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Questions and Answers
What is the primary focus of impact evaluation in program assessment?
What is the primary focus of impact evaluation in program assessment?
Which type of evaluation specifically looks at the implementation of a program according to its protocol?
Which type of evaluation specifically looks at the implementation of a program according to its protocol?
In the context of a smoking cessation program, which intervention is most appropriate for an individual in the relapse stage?
In the context of a smoking cessation program, which intervention is most appropriate for an individual in the relapse stage?
What outcome measure was used to assess the effectiveness of the diabetes management strategies in the PRECEDE-PROCEED model?
What outcome measure was used to assess the effectiveness of the diabetes management strategies in the PRECEDE-PROCEED model?
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Which intervention is recommended at the community level to support a smoking cessation program?
Which intervention is recommended at the community level to support a smoking cessation program?
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What is the initial step in the PRECEDE-PROCEED planning framework?
What is the initial step in the PRECEDE-PROCEED planning framework?
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Which component is associated with the 'P' in PROCEED?
Which component is associated with the 'P' in PROCEED?
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In the context of health education program development, what does 'reinforcing' refer to?
In the context of health education program development, what does 'reinforcing' refer to?
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Which of the following accurately reflects a principle underpinning the PRECEDE portion of the framework?
Which of the following accurately reflects a principle underpinning the PRECEDE portion of the framework?
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Which aspect is NOT included in the evaluation stage of the framework?
Which aspect is NOT included in the evaluation stage of the framework?
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What role do social determinants of health play in the PROCEED phase?
What role do social determinants of health play in the PROCEED phase?
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What is a primary function of the educational constructs in the PRECEDE phase?
What is a primary function of the educational constructs in the PRECEDE phase?
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What should be assessed in Phase 4 to ensure program readiness?
What should be assessed in Phase 4 to ensure program readiness?
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Which of the following best describes the focus of Phase 5 in the Precede-Proceed model?
Which of the following best describes the focus of Phase 5 in the Precede-Proceed model?
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What is the primary goal of conducting barrier assessments in the smoking cessation program?
What is the primary goal of conducting barrier assessments in the smoking cessation program?
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In which phase are data collection plans particularly emphasized?
In which phase are data collection plans particularly emphasized?
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What type of specialists might be assessed for availability in a smoking cessation program?
What type of specialists might be assessed for availability in a smoking cessation program?
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What is critical to consider when identifying needs in a health program?
What is critical to consider when identifying needs in a health program?
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What type of resources might material needs include for a smoking cessation program?
What type of resources might material needs include for a smoking cessation program?
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Which level of behavioral determinants focuses on an individual's personal attitudes and motivation?
Which level of behavioral determinants focuses on an individual's personal attitudes and motivation?
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During which phase is the evaluation of impacts and outcomes prioritized?
During which phase is the evaluation of impacts and outcomes prioritized?
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Which type of assessment occurs first in the Precede-Proceed model?
Which type of assessment occurs first in the Precede-Proceed model?
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What is the primary role of secondary data sources in the epidemiological, behavioral, and environmental assessment?
What is the primary role of secondary data sources in the epidemiological, behavioral, and environmental assessment?
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What do enabling factors refer to in the context of the health program?
What do enabling factors refer to in the context of the health program?
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In the context of addressing smoking cessation, which of the following is considered a distal behavioral determinant?
In the context of addressing smoking cessation, which of the following is considered a distal behavioral determinant?
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What is the significance of prioritizing factors by importance and changeability in health program design?
What is the significance of prioritizing factors by importance and changeability in health program design?
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Which group should gerontology nursing staff primarily engage with during the information gathering phase?
Which group should gerontology nursing staff primarily engage with during the information gathering phase?
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What must programs consider in addition to health education to modify environmental determinants?
What must programs consider in addition to health education to modify environmental determinants?
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Which of the following best describes environmental determinants?
Which of the following best describes environmental determinants?
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Which theory is associated with understanding behavioral changes within community programs?
Which theory is associated with understanding behavioral changes within community programs?
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What factor is critical when designing a health program with the intent to influence behaviors like smoking?
What factor is critical when designing a health program with the intent to influence behaviors like smoking?
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What is the main outcome desired when engaging the community during assessment phases?
What is the main outcome desired when engaging the community during assessment phases?
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What is the primary objective of the Precede-Proceed Planning Framework?
What is the primary objective of the Precede-Proceed Planning Framework?
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In the Precede-Proceed Planning Framework, what does Phase 1 focus on?
In the Precede-Proceed Planning Framework, what does Phase 1 focus on?
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What type of factors does Phase 3 of the framework specifically assess?
What type of factors does Phase 3 of the framework specifically assess?
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What is the final phase of the Precede-Proceed Planning Framework?
What is the final phase of the Precede-Proceed Planning Framework?
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In the case study regarding smoking cessation for older Canadians, what was identified as the primary need?
In the case study regarding smoking cessation for older Canadians, what was identified as the primary need?
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Which phase of the Precede-Proceed Framework involves implementing the identified strategies?
