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The Underlying Theories of
Precede-Proceed Model
Understanding Causal Assumptions
and Intervention Assumptions
Prototype of Causal Models
and Intervention Models
Problem Theory: Causes->->->->->->->Effects
INPUTS
(educational,
organizational
economic, etc.)
X?
OUTPUTS
(health, quality
of life, development)
Different models interpret the content of “X?”
according to different theories (or assumptions)
about causation and control.
Examples of Causal Theories on Which
PRECEDE-PROCEED is Based
• Psychological theories in which X includes behavior,
and its antecedents such as attitudes, beliefs,
perceptions, and other cognitive variables
• Sociological theories in which X includes organizational
functioning and interorganizational exchange and
coalitions.
• Economic theories in which X includes consumer
behavior and organizational response to consumer
demand.
• Pathophysiological theories in which X includes
organisms or environmental exposure processes.
Action
Theoryand
and Program
Program Theory
Use
Causal
Action
Theory
Theory
Use
Causal
Theories to Link Intervention and Outcomes
Theories to Link Interventions & Outcomes
Intervention Variable
Causa l Variable
Action Theory
Success
OutcomeVariable
Program Theory
Success
*Action Theory and Conceptual Theory Intervention Evaluation Model. Chen 1990. p. 200
Mediating and Moderating Variables
Mediator
Intervention
Variable
Outcome
Variable
Mediator
Moderator
Prototype of the ResourceBased Planning Approach*
1. Select Resource or
Service to be Studied
4. Evaluate Use of the
Resource or Service
2. Assess Demand
for the Resource or
Service
3. Increase Resource
or Increase Demand
*A procedural model, as distinct from a causal model.
Strengthening Population-based,
Diagnostic Planning Approaches*
Participatory
Research
4. Evaluate
Program
1. Assess Needs, Assets
of Population
Reassess causes
2. Assess Causes,
Set Priorities
& Objectives
Redesign
3. Design and
Implement Program
*Green & Kreuter, Health Promotion Planning, 3rd ed., Mayfield, 1999.
Surveillance, Planning and Evaluating for Policy and Action:
PRECEDE-PROCEED MODEL*
Phase 5
Administrative &
policy assessment
Public
Health
Phase 4
Educational &
ecological
assessment
Phase 3
Behavioral &
environmental
assessment
Phase 2
Phase 1
Epidemiological
Social
assessment
assessment
Predisposing
Health
education
Behavior
Reinforcing
Health
Policy
regulation
organization
Quality of
life
Environment
Enabling
Phase 6
Implementation
Input
Process
Phase 7
Process evaluation
Output
Phase 8
Impact evaluation
Short-term
impact
Longer-term
health outcome
Phase 9
Outcome evaluation
Short-term
social impact
*Green & Kreuter, Health Promotion Planning, 3rd ed., 1999.
Long-term
social impact