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Theories & Planning Models:

A Deeper Understanding of the PRECEDE-PROCEED Planning Model

Key Terms

Corresponding Terms with Other Theories:

  • Explanatory Theory: Defines as "Multi-variable constructs used to make sense of complex events and situaitions (Davidoff, 2019).

  • Change Theory: Guides the development of health interventions (NIH 2005).

  • The Ecological perspective: The interaction between interdependence factors, individual factors, and social environments (NIH, 2005, p.10)

  • Multi-levels of influence: (1) Intrapersonal or individual factors, (2) Interpersonal factors, (3)institutional or organizational factors,(4)community factors, (5) public policy factors ((Cottrell et al., 2018, p. 96)

  • Reciprocal Causation: "Means the cause- effect relationship are bi-directional, as a cause could later become a effect and vice versa", (Svensson, 2018).

Key Terms

  • Theory: It is a sets of concepts, definitions, and propositions that explain or predict these events or situations by illustrating the relationships between variables (NIH, 2005, p.4).

  • Concepts: The primary elements of theory (Cottrell et al, 2018, p. 93)

  • Constructs: A concept that has been developed, created or adopted for the use of a specific theory (Cottrell et al, 2018, p. 93).

  • Variables: The quantitative measurment of a construct (Cottrell et al, 2018, p. 93).

  • Model: Draw on a number of theroies to help understand a particular problem in a certain setting or context. Some are not specified as a theory (NIH, 2005, p. 4)

Importance of Using theory In Health Education and Promotion

Importance of Theory In Health Education & Promotion

1. Theory helps organize forms of knowledge (e.g. data, facts, and information), (Cottrell et al., 2018, p. 94).

2. Theory also helps health specialists to plan, implement, and evaluate programs (Cottrell et al., 2018, p. 94).

3. Theory is used for a checkpoint throughout history. Theory can be drawn upon through other professional in order to benefit people of the need of specific interventions (Cottrell et al., 2018, p. 94).

4. Theory uses the explanatory Theory and Change theory interchangably to address the wrong or inappropriate behaviors, which also target the overall goal of the intervention (Green, 2000).

*Note: A single theory is not one size fits all. There needs to be a varitey of different theories in order to fit an specific individual, social group, community and etc (NIH 2005, p. 5)

What is Socio-Ecological Approach?

Intrapersonal

Individual characterisitics that influence behavior, such as knowledge, attitudes, beliefs, and personality traits.

Interpersonal

Interpersonal processes and primary groups, including family, friends and peers that provide social identidy, support and role definition

  • The Socio-ecological approach is also known as "The ecological Perspective".

  • The Socio-ecological approach is used to understand human development from a multi-level framework (Cottrell et al., 2018, p, 96).

  • This framework which shapes a human included intrapersonal or individual factors, interpsonal factors, Organizational facotrs, community factors, Public policy, physical ebvironemnt, and culture (Cottrell et al., 2018, p, 96).

Community Level

Institional Factors

Rules, regulations, policies, and informal structures, which may constrain or promote recommended behaviors.

The concept of the Socio-Ecological Approach

Community Factors

Social networks and norms, or standards, which exist as formal or informal among individuals, groups, and organizations

Public Policy

Local, state, and federal policies and laws that regulate or support healthy actions and practices for disease prevention, early detection, control and mangement

(NIH, 2005, p. 11)

How can the Socio-ecological Approach be applied to other theories?

While the Socio-Ecological approach(the ecological perspective uses the multiple levels of influence and reciporcal causation, below in each bubble is demonstrated example of how SEA are applied to other theories using the mentions concepts.

Application to other Theories

Health Belief Model

The individual's perceptions of the threat posed by a health problem (susceptibility, severity), the benefits of avoiding the threat, and the factors influencing the decision to act (barriers, cues to action, and self efficacy), (NIH, 2005, p. 13).

Intrapersonal Level:

HBM

Social Cognitive Theory

Social Cognitive Theory describes a dynmaic, onggoing process in which personal factors, environemntal factors, and human behavior exert infleuence upon each other.

1. Recipcoral Determinism

2. Behavioral Capability

3. Expectations

4. Self-effacacy

5. Observational learning

6.Reinforcements

(NIH, 2005, p. 20)

Interpersonal Level:

SCT

Diffusion of Innovations Theory

Communtiy Level: DIT

Diffusion of Innovations Theory is a Theory at the community level. Which means serving populations on how to use social systems and functions to change effectively.