Which phase of the Precede-Proceed Framework involves implementing the identified strategies?
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Which component is included in the Administrative and Policy Assessment phase?
Which component is included in the Administrative and Policy Assessment phase?
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The educational strategies in the framework are most closely associated with which phase?
The educational strategies in the framework are most closely associated with which phase?
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The Precede-Proceed framework emphasizes the importance of which aspect in program planning?
The Precede-Proceed framework emphasizes the importance of which aspect in program planning?
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Study Notes
Introduction to Program Planning
- This course is offered by the School of Occupational and Public Health at Toronto Metropolitan University.
- The course code is POH705.
- The current week is 11.
Lesson Objectives
- The lesson explores the PRECEDE-PROCEED planning framework.
- The framework is used to create health education programs.
Imagine, as a Health Educator...
- A problem is identified, and you need to create a solution to fix it.
- Theories of health behavior are critical skills for effective program design and delivery.
- The PRECEDE-PROCEED framework provides a roadmap for applying theories into programs.
- It's a tool for designing, implementing, and evaluating health programs.
The PRECEDE-PROCEED Planning Framework
- PRECEDE is based on the educational diagnosis (identifying the problem)
- Interventions are strategically planned to meet demonstrated needs.
- Recognizes the importance of social determinants of health influencing health behaviour (PROCEED).
- Target audience participation in defining problems and solutions
PRECEDE and PROCEED Components
-
PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation)
- Predisposing factors
- Reinforcing factors
- Enabling factors
- Educational/environmental diagnosis
- Evaluation
-
PROCEED (Policy, Regulatory, Organizational Constructs in Educational and Environmental Development)
- Policy
- Regulatory
- Organizational constructs
- Educational and environmental development
The PRECEDE-PROCEED Planning Framework Overview
- The framework starts with the health outcome and works backward.
- It analyses which combinations of intervention strategies result in the most effective program.
- The process involves prioritizing targets and identifying measurable objectives.
- The goal is to start with the problem to develop a solution.
PRECEDE-PROCEED Planning Framework Phases
- (1) Social Assessment: Community involvement, multiple information sources, both objective and subjective, are used to expand understanding of community aspirations.
- (2) Epidemiological, Behavioural and Environmental Assessment: Identifying health priorities, associated factors, and sub-groups. Translating concerns into measurable priorities.
- (3) Education and Ecological Assessment: Identifying precursors/reinforcing factors to behavior change that are necessary for initiating and sustaining behavioral change. Classifies factors as predisposing, reinforcing, and enabling.
- (4) Administrative and Policy Assessment: Planning and aligning program components, identifying barriers, and relevant policies.
- (5) Implementation: Implementation of program. Determining human and material resources.
- (6) Process Evaluation: Process evaluations look at how the program is being carried out.
- (7) Impact Evaluation: Measuring the impact of the interventions.
- (8) Outcome Evaluation: Determining the effects of the program on health, quality of life etc.
Case Study: Smoking Cessation Program for Older Canadians in Nursing Homes (Aldiabat and Navenec, 2013)
- The study aims to guide gerontology nurses towards implementing smoking cessation programs in nursing homes
- It addresses the high health risk of smoking among older adults.
- The PRECEDE-PROCEED framework guides the development of goals and objectives along with specific activities
- Built upon health behavior theories
What is the First Step in Developing a Program?
- Social Assessment, Participatory Planning, and Situation Analysis.
Phase 1: Social Assessment, Participatory Planning, and Situation Analysis
- Planners expand their understanding of the community through multiple data collection activities.
- Engage with the community to identify their specific concerns and challenges,
- Predetermined programs should also be aligned to local community perceptions, needs and challenges.
How to Collect Information
- Use planning committees
- Conduct community forums.
- Implement focus groups to determine stakeholder readiness
- Utilize surveys.
- Employ key informant interviews.
- Analyze secondary data.
Example of Community-Engaged Planning
- Needs assessments are crucial in community-based research.
- Used to identify community priorities (known as aka)
Example: Needs Assessment with Ile-
- Covid-19 was initially the focus due to its immediate, time-sensitive impact.
- Subsequent concerns included climate change, environmental hazards (flooding), changes in environment and wildlife patterns.
- Subsequent priorities identified for the community included mental health and wellbeing, food security, and sovereignty.
Example: Needs Assessment (with specifics)
- Understanding community via data collection activities (focus groups, key informant interviews)
- Identifying community perceptions, needs, desires, relevance, and timing of issues
- Evaluating community capacity, strengths, resources, readiness to change.
Why are these priorities important?
- Focus on importance and changeability to allow potential for change.
- Improve awareness of harms like smoking.
