Theoretical Foundations of CHN Practice (Part 2)

Self-Efficacy Theory

- by Albert Bandura

- A personal judgment of how well or poorly a person is able to cope with a given situation based on the skills they have and the circumstances they face

- A strong sense of self efficacy promotes human accomplishment and personal well-being. A person with high self-efficacy views challenges as things that are supposed to be mastered rather than threats to avoid. In contrast, people with a low sense of self-efficacy view difficult tasks as personal threats and shy away from them. Low self-efficacy can be linked to higher levels of stress and depression.

Theoretical Approaches of Self-Efficacy Theory

1. Social Cognitive theory

2. Social Learning theory

3. Self-concept theory

4. Attribution theory

Sources of Self-Efficacy

1. Mastery Experiences

2. Vicarious Experiences of Social Models

3. Belief in Success

How self-efficacy affects human function

1. Choices regarding behavior

2. Motivation

3. Work performance

4. Thought patterns and responses

5. Health behaviors

6. Relationship it locus of control

Factors affecting self-efficacy

1. Experience, or "enactive attainment"

2. Modeling, or "vicarious experience"

3. Social persuasion

4. Physiological factors

Precede-Proceed Model

- by Lawrence W. Green

- A cost-benefit evaluation framework that can help health program planners, policy makers and other evaluators, analyze situations and design health programs efficiently.

- One purpose and guiding principle is to direct initial attention to outcomes, rather than inputs. It guides planners through a process that starts with desired outcomes and then works backwards in the causal chain to identify a mix of strategies for achieving those objectives

Fundamental Assumption of Proceed-Precede Model

the active participation of its intended audience — that is, that the participants ("consumers") will take an active part in defining their own problems, establishing their goals and developing their solutions.

Precede-Proceed Model

a comprehensive structure for assessing health needs for designing, implementing, and evaluating health promotion and other public health programs to meet those needs.

Precede

- provides the structure for planning a targeted and focused public health program

- stands for Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation.

Precede Assessment

- Social assessment

- Epidemiological assessment

- Ecological assessment

- Identify administrative and policy factors that influence implementation and match appropriate interventions that encourage desired and expected changes.

- Implementation of interventions.

Social Assessment

Determine the social problems and needs of a given population and identify desired results.

Epidemiological Assessment

Identify the health determinants of the identified problems and set priorities and goals.

Ecological Assessment

Analyze behavioral and environmental determinants that predispose, reinforce, and enable the behaviors and lifestyles are identified.

Proceed

- provides the structure for implementing and evaluating the public health program

- stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development

Proceed

involves the identification of desired outcomes and program implementation:

- Implementation

- Process Evaluation

- Impact Evaluation

- Outcome Evaluation

Implementation

Design intervention, assess availability of resources, and implement program.

Process Evaluation

Determine if program is reaching the targeted population and achieving desired goals.

Impact Evaluation

Evaluate the change in behavior.

Outcome Evaluation

Identify if there is a decrease in the incidence or prevalence of the identified negative behavior or an increase in identified positive behavior.

Implementation Considerations of Proceed-Precede Model

- The PRECEDE-PROCEED model provides a structure that supports the planning and implementation of health promotion or disease prevention programs.

- This model has worked well for many health promotion topics, and can effectively support one-time interventions or long-running programs.

- Like the Community Readiness Model, PRECEDE- PROCEED invites participation from community members, and has the potential to increase community ownership of the program.

Implementation Considerations of Proceed-Precede Model

- When determining whether to use PRECEDE-PROCEED as a model for health promotion or disease prevention programs, it is important to consider whether all parts of the model are appropriate for the program and the resources available to support implementation.

- It is also important to remember that components of the plan may be adapted over time, as needed.