PRECEDE-PROCEED MODEL Was developed and introduced by Lawrence W.

Green in the 1970s Is a framework/design used by program planners, policy makers and evaluators Its most fundamental assumption is the active participation of its intended audience that the participants will take an active part in defining their own problems, establishing their goals and developing their solutions. PRECEDE-PROCEED MODEL Health behavior is being influenced by individual and environmental factors hence the model has two distinct parts 1. Educational diagnosis (PRECEDE) 2. Ecological diagnosis (PROCEED) PRECEDE-PROCEED MODEL phases... Phase 1 Social Diagnosis Phase 2 Epidemiological, Behavioral and Environmental Diagnosis Phase 3 Educational and Ecological Diagnosis Phase 4 Administrative and Policy Diagnosis Phase 5 Implementation Phase 6 Process Evaluation Phase 7 Impact Evaluation Phase 8 Outcome Evaluation Phase 1 Social Diagnosis Identifying and evaluating the social problems that have an impact on the quality of life of a population of interest/community From multiple sources of information (subjective and objective Examples of activities during this phase: holding community forums, conducting focus group discussions, surveys and/or interviews It engages the audience in the planning process

Phase 2 Epidemiological, Behavioral and Environmental Diagnosis Epidemiological Assessment determines and focuses on specific health issue(s) of the community May include secondary data analysis/review of records (vital statistics i.e. morbidity and mortality rates, prevalence rates etc.; results of health surveys; medical and administrative records) or Original data collection (weighing and determining BMIs, obtaining BP etc.) Phase 2 Epidemiological, Behavioral and Environmental Diagnosis Behavioral Assessment analysis of behavioral links to the goals or problems identified in the social diagnosis and epidemiological assessment What are the behaviors to assess? 1. behaviors that exemplify the severity of the disease (tobacco use among teenagers, immoderate drinking of alcoholic beverages etc.) 2. behavior of individuals who directly affect the individual at risk (parents of teens who keep cigarettes/alcoholic beverages at home) 3. actions of the decision-makers that affect the environment of the individual at risk (law enforcement actions that restrict the teens access to cigarettes) Phase 2 Epidemiological, Behavioral and Environmental Diagnosis Environmental Assessment parallel assessment of the social and physical environmental factors that may affect the behavior of the individual at risk Environmental factors beyond the control of the individual are modified to influence the health outcome desired (ex. poor nutritional status among children is due to availability of unhealthy foods in the school canteen, cigarettes are being readily sold to university students etc.) Phase 3 Educational and Ecological Diagnosis Involves selecting factors that if modified will most likely result in behavior change and sustain change process Classified as: predisposing, enabling and reinforcing factors Phase 3 Educational and Ecological Diagnosis Predisposing factors characteristics that motivate performance of certain behavior prior to or during the occurrence of that behavior

Ex.(knowledge, beliefs, values, attitudes) Enabling factors characteristics of the environment that facilitate action and any skill or resource required to attain specific behavior Ex. (availability and accessibility of health programs and services, new skills like computer literacy, BP measurement etc.) Phase 3 Educational and Ecological Diagnosis Reinforcing factors rewards or punishments following or anticipated as a consequence of a behavior (ex. social support, peer support) Phase 4 Administrative and Policy Diagnosis Focuses on administrative and organizational concerns which must be addressed prior to program implementation Assessment of resources, budget, looking at organizational barriers, coordination of the program with other departments or sectors that may be involved and coordination with the community Phase 5 Implementation of the Program According to the planned interventions and strategies that are founded upon the assessments done Phase 6 Process Evaluation Evaluates the process by which the program is being implemented that is, if the program is being implemented as planned Phase 7 Impact Evaluation Measures the effectiveness of the program in relation to the intermediate objectives as well as the changes in the predisposing, enabling and reinforcing factors Phase 8 Outcome Evaluation Measures change in terms of overall objectives and changes in health and social benefits or the quality of life. It determines the effect the program had in the health and quality of life of the community.