Week 2 Application and Analysis - Precede-Proceed Model
Shannon Mikrut
Principles of Health Behavior
October 10th, 2013
The PRECEDE PROCEED Model (PPM) was used as guideline in the “My Body
Knows When” intuitive-eating (IE) pilot program. The authors began by starting at phase
one of the PPM. They identified their ultimate outcome; the goal was to improve military
spouses’ health and quality of life by transitioning both individuals and the targeted
community away from a “dieting” mindset and towards an overarching holistic mindset and
attitude focused on intuitive eating. This first phase allowed for the researchers to identify
not only the results and impact they wanted to have, but also a target population.
The researchers then focused on the second phase of the PPM by gathering more
information about military spouses. They strived to meet the needs of the population and
looked at the community as a whole. A survey was sent to spouses to gather more
information about their demographics, family history, lifestyle, and issues/problems that they
personally thought were important to address. Researchers also did additional research to
determine if information was available about using the IE approach; limited information was
found. Moving into phase three, the authors evaluated what factors influence the current
attitudes and behaviors around eating habits and attitudes in military spouses. Factors such
as, stress, deployment of spouse, relocation, lack of family support, and others were
identified. Examining these predisposing factors is crucial for helping researchers develop a
successful intervention program that can address or work around these barriers.
Phase four introduces study design. The researchers formed a program design that
was implemented one month after the pre-survey. It was decided to have both and
intervention and control group. Implementation began and the intervention participants
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attended ten one-hour classes over a ten week period that introduced new topics during
each session. The topics were identified based on the IE model and upon the responses
gathered from the pre-test. Phase four introduces study design. The researchers formed a
program design that was implemented one month after the pre-survey. It was decided to
have both and intervention and control group. Implementation began and the intervention
participants attended ten one-hour classes over a ten week period that introduced new
topics during each session. The topics were identified based on the IE model and upon the
responses gathered from the pre-test. Disease education was introduced into the
development of the program based on feedback from the target population.
Once implementation of the intervention had started, the authors began the
evaluation phases of the PPM. The researchers received bi-weekly evaluations from the
participants throughout the duration of the study. Feedback was given to the planning
committee for evaluation to determine if changes or adjustments needed to be made. The
PROCEED phases implemented often referred back to the appropriate PRECEDE phases.
The evaluators sought to ensure that the goals established prior to implementation were
being addressed and met. It was identified that childcare was an issue for many
participants, and this resulted in many mothers being unable to attend all ten of the classes
offered. Researchers attempted to make changes by offering childcare services in hopes to
increase attendance. Additionally, incentives were offered to try and boost participation.
Other efforts and adjustments were made throughout the intervention, but a majority of the
efforts were unsuccessful. A posttest and six-month follow-up were also completed to
evaluate the program design, effectiveness, quality of material provided, participant
satisfaction, and several other factors. Feedback from participants inspired the researchers
to provide a newsletter after the program to help offer intervention participants continued
support.
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The PPM was an appropriate approach for the study, however, I do not feel that the
researchers correctly implemented all phases of the model throughout the study. Based on
the article, it seems that the authors did not spend enough time in the PRECEDE phases of
the model. Barriers, availability and access of resources, and predisposing factors were not
thoroughly explored prior to designing the intervention. Childcare, timeline of
implementation, priorities, and other factors were not accurately prepared for. Additionally,
evaluation, adjustments, and supplemental materials provided during the PROCEED
phases were largely unsuccessful. There seemed to be a lack of knowledge and
understanding about the beliefs, values, attitudes, and priorities of the target population.
Ultimately, the PPM is a great resource and framework that allows researchers to fully plan
out and evaluate the intervention during all phases. However, the PPM was not exercised to
its full potential by the study designers, and could be utilized more effectively by
researchers fully exploring each of the eight phases thoroughly.
In regards to use of the PPM, other approaches have been taken during studies.
Based on other successful interventions, emphasis of the PPM focused on development
and accurate evaluation of the study both during and after the intervention. Preparation,
planning, and knowledge of the target population was crucial in creating an effective study
design. A study completed by Li, Cao, Lin, Li, Wang, & He (2009) completed health needs
assessments, surveys, and held group discussions in order to better understand the
community and the issues within it. Epidemiological surveys provided pertinent information
to identify priority health problems. The community was involved in every phase of the
process. Additionally, the researchers explored policies, regulations, and alternate
resources to facilitate in the development of the study design. Ultimately, “successful
community health promotion requires a thorough understanding of community health
members, use of existing community resources, involvement of all relevant local
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constituencies, and incorporation of multiple intervention strategies” (Li, Cao, Lin, Li, Wang,
& He, 2009, p. 189).
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References
American Journal of Health Promotion. (n.d). Models from program planning in health
promotion. Retrieved from:
www.csun.edu/.../Models%20for%20Program%20Planning%20in.ppt
Cole, R., & Horacek, T. (2010). Effectiveness of the “my body knows when” intuitive
eating pilot program. American Journal of Health Behavior, 34(3), 286-297.
DiClemente, R., Salazar, L., & Crosby, R. (2013). Health behavior theory for public health
principles, foundations, and applications. Burlington, MA: Jones & Bartlett Learning.
Li, Y., Cao, J., Lin, H., Li, D., Wang, Y., & He, J. (2009). Community health needs
assessment with precede-proceed model: a mixed methods study. BMC Health
Services Research, 9, 181-194. doi:10.1186/1472-6963-9-181
Matlo, C. (2012). Using the Precede-Proceed Model. Retrieved from:
http://www.sfu.ca/uploads/page/23/GERO820_2012FALL_PRECEDE-PROCEED.pdf
Tramm, R., McCarthy, A., & Yates, P. (2012). Using the Precede-Proceed Model of health
program planning in breast cancer nursing research. Journal of Advanced Nursing, 68
(8), 1870-1880. doi:10.1111/j.1365-2648.2011.05888.x
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