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Summary readings PROCEED-PROCEED and Intervention Mapping
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Summary Interventions and Policies literatureArticle 1: What is a planning model? An introduction to PRECEDE-PROCEED
Planning models serve as an organizing framework for an entire health promotion effort aimed at
fostering reduction in a given disease.
The PRECEDE-PROCEED planning model (PPM) embodies two key aspects of intervention a)
planning, and (b) evaluation. The model guides the program planner tot hink logically about the
desired end point and work ‘backwards’ to achieve that goal.
Theory is a tool that allows one to inform and strengthen practical solutions to old and emerging
problems in public health and is made out of testable propositions.
Planning models are not made up of these propositions. Rather serve as a blueprint for building and
improving intervention programs. It functions as a general blueprint (planning model) for something
we are trying to build (health promotion program). The blueprint does not specify the exact theory
that should be used in the program, it does specify basic guidelines that guide us through the
process of making key decisions, including choosing an appropriate theory for the program.
PRECEDE stands for Predisposing, Reinforcing and Enabling Constructs in Eductional/environmental
Diagnosis and Evaluation. (Step 1-4)
PROCEED stands for Policy, Regulatory, and Organizational Constructs in Educational and
Environmental Development. (5-9)
It has an ecological approach, meaning to focus on a person’s environment, as well as the person
own cognitions, skills and behavior. Intervention efforts require constant maintenance and updating.
Program evaluations provides ‘built-in’ mechanisms for feedback tot he program planners to make
judgments about what is working and what requires refinement. Evaluation is a macro-function of
planning models.
Understanding the target audience is necessary first step in eany health promotion endeavor.
The PPM is a framework that fuides the user to engage the target community to develop a sound
ecologically based approach to the problem at hand. Theory application is not mandaroty to the
, PPM, however it is quite likely that better programs will indeed be drawing upon one or more
theories as the PPM guided process unfolds.
The PPM
It consists of planning (step 1-5) and evaluation (6-9).
Planning begins with the largest goal: improve quality of life and culminates in an administrative and
policy assessment.
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. The goal is improved quality of life as defined by the community
Step 1: Social diagnosis/assessment – Ask and answer key questions related to the health issue
Pre-identifying a health issue that has substantial impact on quality of life in the community.
Identifying it by key investigation questions in a process of making a thorough social diagnosis. Once
the social diagnosis is well underway it is wise to form a community advisory board (CAB). Cultivating
the ongoing input from these individuals is the basis of a key PPM principle – community
participation.
Step 2: Epidemiological diagnosis – Create measurable, time-limited, health-related objectives. The
success of the program will ultimately be judged by these objectives
Goal is to create measurable health-related objectives and will become the standard to judge the
success of the program. The objectives serve as the overarching guides for the remainder of the
planning process. These objectives should be formulated clear and specifically, measurable and has
a time limitation. This step of the planning process should be predicted on existing data and should
be directly responsive to the identified needs of the community.
Step 3: behavioral and environmental diagnosis – Identify key environmental and behavioral factors;
these will become sub-objectives that direct planning for intervention activities. Environments that
support risk behaviors relevant and applicable to the objectives developed in step 2 must all
beidentified at this point in the planning process. All possible “types” of environments should be
considered. This includes economic environments, policy and legal environments, family
environments, and local culture.
Step 4: Educational and ecological diagnosis – Develop a unique plan to achieve each sub-objective
from step 3; consider predisposing, reinforcing and enabling factors and use theory. In essence a type
of pyramid can be visualized as showing how the overarching goal (step 1) becomes the epitome of
an expansive number of supporting activities (Steps 2-9)
Predisposing factors exist at the cognitive level, constructs such as self-efficacy, attitudes, and
beliefs. Once these are identified the concept of reinforcement comes into play. Considering how a
given behavior can be encouraged in a community to the point of maintenance. Basically, helping to
assure the desired behavior recurs. Can be environmentally or socially engineered.
By enabling factors, the necessary conditions that must be present for the behavior to occur are
enabled.
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