If we want more evidence-based practice, we need more practice-based evidence.*
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Home Endnotes and Links: Preface Chap 1 Chap 2 Chap 3 Chap 4 Chap 5 Chap 6 Chap 7 Chap 8 Chap 9 New Features, Flow, and Updated References in 4th Edition, 2005 New Title: Health Program Planning: An Educational and Ecological Approach New Publisher: McGraw-Hill. Publication date: Aug. 1, 2005. Table of Contents* Some Contraction to Compensate for the Expansion Chapter 1 new references, links and endnotes The Precede-Proceed Model* Chapter 2 new links and endnotes: Phase I--Social Diagnosis and Participatory Planning Chapter 3 new links and endnotes: Phase II--Epidemiological Diagnosis: Health, Behavioral, & Environmental Assessment Chapter 4 new links and endnotes: Phase III--Ecological and Educational Diagnosis Chapter 5 new links and endnotes: Phase IV--Administrative, Organizational, and Policy Diagnosis Chapter 6 new links and endnotes: Applications in Community Settings Chapter 7 new links and endnotes: Applications in Occupational Settings Chapter 8 new links and endnotes: Applications in School Settings Chapter 9 new links and endnotes: Applications in Health Care Settings *See detailed Table of Contents of the nine chapters below Introduction to this Web Version of Endnotes The new, 4th edition of this book will expand the presentation and application of the Precede-Proceed Model beyond health education and health promotion planning to the wider range of population health program applications of planning and evaluation. We believe this edition will be particularly valuable to the newly emerging generic MPH degree and Doctor of Public Health programs in Schools of Public Health, and community health graduate programs in other schools. It should serve also as a handbook for practitioners and scholars. In the following website notes and those in each of the subsequent chapters, we will document the major changes taking shape in this new edition by way of updating the endnotes with new citations (published since the previous edition went to press in 1998, shown as indented references) and with explanations for our changes in the model and its presentation in the 4th edition. Other references cited in the new edition but not included here are found in the bibliography of the 3rd edition. These are retained because of the more enduring, even classic, character in the literature on health program planning, disease prevention, health promotion, and population health. To make this website truly complementary and of added value to the print version of the book, we provide here the full citation of references cited in the endnotes and link many of them to their online abstract or full text. This inclusion of the full references with the endnote will make the lookup process more efficient for readers, who can read the chapters without having to flip pages to the Endnotes and again to the references. The added value of the website will be the linking of many of the references cited in the endnotes and bibliography to the Medline abstract, our own abstract and notes, or other sources of their abstracts or full-text online version of the article, book (e.g., publisher's website catalogue page with table of contents, reviews, etc.), report, chapter, website, or manuscript file. This feature will be of particular value to scholars and other readers who want to go deeper on a given topic and will save them having to type in the URL or each link they wish to pursue. As a footnote at the beginning of each chapter of the book, the reader will be pointed to the part of the www.lgreeen.net URL that links to the endnote pages for that chapter. E.g., for Chapter 1, this will be "...hpp/endnotes/chapter1Endnotes.html". Thus the user would go to our website (www.lgreen.net) and enter this suffix to the home page, or type the full following URL: www.lgreen.net/hpp/endnotes/Chapter1Endnotes.html. The user will become familiar soon with the web pages and navigating among them. Some major new features of the fourth edition of the book are: 1. A significantly streamlined Precede-Proceed Model and text, with the merging of the Epidemiological Assessment and the Behavioral and Environmental Assessment Phases (plus genetics) into one phase and one chapter rather than two. This overcomes the confusion that what previous editions had as Chapter 4, the Behavioral and Epidemiological Assessment, was in fact epidemiological diagnosis extended from the descriptive epidemiology of Chapter 3 to etiological epidemiology of the determinants of health. Chapter 1 also introduces a flow diagram or algorithm to enable users of the Model to find a more efficient starting point, depending on what previous work and understanding has gone before their application of the Model. 