Models for Program Planning in Health Promotion

HSC 489

Presentation Overview

The Purpose of Theories and Models

Various Models

How Grants Fit In

The Purpose of a Model“Models? I hate models!”

“Not another model!”

“What’s a model?”

“Rats!”

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)

Phases of MATCH

5: Evaluation – Conduct process evaluation, measure impact and monitor outcomes

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 Community2. Collecting and organizing data3. Choosing health priorities and target

groups4. Choosing and conducting interventions5. 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.

APEXPH

Organizational Capacity Assessment Community Process Completing the Cycle

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 & Description2. Problem Analysis3. Communication Program Planning4. Program & Evaluation Development5. Program Implementation & Management6. Feedback

How Grants Fit In? A statement of the obvious

Models

Programs

Plans

Money

FundingResources