Models for Program Planning in Health Promotion OK

8/20/2019 Models for Program Planning in Health Promotion OK

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A Model for Program

Planning inHealth Promotion

Mg. Anita Campos M.

[email protected]



Planning Models: Background

Information Models serve as frames from which to

!ild" Provide str!ct!re # organi$ation for

the planning process Man% different models

Common elements& !t different laels



Background Information (con’t.)

'o perfect model Can e !sed in entiret%& parts& # cominations

(hree )s of program planning help with selecting theappropriate model )l!idit% * steps are se+!ential )le,iilit% * adapt to needs of sta-eholders )!nctionalit% * !sef!l in improving health conditions Categories

Practitioner driven Cons!mer*ased



hat is P/ECEDE0P/OCEED1

P/ECEDE0P/OCEED is a comm!nit%*

oriented& participator% model for creating

s!ccessf!l comm!nit% health promotioninterventions.



P/ECEDE has five phases2

Phase 32 Social diagnosis

Phase 42 Epidemiological diagnosis

Phase 52 6ehavioral and environmentaldiagnosis

Phase 72 Ed!cational and organi$ational

diagnosis Phase 82 Administrative and polic% diagnosis



P/OCEED has fo!r phases2

Phase 92 :mplementation

Phase ;2 Process eval!ation

Phase <2 :mpact eval!ation

Phase =2 O!tcome eval!ation



Ass!mptions ehind

P/ECEDE0P/OCEED2 Since ehavior change is % and large vol!ntar%& health

promotion >and& % e,tension& the promotion of othercomm!nit% enefits? is more li-el% to e effective if its

participator%. ealth and other iss!es m!st e loo-ed at in the conte,t

of the comm!nit%. ealth and other iss!es are essentiall% +!alit%*of*life

iss!es. ealth is itself a constellation of factors that add !p to a

health% life for individ!als and comm!nities.



h% !se P/ECEDE0P/OCEED1

A logic model provides a proced!ral str!ct!re forconstr!cting an intervention.

A logic model provides a framewor- for critical

anal%sis. P/ECEDE0P/OCEED is participator%& th!s ass!ring

comm!nit% involvement. Comm!nit% involvement leads to comm!nit% !%*in.

P/ECEDE0P/OCEED incorporates a m!lti*leveleval!ation& which means %o! have the chance toconstantl% monitor and adB!st %o!r eval!ation.

(he model allows leewa% to adapt the content andmethods of the intervention to %o!r partic!lar needsand circ!mstances.



ow do %o! !se

P/ECEDE0P/OCEED1 :n Phase 3& social diagnosis& %o! as- the

comm!nit% what it wants and needs to improve

its +!alit% of life. :n Phase 4& epidemiological diagnosis& %o!identif% the health or other iss!es that mostclearl% infl!ence the o!tcome the comm!nit%

see-s. :n these two phases& %o! create the oBectives

for %o!r intervention.



ow do %o! !se

P/ECEDE0P/OCEED1 >cont.? :n Phase 5& ehavioral and environmental diagnosis&

%o! identif% the ehaviors and lifest%les and0orenvironmental factors that m!st e changed to affect

the health or other iss!es identified in Phase 4& anddetermine which of them are most li-el% to echangeale.

:n Phase 7& ed!cational and organi$ational diagnosis&

%o! identif% the predisposing& enaling& and reinforcingfactors that act as s!pports for or arriers to changingthe ehaviors and environmental factors %o! identifiedin Phase 5.

:n these two phases& %o! plan the intervention.



ow do %o! !se

P/ECEDE0P/OCEED1 >cont.? :n Phase 8& administrative and polic% diagnosis&

%o! identif% >and adB!st where necessar%? the

internal administrative iss!es and internal ande,ternal polic% iss!es that can affect the

s!ccessf!l cond!ct of the intervention.

(hose administrative and polic% concerns

incl!de generating the f!nding and otherreso!rces for the intervention.



ow do %o! !se

P/ECEDE0P/OCEED1 >cont.? :n Phase 9& implementation& %o! carr% o!t the

intervention. :n Phase ;& process eval!ation& %o! eval!ate the process

of the intervention i.e.& %o! determine whether theintervention is proceeding according to plan& and adB!staccordingl%.

:n Phase <& impact eval!ation& %o! eval!ate whether theintervention is having the intended impact on the

ehavioral and environmental factors its aimed at& andadB!st accordingl%. :n Phase =& o!tcome eval!ation& %o! eval!ate whether

the interventions effects are in t!rn prod!cing theo!tcome>s? the comm!nit% identified in Phase 3& andadB!st accordingl%.



