If we want more evidence-based practice, we need more practice-based evidence.*

 

Home    Endnotes and Links: 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, 2004. Dated 2005.

Table of Contents*

    Preface       

       Features of the 4th Edition

        Rationale for Expansion of the Book's Scope to Health Program Planning from Health Promotion Planning

        Some Contraction to Compensate for the Expansion

        Acknowledgments

        Detailed Table of Contents

   Chapter 1 new references, links and endnotes  The Precede-Proceed Model*

   Chapter 2 new links, references, 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, references, and endnotes: Phase III--Ecological and Educational Diagnosis

   Chapter 5 new links, references, and endnotes: Phase IV--Administrative, Organizational, and Policy Diagnosis

   Chapter 6 new links, references, and endnotes: Applications in Community Settings

   Chapter 7 new links, references, and endnotes: Applications in Occupational Settings

   Chapter 8 new links, references, and endnotes: Applications in School Settings

   Chapter 9 new links, references, and endnotes: Applications in Health Care Settings

*Detailed outline of chapters below; for full endnotes and references cited in each chapter, click on chapter above.

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, 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, as it is taking shape in the revisions,  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.

From the Preface to 4th edition

Rationale for the Expansion

The Precede-Proceed model has evolved with each successive edition of the book from its earliest formulation as a framework for the cost-benefit evaluation of health education (Green, 1974), and for the integration of theories applicable to change processes in health (Green, 1976a, b), through the teaching applications and randomized-controlled trials testing of the model in clinical and community settings (e.g., Green, Levine & Deeds, 1975; Levine et al., 1979; Morisky et al, 1980, 1981, 1982, 1983); from the first edition of the book in which it was presented as a planning model for health education programs in various settings (Green, Kreuter, Deeds & Partridge, 1980) to the second edition in which its application was expanded from PRECEDE to PROCEED with the addition of the policy, regulatory, and organizational aspects of planning for environmental changes that took health promotion beyond health education (Green & Kreuter, 1991; 1992).

The 3rd edition (Green & Kreuter, 1999) strengthened the ecological approach reflected in the social- environmental aspects that were increasingly relevant to the emerging infectious diseases and problems of  lifestyle and social conditions surrounding the development of chronic diseases. As we now approach the 4th edition in a new century, we find that the 900 published applications of the Precede-Proceed model have ranged increasingly beyond what many of its users think of as health education or even health promotion. The model has found increasing application in public health, community health, and population health planning and evaluation. At the same time, the Institute of Medicine (IOM) has issued two recent reports on the Future of the Public's Health in the 21st Century (IOM, 2002; 2003) that have urged the wider application and teaching of ecological and participatory approaches in public health, the two cornerstones of our "educational and ecological approach" to Precede-Proceed planning.

Display Catalog Information                        

Institute of Medicine (2002). The Future of Public Health in the 21st Century. Washington, DC: The National Academy Press. Full-text online.

Institute of Medicine (2003). Who will keep the public healthy? Educating public health professionals for the 21st century. Washington, DC: The National Academy Press. Full-text online.

Our 4th edition takes its inspiration from these sources that the cornerstones of health education and health promotion planning and evaluation have come of age sufficiently to offer the Precede-Proceed model as an educational and ecological approach to broader public health and population health planning. This expansion of the scope of application and range of potential users makes the model no less useful to health educators and those who seek to apply the approach to more strictly defined health promotion issues. We seek mainly to adapt the model in this edition as needed to respond to the challenges of the IOM report on the future of public health. If health educators and other health promotion professionals can provide the leadership within the health professions to help bring these educational and ecological approaches to bear on broader health planning and evaluation, more power to them, and, not inconsequentially, more power to health education and health promotion.

One other significant addition is the inclusion in this edition of a specific place for genetic factors, alongside the environmental and behavioral determinants of health. We have skirted their inclusion in previous editions because of the limited range of interventions and the ethical challenges that could be anticipated for attempts to address genetic predispositions. Now, with the advances under the banner of the Human Genome Project, and the increasing attention public health is giving to genetic factors, we are prepared to make at least some conceptual space for genetics in the model, and to suggest some directions for their inclusion in epidemiological diagnoses and program planning. In the first edition of this book, genetics were hidden in a box called "non-behavioral factors" that was floating in hyperspace above the connected boxes and arrows. We are, at last, ready to open that box and begin to incorporate genetics more formally and practically in the planning model and procedures. Websites for relevant genetic information include the University of Kansas Medical Center and the Human Genome Management Information System's (HGMIS) genetics website, which provides a short list of other websites linking to general information on genetics.

Some Contraction to Compensate for the Expansion

Given the expanded breadth of applications of the model, the book needs to be trimmed to make room for the new content. It was getting bottom-heavy with the carry-over of material from previous editions that no longer needed to be repeated, especially older references. We are accomplishing the trimming, first, with a severe excision of older references, saving a few "classics" and landmark citations, but mostly replacing every two older references with one new reference of post-1998 vintage, the year the previous edition went to press.

