Health education planning: a diagnostic approach.
This book offers PRECEDE (an acronym for predisposing, reinforcing, and enabling causes in educational diagnosis and evaluation) as a model for health education planning. 2 basic propositions are emphasized: 1) health and health behavior are caused by multiple factors; and 2) because health and health behavior are determined by multiple factors, health education efforts to affect behavior must be multidimensional. The procedure has 7 basic phases. The 1st involves assessing the quality of life of a population by studying the kinds of social problems a given community experiences. The task in phase 2 is to identify those specific health problems that appear to be contributing to the social problems noted in phase 1. Phase 3 consists of identifying the specific health-related behaviors that appear to be linked to the health problems of phase 2. Intervention will be tailored to affect these behaviors. The 4th phase is sorting and categorizing the factors that seem to have direct impact on behavior. The 3 classes of factors are predisposing factors, enabling factors, and reinforcing factors. Study of these 3 factors takes the educator into the 5th phase of PRECEDE--deciding which of the factors making up the 3 classes are to be the focus of the intervention. Phase 6 is the actual development and implementation of a program. This involves selection of the right combination of interventions and an assessment of administrative problems and resources. Evaluation is the last phase, although it should be an integral and continuous part of working with the entire framework. The book ends with examples of the application of PRECEDE to 2 settings: public schools and patient care.