Chapter 2 Notes
• health educator is associated with planning, implementing, and evaluating health
• models : means by which structure and organization are given to the planning
• The Generalized Model for Program Planning: (basic steps in a model in order to plan
a health program)
• assessing needs
• setting goals and objectives
• developing an intervention
• implementing the intervention
• evaluating the results
• knowing the Generalized Model for Program Planning with help you better understand
all planning models, prepare you to adapt to any planning situation in professional
practice, and help you better understand related processes such as grant writing
• models change over time, and come and go frequently
• what doesnʼt change over time are the things outlined in the Generalized Model for
• all the things outlined in the generalized model may seem one step to another, but
they are actually all related to each other.
• generalized model is like the “North Star” for planning.
• building blocks for all other models
• generalized model is also important as a professional when looking at applications of
• when selecting a planning model, one must take into account:
• the preferences of the stakeholders (e.g. who will be funding the program)
• how much time and funding
• how many resources available for data analysis and collection
• three Fʼs of Program Planning:
• ﬂuidity - steps are in sequence and they build up on one another
• ﬂexibility - adaptive to the needs of the stakeholders.
• functionality - being able to improve health conditions, reach goals, etc.
• planners also must consider the ecological framework, that families, communities,
schools, peers, etc inﬂuence oneʼs health behaviour
• FOUR models focused in this chapter:
• PRECEDE- PROCEED
• PRECEDE - PROCEED Model
• developed over the course of 20 years
• PROCEED is an elaborated version of PRECEDE
• has 8 phases / steps • goal of the model is to identify the desired outcome, what causes it, and to design
• Phase 1: Social Assessment and Situational Analysis
• deﬁne quality of life
• involves individuals to assess their own needs and ambition
• Phase 2: Epidemiological Assessment
• planners use data (mortality, morbidity, etc) to rank their health goals and
• also take into account genetic, behavioural, and environmental factors
• Phase 3: Educational and Ecological Assessment
• classiﬁes factors that affect behaviour into 3 classes:
•predisposing - knowledge, personality, values
•enabling - access to health care, resources available
•reinforcing - feedback and rewards
• Phase 4: a) Intervention Alignment and b) Administrative and Policy Assessment
• a) Intervention Alignment
•match appropriate strategies with projected changes and outcomes
• b) Administrative and Policy Assessment
•determines if the capabilities and resources for the program to work are
• ****PROCEED BEGINS****
• Phase 5: Implementation
• select methods and strategies of the intervention and implementation begins
• Phase 6: Process Evaluation
• Phase 7: Impact Evaluation
• Phase 8: Outcome Evaluation
• MATCH Model
• acronym for Multilevel Approach to Community Health.
• developed in the late 1980s
• an ecological planning perspective that recognizes that intervention approaches
can and should be aimed at a variety of objectives and individuals.
• compromised of 5 phases
• Phase 1: Goals Selection
• take into account relative signiﬁcance of the problem, changeability of the
problem, and environmental factors
• Phase 2: Intervention Planning
• matches intervention objectives with the intervention targets and intervention
• begins with identifying the targets of the intervention actions (TIAs)
• TIAs are individuals who inﬂuence personal or environmental conditions that
are related to health.
• identify which level of harm is made (personal, family, society, etc)
• intervention action is used (teaching, counseling, etc)
• Phase 3: Program Development
• creation of program units
• includes the development of individual sessions and lesson plans • Phase 4: Implementation Preparations
•prepare for implementation and interventions are made.
•effective implementation must include:
• speciﬁc proposal for the adoption of change
• develop the need, readiness, and environmental supports for change
• provide evidence that the intervention works
• identify and select change agents and opinion leaders and convince them of
the need for change.
• establish good working relationships with the decision makers
• Phase 5: Evaluation
•also includes process, impact, and outcome components.
•process - quality of implementation and direct learning outcomes
•impact - measuring the targeted mediators (knowledge, attitudes, etc), health
behaviours and environmental factors
•outcome - typically focus on health behaviours and monitors long-term
maintenance of changes in behaviour or environmental factors
• Consumer-Based Planning
• The two models listed above have been used by many planners successfully in the
• consumer-based planning: most decisions are based on consumer input and made
with consumers in mind
• includes consumers throughout the whole planning process
• Health Communication: the use of strategies to informs and inﬂuence individual
and community decisions to enhance health.
•can be in the form of a brochure, a website, etc
•private sector - very successful at relaying health information by using new
• these people need to understand how to work the new technology in order
to properly communicate
•planners must avoid unrealistic expectations
•health communication alone is not sufﬁcient enough to change behaviour and
reduce the risk for disease.
•not only on an individual basis must they communicate, but they should also
communicate with health care providers, health promotion partners, the media,
•in the next 10 years, application of new technologies in HC will provide cost-
effected applications that can be more easily tailored to large populations.
• Social Marketing
•audience centered program development
•promotion of voluntary behaviour change
•audience segmentation and proﬁling.
•“the application of commercial marketing technologies to the analysis, planning,
execution, and evaluation of programs designed to inﬂuence the voluntary
behaviour of target audiences in order to improve their personal welfare and
that of their society.” • primitive social marketing focused on family planning, nutrition, immunizations,
and agricultural reforms.
• now, North American social marketing focuses on bigger global issues such
as HIV/AIDS, cardiovascular disease, low-fat eating, prevention and
treatment of drug use, and breast cancer screening.
• two models that capture health communication and social marketing are
CDCynergy and SMART.
• CDCynergy (CD-Rom)
• developed in the mid-1990s by the Centre for Disease Control Prevention (CDC)
• developed primarily for public health professionals at the CDC with responsibilities
regarding to health communication
• basic edition of CDCynergy (3.0) includes: general methodology for health
communication planning, step-by-step guide, reference library, links to templates
that allow personalization.
• now more editions are made, targeted to speciﬁc health problems including
cardiovascular disease, diabetes, and tobacco prevention and control
• Phases of CDCynergy:
• Phase 1: Describe Problem
• using epidemiologic data, identify the health problem that merits attention
and that the organization has the means to address.
• a short written statement describing terms such as who is affected, to what
extent, where it is geographically, and as to what the trends are.
• also examines whether an organization is ʻﬁtʼ enough to address the issue.
Thus, Cynergy analyzes whether an organization has enough human
resources, technology resources, and the political climate in general.
• also need a rationale as to why the organization is addressing the problem,
and a list of factors that justify the organizationʼs involvement with the
• Phase 2: Analyze Problem
• describes problem more in detail such as factors that directly and indirectly
contribute to the problem.
• prioritize the importance of subproblems by the complexity or difﬁculty of the
direct and indirect causes leading to the health problem.
• **better to do a few things well - planning avoids overcommitting scarce
resources and addressing too many problems
• once subproblems are selected, goals are developed for each to identify
outcomes and time frames
• SWOT (strengths, weaknesses, opportunities, and threats) are discussed
for each intervention, then one is chosen for each subproblem.