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Chapter 2

Chapter 2. Models for Program Planning in Health Promotion. Lecture by J. McKenzie. Background Information - 1. Good health promotion programs are not created by chance Models serve as frames from which to build; structure & organization for the planning process Many different models

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Chapter 2

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  1. Chapter 2 Models for Program Planning in Health Promotion Lecture by J. McKenzie

  2. Background Information - 1 • Good health promotion programs are not created by chance • Models serve as frames from which to build; structure & organization for the planning process • Many different models • Common elements, but different labels • Must understand the Generalized Model for Program Planning

  3. A Generalized Model for Program Planning

  4. Background Information - 2 • No perfect model • Can be used in entirety, parts, & combinations • Three Fs of program planning help with selecting the appropriate model • Fluidity - steps are sequential • Flexibility - adapt to needs of stakeholders • Functionality - useful in improving health conditions • Also, consider… • Population-based approach • Ecological framework – individuals/priority populations influenced by many different levels

  5. PRECEDE–PROCEED - 1 • PRECEDE – “predisposing, reinforcing, and enabling constructs in educational/ecological diagnosis & evaluation” (Green & Kreuter, 2005, p. 9) • Developed in the early 1970s • PROCEED – “policy, regulatory, and organizational constructs in educational & environmental development” (Green & Kreuter, 2005, p. 9) • Developed in the 1980s

  6. PRECEDE–PROCEED - 2 • Created Lawrence W. Green & Marshall W. Kreuter • Best known & often used model • Theoretically grounded • Comprehensive in nature • Found in many government programs, including PATCH

  7. PRECEDE–PROCEED - 3 • PRECEDE • First 4 phases are assessment phases; social, epidemiological, behavioral & environmental, educational & ecological, administrative & policy and intervention alignment • PROCEED • Last 4 phases; implementation, and process, impact, & outcome evaluation • Underlying approach – …begin by identifying the desired outcome, to determine what causes it, & then design an intervention to reach the desired outcome

  8. PRECEDE–PROCEED - 4

  9. Phase 1 - Social Assessment and Situational Analysis • Phase 1 - seeks to subjectively define the QOL (problems & priorities) of those in the priority population • Best accomplished by involving those in the priority population in self-assessment of needs & aspirations • Assessment means… • identify • describe • prioritize • Examples of social indicators of QOL: achievement, alienation, comfort, crime, happiness, self-esteem, unemployment, & welfare

  10. Phase 2 - Epidemiological Assessment - 1 • Phase 2 – is the step in which planners use data to identify & rank the health goals or problems that may contribute to or interact with problems identified in Phase 1 • Data include vital indicators (e.g., morbidity, mortality, & disability data) as well as genetic (new addition looks at relationship between genes & health/illness), behavioral (patterns of behavior that protect or put at risk), & environmental (things outside person that can be changed to impact health) factors • Not all problems health related, then skip Phase 2. • Risk factors/determinants can be prioritized with 2 X 2 matrix

  11. Prioritization Matrix

  12. Phase 3 - Educational & Ecological Assessment • Phase 3 – identifies & classifies factors that have potential influence behavior or change the environment • Predisposing factors – antecedent; impact motivation; e.g., knowledge, attitudes, beliefs, perceptions, & values • Enabling factors – antecedent; barriers & vehicles; e.g., skills, access, availability, rules, & laws • Reinforcing factors – subsequent; feedback & rewards; e.g., social benefits such as recognition, appreciation; incentives; disincentives • Priorities become focus of intervention

  13. Phase 4 - Intervention Alignment &Administrative & Policy Assessment • The intent of intervention alignment is to match appropriate strategies & interventions with projected changes and outcomes identified in earlier phases • In administration & policy assessment, planners determine if capabilities & resources are available to develop & implement program • Close to the end of PRECEDE & moving toward PROCEED; though not a distinct break

