Models for Program
Planning in
Health Promotion
HSC 489
Presentation Overview

The Purpose of Theories and Models

Various Models

How Grants Fit In
The Purpose of a Model
“Models? I
hate models!”
“Not
another
model!”
“Rats!”
“What’s a
model?”
Theory versus Models
A theory 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
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

PRECEDE/PROCEED Model
Phase 5
Administrative
& policy
assessment
Phase 4
Educational &
ecological
assessment
Health
Promotion
Predisposing
Factors
•Health
Education
•Policy
Reinforcing
Factors
Phase 3
Phase 2
Behavioral & “Epi”
environmental assessment
assessment
Behavior
Health
Environment
Enabling
Factors
Phase 6
Phase 7
Implementation
Process
Evaluation
Phase 1
Social
assessment
Phase 8
Impact
Evaluation
Phase 9
Outcome
Evaluation
Quality
of Life
Phase 1: Social Assessment
Define the quality of life (problems &
priorities) of the target population
 Involve members of population in a selfstudy of their needs
 Social indicators: absenteeism, alienation,
crime, discrimination, happiness, riots,
self-esteem, welfare, unemployment

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)

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)

Prioritization Matrix
Importance +
Changeable +
Changeable -
High Priority for
program focus
Priority for
innovative
program
Importance -
Low priority
No program
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

Phase 5: Administrative & Policy
Assessment
Determine if the resources are available to
develop and implement the program
 Establish Goals and Objectives
 Precede ends

Phase 6: Implementation
Select models and strategies of the
intervention
 Implementation begins
 Proceed begins

Phase 7: Process Evaluation
Based on Goals & Objectives of P5
 Measurements gathered during
implementation
 To control, assure, or improve program
quality

Phase 8: Impact Evaluation
The immediate observable effects of a
program
 Leads to the intended outcomes of a
program
 Intermediate outcomes

Phase 9: Outcome Evaluation
An ultimate goal or product of a program
 Generally measured by morbidity or
mortality, vital measures, symptoms, signs

MATCH
Multilevel Approach to Community Health
(MATCH)
 Intervention activities should be aimed at a
variety of objectives and individuals

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

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

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.

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)

Phases of MATCH

5: Evaluation – Conduct process
evaluation, measure impact and monitor
outcomes
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

PATCH Steps
1.
2.
3.
4.
5.
Mobilizing the Community
Collecting and organizing data
Choosing health priorities and target
groups
Choosing and conducting interventions
Conducting Evaluations
PATCH suggested elements
1.
2.
3.
4.
5.
6.
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
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.
APEXPH
Organizational Capacity Assessment
 Community Process
 Completing the Cycle

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
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
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

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)

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)

CDCynergy
Most comprehensive and theoretically
based health communication model
 CD-ROM tool
 Six Phases
 Creation of a Social Marketing Plan

Phases of CDCynergy
1.
2.
3.
4.
5.
6.
Problem Definition & Description
Problem Analysis
Communication Program Planning
Program & Evaluation Development
Program Implementation & Management
Feedback
How Grants Fit In?
A statement of the obvious
Programs
Models
Plans
Money
Funding
Resources