2. A giant step toward making the book work more seamlessly with this highly resource-based website, in which the authors provide links to the rest of the World Wide Web, streamlined internal links to bibliographies of published applications of the Model, updated headlines, milestones and benchmarks, PowerPoint slides with animated (build features) in some of the more complex graphs and charts that appear in the book, and links to related material in several other books published by the authors and by McGraw-Hill. Finally, we have linked both conceptually and via the World Wide Web to other planning models and tools that have become more detailed spin-offs of specific phases from PRECEDE-PROCEED, or that have developed tools and procedures that link to phases in PRECEDE-PROCEED. 3. We have integrated some of our phases with those of PATCH, APEX-PH, and MAPP, all sponsored by CDC and growing out of an original formulation of PATCH on the Precede-Proceed Model. We have also sought to integrate PRECEDE-PROCEED with MATCH, D'Onofrio's Pooling of Prior Intervention Information, Bartholomew et al's Intervention Mapping, and Sussman's Six-Step Program Development Chain Model. 4. The integration of evaluation considerations into each phase, rather than leaving that subject to a later chapter presenting evaluation as though it were only a final phase. Formative evaluation, and the establishment of goals and objectives and baseline measures during the earlier assessment or diagnostic phases are now discussed in earlier chapters as part of the evaluation process. 5. The integration of technological tools into the application chapters, rather than leaving these considerations to a final chapter on technological applications of the Precede-Proceed model. This particularly addresses the opportunity presented by the explosion of new research and development to fill the gap between the assessment phases and the evaluation phases with more specific guidelines to the selection of interventions to match the population needs and contextual circumstances, using theory and previous research and evaluation compilations to guide the intervention mapping process. It will also help planners as they tackle health issues that are embedded in ecological complexities. 6. The widening of the intended audience for this edition beyond health education students and professionals to include all health professionals and health science students who would apply educational and ecological principles to their planning of health programs (not just health education programs). As the scientific literature of health education and the behavioral and social sciences applied to health promotion has matured, and the scope of health promotion has broadened to encompass most public health, community health, and population health applications, the Precede-Proceed Model has been used increasingly outside health education by professionals other than health educators, making health education more central rather than peripheral to health planning, and infusing more educational and ecological thinking and methods into health programs of all types. Chapter 1: A Framework for Planning KEY CONCEPTS A "population health" program The ecological and educational approach Respecting context and people in the adaptation of "best practices" THE PRECEDE-PROCEED MODEL What are the phases of the Precede-Proceed approach to population health planning? How does the Precede-Proceed Model work? Phase 1: Social Assessment and Situational Analysis Phase 2: Epidemiological Assessment Phase 3: Educational and Ecological Assessment Phases 4, 5, 6: Intervention Alignment, Administrative and Policy Assessment, and Evaluation HALLMARKS Flexibility Evidence-based and Evaluable Participation A platform for Evidence-Based "Best Practice" EXERCISES NOTES AND CITATIONS
