1. Models for Program Planning in Health Promotion
HSC 489

2. Presentation Overview
The Purpose of Theories and Models
Various Models
How Grants Fit In

3. The Purpose of a Model “Models? I hate models!” “Not another model!”
“Rats!”
“What’s a
model?”

4. Theory versus Models A theory is… A model is…
“a tool to help health educators better understand what influences health”--Hochbaum et. al, 1992
explains how/why life happens
developed over time
A model is…
represents theory
framework for investigation/design
Examples:
PATCH PRECEDE/PROCEED

5. Precede-Proceed Model
PRECEDE: Predisposing, Reinforcing & Enabling constructs in Educational/Ecological Diagnosis & Evaluation
PROCEED: Policy, Regulatory & Organizational Constructs in Educational and Environmental Development
Green & Kreuter

6. PRECEDE/PROCEED Model
Phase 5
Administrative
& policy
assessment
Phase 4
Educational &
ecological
assessment
Phase 3
Behavioral &
environmental
assessment
Phase 2
“Epi”
assessment
Phase 1
Social
assessment
Health Promotion
Health Education
Policy
Predisposing Factors
Behavior
Quality of Life
Reinforcing Factors
Health
Environ-ment
Enabling Factors
Phase 6
Implementation
Phase 9
Outcome
Evaluation
Phase 8
Impact Evaluation
Phase 7
Process
Evaluation

7. Phase 1: Social Assessment
Define the quality of life (problems & priorities) of the target population
Involve members of population in a self-study of their needs
Social indicators: absenteeism, alienation, crime, discrimination, happiness, riots, self-esteem, welfare, unemployment

8. Phase 2: Epi. Assessment
Use data to ID and rank health goals or problems that identified in P1.
Data: disabilities, fertility, fitness, morbidity/mortality, physiological risk factors (incidence, prevalence, etc)
Add notes from book.

9. Phase 3: Behavioral & Environmental Assessment
Determining & Prioritizing Behavioral and Env. Risk Factors linked to P2 health problems
Behavioral: compliance, coping, prevention activities, self-care
Environmental: economic, services, society (access, affordability)

10. Prioritization Matrix
Importance +
Importance -
High Priority for program focus
Low priority
Priority for innovative program
No program
Changeable +
Changeable -

11. Phase 4: Educational & Ecological Assessment
IDs and classifies factors that have the potential to influence a behavior
Predisposing: knowledge and traits
Reinforcing: Rewarding/feedback
Enabling: barriers created by societal forces

12. Phase 5: Administrative & Policy Assessment
Determine if the resources are available to develop and implement the program
Establish Goals and Objectives
Precede ends

13. Phase 6: Implementation
Select models and strategies of the intervention
Implementation begins
Proceed begins

14. Phase 7: Process Evaluation
Based on Goals & Objectives of P5
Measurements gathered during implementation
To control, assure, or improve program quality
Add measurements from pg 273

15. Phase 8: Impact Evaluation
The immediate observable effects of a program
Leads to the intended outcomes of a program
Intermediate outcomes

16. Phase 9: Outcome Evaluation
An ultimate goal or product of a program
Generally measured by morbidity or mortality, vital measures, symptoms, signs

17. MATCH Multilevel Approach to Community Health (MATCH)
Intervention activities should be aimed at a variety of objectives and individuals

18. MATCH, when is it used?
When behavioral and environmental risk and protective factors are known
When general priorities for action have been determined
Focuses on program development

19. Phases of MATCH
1: Goal Selection – select health-status goals, priority populations, select health behavior goals, and environmental factors/goals
2: Intervention Planning – match intervention objectives with intervention targets and intervention actions

20. TIAs: Targets of the Intervention Actions
Individuals that exert influence or control over the personal or environmental conditions related to the health & behavior goals
Levels of TIAs: individual, interpersonal, organizational, societal, and governmental.

21. Phases of MATCH
3: Program Development – create program units or components, select or develop curricula, develop session plans, create or acquire materials
4: Implementation Preparations – facilitate adoption, implementation and maintenance; select and train implementors (educators)

22. Phases of MATCH
5: Evaluation – Conduct process evaluation, measure impact and monitor outcomes

23. PATCH Planned Approach to Community Health (PATCH)
Developed by CDC in the mid 1980s
With the Community definition of…
Can be used in a variety of health ed and health promotion situations
5 Steps

24. PATCH Steps Mobilizing the Community Collecting and organizing data
Choosing health priorities and target groups
Choosing and conducting interventions
Conducting Evaluations
1st three can be considered facets of a needs assessment, but only serve as a very general reminder of what should be done.

25. PATCH suggested elements
Community support and participation
Data collection and analysis
Objectives and standards to help plan and evaluation
Adoption of multiple strategies in multiple situations
Sustained monitoring and evaluation
Local and national support
Six elements critical to successful planning and action in community based public health programs.

26. APEXPH and MAPP
Assessment Protocol for Excellence in Public Health (APEXPH) and Mobilizing for Action through Planning and Partnership (MAPP)
APEXPH – a tool for local health departments for all components of program planning
MAPP – enhanced APEXPH, more structured framework for assessment and program planning.

27. APEXPH Organizational Capacity Assessment Community Process
Completing the Cycle

28. MAPP Four Assessments Community themes and strengths assessment
Local public health system assessment
Community health status assessment
Forces of change assessment
Prioritize strategic issues
Goals & Objectives
Action Cycle – planning, implement, evaluate

29. Health Communication
Any type of human communication concerned with health
The art and technique of informing, influencing, and motivating audiences about important health issues
Includes health education, social marketing, and mass communication

30. Social Marketing
A program planning process designed to influence the voluntary behavior of a specific audience segment to achieve a social rather than a financial objective
Positions consumers at the core of all activity
Not complicated, just time-consuming and costly

31. Social Marketing – key elements
Audience centered program development
Promotion of voluntary behavior change
Audience segmentation and profiling
Formative research to develop & test programs
Range of product development based on audience research (AR)

32. Social Marketing – key elements
Product distribution based on AR
Program promotion through channels identified in AR
Process evaluation
Outcome evaluation
Audience & community involvement in the planning process (i.e, focus groups)

33. CDCynergy
Most comprehensive and theoretically based health communication model
CD-ROM tool
Six Phases
Creation of a Social Marketing Plan

34. Phases of CDCynergy Problem Definition & Description Problem Analysis
Communication Program Planning
Program & Evaluation Development
Program Implementation & Management
Feedback

35. How Grants Fit In? A statement of the obvious
Programs
Money
Models
Funding
Resources
Plans