PRECEDE–PROCEED model: Difference between revisions

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The '''PRECEDE–PROCEED model''' is a cost–benefit evaluation framework proposed in 1974 by Dr. [[Lawrence W. Green]], that can help health program planners, policy makers, and other evaluators analyze situations and design health programs efficiently.<ref name="Green74">Green, L.W. (1974). Toward cost–benefit evaluations of health education: some concepts, methods, and examples. ''Health Education Monographs'' 2 (Suppl. 2): 34–64.</ref> It provides a comprehensive structure for assessing health and quality of life needs, and for designing, implementing, and evaluating health promotion and other public health programs to meet those needs.<ref name="Green05">Green, L., Kreuter, M. (2005). ''Health program planning: An educational and ecological approach''. 4th edition. New York, NY: McGraw-Hill</ref><ref name="Gielen08">Gielen, A.C., McDonald, E.M., Gary, T.L., and Bone, L.R. (2008). Using the PRECEDE/PROCEED Model to Apply Health Behavior Theories. In K. Glanz, F.M. B. K. Rimer, & K. Viswanath, (Eds.), ''Health Behavior and Health Education: Theory, Research and Practice''. 4th edition, pp. 407–433. San Francisco: Jossey-Bass</ref><ref name="Freire06">Freire, K., and Runyan, C.W. (2006). Planning Models: PRECEDE–PROCEED and Haddon Matrix. In A. C. Gielen, D. A. Sleet, and R. J. DiClemente (Eds.) ''Injury and Violence Prevention: Behavioral Science Theories, Methods, and Applications''. 1st edition, pp. 127–158. San Francisco: Jossey-Bass</ref> One purpose and guiding principle of the PRECEDE–PROCEED model is to direct initial attention to outcomes, rather than inputs. It guides planners through a process that starts with desired outcomes and then works backwards in the causal chain to identify a mix of strategies for achieving those objectives.<ref name="Glanz05">Glanz, K. and Rimer, B. (2005). ''Theory at a Glance: A Guide for Health Promotion Practice'', 2nd Edition. Publication Number: T052. NIH Number: 05-3896. U.S. Department of Health and Human Services. National Institutes of Health. Bethesda: National Cancer Institute. Accessed on June 26, 2011 at [http://www.cancer.gov/cancertopics/cancerlibrary/theory.pdf]</ref> A fundamental assumption of the model is the active participation of its intended audience – that is, that the participants ("consumers") will take an active part in defining their own problems, establishing their goals, and developing their solutions.<ref name="Green05" />

In this framework, health behavior is regarded as being influenced by both individual and environmental factors, and hence has two distinct parts. First is an "educational diagnosis" – ''PRECEDE'', an acronym for Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation. Second is an "ecological diagnosis" – ''PROCEED'', for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development.<ref name="Green05" /><ref name="Gielen08" /><ref name="Glanz05" /> The model is multidimensional and is founded in the social/behavioral sciences, epidemiology, administration, and education. The systematic use of the framework in a series of clinical and field trials confirmed the utility and predictive validity of the model as a planning tool (e.g. Green, Levine, & Deeds).<ref name="Green75">Green, L.W., Levine, D.M. and Deeds, S.G. (1975). Clinical trials of health education for hypertensive outpatients: design and baseline data. ''Preventive Medicine'' 4(4): 417–25</ref>

== Brief history and purpose of the model ==

The PRECEDE framework was first developed and introduced in the 1970s by Green and colleagues.<ref name="Green74" /><ref name="Green05" /><ref name="Gielen08" /><ref name="Glanz05" /><ref name="Green80">Green, L.W., Kreuter, M.W., Deeds, S.G., Partridge, K.B. (1980). ''Health Education Planning: A Diagnostic Approach''. Mountain View, California: Mayfield</ref> PRECEDE is based on the premise that, just as a medical diagnosis precedes a treatment plan, an educational diagnosis of the problem is very essential before developing and implementing the intervention plan.<ref name="Gielen08" /><ref name="Glanz05" /><ref name="Green80" /> Predisposing factors include knowledge, attitudes, beliefs, personal preferences, existing skills, and self-efficacy towards the desired behavior change. Reinforcing factors include factors that reward or reinforce the desired behavior change, including social support, economic rewards, and changing social norms. Enabling factors are skills or physical factors such as availability and accessibility of resources, or services that facilitate achievement of motivation to change behavior.<ref name="Green74" /><ref name="Glanz05" /><ref name="Green80" /><ref name="Ransdell01">Ransdell, L.B. (2001). Using the PRECEDE–PROCEED Model to Increase Productivity in Health Education Faculty. ''The International Electronic Journal of Health Education'', 4: 276–282</ref> The model has led to <span class="plainlinks"> more than 1000 </span> published studies, applications and commentaries on the model in the professional and scientific literature.

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In 1991, "PROCEED" was added to the framework in consideration of the growing recognition of the expansion of health education to encompass policy, regulatory and related ecological/environmental factors in determining health and health behaviors.<ref name="Green05" /><ref name="Gielen08" /><ref name="Glanz05" /><ref name="Green91">Green, L., Kreuter, M. (1991). ''Health promotion planning: An educational and environmental approach''. 2nd edition. Mountain View, CA: Mayfield Publishing Company</ref> As health-related behaviors such as smoking and alcohol abuse increased or became more resistant to change, so did the recognition that these behaviors are influenced by factors such as the media, politics, and businesses, which are outside the direct control of the individuals. Hence more "ecological" methods were needed to identify and influence these environmental and [[social determinants of health]] behaviors. With the emergence and rapid growth in the field of genetics, the PRECEDE–PROCEED model was also revised also in 2005 to include and address the growing knowledge in this field.<ref name="Green05" /><ref name="Gielen08" />

== Description of the model ==

The PRECEDE–PROCEED planning model consists of four planning phases, one implementation phase, and 3 evaluation phases.<ref name="Green05" /><ref name="Gielen08" /><ref name="Glanz05" />