This document discusses planning models for health promotion programs. It describes the PRECEDE and PRECEDE/PROCEED models, which are two of the most commonly used frameworks. The PRECEDE model involves 7 phases including social, epidemiological, behavioral, and educational diagnosis. The updated PRECEDE/PROCEED model contains 9 phases and adds administrative/policy assessment and evaluation phases. Both models use a systematic approach involving assessment of needs, behaviors, and factors to plan and evaluate health promotion programs.

1. PLANNING OF HEALTH
PROMOTION
CHAPTER 7

2. Planning a Health Promotion
Program
■ Health educators’ responsibilities are involved in some way
with program planning, implementation & evaluation
■ All approaches for HP program generally include:
■ Assessing the needs of the target
population
■ Identifying the problems
■ Developing appropriate goals & objectives
■ Creating an intervention that considers the
peculiarities of the setting
■ Implementing the intervention
■ Evaluating the results

3. Planning a Health Promotion
Program
■ A good health promotion programs are not created by chance;
they are product of much effort and should be based on well-
developed models

4. Planning a Health Promotion
Program
■ Importance of using a model for planning a program:
– Models are means by which planners give
structure and organization to the programming
process
– Models provide planners with
– Direction and supply a frame on which to build
■ No prefect models yet exists, however each one has its own strengths and
weaknesses
■ Most of the models can be classified as “attitude” models

5. Planning a Health Promotion
Program
■ There are many types of planning models for health
education/promotion program:
– PRECEDE (Green et al., 1980)
– PRECEDE/PROCEED (Green & Kreuter, 1991)
– MHEP (Ross & Mico, 1980)
– CHEM (Sullivan, 1973)
– MHEPRD (Bates & Winder, 1984)
– GHFDS (Patton et al., 1986)
– PATCH (Green & Kreuter, 1999; CDC1983)
■ Best known model and most often used in health promotion is the
original PRECEDE and lately is the PRECEDE/PROCEED framework

6. PRECEDE
■ Developed by Green, Kreuter, Deeds & Partridge (1980)
■ PRECEDE was an acronym for Predisposing, Reinforcing and
Enabling Causes in Educational Diagnosis and Evaluation

7. PRECEDE
■ The framework based on the requirements of four disciplines:
■ Epidemiology
■ Social/behavioral sciences
■ Administration
■ Education

8. PRECEDE
■ It consisted of seven (7) phases:
– Social Diagnosis
– Epidemiological Diagnosis
– Behavioral Diagnosis
– Educational Diagnosis
– Educational Diagnosis (continue)
– Administrative Diagnosis
– Evaluation

9. Social Diagnosis
– An assessment of the quality of life (QOL)
– Planners use appropriate needs assessment techniques
to determine the QOL as defined by social problems in
the target population (illegitimacy, welfare,
unemployment, absenteeism and crime)

10. Epidemiological Diagnosis
– Planners use epidemiological data to determine what
specific health problem were contributing to social
problems identified in phase 1:
■ Morbidity
■ Mortality
■ Fertility

11. Behavioral Diagnosis
– To identify those specific health related behaviors that
seemed to be associated with the prioritized health
problems in phase 2

12. Educational Diagnosis
 Planners try to assess the cause of the health behavior buy
identifying, sorting and categorizing three classes of factors that
have potential to affect health behavior
■ Predisposing factors
– Attitudes, values, beliefs, knowledge
– Smoking – feel cool (belief),
accepted by peers (value), danger
(knowledge)

13. Educational Diagnosis
■ Enabling factors
– Rewards or encouraging feedback (+ ve or – ve)
– Smoking – encouragement by peers but can be
positively influenced by nonsmoking role
models (popular athletes)
■ Reinforcing factors
– Resources and skills needed for behavior
change
– Exercise – safe and convenient place: improper
exercise can cause muscle soreness and injury.

14. PRECEDE/PROCEED
■ Updated and improved by Green & Kreuter (1999)
■ One of the most widely used health assessment and planning
models
■ PROCEED stands for – Policy, Regulatory, and Organizational
Constructs in Educational and Environmental Development

15. PRECEDE/PROCEED
■ Contains nine (9) phases:
– Social Assessment
– Epidemiological Assessment
– Behavioral & Environmental Assessment
– Educational & Ecological Assessment
– Administrative & Policy Assessment
– Implementation
– Process Evaluation
– Impact Evaluation
– Outcome Evaluation

16. Phases
■ Social Assessments
– To identify social indicators that reflect target population
with quality of life
■ Epidemiological Assessment
– Data are collected to determine the incidence and
prevalence of community health problems that affect the
community’s QOL.
– Communicable disease (measles & hepatitis), Chronic
disease (cancer & heart disease) health related risk factors
(malnutrition, anemia & hypertension) and other recognized
health problems (domestic violence & adolescent
pregnancy)

17. Phases
■ Behavioral & Environmental Assessment
– Specific behaviors and environmental factors that
contribute to the targeted health problem(s) are
identified and prioritized
■ Educational & Ecological Assessment
– Composed of predisposing, reinforcing and enabling
factors

18. Phases
■ Administrative & Policy Assessment
– To assess the resources needed to develop and
implement the HE program
– To compare the needs with the available resources in
the community
■ Time, personnel and budget – identified community
assets and capacities
– To assess barriers to implementation
■ Staff commitment and attitudes or community concerns
– Policy assessment: local politics and organizational
systems that may influence program implementation

19. Phases
■ Implementation
– Planners select the methods and strategies of the
intervention
■ Process Evaluation
■ Impact Evaluation
■ Outcome Evaluation