DIT addresses how new ideas, products, and social practices spread within a organization, community, or society, or from one society to another, (NIH 2005, p.23)

What is the PRECEDE-PROCEED Planning Model?

PROCEDE-PROCEED

  • The Precede- Proceed is a planning model which is much different from a theory, a theory is one way to explain why a situation or event is occuring. While a planning model is a roadmap or blueprint on how to prevent a disease through a variety of steps. (Crosby & Noar, 2011).

  • The Procede-Proceed Model was a planning model shaped for 15-20 years (Cottrel et al., 2018, p. 115).

  • The Precede framework was created in the early 1970s and the Proceed portion was adopted in the 1980s.

  • The underlying appraoch of this model begins by identifying the desired outcome, the determines, what causes it, and finally designs an implementation aimed at reaching the desired outcome.

  • In easier terms, this models starts with the final consequences and works backwardsto the causes.

(Cottrel et al., 2018, 115)

What approaches or promotion can come out of PRECEDE-PROCEED Planning Model?

Approaches to PRECEDE-PROCEED

The approaches to the Precede-proceed planing consist of (1) planninng and (2) Evaluation.

The Model consists of eight phases. The first four phases are the Precede portion and the second four consist of the Proceed portion. The Model consists of eight phases. The first four phases are the Precede portion and the second four consist of the Proceed portion (Cottrell et al, 2018, p. 115).

During each step of Precede-Proceed planning model or PPM, there are different Diagnostic elements that will need to take place:

1. Social assessment

2. Epidemiological Assessment

3. Behavioral/Environmental Assessment

4. Educational/Ecological Assessment

5.Administrative/policy Assessment

1.

(NIH, 2005, p. 41-42).

Components of PRECEDE-PROCEED

Components

PRECEDE COMPONENTS

PRECEDE Phases

Predisposing

Reinforcing

Enabling

Constructs

in

Educational/envrionemental

Diagnosis

and

Evaluation

(Crosby & Noar, 2011)

PROCEED COMPONENTS

Policy

Regulatory

Organizational

Constructs

in

Educational

and

Environmental

Diagnosis

(Crosby & Noar, 2011)

PROCEED

Phases

What is the Importance of the PRECEDE-PROCEED Planning Model?

The importance of the Precede-Proceed Planning model helps practitioners to develop programs, step by step by integrating multiple theories to explain and address the health problem (Cottrell et al., 2018, p. 115).

Importance and Visual of the PRECEDE- PROCEED Planning Model

More specifically, the Precede-Proceed planning model is a unique way of solving health issues by combining the two elements of the model.

Each element consists of 4 different steps in order to research the desired outcome (NIH, 2005, p. 3). The first four phases are the Precede component and the second set of four phases ar the Proceed.

PRECEDE-PROCEED

Planning Model

Below is attached a video using different and interactive visuals of the Precede-Proceed Planning model. To the right is a flow chart of the phases of Precede-Proceed Model from start to finish.

PRECEDE-PROCEED Planning Model Visual

(Cottrell et al., 2018, p. 115)

(Gilmore, 2019)

Scenrio of PRECEDE-PROCEED Planning Model

As Administration approves the curriculm withn schools to start infleuences students and parents or gardians to begin other physical activties within their homes, the implementation is put into place for a period of time. ((Implementation)

In the first steps of the Precede portion of the model, to figure out why the small population in a rural area of Northern NY has such low rate of physical activity within their communities.

First, I would use the social assessment, i would perform interviews, data collections, and participant observations. observing school functions and staff interviews, and discuss with the parents the current participation in physical activity or sports for the community (Phase 1: Social Assessment).

