PRECEDE-PROCEED Study Activity
As a study tool, please list each step
Developed by Green et al 1970s
Predisposing, reinforcing and enabling constructs in educational/environmental diagnosis and evaluation
Educational diagnosis should precede a intervention plan
Counter emphasis on implementation without proper planning
Developed in 1991
Policy, regulatory, and organizational constructs in educational and environmental development
Recognize environmental factors impact on health
PRECEDE-PROCEED Planning Model
Step1: Social Assessment
People have come together and have a “shared vision”
Felt needs are identified
A specific health problem has been identified and some preliminary measurable health objective has been stated.
Some activities have commenced to initiate a needs assessment and learning about the problem.
Key informant interviews
These activities help to clarify the first phase in the model and move the group into the second phase.
Step 2: Epidemiological Assessment
Often secondary sources
Set priorities and prepare to write goals and objectives
Step 3: Behavioral and Environmental Assessment
List all possible risk factors associated with the problem. This should incorporate a thorough literature review.
Break into two lists – one titled behavioral with the other titled environmental.
Step 3 (con’t)
Identify criteria to shorten the list. Talk with experts and community personnel to determine which ones to eliminate
Determine prevalence of the behavior or how frequently the environmental factor is involved.
Determine if there is sufficient evidence whether the factor contributes to the problem
Each factor should be classified as important or not as important
Group process in conjunction with literature review should allow classification of low or high likelihood of change.
Create an importance and changeability matrix.
Step 3 cont.
Set objectives on the important and changeable factors.
Who is expected to change?
What is expected to change?
How much will change?
When will it change?
Step 4: Educational and Ecological Assessment
cognitive and affective attributes
knowledge, self-efficacy, locus of control, attitudes, beliefs, perceptions
these provide a rationale or motivation to perform a given behavior
Step 4 cont
Social support and the role it plays in rewarding or supporting a given behavior
Parents, family members, co-workers, peers, friends, health care providers, supervisors, can also include influential media.
Step 4 cont.
Factors that assist in promoting the chosen action.
Educational resources, supportive policies, changes, skill development environmental
“At the end of this phase, there should be specific objectives stated for each of the three factors”
Step 5: Administrative and Policy Assessment
Plan for time utilization and personnel needs.
Gantt Charts should be used to outline both areas.
Assessment of Available Resources
Material needs (educational, computer, paper, curriculum etc), building needs, training or re-training of personnel. Etc.
Identification of barriers. Financial, goal conflict, amount of change necessary, group and staff commitment etc.
Assess policies, regulations, organization
Determine – loyalty of personnel
are your goals consistent within the organization?
do you have the flexibility to do new things?
is there flexibility for the administrators to determine policy implementation?
Assessment of politics
Who within the organization and outside of the organization want this to succeed?
A plan for maximizing involvement of those who can help.
Steps 6-9: Implementation and Evaluation
Step 6; Implementation
Programs are like a child, it needs room to breathe, to experiment, to adapt to new circumstances and people“
Checklists – process evaluation begins.
Step 7; Process Evaluation
Are you doing what you said that you would do?
Are you following the Gantt charts as set out in the original document?
If there are changes, how have these been documented?
Methods – interviews, focus groups, paper trail. Discussions center on predisposing, reinforcing, and enabling factors.
Step 8; Impact Evaluation
There should be measurable changes as set out by the objectives derived in phase 3. Planning should have defined how these changes would be measured. Generally, paper and pencil measures, measures of observation, records etc.
Step 9; Outcome Evaluation
Are you achieving the program’s goals? Is there a reduction in CVD, perhaps a type of cancer, STD’s, illegal use of substances etc. Etc.
Usually done by examining the bottom line after a few years of programming.
of the planning model. Then, list actions that take place at each step to help you plan a program.