Phase 3 * Social Assessment

Assessment means :dentif%

DescriePrioriti$e

Phase 3 * see-s to s!Bectivel% define the OF

>prolems # priorities? of priorit% pop!lation

Self*assessment of needs # aspirations



Phase 4 * Epidemiological

Assessment Epidemiolog% * st!d% of the distri!tion #

determinants of disease

hat are the health prolems associatedwith the desired OF1

'ot all prolems health related" :f Phase 4

not applicale& s-ip and move on to Phase5.



Phase 2: Eidemiological

Assessment Epidemiological Data2

Mortalit%

Moridit%

Disailit%

)ertilit%

:ncidence rates

Prevalence rates




Assessment Creating Priorities2hich prolem has the greatest impact in

terms of death& disease& da%s lost from wor-&rehailitation costs& disailit%& famil%

disorgani$ation& and costs to comm!nities

and agencies for damage repair or loss and

cost recover%1




Assessment Creating priorities >contin!ed?hich prolems are most changeale1

hich prolem has the greater potential foran attractive %ield in improved health stat!s&

economic savings and other enefits1




Assessment Creating priorities Are certain s!*pop!lations s!ch as teenagers&

to!rists& elderl%& immigrants& at ris-1hich prolem is not eing addressed % other

agencies in the comm!nit%1

:s there a need eing neglected1

Are an% of the prolems highl% ran-ed as a

regional or national priorit%1



Phase !: Beha"ioral

#iagnosis )oc!ses on ehavioral and non*

ehavioral ca!ses >personal and

environmental factors? which seem to elin-ed to health prolems defined in Phase

4



Beha"ior of Interest Ma$

%e& 6ehavior of the people whose health is in

+!estion& O/

6ehavior of those who control reso!rces orrewardsComm!nit% FeadersFegislators

Parents(eachersealth Professionals



En"ironmental or 'on

Beha"ioral actors Genetic Predisposition

Age

Gender

E,isting Disease

or-place Ade+!ac% of ealth Care )acilities



En"ironmental actors

Include Determinants o!tside the person that can

e modified to s!pport ehavior& health& or

+!alit% of life.Ph%sical

Social

Economic



Phase !: Beha"ioral *

En"ironmental #iagnosis ealth and environmental factors

identified are the ris- factors or ris-

conditions that the intervention will etailored to affect.




En"ironmental #iagnosis Each factor is rated in terms of its

imortance to the health prolem

And rated in terms of its changea%ilit$



#ecision Matri+

More Imortant ,ess Imortant

More

-hangea%le

igh Priorit% for

Program )oc!s

Fow Priorit% E,cept

to Demonstrate

Change for Political

P!rposes

,ess

-hangea%le

Priorit% for

:nnovative

Program"

Eval!ation Cr!cial

'o Program




En"ironmental #iagnosis :f planners fail at this stage to ecome

rigoro!s in identif%ing and ran-ing these

factors and how the% infl!ence theo!tcomes so!ght& the whole planning

process will collapse !nder its own weight.




En"ironmental #iagnosis Once target ehaviors and conditions are

identified& ehavioral oBectives are written

Specificit% is vital




En"ironmental #iagnosis ow man% will -now& elieve& or e ale to

do what % when1

ow m!ch of what reso!rce will eavailale to whom % when1



Phase : Educational *

/rgani0ational #iagnosis :dentifies causal factors that m!st e

changed to initiate and s!stain the

process of ehavioral and environmentalchange identified in Phase 5



Phase 5 * 6ehavioral #

Environmental Assessment 6ehavior of priorit% pop!lation

Determining # prioriti$ing ehavioral #

environmental ris- factors or conditions lin-ed tothe health prolem

Environmental factors * determinants o!tside an

individ!al& that can e modified to s!pport

ehavior& health& or OF

Once identified& m!st e prioriti$ed



1e"ie of P1E-E#E

Model

Phase Educational *

Ecological

Assessment

Predisosing

actors

1einforcing

actors

Enaling

)actors



Predisosing actors

Hnowledge

Attit!des

Val!es

6eliefs

Perceived 'eeds and Ailities



Ena%ling actors

Environmental and Personal /eso!rces that impact2

Accessiilit%& Availailit% and Affordailit% Programs # Services S-ills

Mone% # (ime )acilities Faws



1einforcing

Positive or 'egative )eedac- )rom2 Peers

)amil% ealth Care or-ers Faw Enforcement

(he Media Others




Ecological Assessment After identif%ing the three t%pes of infl!encing

factors& assess their relative importance andchangeailit%

(hen related learning and organizationalobjectives can e written& and state so thathealth promotion programs can foc!s wherethe% will do the most good in facilitatingdevelopment of or changes in ehavior andenvironment




