Models for Program Planning in Health Promotion

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Models for Program Planning in Health Promotion

• Chapter 2

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Planning Models 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

A Generalized Model for Program Planning
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Background Information (cont.)

• No perfect model
• Can be used in entirety, parts, combinations
• Three Fs 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

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PRECEDE - PROCEED

• PRECEDE - predisposing, reinforcing, and enabling
  constructs in education / ecological diagnosis
  evaluation
• PROCEED - policy, regulatory, and organizational
  constructs in educational environmental
  development

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PRECEDE - PROCEED

• Larry Green Marshall Kreuter
• PRECEDE created in early 1970s
• PROCEED created in the 1980s
• Best known often used model
• Theoretically grounded
• Comprehensive in nature
• Found in many government programs

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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

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Phase 2 - Epidemiological Assessment

• Epidemiology - study of the distribution
  determinants of disease
• What are the health problems associated with the
  desired QOL?
• Not all problems health related If Phase 2 not
  applicable, skip and move on to Phase 3.

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Phase 3 - Behavioral Environmental Assessment

• Behavior of priority population
• Determining prioritizing behavioral
  environmental risk factors or conditions linked
  to the health problem
• Environmental factors - determinants outside an
  individual, that can be modified to support
  behavior, health, or QOL
• Once identified, must be prioritized

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Phase 4 - Educational Ecological Assessment

• Identifies classifies factors that have
  potential to influence behavior or change the
  environment
• Predisposing factors - antecedent impact
  motivation e.g., knowledge, attitudes , beliefs,
  values
• Enabling factors - antecedent barriers
  vehicles e.g., access, availability
• Reinforcing factors - subsequent feedback
  rewards e.g., incentives, disincentives
• Priorities become focus of intervention

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Phase 5 - Administrative Policy Assessment

• Determine if capabilities resources are
  available to develop implement program
• Close to the end of PRECEDE moving toward
  PROCEED

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Phase 6 - Implementation

• Beginning of PROCEED
• Selection of methods and strategies of the
  intervention, for example, education /or other
  resources
• Program begins

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Phases 7, 8, 9 - Evaluation

• Process evaluation - measurements of
  implementation to control, assure, or improve the
  quality of the program
• Impact evaluation - immediate observable effects
  of program
• Outcome evaluation -long-term effects of the
  program
• Line up with PRECEDE

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MATCH

• Multilevel Approach to Community Health
• Developed in late 1980s
• Used by U.S. Government
• Applied when behavioral environmental risk
  protective factors for disease / injury are known
  general priorities determined
• Includes ecological planning - levels of influence

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Phase 1 - Goals Selection

• Select goals - consider prevalence, importance,
  changeability
• Select priority (target) population
• Identify behaviors associated with health status
• Identify environmental factors (barriers
  vehicles)

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Phase 2 - Intervention Planning

• In this phase intervention objectives are matched
  with intervention targets intervention actions
• Identify targets of intervention actions (TIAs)
  consider levels of influence

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Ecological Approach

• Simons-Morton et al., (1995)
• Governments
• Organizations
• Communities
• Individuals

• McLeroy et al., (1988)
• Intrapersonal
• Interpersonal
• Institutional
• Community
• Public policy

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Phase 2 - Intervention Planning

• In this phase intervention objectives are matched
  with intervention targets intervention actions
• Identify targets of intervention actions (TIAs)
  consider levels of influence

• Select intervention objectives (what will
  change?)
• Intervention actions (activities / strategies)
  (how to change?)

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Remaining Phases of MATCH

• 3 - Program Development (create program units or
  components)
• 4 - Implementation (adoption, implementation,
  maintenance)
• 5 - Evaluation (process, impact, outcome)

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Consumer-Based Planning

• Decisions based on consumer input made with
  consumers in mind include consumers throughout
• Based on concepts from
• health communication - strategies to inform
  influence individual community decisions to
  enhance health (NCI, 2002)
• social marketing - planning process designed to
  influence the voluntary behavior of a specific
  audience segment to achieve a social rather than
  financial objective

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Consumer-Based Planning Models

• CDCynergy, or Cynergy for short, is a job aid or
  tool to help educators systematically
  conceptualize, plan, implement, and evaluate
  interventions within a public health context
  (G. Cole, 2002)
• SMART - Social Marketing Assessment and Response
  Tool

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About CDCynergy

• Developed by the Office of Communication at the
  CDC in 1997
• First issued in 1998
• Developed initially for public health
  professionals at CDC with responsibilities for
  health education
• Developed for health communication but

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About CDCynergy (cont.)

• Because of widespread interest, CDC has made it
  available to others
• CDCynergy 2001 is disseminated through SOPHE
• To date 2.6 million has been spent to develop it
• Wide-spread use will bring standardization
• Models, examples, resources, consultants,
  information on a single CD-ROM
• Links to templates to create plans

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P 3 Plan Intervention (Is communication dominant
or supportive?)
CDCynergy
P 5 Plan Evaluation
Navigation controls Contains 52 steps divided
among the phases
P 1 Describe Problem (identify define)
P 2 Analyze Problem (causes, goals, intervention
strategies
P 6 Implement Plan
P 4 Develop Intervention

• Other links
• Lite
• Glossary
• Index
• CDC Web
• Help
• My Plan

Active buttons change with phase step
(examples, resources, consultant)
Non-changing buttons (tools for research media
library)
There is also a supplemental resources CD for
CDCynergy 3.0
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The future of CDCynergy

• Plans to make CDCynergy web-based
• Several versions more to come
• http//www.cdc.gov/communication/cdcynergy.htm

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Social Marketing Assessment Response Tool
(SMART)(Neiger, 1998)
P 1 Preliminary Planning problem, name in
terms of behavior, develop goals, project costs
P 2 Consumer Analysis segment priority
population determine needs, wants,
preferences also secondary tertiary audiences
P 3 Market Analysis 4Ps, competitors,
partners
P 4 Channel Analysis interpersonal, small
group, organizational, community, mass media
P 5 Developing Interventions, Materials,
Pretesting
Implementation
Evaluation
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Other Planning Models

• A systematic Approach to Health Promotion
  (Healthy People 2010)
• Components goals, objectives, determinants of
  health, health status

• Mobilizing for Action Through Planning
  Partnerships (MAPP) (NACCHO)
• Components Organizing, Visioning, Assessments,
  Identify Strategies Issues, Formulate Goals
  Strategies, Action Cycle

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Other Planning Models (cont.)

• Assessment Protocol for Excellence in Public
  Health (APEX-PH) (NACCHO) PACE-EH
• Components Organizational capacity Community
  Process, Completing the Cycle

• Strengths, Weaknesses, Opportunities, Threats
  (SWOT) Analysis

S
W
O
T
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Other Planning Models (cont.)

• The Health Communication Model (NCI)

• Healthy Plan-IT (CDC)
• Components Priority Setting, Establishing
  Goals, Outcome Objectives, Strategy, Evaluation,
  Budget

• Healthy Communities (Healthy Cities) (USDHHS)
• Components Mobilize, Assess, Plan for Action,
  Implement, Track Progress Outcomes

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Models for Program Planning in Health Promotion

• Chapter 2 - The End