Running head: PRECEDE-PROCEED MODEL 1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589774/

Applications of the PRECEDE-PROCEED Model to Create a Plan for Unprotected

Sex among Teens  

Name

Institutional Affiliation

Date of Submission
 PRECEDE-PROCEED MODEL 2

Applications of the PRECEDE-PROCEED Model to Create a Plan for Unprotected

Sex among Teens  

Executive Summary

Unprotected sex among teens has been on the rise across the globe. Majority of teenagers

engaging in sex do not use protection, just a small percentage of those teenagers who engage in

sex use protections. Unprotected sex is a major cause of many health conditions such as sexually

transmitted diseases, it is also a risk factor for unwanted adolescent pregnancy among other

issues. For instance, Sexually Transmitted Diseases (STDs) has become a chief problem in the

public health in most countries across the globe and research shoes that this issue is contributed

mainly by unprotected sex.

Additionally, Adolescent pregnancy is another major result of unprotected sex among

teens, this usually happens to individuals aged between 10 and 19 years according to the World

Health Organization (World Health Organization [WHO], 2015). This problem is becoming

rampant and disturbing especially in less developed countries because it seems to have a strong

relationship or association with poverty. Research shows that about 17 million teenage

pregnancies occurs annually.

The Predisposing, reinforcing, as well as the enabling constructs in educational diagnosis

as well as evaluation (PRECEDE) and the policy, regulatory, and organizational constructs in

educational and environmental development (PROCEED) is the foundation of the PRECEDE-

PROCEED model. The model is majorly applied as a planning model particularly in health

promotion as well as in health education. The Model takes into consideration various planning

techniques as well as various evaluation techniques. This model has eight phases. This paper
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Applies the PRECEDE-PROCEED model to address Unprotected sex among teens that has been

identified as a dangerous health behavior. The conclusion is based on the fact that the

Knowledge of the deleterious effects of unprotect sex among teens can be understood and

addressed clearly if all the factors contributing to this health behavior is clearly identified and

addressed.

Graphic organizers for the planning model

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Introduction

The health behavior selected to be addressed by the PRECEED-PROCEED model is the

unprotected intercourse/sex among teens. The reports of an online survey conducted on the

TyraShow.com shows that 52 % of teens do not use protection when having sex (Chaffin, 2008).

Additionally, Statistics results show that majority of the teens engage in unprotected sexual

intercourse despite the fact that they know the various negative consequences. There are

numerous negative consequences of engaging in unprotected sex and they may include

contracting sexually transmitted diseases (STD), contracting HIV/AIDS, getting unwanted

teenage pregnancy. Since, sexual intercourse is a personal desire; it is becoming difficult for

majority of the teenagers to control themselves.

The behavior of teens engaging in unprotected sexual intercourse is problematic because

it brings back the effort that has been made by the government and non-government agencies in

controlling the spread of STDs and HIV/AIDS. When the rate of infection of STDs increases, it

affects the performance of teens in participating in the development of the economy. Moreover,

individuals who already know that they have STDs are still engaging in unprotected sexual

intercourse and this is adding more problem (Bahadoran et al., 2015). The PRECEDE-

PROCEED model may be applied in attempting to address this particular health behavior.

Phase 1: Social Assessment

In this phase, the paper identified factors impacting health outcomes as well as quality of

life among teenagers. The paper used various methods for data collection which included:

interviews with key informants, surveys and focus group discussions with targeted teenagers.
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Results showed that over 52% of teens engage in unprotected sex, therefore, unprotected

intercourse among teenagers is a sexual risk behavior putting majority of teens at risk for HIV

infections, sexually transmitted diseases (STDs), as well as unintended early pregnancy. The

result further indicated that Teens made up to about 21% of all new HIV diagnoses and

infections. Additionally, more than half of the STDs reported annually consist of the teens.

Moreover, about 210,000 babies were born to teen girls. In this regard therefore, the paper saw a

need to address unprotected intercourse among the teens.

However, in this regard, the assessment of health will take into consideration several

aspects. The major three aspects include the; health status measurement, life quality

measurement as well as healthcare measurement (Crouch, Rumbold, Thompson, & Turner,

2016). It is important to note however that, health status measurement is accomplished through

clinical methods and takes into consideration the temperature, blood pressures et cetera.

On the other hand, Measures of quality of life help in determining the expectations as

well as the hopes of a person taking into consideration a person’s life circumstances. This is

mainly accomplished via interviews as well as through the use of various instruments such as a

stethoscope for Asthma patients.

Measures of health care are determined by numerous factors such as injury response

effectiveness, a measure of medication/therapy effectiveness et cetera (Kanarek, 2013).

Generally, Healthcare is all about the satisfaction of the patient, quantity as well as the quality of

healthcare providers, et cetera.

