Thursday, March 15, 2012
Dear friends: I’m in grad school for a Masters in Public Health (MPH).
I needed to write about the “PRECEDE-PROCEED” health planning model with an example of my choice for a mid-term exam. I turned in something similar to this. This is a slightly tweaked version from my actual mid-term answer. Enjoy…
One example of a Precede-Proceed application may be an intervention upon the political-economy. There have been studies that suggest that the political-economy influences poverty and income inequities in a society. The political economy is influenced by participation in mass movements, unions, political parties, and electoral systems.
Let’s assume that a mass movement has appeared arguing against the concentration of political and economic power in the hands of a few people in society, maybe the top 1%. Health promotion workers being concerned about the prerequisites of health as mentioned in the Ottawa Charter for Health Promotion get together to see how they can form a health promotion program in support of this movement. They looked at how to work on healthy policy, supportive environments, community action, individual skills, and reorienting medical services.
The ultimate desired result as expressed by the mass movement is an equitable society. Health promotion workers offer to provide support on these issues and develop a “healthy society” intervention. Listening to participants of the movement, and also having conversations with people from non-profits, social justice organizations with paid staff, the few radical elected officials, and other public health workers the health promotion healthy society team will develop a menu of well-researched issues which contribute to the concentration of power and resources, or toward an equitable society (depending on how research has been done previously), then present that to the stakeholders.
They also look at previous research and decide to provide health education on how political systems, economics, racism, sexism, classism, party in power, unions, and mass movement influence health. There is plenty of scientific evidence that supports the idea that a strong “Left” movement will make a difference in income equity, health, and general quality of life. They take diffusion of innovation theory, theory of freeing, and other health models and apply it to create a strong impact for health education approaches.
Electoral systems, laws around ballot access for political parties, and laws concerning unionization are identified as barriers to implementation of a “healthy society” intervention. Laws around gathering in public are also identified as barriers. Banking laws, especially mortgage lending laws, are seen as huge barriers as well. General distrust of unions, political parties, politicians, and a weakening of democracy by the two-corporate-party system is another huge barrier and interventions specifically around this start getting planned to present back to the group.
This information is taken back to a movement “general assembly” where the information is shared and is then discussed over the course of several meetings. The assembly feels ownership sufficiently to engage the health promotion team with planning around increasing participation in the mass movement, and decreasing the concentration of power through mandatory public financing of all elections. The health promotion team delves back into the literature and begins to design specific interventions that will help get more people involved in the mass movement, and also looks at the process for changing electoral financing laws, and other issues prioritized.
The general assembly creates a “healthy society” working group that meets regularly. Process evaluation is done at every meeting. It is decided that that every three months there will be some impact evaluation. Since this is not a funded project the members of the movement ask the health promotion workers if they would invest time in training a variety of people in evaluation so that an outcome evaluation may be done at the end.
We can call this the "sample" piece.