HSCI 312 Study Guide - Final Guide: Health Promotion, Occupational Safety And Health, Liver Disease
16 May 2018
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CHAPTER 8: ECOLOGICAL PERSPECTIVE AND MOVE FROM THEORY TO PRACTICE
PROCEDE-PROCEED APPROACH
Most well-known approach for planning, implementing and evaluating
What it entails: a process of assessment and planning before putting a program in place
(PROCEDE) followed by implementation and evaluation of the program (PROCEED)
INVOLVES 3 STEPS:
1. assessment/diagnosis
• of the health problem and its causal/supporting factors
2. development of an intervention
• based on assessment, targeting selected factors identified in the assessment (and utilizing
appropriate theory to guide intervention components)
3. evaluation of the intervention
• determine if it has been implemented as planned and if it has actually affected the causal or
related factors that it was intended to affect
all 3 parts work together in a continuous feedback loop:
assess nature of problem → causes, ecological context etc. → directs applicable theories →
intervention that should be undertaken → variable to be evaluated to determine effectiveness
of intervention
PROS
CONS
Comprehensive → designed to work within an
ecological framework for understanding a health
problem and help guide the selection of factors to
target
Oriented toward addressing health problems at
community/local level (easier to identify factors
and issues related as it occurs in community)
Lifestyle: a complex of related practices and behavioural patterns in a person or group,
maintained with some consistency over time. It includes conscious health-directed behavior as
well as unconscious health-related behavior and practices pursued for non-health purposes but
with health consequences or risks
PROCEDE-PROCEED FRAMEWORK STAGES
PHASE 1 → SOCIAL ASSESSMENT AND SITUATIONAL ANALYSIS
What it is
Sources of info
What this tells you
find more resources at oneclass.com
find more resources at oneclass.com
Assessment of quality of life
and social factors surrounding
1+ health problems
Ranking or positioning the
health problem in context
Social indicators like employment
rates, availability of healthcare
services, education, crime,
housing, parks/recreation
facilities etc.
From an ecological perspective,
the social assessment provides
an overview of the interplay
b/w health and other factors
including potential social or
quality-of-life outcomes for
program
Gives an indication of the
importance placed on a
particular health issue in the
community
PHASE 2 → EPIDEMIOLOGICAL ASSESSMENT
What it is
Sources of info
What this tells you
Assessment of
prevalence/incidence of a health
condition, comorbid conditions
and affected population
Local surveillance data from
public health sources or other
relevant sources like schools,
emergency rooms, police
Nature and extent of a health
problem(s), patterns and
trends and affected pop.
Info. needed to conduct epidemiological assessment:
• morbidity data
• mortality data
• comorbidity
• incidence
• prevalence
PHASE 3 → BEHAVIORAL AND ENVIRONMENTAL ASSESSMENT
• how to address program ideas → need idea of factors causing/contributing to spread of health
problem
• identifies risk factors (behavioural and environmental)
behavioural risk factors: internal/related to persons (what people do)
environmental risk factors: conditions/situations (ex. Factory upstream → cause pollution in
drinking water)
What it is
Sources of info
What this tells you
Assessment of behavioural and
environmental risk factors linked
to health conditions you want to
address as identified and
Local survey, focus group, other
data from public health sources
(schools, community groups,
work-related sources)
Behaviors and environmental
conditions that you may need to
target in an intervention in
order to address the identified
health problem(s)
find more resources at oneclass.com
find more resources at oneclass.com
described in epidemiological
data
Environmental risk data from
environmental agencies, public
health agencies, occupational
health agencies or organizations
EXAMPLE: alcohol abuse
• alcohol abuse → behavioural risk factor related to liver problems (cirrhosis) and drunk driving accidents in
North Hill Country
• smoking → behavioural risk factor related to health problem of cancer in women and respiratory
problems in children
• roads → eiroetal risk fator otriutig to aidets if theyre arro, poor isiility ad ot ell
lit
COLLECTING DATA:
• DCD → collect data on risk behaviours in adults and youth across country by Behavioural Risk Factor
Survey
• NCHS has national data from surveys concerning behavioural risk factors (diet, smoking, exercise)
• WHO etc. collect data on global health problems (ex. HIV, AIDS) including behavioural info.
PHASE 4 → EDUCATIONAL AND ECOLOGICAL ASSESSMENT
• Find factors that contribute to risks → related to theoretical issues (attitudes, decision-making processes,
social and cultural influences, social/economic factors)
EXAMPLE: alcohol abuse
• What kinds of attitudes, beliefs and social rewards promote heavy alcohol use in North Hill Country?
o Social acts → glorified and contributes to reputation in society → legitimize reputation of person
doing it
o Shared attitudes and beliefs involved
• Attempt to understand what these beliefs/attitudes are and the role of alcohol abuse
3 WAYS TO CATEGORIZE INFO FOR PHASE 4
1. Predisposing factors: pop. Knowledge, attitudes, beliefs, values, perceptions, genetic predisposition etc.
2. Enabling factors: skills, resources, and barriers that help/hinder desired behavior
3. Reinforcing factors: what rewards are received or available when people adopt the desired behavior?
What rewards are available when people engage in unhealthy alcohol-related behaviours?
What it is
Sources of info
What this tells you
Assessment of attitudes,
knowledge, social norms, patterns
of social and community
organization, and similar factors
contributing to the risk behaviours
and environmental risks identified
in phase 4.
Local survey, focus group, or other
specialized data from public health
resources, local research
institutions, NGOs, schools, work-
related groups
In order to influence behavior,
need to address attitudes, norms,
social support systems and other
close-in factors that are involved.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Chapter 8: ecologica l perspective and move from theory to pr actice. Most well-known approach for planning, implementing and evaluating. What it entails: a process of assessment and planning before putting a program in place (procede) followed by implementation and evaluation of the program (proceed) Directs applicable theories intervention that should be undertaken variable to be evaluated to determine effectiveness of intervention. Comprehensive designed to work within an ecological framework for understanding a health problem and help guide the selection of factors to target. Oriented toward addressing health problems at community/local level (easier to identify factors and issues related as it occurs in community) Lifestyle: a complex of related practices and behavioural patterns in a person or group, maintained with some consistency over time. It includes conscious health-directed behavior as well as unconscious health-related behavior and practices pursued for non-health purposes but with health consequences or risks. Phase 1 social assessment and situational analysis.