Ecological Assessment(heor% is applied in this Phase

Predisposing :ndivid!al )actors *

:ndivid!al (heories Enaling )actors :nterpersonal Fevel

(heories

/einforcing )actors Comm!nit% Fevel

and S%stems (heories



Phase 32 Administrati"e and

Polic$ #iagnosis Predisosing

actors

1einforcing

actors

Ena%ling

actors

ealth

Programs

ealth

Ed!cation

Polic%/eg!lation

Organi$ation




Polic$ #iagnosis )oc!ses on administrative and

organi$ational concerns which m!st e

addressed prior to programimplementation :ncl!des assessment of reso!rces& !dget

development and allocation& developmentof implementation timetale& organi$ationand coordination with others



Phase 32 Administrati"e

and Polic$ #iagnosis Administrative Diagnosis Anal%sis of policies& reso!rces and

circ!mstances prevailing organi$ationalsit!ations that co!ld hinder or facilitate thedevelopment of the health program Polic%Diagnosis

Assesses the compatiilit% of %o!r programgoals0oBectives with those of the organi$ationand its administration




Polic$ #iagnosis or- in this phase is specific to the

conte,t of the program and the sponsoring

organi$ation>s? and re+!ires political savv%as m!ch as theoretical or empirical

-nowledge

:nformed % theories& partic!larl%comm!nit%*level theories



Phase 32 Administrati"e

and Polic$ #iagnosis Assess limitations and constraints

Select the est comination of methods

and strategies Development of organi$ational and

reso!rce oBectives follows



#esign a -omrehensi"e

Inter"ention



1educing #runk and

#rugged #ri"ing %$ 'e

#ri"ers in Montana



4hat did $ou include in

$our inter"ention design5 hich Predisposing& Enaling and

/einforcing )actors did %o! choose to

change1 h%1 hat are %o!r impact oBectives1



P1/-EE# Model

:mplementation and Eval!ation



Phase 6:

Imlementation (he act of converting program oBectives

into actions thro!gh polic% changes&

reg!lation and organi$ation >Green #Hre!ter& 3==3& p.754?.



Phase 7 * Ed!cational # Ecological

Assessment :dentifies # classifies factors that have potential

to infl!ence ehavior or change the environment Predisposing factors * antecedent" impact

motivation" e.g.& -nowledge& attit!des & eliefs&val!es

Enaling factors * antecedent" arriers # vehicles"e.g.& access& availailit%

/einforcing factors * s!se+!ent" feedac- #rewards" e.g.& incentives& disincentives Priorities ecome foc!s of intervention



Phase 8 * Administrative #

Polic% Assessment Determine if capailities # reso!rces

are availale to develop # implement

program Close to the end of P/ECEDE # moving

toward P/OCEED



Phase 9 * :mplementation

6eginning of P/OCEED

Selection of methods and strategies of the

intervention& for e,ample& ed!cation #0orother reso!rces

Program egins



Phases ;& <& # = * Eval!ation

Process eval!ation * meas!rements of

implementation to control& ass!re& or improve

the +!alit% of the program :mpact eval!ation * immediate oservale

effects of program

O!tcome eval!ation *long*term effects of the

program Fine !p with P/ECEDE



American Io!rnal of ealth Promotion

Predictors of at Intake Beha"ior

#iffer Beteen 'ormaleightand /%ese 4I- Mothers

Purose. (o determine whether predictors of fat inta-e ehavior were the

same for normal*weight and oese :C mothers when appl%ing theP/ECEDE*P/OCEED model and to identif% predictors for each gro!p.

-onclusions. :nterventions to modif% low*income womens fat inta-e ehavior

might enefit from targeting ehavioral predictors that differ with od% si$e.

Messages that emphasi$e weight control intentions& sensor% appeal& andmood are li-el% to affect oth normal*weight and oese women. :nformation

ao!t cost of food& availailit% of time to prepare food& and accessiilit% to

p!rchase food is li-el% to e more effective with oese women.

Models for Program Planning in Health Promotion OK

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