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Phase 2: Epidemiological, Behavioral, and Environmental Assessment

In this phase, existing data related to unprotected intercourse among teenagers were

collected. In this case, the assessments selected is the health need assessment which was

typically conducted at a Gill Shapero, a school located in Newcastle. In this case, the objective or

goal of the assessment focuses on evaluating the nature as well as the state of the lifestyle of the

student concerning the student’s sexual health as well as drug abuse (National Institute for

Health and Clinical Excellence, 2005). The development of the need’s assessment plan was the

first procedure in this first assessment. The formulation of the steps helped significantly towards

the development of the plan. The procedure took into consideration objectives Clarification,

audience selection, sample population selection, this was selected from the school, it also

included data collection, identification of the appropriate survey instrument as well as the

analysis of the collected data.

There were various methods of collecting Data and it included the circulation of a

structured questionnaire on sexual knowledge of the students as well as conduction of the drug

tests particularly from unspecified as well as voluntary urine samples. In this regard, the data

gathered through questionnaires showed that the majority of the students never used protection

when they had sexual encounters. Moreover, the majority of the unspecified urine samples tested

positive for drugs (National Institute for Health and Clinical Excellence, 2005). Therefore, these

findings indicate a lack of knowledge as well as information about sexually transmitted diseases

and also a lack of knowledge on the dangers of drug abuse. As a result, there was the

recommendation of the development of curricula as well as scheduling of classes which would

basically help in creating awareness and also providing education to the students about
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protection against sexually transmitted diseases and the dangers of the drug as well as the

negative impacts of drug abuse.

Phase3: Educational and Organizational Assessments

In this phase the paper identified the predisposing, enabling, as well as reinforcing factors, which

leads to Unprotect sex among teens. They are as follows:

Predisposing factors

Predisposing factors for increased unprotected sex among teens include drug abuse, peer

pressure, desire for money, and age. The highest percentage of individuals who abuse drugs such

as alcohol are teens (Omigbodun, & Babalola, 2004). When someone abuse drug, they are likely

to be influenced to practice risky behaviors because they don’t have control of their bodies. A

sober mind can quickly assess the situation and make the right decision of not endangering life

through practicing unprotected sexual intercourse, unlike someone who is under the influence of

prohibited drugs. Peer pressure is shared among the teens, and because individuals compare

themselves with others, they are most likely to participate in unprotected sexual intercourse as

one way of justifying their superiority among their peers. In the process, they end up contracting

diseases that affect their health status. Age is another factor why most teens are not using

protection during sexual intercourse. Most teens have not reached the age they make them

capable of making a better decision. They still need guidance from the senior, but nowadays,

most of them spent a lot of time amongst themselves, which limit them from getting sexual

teachings from adults.

Reinforcing factors for unprotected sex among teens

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Reinforcing factors are those factors that act as a reward to the individuals who decide to

change their behavior. The first factor is the popularity that teens gain due to the peer pressure

they get from their fellow teens. They are forced to practice unprotected sex because they need to

remain popular. The second factor is the money they receive after having unprotected sex. Some

teens engage in unprotected sex with the desire to make more money, especially those who

practice sex for exchange for cash. Teens who lack basic needs and proper guidance from the

guardians are the ones that mostly engage in unprotected sex intending to obtain financial gain.

Socio norms within the society are changing, and it seems like it is just normal for the teen to

practice sex due to a high number of those who are currently practicing sex. They are motivated

to participate in unprotected sex to change with the change in the social norms of society

(Holmberg, 2007).

Enabling factors for unprotected sex among teens

Disorganization in the community set up, especially the leadership, has contributed to a

high level of unprotected sexual intercourse among teens. Community leaders are the ones who

are supposed to guides the teens and ensure that they follow the values of society. Still, when

they are disorganized, it becomes hard for them to educate the teens on the benefits of the

community. The second factor is poverty among some families, which forces the teens to look

for any way of making money to meet their basic needs. Some of the teens decide to practice

unprotected sex as one way of getting money to buy basic needs, such as food. Some teen

believes that the use of condom as protection during sexual intercourse reduces pleasure. This

belief is what influences most of the teens who decide not to use protection while having sex

(Omigbodun, & Babalola, 2004).

 PRECEDE-PROCEED MODEL 9

These factors were identified from scholarly work where. Additionally, Critical thinking

as well as use of questionnaires helped in the identification of the predisposing, reinforcing, and

enabling factors.