Chapter 2: Social Assessment, Participatory Planning, and Situation Analysis SOCIAL DIAGNOSIS AND PARTICIPATION: THE RATIONALE Social and Health Conditions: A Reciprocal Relationship Health as an Instrumental Rather Than Terminal Value QUALITY OF LIFE: AN EXPRESSION OF ULTIMATE VALUES ELICITING SUBJECTIVE ASSESSMENTS OF COMMUNITY QUALITY OF LIFE Measuring Quality Of Life Relevance of an Ecological and Environmental Approach THE PRINCIPLE AND PROCESS OF PARTICIPATION Forms of Participation Participation in Setting Priorities Public Perception and Professional Diagnosis: Common Ground THE CAPACITY-BUILDING AND SUSTAINABILITY CASE FOR PARTICIPATION Examining the Steps of Assessment Two Functional Levels Technical Support Tasks Common Across Precede Phases Official Functions Implementation and Evaluation The Capacity-Building, Self-Reliance, and Sustainability Cycle Evaluation, Demonstration and Diffusion Keeping Perspective on Participation and Partnership METHODS AND STRATEGIES FOR SOCIAL DIAGNOSIS AND SITUATION ANALYSIS Assessing Urgency and Assets: Situation Analysis Assessing Capacity: Community Competence and Readiness Effects of Social Capital on Community Health Asset Mapping The Social Reconnaissance Method for Community Social Diagnosis Application at the State Level Application at the Community Level Other Assessment Methods Nominal Group Process The Delphi Method Focus Groups Central Location Intercept Interviews Surveys Public Service Data USING DATA FROM A SOCIAL ASSESSMENT AND SITUATION ANALYSIS TO MAP THE PLANNING PROCESS Social Diagnosis and Situation Analysis “After the Fact” Situation Analysis: Cutting To the Chase, Leaping Past the Obvious SUMMARY EXERCISES NOTES AND CITATIONS
Chapter 3: Epidemiological Diagnosis, Health, Behavioral and Environmental Assessments Where’s the Evidence? Organization of the Chapter STARTING IN THE MIDDLE: A REALITY FOR PRACTITIONERS Three Reasons Why Planners Should Know the Whole Model Reason 1 Reason 2 Reason 3 Maintaining a Reciprocal Balance KEY PRINCIPLES AND TERMS OF DESCRIPTIVE EPIDEMIOLOGY Epidemiology: A Definition What is the Problem? Rates Specific and Adjusted Rates Incidence and Prevalence Prevalence Prevalence of Chronic Disease Rates: A Caveat Surveillance Making Comparisons to Gain Insight Obtaining Data to Make Comparisons SETTING PRIORITIES AND OBJECTIVES FOR HEALTH PROGRAMS Key Questions Developing Health Objectives ETIOLOGY: WHY DO THOSE WITH THE PROBLEM HAVE IT? Risk Factors: Finding Relevance for Planning Risk Factor Surveillance Population-Attributable Risk Cost-benefit Analysis from PAR Data: Follow the Signs Ecological Correlations Advantages Disadvantages An Example: Coal Miners in Appalachia “Protective” Factors SECTION 5 - BEHAVIORAL DIAGNOSIS Three Levels or Categories of Behavior Genetics and Behavioral Interactions Step 1: Listing Potential Behavioral Risks for the Health Problem Keep an eye on the literature Systems thinking Case example: Roseville Step 2: Rating Behaviors on Importance Continuing the Roseville Case Step 3: Rating Behaviors on Changeability Step 4: Choosing Behavioral Targets Step 5 Stating Behavioral Objectives ENVIRONMENTAL DIAGNOSIS Step 1: Identifying Environmental Factors Step 2: Rating Environmental Factors on Relative Importance Step 3: Rating Environmental Factors on Changeability Step 4: Choosing the Environmental Targets Step 5: Stating Environmental Objectives EVALUATION SUMMARY Definition Objects (and Order) of Interest Standards of Acceptability Being an “Accountable Practitioner” Outcome Evaluation Impact Evaluation Process evaluation EXERCISES NOTES AND CITATIONS
Chapter 4: Ecological and Educational Diagnosis FACTORS INFLUENCING BEHAVIOR AND THE ENVIRONMENT The Theory Underlying This Part of the Model The Practical Uses of This Component of the Model PREDISPOSING FACTORS Capacity-Building Cycle of Predisposing and Enabling Factors Awareness and Knowledge Beliefs, Values, and Attitudes Beliefs Fear Values Attitudes Self-Efficacy and Social Cognitive Theory Behavioral Intention Precontemplation to Contemplation and Preparation Existing Skills ENABLING FACTORS The Health Care Environment Other Environmental Conditions That Affect Health-Related Behavior New Skills Reinforcing Factors SELECTING DETERMINANTS OF BEHAVIOR AND ENVIRONMENTAL CHANGE Step 1: Identifying and Sorting Informal Methods Formal Methods Step 2: Setting Priorities among Categories Step 3: Establishing Priorities within Categories Importance Changeability LEARNING AND RESOURCE OBJECTIVES SUMMARY EXERCISES NOTES AND CITATIONS
