GPH 301 Exam 1

PRECEDE-PROCEED Model

A widely used 8-phase health promotion planning framework (not a behavioral theory) that guides the systematic development, implementation, and evaluation of public health programs through an ecological lens.

PRECEDE

Phases 1-4 of the PPM; stands for Predisposing, Reinforcing, and Enabling Constructs in Educational/environmental Diagnosis and Evaluation, focusing on diagnostic planning and target identification.

PROCEED

Phases 5-8 of the PPM; stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development, focusing on programmatic execution, policy changes, and evaluation.

Phase 1: Social Assessment

The first step of PRECEDE-PROCEED which works in partnership with the community to identify quality-of-life concerns, social equity, and community needs, grounding all efforts in community participation.

Phase 2: Epidemiological Assessment

The identification of specific health goals along with behavioral and environmental factors that directly influence the targeted health outcomes, resulting in measurable, realistic health objectives.

Phase 3: Educational and Ecological Assessment

The diagnostic phase where planners categorize target factors into predisposing, reinforcing, and enabling factors to determine specific hypothesized mediators of behavior change.

Predisposing Factors

Internal, cognitive factors ("between the ears") that motivate or hinder behavior change prior to action, including knowledge, attitudes, beliefs, values, perceived threat, and self-efficacy.

Reinforcing Factors

Internal or external rewards (social encouragement, peer praise, symptom relief, financial perks) received following a behavior that encourage or discourage its repetition.

Enabling Factors

External environmental resources, accessible services, supportive organizational policies, and physical skill acquisition that allow individuals to translate motivation into actual behavioral performance.

The Four A's

Four critical environmental targets evaluated during policy and organizational alignment: Accessibility, Affordability, Availability, and Acceptability.

Phase 4: Administrative & Policy Assessment

The assessment of organizational capacity, available resources, and policy structures needed to align interventions (health education and structural policy changes) before launching a program.

Phase 5: Implementation

The formal initiation of the planned health promotion program, signaling the transition from formative PRECEDE diagnostics to active PROCEED actions.

Phase 6: Process Evaluation

Evaluation measuring program delivery, assessing whether activities were executed as designed, tracking participant reach, and monitoring continuous quality improvement.

Phase 7: Impact Evaluation

Evaluation assessing immediate, short-term changes in hypothesized mediators, including knowledge gains, attitude shifts, behavioral execution, and environmental modifications.

Phase 8: Outcome Evaluation

Evaluation determining long-term program results, specifically measuring changes in population morbidity, mortality, overall health status, and overall community quality of life.

Logic Model

A graphical, blueprint-like representation of an intervention program illustrating the causal flow of input activities, outputs, and intended short- and long-term objectives.

Value-Expectancy Theories

A broad class of behavioral theories (e.g., TRA, TPB, HBM) assuming individuals choose health behaviors based on calculating the expected net balance of personal benefits versus costs

Theory of Reasoned Action (TRA)

A behavioral theory asserting that behavioral intention is the direct precursor to behavior and is determined by attitude toward the behavior and subjective norms

Attitude Toward the Behavior

An individual's positive or negative evaluation of performing a specific behavior, formed by combining personal behavioral beliefs with evaluations of expected outcomes

Subjective Norms

Perceived social pressure to perform or not perform a behavior, calculated by combining normative beliefs about referent others' expectations with motivation to comply with those sources

Behavioral Intention

An individual's explicit cognitive decision or plan to perform a specific protective behavior, measured by specifying target, action, context, and timeframe

Theory of Planned Behavior (TPB)

An extension of the TRA created by adding Perceived Behavioral Control to account for situations where individuals lack complete volitional control over a behavior[

Perceived Behavioral Control

An individual's perception of how easy or difficult executing a behavior will be, based on evaluating facilitating and inhibiting control beliefs and their perceived power

Facilitating Factors

External or structural elements that increase the likelihood or ease of engaging in a targeted protective behavior (e.g., nearby walk-in clinics)

Inhibiting Factors

External or structural barriers that impede or reduce the likelihood of performing a protective behavior (e.g., high out-of-pocket medical expenses, restrictive clinic hours)

Information-Motivation-Behavioral Skills (IMB) Model

A health behavior model specifying that information, motivation, and behavioral skills are the fundamental determinants of performing complex health actions

IMB: Information Construct

Behavior-specific knowledge necessary to understand how to execute a health protective action; essential as a baseline, but rarely sufficient alone to alter complex habits

IMB: Motivation Construct

The combination of personal attitudes toward a health action and social motives/perceptions regarding social approval for performing that specific behavior

IMB: Behavioral Skills Construct

An integration of an individual's objective capabilities and task-specific self-efficacy required to execute a targeted health behavior correctly

IMB: Three Model Phases

The structured implementation process of the IMB framework consisting of Elicitation (needs assessment), Intervention (program execution), and Evaluation (outcome assessment)

Perceived Threat

The central driving cognitive force in fear appeals, defined mathematically and conceptually as the combination of perceived severity and perceived susceptibility

Perceived Severity

An individual's subjective assessment regarding how serious, painful, or damaging the medical or social consequences of a disease/condition would be

Perceived Susceptibility

An individual's subjective evaluation regarding their personal probability or vulnerability to acquiring a specific illness or negative health condition[

Fear Appeal

A persuasive communication strategy designed to arouse fear by highlighting significant risks, intended to motivate individuals to adopt recommended health behaviors

Health Belief Model (HBM)

A value-expectancy model postulating that likelihood of action depends on perceived threat, expected net gain (benefits minus barriers), self-efficacy, and cues to action.

Expected Net Gain

The cognitive calculation in HBM where anticipated benefits of taking health action are weighed against perceived barriers, monetary costs, or personal sacrifices

Cues to Action

Internal physical symptoms or external triggers (mass media campaigns, physician advice, postcard reminders) that prompt an individual to execute a health behavior

Protection Motivation Theory (PMT)

A communication-based cognitive model explaining responses to fear appeals through two sequential parallel evaluations: threat appraisal and coping appraisal

PMT: Threat Appraisal

The cognitive evaluation of a fear message where an individual weighs intrinsic/extrinsic rewards of maladaptive actions against perceived severity and vulnerability

PMT: Coping Appraisal

The cognitive evaluation where an individual weighs perceived response efficacy and self-efficacy against the physical, emotional, or financial costs of taking action

Response Efficacy

An individual's belief regarding whether the recommended protective behavior will actually prove effective in eliminating or averting the health threat

Self-Efficacy

An individual's task-specific confidence in their personal capability to successfully execute a recommended behavior, introduced by Bandura and integrated into HBM/PMT

Extended Parallel Process Model (EPPM)

A fear appeal theory analyzing how individuals process threat-based messages and determining whether they engage in danger control or fear control

Danger Control Process

A cognitive processing outcome occurring under conditions of High Threat + High Efficacy, leading individuals to accept messages and act directly to lessen the actual risk[

Fear Control Process

An emotional processing outcome occurring under conditions of High Threat + Low Efficacy, causing individuals to manage internal anxiety via denial, avoidance, or message rejection

Defensive Avoidance

A psychological coping mechanism in fear control where individuals block out health information, avoid discussions, or dismiss risk warnings to manage overwhelming fear[

Maladaptive Responses

Negative health choices or defensive mechanisms (e.g., smoking cessation avoidance, screening denial) chosen when individuals ignore threats or attempt to manage fear without addressing actual danger