  14. Phase 5 - Implementation • Beginning of PROCEED • Phase 5 – with resources in hand, planners select methods and strategies of the intervention; examples education, communication, evironmental change, etc. • Program begins

  15. Phases 6, 7, & 8 - Evaluation • Process evaluation – measurements of implementation to control, assure, or improve the quality of the program • Impact evaluation – immediate observable effects of program • Outcome evaluation – long-term effects of the program • Line up with PRECEDE • Which ones are used depends on the evaluation requirements of the program

  16. Multilevel Approach To Community Health (MATCH) - 1 • Developed in late 1980s • Used by U.S. Government • Applied when behavioral & environmental risk & protective factors for disease / injury are known & general priorities determined • Includes ecological planning - levels of influence

  17. MATCH - 2

  18. MATCH - 3 • Phase 1 – Health Goals Section • Select goals - consider prevalence, importance, & changeability • Select priority (target) population • Identify behaviors associated with health status • Identify environmental factors (barriers & vehicles) • Phase 2 - Intervention Planning • Select intervention objectives • Identify targets of intervention (TIAs) • Select intervention approaches (ecological levels): Governments, Organizations, Communities, Individuals

  19. MATCH - 4 • Phase 3 – Development • Create program units or components • Create plans • Phase 4 – Implementation • Adoption • Implementation • Maintenance • Phase 5 – Evaluation • Conduct process evaluation • Measure impact • Monitor outcome

  20. Consumer-Based Planning • Decisions based on consumer input & made with consumers in mind; include consumers throughout • Based on concepts from– • health communication – strategies to inform & influence individual & community decisions to enhance health (NCI, 2002) • social marketing – “the application of commercial marketing technologies to the analysis, planning, execution, and evaluation of programs designed to influence the voluntary behavior of target [priority] audiences in order to improve their personal welfare and that of their society” (Andreasen, 1995, p. 7)

  21. Key Elements that Best Characterize the Practice of Social Marketing

  22. CDCynergy - 1 • Developed by the Office of Communication at the CDC in 1997 • First issued in 1998 • Developed initially for public health professionals at CDC with responsibilities for health communication • Developed for health communication but can be used with all health promotion planning • Available on CD-ROM

  23. CDCynergy - 2 P 6: Implement Plan P 3: Plan Intervention (Is communication dominant or supportive?) P 5: Plan Evaluation P 4: Develop Intervention P 2: Analyze Problem (causes, goals, intervention strategies P 1: Describe Problem (identify & define)

  24. CDCynergy - 3 • Other links • Lite • Glossary • Index • CDC Web • Help • My Plan Navigation controls: Contains 52 steps divided among the phases Active buttons [change with phase & step] (examples, resources,& consultant) Non-changing buttons (tools for research & media library) There is also a supplemental resources CD for CDCynergy 3.0

  25. The future of CDCynergy • Plans to make CDCynergy web-based • Several versions & more to come • http://www.cdc.gov/communication/cdcynergy.htm

  26. Social Marketing Assessment & Response Tool (SMART) - 1 • SMART, created by Neiger & Thackeray (1998), is a social marketing planning framework • A careful review of the model provides an excellent overview of social marketing • SMART has seven phases • The heart of the model is composed of Phases 2, 3 , & 4; usually performed simultaneously

  27. SMART - 2 P 1: Preliminary Planning [problem, name in terms of behavior, develop goals, project costs] P 4: Channel Analysis [interpersonal, small group, organizational, community, mass media] P 2: Consumer Analysis [segment priority population & determine needs, wants, & preferences]; also secondary & tertiary audiences P 3: Market Analysis [4Ps, competitors, & partners] P 5: Developing Interventions, Materials, & Pretesting P 6: Implementation P 7: Evaluation

  28. Other Planning Models Explained in Text • MAPP • APEX-PH • SWOT • Healthy Communities • Healthy Plan-IT • Planned Approach to Community Health

  29. Chapter 2 - The End

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