Implementation Process Evaluation Impact Evaluation Outcome Evaluation

Response one ph-cap-04

I’ve found the social cognitive theory model to prove effective towards helping programs similar to the one I proposed. The social cognitive theory model (SCT) can be used as a theoretical framework to effectively predict trends by connecting the interrelationship between a person’s cognitive processes and personality, their environment (physical and social aspects), and behavior that attribute to a person’s actions in response to those influences (Simons-Morton et al., Behavior Theory in Health Promotion Practice and Research, 2012, p. 30-31). The SCT model has also been used for plans such as emergency preparedness plans to predict hazards such as floods, earthquakes, volcanoes, other environmental hazards, man-made hazards, and etc. (Ejeta et al, 2015). The SCT, used as a theoretical framework for the plans stated above was effective towards predicting environmental hazards etc. by providing “risk perception, critical awareness, anxiety being mediated by outcome expectancy, self-efficacy, and action coping” influenced intention to prepare…and intention to seek information (Ejeta et al, 2015).” For something that is unpredictable, the SCT model could be used to effectively predict health trends – to help reach my program goals, provide awareness and encourage individuals to seek information and prepare.


Ejeta, L. T., Ardalan, A., & Paton, D. (2015). Application of Behavioral Theories to Disaster and Emergency Health Preparedness: A Systematic Review. PLoS Currents. doi:10.1371/currents.dis.31a8995ced321301466db400f1357829

Simons-Morton, B., McLeroy, K., & Wendel, M. (2012). Behavior theory in health

promotion practice and research. Sudbury, MA: Jones & Bartlett Learning.

Response two PH-cap-04

The most useful theoretical framework I’ve found while researching suicide prevention is the Social-Ecological Suicide Prevention Model (Cramer & Kapusta, 2017). This framework is extremely useful because it utilizes existing theories at each socio-ecological level. This ensures that any approach to suicide prevention will target all levels.

The model I find most useful for planning and evaluation of public health programs is the PRECEDE-PROCEED model (PPM). PPM is a planning tool for health promotion and interventions. Based on work first published in “Health Promotion Planning: An Educational and Environmental Approach by Green and Krauter” (1993). PPM is extremely useful because it’s wildly adaptable to the population of interest but also focuses on the individuals within that population. While utilizing PPM it’s important to include the entire community in the PPM process (Perrin, 2014). It’s also designed to be circular or continuous which is important for long-term projects to continue improving. I think PPM would be useful in this suicide prevention program application because it’s extremely adaptable and very community driven.

PPM is broken down into two parts with four phases each. The PRECEDE phases focus on planning and assessments to figure out what needs to be done.

Social Assessments Epidemiological Assessments Educational & Ecological Assessments Administrative and Policy Assessment and Intervention Alignment

During the PROCEED phases, the plan is implemented and evaluated for success.

Implementation Process Evaluation Impact Evaluation Outcome Evaluation

References Cramer, R. J., & Kapusta, N. D. (2017). A Social-Ecological Framework of Theory, Assessment, and Prevention of Suicide. Frontiers in Psychology, 8, 1756. Green, L. W., & Kreuter, M. W. (1993). Health promotion planning: An educational and ecological approach. Perrin, K. M. (2014). Essentials of Planning and Evaluation for Public Health. Jones & Bartlett Publishers. Simons-Morton, B., McLeroy, K. R., & Wendel, M. (2012). Behavior Theory in Health Promotion Practice and Research. Jones & Bartlett Publishers.

Response three ph-cap-03

To address the issue of disproportionality in maternal and infant mortality rates in the Seattle area by increasing access to and use of midwifes, it would be important to apply the Social Cognitive Theory when designing the program.  The Social Cognitive Theory (SCT) proffers that human behavior is a three way, dynamic, reciprocal model where personal elements, environmental influences and behavior are constantly interacting (Glanz, 2016).  In order to positively impact maternal and infant mortality rates amongst African and Native American women, addressing each element of the SCT will be imperative.

The SCT can be effective amongst communities of color, with the application of some of the theories key constructs which include observational learning, reinforcement, self-control and self-efficacy (Glanz, 2016).  It has been determined that the more a person identifies with a traditional heritage, the more they will follow the traditional health and illness beliefs and practices derived from their own ethnocultural heritage (Spector, 2002).  This thought of heritage consistency translates into the SCT elements of observational learning and reinforcement.  When expectant mothers see other women within their communities accessing quality healthcare services and having healthy pregnancies and deliveries it will serve as reinforcement that healthcare during pregnancy is beneficial and effective.

It would be best to apply a right to left or reverse logic model when developing programs to address maternal and infant mortality rates.  The reverse logic model begins with the identification of desired outcomes and then working backward to define activities and inputs (CDC, nd).  This will be particularly helpful in the planning of the program as it requires evaluation of the method to be utilized through each step.  According to the CDC (nd), this approach ensures that sound logic will lead to the desired outcome.


CDC. (nd).  Logic Models [pdf].  Centers for Disease Control and Prevention.  Web.  Retrieved from

Glanz, K. (2016).  Social and behavioral theories [pdf]. National Institutes of Health, Office of Behavioral and Social Science Research.  Web. Retrieved from

· Spector, R. (2002).  Cultural Diversity in Health and Illness.   Journal of Transcultural Nursing, 197-99. Web.

Response four PH-cap-04

Social Influence according to Simon-Morton, is a “prominent aspect of society, and active field of research, and a goal of politics, commerce, and public health”. It’s also regarded as product of information shared among group members to form a Norm (Simon-Morton, 2012). Also stated by Turnock, “Whenever a behavior is known to be accepted within a community, it’s well recognized to be practicable within that community, these norms may include unemployment, abuse of illegal substances that leads to gun violence” (Turnock, 2016).

I leaned towards the Theory of Reasoned Action (TRA) is based on the idea that intention is largely rational, based on an individual’s beliefs and attitudes. The rationale of TRA “is that behavior can be predicted by intentions, intentions are predicted by attitudes, and attitudes are made up of beliefs” (Simon-Morton, 2012). Furthermore, I believed that the individuals must have weighed their options towards the use of gun and whether to not to perform the killing act.

Prevention of violence occurs along a continuum that begins in early childhood with programs to help parents raise emotionally healthy children and ends with efforts to identify and intervene with troubled individuals who are threatening violence (Velicer, et al, 1998). The mental health community must take the lead in advocating for community-based collaborative problem-solving models to address the prevention of gun violence. Community counseling and education should blend prevention strategies in an effort to overcome the tendency within many community service systems to operate. There has been some success with community-based programs involving police training in crisis intervention and with community members trained in mental health first aid. those individuals affected knew quite alright what they are getting into, they behaved according to their intentions when the shooting opportunity presents itself.  Discussion of effective prevention from a community perspective should include identification of the community being examined. Within the larger community, many stakeholders are affected by gun violence that results in a homicide, suicide, or mass shooting. Such stakeholders include community and public safety officials, schools, workplaces, neighborhoods, mental health and public health systems, and faith-based groups (Velicer, et al, 1998).



Simons-Morton, B. G., Mcleroy, K. R., Wendel, M. L. (2012). Behavior theory in health promotion practice and research. Jones & Bartlett Publishers.

Turnock, B. J. (2016). Public Health: What it is and How it Works (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Velicer, W. F, Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Killing Cessation and stress management: Applications of the Theory of Reasoned Action Model of behavior change. Homeostasis, 38, 216-233.


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