Models for Program Planning in Health Promotion

1. Models for Program Planning in Health Promotion HSC 489

2. Presentation Overview • The Purpose of Theories and Models • Various Models • How Grants Fit In

3. The Purpose of a Model “Models? I hate models!” “Not another model!” “Rats!” “What’s a model?”

4. A theory is… “a tool to help health educators better understand what influences health”--Hochbaum et. al, 1992 explains how/why life happens developed over time A model is… represents theory framework for investigation/design Examples: PATCHPRECEDE/PROCEED Theory versus Models

5. Precede-Proceed Model • PRECEDE: Predisposing, Reinforcing & Enabling constructs in Educational/Ecological Diagnosis & Evaluation • PROCEED: Policy, Regulatory & Organizational Constructs in Educational and Environmental Development • Green & Kreuter

6. PRECEDE/PROCEED Model Phase 5 Administrative & policy assessment Phase 4 Educational & ecological assessment Phase 3 Behavioral & environmental assessment Phase 2 “Epi” assessment Phase 1 Social assessment • Health Promotion • Health Education • Policy Predisposing Factors Behavior Quality of Life Reinforcing Factors Health Environ-ment Enabling Factors Phase 6 Implementation Phase 9 Outcome Evaluation Phase 8 Impact Evaluation Phase 7 Process Evaluation

7. Phase 1: Social Assessment • Define the quality of life (problems & priorities) of the target population • Involve members of population in a self-study of their needs • Social indicators: absenteeism, alienation, crime, discrimination, happiness, riots, self-esteem, welfare, unemployment

8. Phase 2: Epi. Assessment • Use data to ID and rank health goals or problems that identified in P1. • Data: disabilities, fertility, fitness, morbidity/mortality, physiological risk factors (incidence, prevalence, etc)

9. Phase 3: Behavioral & Environmental Assessment • Determining & Prioritizing Behavioral and Env. Risk Factors linked to P2 health problems • Behavioral: compliance, coping, prevention activities, self-care • Environmental: economic, services, society (access, affordability)

10. Prioritization Matrix Importance + Importance - Changeable + Changeable -

11. Phase 4: Educational & EcologicalAssessment • IDs and classifies factors that have the potential to influence a behavior • Predisposing: knowledge and traits • Reinforcing: Rewarding/feedback • Enabling: barriers created by societal forces

12. Phase 5: Administrative & Policy Assessment • Determine if the resources are available to develop and implement the program • Establish Goals and Objectives • Precede ends

13. Phase 6: Implementation • Select models and strategies of the intervention • Implementation begins • Proceed begins

14. Phase 7: Process Evaluation • Based on Goals & Objectives of P5 • Measurements gathered during implementation • To control, assure, or improve program quality

15. Phase 8: Impact Evaluation • The immediate observable effects of a program • Leads to the intended outcomes of a program • Intermediate outcomes

16. Phase 9: Outcome Evaluation • An ultimate goal or product of a program • Generally measured by morbidity or mortality, vital measures, symptoms, signs

17. MATCH • Multilevel Approach to Community Health (MATCH) • Intervention activities should be aimed at a variety of objectives and individuals

18. MATCH, when is it used? • When behavioral and environmental risk and protective factors are known • When general priorities for action have been determined • Focuses on program development

19. Phases of MATCH • 1: Goal Selection – select health-status goals, priority populations, select health behavior goals, and environmental factors/goals • 2: Intervention Planning – match intervention objectives with intervention targets and intervention actions

20. TIAs:Targets of the Intervention Actions • Individuals that exert influence or control over the personal or environmental conditions related to the health & behavior goals • Levels of TIAs: individual, interpersonal, organizational, societal, and governmental.

21. Phases of MATCH • 3: Program Development – create program units or components, select or develop curricula, develop session plans, create or acquire materials • 4: Implementation Preparations – facilitate adoption, implementation and maintenance; select and train implementors (educators)

22. Phases of MATCH • 5: Evaluation – Conduct process evaluation, measure impact and monitor outcomes

23. PATCH • Planned Approach to Community Health (PATCH) • Developed by CDC in the mid 1980s • With the Community definition of… • Can be used in a variety of health ed and health promotion situations • 5 Steps

24. PATCH Steps • Mobilizing the Community • Collecting and organizing data • Choosing health priorities and target groups • Choosing and conducting interventions • Conducting Evaluations

25. PATCH suggested elements • Community support and participation • Data collection and analysis • Objectives and standards to help plan and evaluation • Adoption of multiple strategies in multiple situations • Sustained monitoring and evaluation • Local and national support

26. APEXPH and MAPP • Assessment Protocol for Excellence in Public Health (APEXPH) and Mobilizing for Action through Planning and Partnership (MAPP) • APEXPH – a tool for local health departments for all components of program planning • MAPP – enhanced APEXPH, more structured framework for assessment and program planning.

27. APEXPH • Organizational Capacity Assessment • Community Process • Completing the Cycle

28. MAPP Four Assessments • Community themes and strengths assessment • Local public health system assessment • Community health status assessment • Forces of change assessment Prioritize strategic issues Goals & Objectives Action Cycle – planning, implement, evaluate

29. Health Communication • Any type of human communication concerned with health • The art and technique of informing, influencing, and motivating audiences about important health issues • Includes health education, social marketing, and mass communication

30. Social Marketing • A program planning process designed to influence the voluntary behavior of a specific audience segment to achieve a social rather than a financial objective • Positions consumers at the core of all activity • Not complicated, just time-consuming and costly

31. Social Marketing – key elements • Audience centered program development • Promotion of voluntary behavior change • Audience segmentation and profiling • Formative research to develop & test programs • Range of product development based on audience research (AR)

32. Social Marketing – key elements • Product distribution based on AR • Program promotion through channels identified in AR • Process evaluation • Outcome evaluation • Audience & community involvement in the planning process (i.e, focus groups)

33. CDCynergy • Most comprehensive and theoretically based health communication model • CD-ROM tool • Six Phases • Creation of a Social Marketing Plan

34. Phases of CDCynergy • Problem Definition & Description • Problem Analysis • Communication Program Planning • Program & Evaluation Development • Program Implementation & Management • Feedback

35. How Grants Fit In? A statement of the obvious Programs Money Models Funding Resources Plans