Post on 25-Dec-2015
Theory versus ModelsA 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
Quality of Life
Behavior
Environ-ment
Health
Predisposing Factors
Reinforcing Factors
Enabling Factors
Health Promotion
•Health Education
•Policy
Phase 1Social assessment
Phase 2“Epi” assessment
Phase 3Behavioral & environmental assessment
Phase 4Educational &ecological assessment
Phase 5Administrative & policy assessment
Phase 6Implementation
Phase 7 ProcessEvaluation
Phase 9OutcomeEvaluation
Phase 8Impact Evaluation
Phase 1: Social Assessment
Define the quality of life (problems & priorities) of the target population
Involve members of population in a self-study 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
High Priority for program focus
Low priority
Priority for innovative program
No program
Importance + Importance -
Changeable +
Changeable -
Phase 4: Educational & EcologicalAssessment 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)
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. Mobilizing the Community
2. Collecting and organizing data
3. Choosing health priorities and target groups
4. Choosing and conducting interventions
5. Conducting Evaluations
PATCH suggested elements
1. Community support and participation2. Data collection and analysis3. Objectives and standards to help plan and
evaluation4. Adoption of multiple strategies in multiple
situations5. Sustained monitoring and evaluation6. 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.
MAPP
Four Assessments Community themes and strengths assessment Local public health system assessment Community health status assessment Forces of change assessmentPrioritize strategic issuesGoals & ObjectivesAction 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. Problem Definition & Description
2. Problem Analysis
3. Communication Program Planning
4. Program & Evaluation Development
5. Program Implementation & Management
6. Feedback