PRECED/PROCEED MODEL

What is PRECEDE/PROCEED?
PRECEDE/PROCEED is a community-oriented, participatory model for creating successful community health promotion interventions.

1. PRECED PROCEED MODEL By A.L and G.K DEPARTMENT OF OPTOMETRY Gondar,ETHIOPIA 5/13/2019 1

2. OBJECTIVES At the end of this session, you are expected to: Define what PRECEDE-PROCEED model is. Identify phases of the model List the assumptions Generalize the core concepts of the model 5/13/2019 2

3. OUTLINES PRECEDE-PROCEED MODEL Introduction Phases Assumptions Precede model Proceed model Summary References 5/13/2019 3

4. A Model for Program Planning in Health Promotion Background Information: Models serve as frames from which to build, Provide structure & organization for the planning process Many different models Common elements, but different labels 5/13/2019 4

5. …Background Information : No perfect model Can be used in entirety, parts, & combinations Three characteristics 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 Categories Practitioner driven Consumer-based 5/13/2019 5

6. PRECEDE-PROCEED What is PRECEDE/PROCEED? PRECEDE/PROCEED is a community-oriented, participatory model for creating successful community health promotion interventions . Originators Lawrence W . Green Marshall W. Krueter 5/13/2019 6

7. PRECEDE has five phases: Phase 1: Social diagnosis Phase 2: Epidemiological diagnosis Phase 3: Behavioral and environmental diagnosis Phase 4: Educational and organizational diagnosis Phase 5: Administrative and policy diagnosis 5/13/2019 7

8. PROCEED has four phases: Phase 6: Implementation Phase 7: Process evaluation Phase 8: Impact evaluation Phase 9: Outcome evaluation 5/13/2019 8

9. Assumptions behind PRECEDE/PROCEED: Behavior change is voluntary Health promotion is more likely to be effective if it’s participatory . Health and other issues must be looked at in the context of the community . Health and other issues are essentially quality-of-life issues . Health is itself a constellation of factors that add up to a healthy life for individuals and communities. 5/13/2019 9

10. Why use PRECEDE-PROCEED? A logic model provides: => A procedural structure for constructing an intervention. => A framework for critical analysis. => An assurance for community involvement. => A chance to constantly monitor and adjust an evaluation since it incorporates a multi-level evaluation. => An adaptation of the content and methods of the intervention to a particular need and circumstance. 5/13/2019 10

11. PRECEDE model Phase 1 -Social Assessment Assessment means ... Identify Describe Prioritize Phase 1 -seeks to subjectively define the QOL (problems & priorities) of priority population - Self-assessment of needs & aspirations 5/13/2019 11

12. Methods for social diagnosis Community Forums Nominal Groups Focus Groups Surveys Interviews : key personnel , leaders… Literature Review –secondary information 5/13/2019 12

13. Phase 2 –Epidemiological Assessment Epidemiology -study of the distribution & determinants of disease Based on epidemiological Data Epidemiological Data: -Mortality - Morbidity - Disability - Fertility -Incidence rates - Prevalence rates 5/13/2019 13

14. Phase 3: Behavioral Diagnosis Focuses on behavioral and non-behavioral causes (personal and environmental factors) which seem to be linked to health problems defined in Phase 2. A. Behavior of Interest (factors) Maybe… Behavior of the people whose health is in question Community Leaders Legislators Parents Teachers Health Professionals 5/13/2019 14

15. B. Environmental or Non-Behavioral Factors Environmental Factors Include: Determinants outside the person that can be modified to support behavior, health, or quality of life. Physical Social Economic Genetic Predisposition Age Gender Existing Disease Workplace Adequacy of Health Care Facilities 5/13/2019 15

16. Phase 4: Educational &Organizational(ecological) Diagnosis Identifies causal factors that must be changed to initiate and sustain the process of behaviora l and environmental change identified in Phase 3. 5/13/2019 16

17. …Educational &Organizational Diagnosis The three types of influencing factors(P,E,R) should be identified first to assess their relative importance and changeability. Then related learning and organizational objectives can be written, and state so that health promotion programs can focus where they will do the most good in facilitating development of or changes in behavior and environment. 5/13/2019 17

18. …Educational &Organizational Diagnosis Theory is applied in this Phase Predisposing Individual Factors -Individual Theories Enabling Factors –Interpersonal Level Theories Reinforcing Factors –Community Level and Systems Theories 5/13/2019 18

19. The factors(P,E,R) A. Predisposing Factors Knowledge Attitudes Values Beliefs Perceived Needs and Abilities 5/13/2019 19

20. B.Enabling Factors Environmental and Personal Resources that impact: Availability and Affordability Programs & Services Money & Time Accessibility Facilities Skills Laws 5/13/2019 20

21. C.Reinforcing factors Positive or Negative Feedback From : Peers Family Health Care Workers Law Enforcement Media Others 5/13/2019 21

22. Phase 5: Administrative and Policy Diagnosis Focuses on administrative and organizational concerns which must be addressed prior to program implementation Includes : Assessment of resources Budget development and allocation Development of implementation timetable Organization and coordination with others 5/13/2019 22

23. …Administrative and Policy Diagnosis 5/13/2019 23

24. …Administrative and Policy Diagnosis Administrative Diagnosis Analysis of policies, resources and circumstances prevailing organizational situations that could hinder or facilitate the development of the health program Assesses the compatibility of your program goals/objectives with those of the organization and its administration 5/13/2019 24

25. …Administrative and Policy Diagnosis Work in this phase is specific to the context of the program and the sponsoring organization(s) and requires political savvy as much as theoretical or empirical knowledge Informed by theories, particularly community-level theories Assess limitations and constraints Select the best combination of methods and strategies 5/13/2019 25

26. PROCEED Model Implementation & evaluation phase. Goes beyond educational interventions to the political, managerial, and economic actions necessary to make social system environments more conducive to healthful lifestyles and a more complete state of physical, mental and social well- being for all 5/13/2019 26

27. Phase 6:Implementation Implementation - The act of converting program objectives into actions through policy changes , regulation and organization . (Green & Kreuter, 1991, p.432 ) Beginning of PROCEED Selection of methods and strategies of the intervention, for example, education &/or other resources Program begins 5/13/2019 27

28. Evaluation 5/13/2019 28 Clear and concise objectives are the foundation for evaluation From two perspective –Health Program and Health Education program Health Education Programs intermediate to Health Programs Three types of evaluation –Diagnostic, Formative & Summative Three areas of evaluation –process, impact and outcome .

29. 5/13/2019 29 •To evaluate the process by which the program is being implemented •Ongoing; flow of activities •Includes effectiveness of planning meetings, running meetings, communicating with others who are involved Phase 7 Process Evaluation

30. 5/13/2019 30 Health Education Impact –Change in Behavioral and environmental indicators Program Impact –Change in Epidemiological and social indicators It measures the effectiveness of the program with regards to the intermediate objectives as well as the changes in predisposing, enabling, and reinforcing factors. Phase 8-Impact Evaluation

31. 5/13/2019 31 •Outcome may indicate all -output , effect or impact •Output – Immediate outcome •Effect –More qualitative in nature •Impact –Change in quality of life of the people Phase 9-Outcome Evaluation

32. SUMMARY OF THE MODEL 5/13/2019 32

33. REFERENCES American Journal of Health Promotion Green, W. Lawrence. Health Promotion Planning an Educational & Environmental Approach. Second edition. Mayfield Publishing Company. 1991 5/13/2019 33

34. Thank you 5/13/2019 34