Chapter 5: Program, Administrative and Policy Design: Turning the Corner from Formative to Process Evaluation, From Precede To Proceed SOME DEFINITIONS ALIGNING PRIORITY DETERMINANTS WITH PROGRAM COMPONENTS Alignment 1: Intervention Matching, Mapping, Pooling and Patching Mapping Causal Theory, Action Theory and Program Theory Pooling and Patching Prior and Existing Interventions Alignment 2: Formative Evaluation and Blending Interventions into Comprehensive Programs “Best processes” Innovate and Evaluate What is an Innovation? A Summary of the Developmental Process Steps to a Comprehensive Program Fidelity to “Best Practices” Vs. Adaptation to Population and Circumstances Alignment 3: From Formative Evaluation to Process Evaluation: Pretesting Components of Program for Feasibility, Acceptability and Fit THE ADMINISTRATIVE ASSESSMENT AND PROCESS EVALUATION Step 1: Assessment of Resources Needed Time Personnel Budget Attention to Detail Step 2: Assessment, Enhancement, and Process Evaluation of Available Resources Personnel Other Budgetary Constraints Step 3: Assessment, Modification, and Process Evaluation of Factors Influencing Implementation Staff Commitment, Values, and Attitudes Program Goal(s) Familiarity Complexity Space Community Circumstances Quality Assurance, Training, and Supervision POLICY ASSESSMENT AND ACCOUNTABILITY Step 1: Assessment of the Organizational Mission, Policies, and Regulations Being Informed Anticipating Flexibility STEP 2: ASSESSING POLITICAL FORCES Level of Analysis The Zero-Sum Game Systems Approach Exchange Theory Power Equalization Approach Power-Educative Approach Conflict Approach Advocacy and Educating the Electorate Empowerment Education and Community Development Participatory Research and Community Capacity Approaches IMPLEMENTATION AND EVALUATION: ASSURING REACH, COVERAGE, QUALITY, IMPACT, AND OUTCOMES ESTIMATING AND CALCULATING THE INPUTS AND OUTPUTS OF YOUR PROGRAM Practical Realities Population Concerns Need Reach Coverage Impact Efficacy Effectiveness Economic Measures Program Cost Efficiency Cost-Effectiveness Benefits Income Net Gain SUMMARY EXERCISES NOTES AND CITATIONS
Chapter 6: Applications in Communities COMMUNITY: A MEDIUM FOR CHANGE AND A CHANGING MEDIUM Defining Community Community Interventions and Interventions in Communities The Epidemiological Case for the Community Approach The Social-Psychological Case for the Community Approach The Economic Case for the Community Approach The Political Case for the Community Approach The Demonstration and “Multiplier” Value of Smaller Programs Community Participation The Dilemma of Complex Problems and Multiple Stakeholders Tackling Complex Community Problems The Dilemma of External Funding Two Points of View COALITIONS: COMPELLING, IMPORTANT, BUT NOT EASY AND NOT A PANACEA The capacities of communities to support health programs The Politics of Coalitions and Community Power Coalitions: Some Basic Principles Basic Steps to Keep in Mind Creating an Organizational Framework APPLICATIONS IN COMMUNITIES A Kentucky Case Study Results Strategy: Multiple Tactics Implications for Practitioners Implementation Lesson The North Karelia Project The Design The Impact Diffusion Penetrate the Community Never Promise Too Much Too Soon Selecting Multiple Strategies Intervention Matrix Intervention Mapping Reaching the Masses Segmenting A Su Salud Social Marketing: Square One for a Campaign Take It Outside Examples from Developing Countries So Much to Know and Do, So Little Time! SUMMARY EXERCISES NOTES AND CITATIONS
