Program planning models and frameworks are essential tools in public health. They help professionals design effective interventions by providing structured approaches to identify needs, set goals, and plan strategies. These models ensure that programs are evidence-based and address multiple levels of influence on health behaviors.

The PRECEDE-PROCEED model, Logic Model, and Theory of Change are key frameworks used in program planning. They guide practitioners through systematic processes to develop, implement, and evaluate interventions. These models emphasize the importance of considering various factors that impact health outcomes and involving stakeholders throughout the planning process.

Program Planning Models

PRECEDE-PROCEED Model

• PRECEDE stands for Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation
• PROCEED stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development
• Consists of 8 phases: 5 planning phases (PRECEDE) and 3 implementation and evaluation phases (PROCEED)
• Helps plan programs by identifying desired outcomes first, then working backwards to determine strategies to achieve those outcomes
• Considers multiple levels of influence on health behaviors (individual, interpersonal, organizational, community, and policy)

Logic Model

• Visual representation of a program's resources, activities, outputs, and intended outcomes
• Shows the logical relationships between program components and how they contribute to desired results
• Includes inputs (resources needed), activities (what the program does), outputs (direct products of activities), and outcomes (short-term, intermediate, and long-term changes resulting from the program)
• Helps clarify program goals, identify necessary resources, and communicate the program's theory of change to stakeholders

Theory of Change and Intervention Mapping

• Theory of Change (TOC) is a comprehensive description and illustration of how and why a desired change is expected to happen in a particular context
  • Explains the process of change by outlining causal linkages from inputs to outcomes
  • Identifies underlying assumptions and potential risks that could affect the program's success
  • Helps develop a shared understanding among stakeholders and guide program planning, implementation, and evaluation
• Intervention Mapping (IM) is a protocol for developing theory- and evidence-based health promotion programs
  • Consists of 6 steps: needs assessment, program objectives, theory-based methods and practical applications, program production, program implementation, and evaluation planning
  • Ensures that interventions are grounded in theory, tailored to the target population, and systematically planned and evaluated

Behavioral and Social Science Theories

Socio-Ecological Model

• Recognizes that health behaviors are influenced by factors at multiple levels: individual, interpersonal, organizational, community, and policy
• Individual level includes personal characteristics (knowledge, attitudes, skills)
• Interpersonal level includes social networks and support systems (family, friends, peers)
• Organizational level includes rules, regulations, and policies within organizations (schools, workplaces)
• Community level includes norms, values, and resources within a community (built environment, access to services)
• Policy level includes local, state, and federal laws and policies that affect health
• Interventions should address factors at multiple levels to effectively promote health behavior change

Health Belief Model

• Explains and predicts health behaviors based on individuals' perceptions and beliefs
• Key constructs:
  • Perceived susceptibility (belief about the risk of getting a condition)
  • Perceived severity (belief about the seriousness of a condition and its consequences)
  • Perceived benefits (belief in the efficacy of the advised action to reduce risk or severity)
  • Perceived barriers (belief about the tangible and psychological costs of the advised action)
  • Cues to action (strategies to activate readiness, such as reminders or media campaigns)
  • Self-efficacy (confidence in one's ability to take action)
• Interventions should aim to increase perceived susceptibility, severity, benefits, and self-efficacy while reducing perceived barriers and providing cues to action

Program Objectives

SMART Objectives

• SMART is an acronym for Specific, Measurable, Achievable, Relevant, and Time-bound
• Specific: clearly defined and focused on a single outcome
  • Example: "Increase the percentage of adults who engage in moderate-intensity physical activity for at least 30 minutes per day, 5 days per week"
• Measurable: can be quantified and assessed using reliable and valid methods
  • Example: "Increase the percentage from 20% to 30% within 6 months"
• Achievable: realistic and attainable given available resources and constraints
  • Example: "Increase the percentage by 10 percentage points" (rather than an unrealistic goal like 50 percentage points)
• Relevant: aligned with the program's overall goals and the needs of the target population
  • Example: If the program aims to reduce obesity, increasing physical activity is a relevant objective
• Time-bound: specifies a timeframe for achieving the objective
  • Example: "Increase the percentage from 20% to 30% within 6 months" (rather than an open-ended goal)
• Well-crafted SMART objectives provide a clear roadmap for program planning, implementation, and evaluation