A second method of contraction is the elimination of the first 18 or so pages that attempted in the previous edition to define the newly emerging field of health promotion out of its roots in health education, social and behavioral sciences, and philosophical orientations. We are not disavowing our commitment to that history and conceptualization, but having recorded it, we must now leave it behind, as this new edition will be less about health promotion and more about health planning and evaluation. It will apply the concepts and philosophical orientation of health education and health promotion, but will concentrate less on their history and more on their application.

A second means of contracting the length of the text is the condensing and blending of three chapters from the 3rd edition into other chapters that will absorb them in the 4th edition. Chapter 7 in the previous editions was a stand-alone chapter on evaluation. We were always somewhat uncomfortable with the placement of evaluation in this late position, considering our belief that evaluation begins with the first formulation of vision and goals in the planning process, and the first collection of diagnostic baseline data to assess needs. We have chosen, therefore, in the 4th edition to combine the essentials of evaluation in each of the other chapters.

Chapters 3 and 4 in the 3rd edition were both about epidemiology. Chapter 3 was called the Epidemiological Assessment ("Epidemiological Diagnosis" in the first edition), Chapter 4 the Behavioral and Environmental Assessment (Behavioral Diagnosis in the first edition), but the content and methods of Chapter 4 were just as much epidemiological as Chapter 3's. Chapter 3 assessed the extent and distribution of health problems in the community or population; Chapter 4 assessed their etiologies in behavioral and environmental causes or determinants. Etiology of health problems is a matter of epidemiology, too, so we are combining Chapters 3 and 4 into a single Chapter 3 in this edition. This also achieves a more efficient and even flow in the phases. On the matter of efficiency, we also provide an algorithm for some short-cutting of the phases if the planner has reasonable confidence in the assumptions and prior decisions that have determined that the planning should start at the level of selected health problems, health behaviors, environmental problems, or other determinants. The example below is the version of the algorithm that will appear in Chapter 3. One with the boxes above shaded will go in Chapter 2, and versions with other boxes shaded will go on the title pages of Chapters 4 and 5 to orient the user to the potential skip patterns for efficiency in phases 3 & 4.

The third excision and blending of chapters from the previous edition is the material on technological applications of the Precede-Proceed model that was added in that 3rd edition as Chapter 12, with the leadership of Robert S. Gold and Nancy L. Atkinson. Like the chapter on evaluation, this one loses no importance by moving up in pieces from its afterthought position to an integration with earlier chapters. We are indebted to Bob and Nancy for whatever parts of their chapter in the 3rd edition we have moved forward without adequate attribution. A large part of that chapter was based on the EMPOWER software (Gold, Green, & Kreuter, 1996) in which we all participated. We are exploring ways to make some of that or similar interactive learning material available online as an accompaniment to the 4th edition of this text.

We also want to put this edition into the fullest possible linkage with the extensive resources of the World Wide Web, without cluttering the printed text with hundreds of website URLs for the readers to have to type into their Web browsers. The method we have crafted is to put all of the links into our website (http://www.lgreen.net/hpp/Endnotes/) where we can continuously update them and the reader can go routinely. From there the reader can follow the chapter-by-chapter supplementary material and endnotes. The endnotes in the website will follow number-by-number the endnotes in each chapter, offering links to the references to save flipping pages to the bibliography in the book, and from there additional links where available to the publication's organization, corresponding author, abstract, or even full-text online if it is so available. Thus, our readers of the book should be able with an online connection at hand to track the bibliographic references all the way to their original sources without turning pages and without having to type URLs. We believe this bibliographic convenience, together with the other web-based resources we can continue to build or find and link after the book goes to press, will make the 4th edition of the book truly a dynamic, evolving and up-to-date resource on the health planning and evaluation literature.

Acknowledgments

Besides the people acknowledged in the Preface of previous editions, we owe a particular debt to reflections and guidance of recent users of the Third Edition of this book in teaching their courses at the University of North Carolina School of Public Health (Laura Linan, ScD), the Johns Hopkins University Bloomberg School of Public Health (Andrea Gielen, ScD), the Harvard School of Public Health (Rima Rudd, DrPH), the University of Michigan School of Public Health (Edith Parker, DrPH), the Rollins School of Public Health at Emory University (Susan Butler, Ed.D., and Richard Crosby, PhD), the UCLA School of Public Health (Donald Morisky, DrPH), Texas Women's University (William Cissell, PhD), California State University at Long Beach (Kathleen Young, PhD), and State University of New York at Cortland (Bonnie Hodges, PhD).

Detailed Table of Contents

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 ECOLOGICAL 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

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