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Summary Articles Week 1 IP1
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This document gives an overview of the articles from week 1 of the course Interventions & Policies 1.
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IndexCrosby, R., & Noar, S. M. (2011). What is a planning model? An introduction to PRECEDE-PROCEED.
Journal of Public Health Dentistry, 71(Suppl 1), S7-S15. doi: 10.1111/j.1752- 7325.2011.00235.x........2
Whatnall, M., Patterson, A., & Hutchesson, M. (2019). A brief web-based nutrition intervention for
young adult university students: development and evaluation protocol using the PRECEDE-PROCEED
Model. JMIR Research Protocols, 8(3), e11992. doi: 10.2196/11992.....................................................8
Kok, G., Peters, L. W. H. & Ruiter, R. A. C. (2017). Planning theory- and evidence-based behavior
change interventions: A conceptual review of the intervention mapping protocol. Psicologia: Reflexão
e Crítica, 30, 19. doi: 10.1186/s41155-017-0072-x...............................................................................11
Van Pelt, S., Massar, K., Shields-Zeeman, L., de Wit, J. B. F., van der Eem, L., Lughata, A. S., & Ruiter,
R. A. C. (2021). The development of an electronic clinical decision and support system to improve the
quality of antenatal care in rural Tanzania: lessons learned using Intervention Mapping. Frontiers in
Public Health, 9, 645521. doi: 10.3389/fpubh.2021.645521)...............................................................14
,Crosby, R., & Noar, S. M. (2011). What is a planning model? An introduction to PRECEDE-PROCEED.
Journal of Public Health Dentistry, 71(Suppl 1), S7-S15. doi: 10.1111/j.1752- 7325.2011.00235.x
Planning models exist at a macroscopic level; they serve as an organizing framework for an entire
health promotion effort aimed at fostering reduction in a given disease. An example of a planning
model is the PRECEDE-PROCEED planning model (PPM). The PPM is actually quite simple to
understand once one realizes that it embodies two key aspects of intervention: a) planning, and (b)
evaluation. The PPM guides the program planner to think logically about the desired end point and
work “backwards” to achieve that goal. Through community participation, the planning process is
broken down into objectives, step 3 sub-objectives, and step 4 sub-objectives. Conceptually, this
approach to health promotion provides context to the use of theory, with theory being applied at the
fourth step. This observation teaches a vital lesson, namely that program planning is larger and is a
more comprehensive task compared to the subservient function of theory selection and application.
Introduction
A theory is a set of testable propositions that help us to explain and predict phenomena.
A theory is and always should be in a state of evolution (dynamic rather than static).
Reviews have shown theory-based interventions to be superior to those that are a-
theoretical.
Unlike theories, planning models are not made up of a set of testable propositions.
Planning models, then, are much broader than theories, and they, in fact, are inclusive of
theories. In particular, they instruct the practitioner about which theory (or theories) should
be used and when and how they should be applied.
As a metaphor, we might think of a planning model as a general blueprint for something we
are trying to build (in this case, a health promotion program). This blueprint (planning model)
is essentially a roadmap for how we go about building the program. While it does not contain
all of the specific details within it (e.g., the specific program elements), the blueprint does
provide a very useful step-by-step guide for constructing (and evaluating) the program.
Where theory comes in is as follows: Theory is an essential part of that blueprint, one that is
necessary for building a successful program. While our blueprint (planning model) does not
specify the exact theory that we should use in the program, it does specify basic guidelines
that will guide us through the process of making these key decisions, including choosing an
appropriate theory for the program.
A particularly useful, widely applied, and easy-to-follow example of a planning model is the
PRECEDE-PROCEED planning model (PPM).
The PPM is very much an ecological approach to health promotion.
In a nutshell, an ecological approach means that all aspects of a person’s environment are
considered as potential intervention targets, as well as the person’s own cognitions, skills,
and behavior. In many cases, a strict focus on the individual may be the key to health
promotion.
An ecological approach acknowledges these “higher-order” influences on health behavior
and seeks to address those factors that can be changed or mitigated at the community level.
Again, being quite distinct from theory per se, evaluation is a macro-function of planning
models. Program evaluation provides “built-in” mechanisms for feedback to the program
planners to make judgments about what is working and what requires refinement.
, Understanding the target audience is a necessary first step in any health promotion
endeavor. Sometimes even to the extent of engaging these folks in the planning process,
including evaluation.
The PPM is a framework that, when used properly, guides the user to engage the target
community to develop a sound ecologically based approach to the problem at hand.
The PPM
The PPM is actually quite simple to understand once one realizes that it embodies two key
aspects of intervention: (a) planning (1-5), and (b) evaluation (6-9).
The basic assumption of the PPM is that behaviors are complex and have multidimensional
etiologies.
This planning model is not a theory; instead, it is a method of approaching the complex task
of making substantial progress in the reduction of morbidity and mortality at the community
level through developing, implementing, and evaluating health promotion programs
The arrows point from left to right, yet the steps are numbered from right to left. This is
actually a key point of the planning model. This layout necessitates that you plan
“backwards”– working from the end goal to produce objectives and sub-objectives that, if
met, will culminate in the realization of that goal.
Social diagnosis (step 1)
The goal is improved quality of life as defined by the community. Of course, a community
may have multiple issues that impinge on quality of life, so, it is often the case that the
program planner must begin by “pre-identifying” a health issue that is believed to have a
substantial impact on quality of life in the community. (Clearly, in many communities,
improved oral health is an example of a key issue.)
Tasks; ask and answer key questions related to the health issue.
Once the social diagnosis is well underway, it is wise to form a community advisory board
(CAB). A 10-member CAB, for example, may be a good way to begin finding out more about
the community and what, who, and how the change efforts might look like in an ideal
scenario. Cultivating the attention and ongoing input from these individuals is the basis of a
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