The next step includes carrying out the plan or adding to the implementaton. For increasing participating in physical activity the students starts to introduce different functions att schools and nearby parks to involve the community to participate. There are fun runs, specific dog walks to raise money for other functions, roller blades group tours, bike tours, and other external professional that come to initiate the increase of participation for physical activity within the communities. ( Phase 6: Process Evaluation)

Following that step, I would use different data from other areas and compare to the population of Northern NY based on the average of participation of physical activity. Based on these results, i would strategize what the community is in need of in regards to implementing ways to increase physical activity within the community. (Phase 2; Epidemiological assessment)

Application of PRECEDE-PROCEED Planning Model

Using the different strategies to promote physical activity which main source is through schools and families can giving the families and student reason behind why physical activitiy is important to living a quality life without diease or illness. To keep implementing different promotion strategies like creating different communal groups with different activities to try and get involved are way you can make an impact on indidivuals lives within this community or area. (Phase 7; Impact Evaluation).

The next step includes what kind of barriers block them reduce the participation levels of physical activity. This could include a variety factors such are cost barriers, distance, lack of resources, no local services, and low educational information on knowledge on the subject that is being influence in this area. (Phase 3; Behavioral and Environemental Assessment).

The last phase consist of the result of if the intervention or implementation had changed the behaviors, attitudes or beliefs of the individuala about physical activity. This can be measured through pre- and post interviews from pervious particiants. This also can be measured based on a epidemilogical view and seeing the rate of how many families with the near by school distrist participate in schedules weekly physical activities. (Phase 8: Outcome Evaluation)

In the fourth step of the Precede portion, is implementing new curriculm in schools, promoting clubs around town including youth and adult participation in order to change the behavior or even mindsets of individuals. There are many more ways to influene the areas idea of physical activity. Using social media or other things that individuals view on a daily basis to show them simply having more movement throughout your day can be just as abenefical as exercising in order to reduce the risk of disease or death. (Phase 4: Educational and Ecological Assessment).

Some souces refer to the last steps as Administravtive and Policy Diagnosis9 Phase 4.a). For my example, I would present a implementation in embedding different currciulm for schools to promote different strategies of physical activitiy for students and parents. Also posible entering new ways to promote physical activitiy with simple examples such as taking a walk, moving the grass, sholving the drive way, doing house chores. This can be easily be a simple change as long as the efforts are applied.

Summary

Defining theory to a planning model has it's differences. For example a theory is one set way to fix a health issue. Whereas a planning model, is a roadmap to implementing solutions to fix a health problem with a speicifc community or area. In addition the social-ecological approach can help a planning model such a the Precede-Proceed planning model to guide a community of what is vital to help their communties thrive as individuals anda as a population. This requires a mutli-level framework which breaksbown all the different factors that could be causing the behaviors in the first place. As for the Precede-Proceed model, there is a intended goal intitally and is worked backwards in order to investigate the the beginning factors of the health problem. The model uses 8 steps to help create different programs, interventions, and other promotions to influence the positive behaviors on how to prevent the issues from continuing.

APA Bibliopgrpahy

APA Bibliography

Crosby,R., Noar, S.M. (2011). What is Planning a Model?: An Introduction to Precede-Procede. Journal of Public Health Dentistry. https://doi.org/10.1111/j.1752-7325.2011.00235.x

Cottrell, R. R., Girvan, J. T., Siebert, D., Spear, D. & McKenzie, J. F. (7th edition). (2018) Principles & foundations of health promotion and education. New York, NY; Pearson Education.

Davidoff, F. (2019) Understanding Contexts: How Explaining Theories Can Help. Implementation Science. 14 (23). https://implementationscience.biomedcentral.com/articles/10.1186/s13012-019-0872-8#citeas

Gilmore, N.[Nancy Gilmore]. (2019, October 6). Precede-Proceed Model. [Video]. Youtube. https://www.youtube.com/watch?v=YmD4Ju0TGS0

Green, J. (2000). The Role of Theory in Evidence-Based Health Education Research. 15(2) 125-129. https://doi.org/10.1093/her/15.2.125

National Insititute of Health.(2005). National Cancer Institute . Theory at a Glance: A Guide for Health Promotion Practice. http://www.sbccimplementationkits.org/demandrmnch/wp-content/uploads/2014/02/Theory-at-a-Glance-A-Guide-For-Health-Promotion-Practice.pdf

Oxford University Press. (2011). Dependent and Independent Variables. Dictionary of Media and Communication (1, 472).

Svensson, E. (2018). On Reciprocal Causation in the Evolutionary Process. Evolutionary Biology. National Library of Medicine. 45(1):1-14. https://doi.org/10.1007/s11692-017-9431-x

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