Chapter 7: Applications in Occupational Settings THE ECOLOGICAL CONTEXT OF WORKPLACE HEALTH PROGRAMS Historical Context of Health Programs in the Workplace Demographic Context Regulatory Context: Occupational Health and Safety Legislation Legislative Initiatives The Problem of Coordination Problems Requiring Regulatory Intervention Environmental Protections versus Health Promotion Protection of Women Educational Protections Medical Surveillance and Risk Assessment Psychosocial Factors Recent Trends Current Limitations Economic Context Containing Health Care Costs Econometric Evaluation Tobacco Control Stress Management, Nutrition and Physical Activity Hypertension Comprehensive Programs Limitations of Evaluation Employee Dependents Substance Abuse Context: Employee Assistance Programs The U.S. Organizational Context The Canadian Organizational Context The Diffusion of EAPs From Medical Model to Constructive Confrontation From Treatment to Secondary Prevention Converging Interests of EAPs and Health Promotion The Blending Of the Four Work-Site Health Ecologies Prevention versus Health Promotion Health Risk Appraisals Work Organization, Control, and Health Organizational Culture CAVEATS Ethical Concerns The “Victim-Blaming” vs. Paternalism Problems The Divided Loyalties Problem Caution: Do Not “Over-Sell” Economic Benefits APPLICATION OF PRECEDE-PROCEED Phase 1: Social Diagnosis and Participation From the Perspective of Employers From the Perspective of Employees Phase 2: Epidemiological Assessment Phase 3: Educational and Ecological Assessment Predisposing Factors Reinforcing Factors Enabling Factors Phase 4: Administrative, Organizational and Policy Assessment Phase 6: Implementation and Evaluation Screening and Wait-Listing Self-Care and Community Referrals Triage and Stepped Program of Interventions A CASE STUDY: AIR QUALITY CONTROL IN A STATE AGENCY Social and Epidemiological Assessments Educational and Ecological Assessment The Environment Behavior/Lifestyle From Administrative and Policy Assessment to Implementation Implementation and Structural Evaluation Process Evaluation Impact Evaluation Outcome Evaluation SUMMARY EXERCISES NOTES AND CITATIONS
Chapter 8: Applications in Educational Settings WHAT IS A SCHOOL HEALTH PROGRAM? Key Concept: “Coordinated” PROGRESS IN SCHOOL HEALTH RESEARCH AND POLICY Assessing the Effects of School Health Education The National Institutes of Health The Challenge of Parental Participation Policy Analysis and Advances Policy Surveys Policy Analysis Comprehensive School Health Education: A Response to the Aids Epidemic USING PRECEDE AND PROCEED FOR PLANNING IN SCHOOLS Social Assessment Health: An Instrumental Value for Schools Education and Health: A Two-Way Relationship Developmental Assets Epidemiological Assessment Using Multiple Approaches Health Problems and Health Behaviors Emphasize Flexibility The School Health Index: A Practical Example of Epidemiologic Assessment Behavioral, Environmental, and Educational Assessment What Is the Goal? Skills: A Legitimate Focus Using Theory PRECEDE-PROCEED AND SCHOOLS: A HYPOTHETICAL CASE Where Are We? What Matters? Sorting Out the Complexity Can The Literature And Other “Outside Sources Help Us? Time and Resources “Within Reason” Public Opinion Using Policy SUMMARY EXERCISES NOTES AND CITATIONS
Chapter 9: Applications in Health Care Settings DISEASE PREVENTION, HEALTH PROMOTION, AND SELF-CARE AS PRIORITIES OF CLINICAL CARE Definitions The Opportunity Clinical Credibility Access to Teachable Moments Public Interest Readiness of Clinical Practitioners The Missed Opportunity The Rationale AN ECOLOLOGICAL AND COMMUNITY APPROACH TO HEALTH CARE Epidemiology of Health Care Errors Health-Care Errors of Omission The Undiagnosed Nonusers Health-Care Errors of Commission Professional Errors Patient Errors Special Groups PATIENT CONSIDERATIONS IN TARGETING INTERVENTIONS The Undiagnosed Diagnosed Nonusers Who Received Inappropriate Medical Recommendations Nonusers Who Did Not Obtain a Recommended Drug or Device Policy Changes Misusers Allocation Decisions APPLICATION OF EDUCATIONAL AND ECOLOGICAL ASSESSMENT TO INDIVIDUAL PATIENTS A HIERARCHY OF FACTORS AFFECTING SELF-CARE BEHAVIOR Triage According To Motivation Triage According To Enabling Factors Assessing Reinforcing Factors Necessary for Patients’ Adherence Balancing the Three Sets of Determinants Making Reinforcement Intrinsic Rather than Extrinsic Self-Monitoring CHANGING THE BEHAVIOR OF HEALTH CARE STAFF EDUCATIONAL AND EDUCATIONAL ASSESSMENT OF PRACTITIONERS’ BEHAVIOR Predisposing Factors Enabling Factors Reinforcing Factors Managed Care Complications and Barriers SUMMARY EXERCISES NOTES AND CITATIONS
Glossary Bibliography Go to Endnotes: Preface Chap 1 Chap 2 Chap 3 Chap 4 Chap 5 Chap 6 Chap 7 Chap 8 Chap 9
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