Program Planning: Models and Theories
Why Theories and Models?
• Builds clarity in understanding targeted health behavior and environmental context.
• Directs program planning - why, what and how?
• Directs evaluation as integral part
Explanatory Theory = Theory of the Problem (Health Belief Model, the Theory of Planned Behavior, Precaution Adoption Process Model)
Change Theory = Theory of Action (Ex: Community Organization, Diffusion of Innovations)
Planning Models
Social Marketing Approach
Key Concepts of Social Marketing
• Consumer orientation not expert driven• Concentrates on a defined target group• Must understand what drives current
behavior and what “levers” can be used to drive and maintain new behavior
4 “Ps” of Social Marketing
• Product• Price• Place (distribution)• Promotion (communication)
PRECEDE-PROCEED (Green and Kreuter)
• Systematic planning process• Empowers individuals with
– understanding– motivation– skills– active engagement in community affairs
9 phases
• 1-5 are diagnostic• 6-9 are implementation and evaluation
What is a Theory?
• Set of concepts, definitions, and propositions
• Systematic view of events or situations• Allows explanation of events or
situations
Applying Theories to Health Promotion
• Different theories work in different situations
• Combinations of theories are often most effective
A Good Fit Theory
• Is logical• Is consistent with observations• Is similar to those used in previous
successful interventions for a similar situation
Two Main Options
• Change people• Change the environment
• The most powerful approaches do both
3 Key Concepts at the Individual & Intrapersonal Level
1. Behavior is mediated by cognitions; that is, what people know and think affects how they act.
2. Knowledge is necessary for, but not sufficient to produce, most behavior changes.
3. Perceptions, motivations, skills, and the social environment are key influences on behavior.
Theory Focus Key concepts
Stages of Change Model
Individuals' readiness to change or attempt to change toward healthy behaviors
Precontemplation Contemplation Decision/determination Action Maintenance
Health Belief Model
Persons' perception of the threat of a health problem and the appraisal of recommended behavior(s) for preventing or managing the problem
Perceived susceptibility Perceived severity Perceived benefits of action Perceived barriers to action Cues to action Self-efficacy
The Theory of Planned Behavior /Theory of Reasoned Action
Behavioral intention is key, intention is driven by attitude and beliefs about what others who are important think
Behavioral Intention Attitude Subjective Norm Perceived Behavioral Control
Individual Level
Interpersonal Level
Theory Focus Key Concepts
Social Cognitive Theory
Behavior is explained via a 3-way, dynamic reciprocal theory in which personal factors, environmental influences and behavior continually interact
Behavioral capability Reciprocal determinism Expectations Self-efficacy Observational learning Reinforcement
Community Level
Theory Focus Key ConceptsCommunityOrganizationTheories
Emphasizes activeparticipation anddevelopment of communitiesthat can better evaluate andsolve health and socialproblems
EmpowermentCommunity competenceParticipation and relevanceIssue selectionCritical consciousness
Organiza-tionalChangeTheory
Concerns processes andstrategies for increasing thechances that healthy policiesand programs will be adoptedand maintained in formalorganizations
Problem definition(awareness stage)Initiation of action(adoption stage)Implementation of changeInstitutionalization of change
Diffusion ofInnovations
Addresses how new ideas,products, and socialpractices spread within asociety or from one society toanother
Relative advantageCompatibilityComplexityTrialabilityObservability