PHASE 2: Epidemiological, Behavioural and Environmental Assessment
- Identifying health priorities
- Determine behavioural and environmental factors
- Classifies factors as behavioural or environmental
- Uses secondary data (e.g., statistics, population health assessments, hospital records, and previous studies)
Behavioral Assessment (Levels)
- Proximal factors relate to attitude, motivation, and ability to participate
- Intermediate factors relate to peers and family that affect behaviour, and social support
- Distal factors are more comprehensive and relate to social determinants, including social support
Environmental Determinants
- Social and physical factors that influence health outcomes outside of individual behavior, and that can be modified. Consider strategies beyond educational programs.
PHASE 2: Epidemiological, Behavioural and Environmental Assessment
- Decisions should be guided by the community and supported by community health data
- prioritisation of factors should be based on importance and changeability
- Use of resources directed towards most important factors that are modifiable (e.g. attitudes, knowledge, access to resources, organizational level)
CASE STUDY: PHASE 1 and 2 Information Gathering
- Information gathering activities for gerontology nursing staff to assess community needs.
- Involve the community to understand their needs, capacity and readiness to change
- Involve residents that are current / potential smokers to understand perceptions of smoking.
- Consider institutions and risk factors
WHO do we involve in this process?
- Engage nursing home residents who smoke, staff, and other residents to understand other concerns.
HOW do we engage/involve them?
- Use individual sessions including focus groups
- Use questionnaires
- Utilize organizational forums
- Analyze nursing home records and reports.
- Refer to previous research literature
PHASE 3: Education and Ecological Assessment
- This phase identifies the precursors and reinforcing factors needed to initiate and sustain change
- Recognizes predisposing, reinforcing, and enabling factors.
Predisposing Factors
- Antecedents (precursors) to a behavior, that provide rationale or motivation for a behaviour
- Examples include knowledge, attitude, beliefs, and skills.
Reinforcing Factors
- Factors that follow a behavior to provide continued reward or incentive.
- Examples include social support, peer influence, and social norms
Enabling Factors
- Antecedents to a behavior or environmental change
- Include the motivation or environmental factors that allow a change to occur
- This is about policies or external factors that facilitate behavior change
Goals and Objectives of the Program
- Goals and objectives aimed at helping older Canadian people living in nursing homes quit smoking
To prepare for a one small, private, equipped room...
- This is a process (i.e., activity) of counselling and treatment for those in the nursing home.
PHASE 4: Administrative and Policy Assessment
- Alignment of program components with identified priorities and goals
- Identify administrative barriers, and relevant policies.
PHASE 4: Administrative and Policy Assessment
- Two levels of alignment:
- Macro Level: Interventions affecting enabling factors for environmental change.
- Micro Level: Interventions aimed directly at predisposing, reinforcing and enabling behaviours
CASE STUDY: PHASE 4
- Human and material resources needed for smoking cessation programs (e.g. personnel, medical supplies).
- Identify barriers for implementing a smoking cessation program
- Implement a PROCEED framework, including phase 5.
PHASE 5–8: Implementation and Evaluation
- Data collection plans for evaluation, including determining if the program worked.
- Process evaluation (assessment of how the program was implemented)
- Impact evaluation (assessing change in predisposing, reinforcing, and enabling factors, as well as behavioral and environmental factors)
- Outcome evaluation (effect of the program on health and quality of life).
PHASE 5–8: Implementation and Evaluation
- Identify different types of evaluations, including formative, process, impact, and outcome evaluation.
- Consider community analysis, materials development, focus groups, training, pilot testing, goals, objectives, interventions, resources, budget, presentations, classroom instruction, skills training, inspections, home surveys, and meetings.
CASE STUDY: PHASE 5–8
- Identify interventions based on policy and administrative diagnoses for the smoking cessation program.
- Individual level interventions (e.g., counseling, education, nicotine patches).
- Community level interventions (e.g., preventing second-hand smoke exposures, relapse).
Applied Example #1: Diabetes Management
- Aims to identify health management strategies that improve diabetes-related patient outcomes.
- Chronic disease health management strategies will address diabetes knowledge, lower blood glucose levels, improve self-efficacy, and self-management
- Uses the PRECEDE-PROCEED model for strategy implementation and evaluation
Applied Example #2: Physical Activity Intervention
- Aims to pilot an intervention promoting physical activity and sedentary behavior reduction among female healthcare workers based on the PRECEDE-PROCEED model
- Participants achieved the recommended minimum of 7,000 steps per day after the 12-week intervention, reducing sedentary time
- Improvements in health-related psychosocial measures followed.
Applied Example #3: Creating an Inclusive Environment
- Aims to create an inclusive environment for people with physical disabilities at a shopping centre in Montreal,
- Measures effectiveness by assessing changes in accessibility
Canadian Best Practices Portal
- Provides resources for program planning and evaluation in the Canadian context.
- An online tool that supports planning and evaluation.
Other Important Information
- Dates: Introduction to Program Evaluation (in-person), Communication Tools (posting/recording early), and the final exam.
- Resources: Consult the course page for further details
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Description
This quiz focuses on the PRECEDE-PROCEED planning framework used in health education. Learn how to design, implement, and evaluate health programs through the lens of health behavior theories. Test your understanding of the essential concepts discussed in week 11 of the course.
