior of the people whose health is in question
 Community Leaders
 Legislators
 Parents
 Teachers
 Health Professionals

13. B. Environmental or Non-Behavioral Factors
• Environmental Factors Include:
Determinants outside the person that can be modified to support
behavior, health, or quality of life.
a) Physical
b) Social
c) Economic
• Genetic Predisposition
• Age
• Gender
• Existing Disease
• Workplace
• Adequacy of Health Care Facilities

14. Phase 4: Educational &Organizational(ecological)
Diagnosis
• Identifies causal factors that must be changed to initiate
and sustain the process of behavioral and
environmental change identified in Phase 3.
The three types of influencing factors(P,E,R) should be
identified first to assess their relative importance and
changeability.
Then related learning and organizational objectives can be
written, and state so that health promotion programs can
focus where they will do the most good in facilitating
development of or changes in behavior and environment.

15. …Educational &Organizational Diagnosis
Theory is applied in this Phase
 Predisposing Individual Factors -Individual
Theories
 Enabling Factors –Interpersonal Level
Theories
 Reinforcing Factors –Community Level and
Systems Theories

16. The factors(P,E,R)
A. Predisposing Factors
I. Knowledge
II. Attitudes
III. Values
IV. Beliefs
V. Perceived Needs and Abilities

17. B.Enabling Factors
• Environmental and Personal Resources that impact:
 Availability and Affordability
 Programs & Services
 Money & Time
 Accessibility
 Facilities
 Skills
 Laws

18. C.Reinforcing factors
• Positive or Negative Feedback From:
Peers
Family
Health Care Workers
Law Enforcement
Media
Others

19. Phase 5: Administrative and Policy Diagnosis
• Focuses on administrative and organizational
concerns which must be addressed prior to
program implementation
• Includes:
Assessment of resources
Budget development and allocation
Development of implementation timetable
Organization and coordination with others

20. …Administrative and Policy Diagnosis

21. …Administrative and Policy Diagnosis
Administrative Diagnosis
• Analysis of policies, resources and
circumstances prevailing organizational
situations that could hinder or facilitate the
development of the health program
• Assesses the compatibility of your program
goals/objectives with those of the organization
and its administration

22. …Administrative and Policy Diagnosis
• Work in this phase is specific to the context of the
program and the sponsoring organization(s) and
requires political savvy as much as theoretical
or empirical knowledge
• Informed by theories, particularly community-
level theories
• Assess limitations and constraints
• Select the best combination of methods and
strategies

23. PROCEED Model
 Implementation & evaluation phase.
 Goes beyond educational interventions to the
political, managerial, and economic actions
necessary to make social system environments
more conducive to healthful lifestyles and a
more complete state of physical, mental and
social well- being for all

24. Phase 6:Implementation
Implementation -The act of converting program
objectives into actions through policy changes,
regulation and organization.
(Green & Kreuter, 1991, p.432)
• Beginning of PROCEED
• Selection of methods and strategies of the
intervention, for example, education &/or
other resources
• Program begins

25. Evaluation
•Clear and concise objectives are the foundation for
evaluation
•From two perspective –Health Program and Health
Education program
•Health Education Programs intermediate to Health
Programs
•Three types of evaluation –Diagnostic, Formative
& Summative
•Three areas of evaluation –process, impact and
outcome.

26. •To evaluate the process by which the program is
being implemented
•Ongoing; flow of activities
•Includes effectiveness of planning meetings,
running meetings, communicating with others
who are involved
Phase 7 Process Evaluation

27.  Health Education Impact –Change in Behavioral
and environmental indicators
 Program Impact –Change in Epidemiological
and social indicators
 It measures the effectiveness of the program with
regards to the intermediate objectives as well as
the changes in predisposing, enabling, and
reinforcing factors.
Phase 8-Impact Evaluation

28. •Outcome may indicate all -output, effect or
impact
•Output –Immediate outcome
•Effect –More qualitative in nature
•Impact –Change in quality of life of the people
Phase 9-Outcome Evaluation

29. SUMMARY OF THE MODEL

30. REFERENCES
• American Journal of Health Promotion
• Green, W. Lawrence. Health Promotion
Planning an Educational & Environmental
Approach. Second edition. Mayfield Publishing
Company. 1991

31. Thank you