The parents and guardians need to find the time and have sexual education with their

teens so that they may understand all the risks associated with unprotected sex. It will help them

in overcoming peer pressure that may lure them into practicing unprotected sex—providing teens

with basic needs so that they may not have a desire for money, which might encourage them to

participate in first sexual intercourse. There is a need for the leaders and guardians to stress on

society and sexual values so that the teens from early childhood grow up knowing how they are

supposed to conduct themselves. Peer pressure can be controlled by engaging teens in useful

activities sponsored by the schools and the church so that they don't get idle time to start

discussing evil actions.

The predisposing factor, for instance, where a teen was raised in an environment or a

home as well as a neighborhood encouraging drug abuse. In such a case, therefore, the teenager

will regard the drug abuse as acceptable hence practicing it. On a similar note, when a child is

raised in an environment shunning the drug abuse, they are likely not to engage in drug abuse

which will, in turn, influence them to engage in unprotected sex. Secondly, research has also

shown some relation between drug abuse and some of the genetically transferable genes. In this

case, therefore, it means that an individual is likely to engage in drug abuse because the parent

had a history of drug abuse (Galizio & Maisto, 2013) and this may result in increased

unprotected sex among teenagers.

Just as discussed already, an individual’s attitude, as well as the individual’s belief, is the

key determinant factor for a particular behavior. For instance, a teenager believing that drug
 PRECEDE-PROCEED MODEL 10

abuse is acceptable will abuse drugs while the one believing that drug abuse is unacceptable will

not abuse drugs. Moreover, it is important to understand that children usually adopt societal

norms, particularly during their early age through the observations. They develop a belief that the

observed behavior is necessary and acceptable and they, therefore, engage in it.

The second factor is the reinforcing factors which in this case we have identified the

media as well as the friends’ approval. Usually, the media presents the society’s trending. The

media usually presents images, songs, and videos that encourage pre-marital sex as well as drug

abuse. Teenagers have been considered to be vulnerable hence likely to be influenced by the

images, songs, videos, therefore, they are likely to engage in drug abuse as well as sexual

behaviors. On the same note, if the media shuns drug abuse, then we expect the teenagers not to

be involved in drug abuse. Moreover, approval from peers will raise the engagement level in

drugs as well as unprotected sex. In this regard, the paper examines that lack of support for the

drugs and unacceptable sexual behavior by the parents will make the teenagers behave good so

that they can be able to get approval from the parents and this will, therefore, reduce their risk of

involving in unprotected sex (Galizio & Maisto, 2013).

The paper recognized the availability of drugs as the major enabling factor in this case.

This is because, when the drugs to be abused are available, it means the level of abuse of drugs

and alcohol by the teens will be high. The availability of these drugs permits their drug abuse

behavior because they are likely to convince the adults to buy for them (Galizio & Maisto, 2013).

School teenagers especially those coming from low-income areas are the major target by the

drug dealers who then cheat them into other bad activities. However, those children coming from

well-off areas with a very low prevalence of drug abuse as well as other bad behaviors are likely

to be safe from drug abuse and unacceptable sexual activities.

 PRECEDE-PROCEED MODEL 11

The identified behavior may be addressed via several means. Some of the identified ways

are typical civic education. This will involve educating the society regarding the effects of drug

abuse as well as the negative implication of unprotected sex among teenagers. The measure is

meant to make the community or the society proactive so that each member of the society can

take protective measures for the children. In this regard, therefore, the parents may communicate

and teach teenagers about sex while society at large provides after-school programs for the

children. This will help in ensuring that the children become completely occupied by

constructive ideas while being educated on the implication of the unprotected sex as well as drug

abuse. This measure will help in reducing the levels of unprotected sex among teenagers

((Brunaud & Quilliot, 2019). The major advantage of this approach is that it will significantly

help those children who were raised in poor areas having a high level of substance abuse, this is

because it will help in reshaping perspective and make them comprehend that drug abuse is not

right and is unacceptable. After all, it increases the risk of unprotected sex. Through

collaboration within the society, teenagers are likely to be guided to the correct path. However,

the major disadvantage of this approach is that community collaboration is likely to be a

challenge and this is likely to lead to the collapse of the program, facilitating drug abuse and

unprotected sex among teenagers.

Secondly, mandatory random drug tests in schools is an important measure that will help

to address this issue. This will ensure that any teenager who tests positive is disciplined

accordingly, for instance, reporting them to the police as well as giving them counseling. The

major advantage of the measure is that it prevents teenagers from involving themselves in drug

abuse and other bad related behaviors, this is because they will be fearing to be disciplined. The

major disadvantageous of this approach, however, is that the teenagers are likely to use the drugs
 PRECEDE-PROCEED MODEL 12

that cannot be detected by tests such as LSD and the program might be futile (Dasgupta, 2010).

Lastly, teenagers are likely to be rebellious and this means that they might take part in

unprotected sex.

Phase 4: Administrative and Policy Assessments

Identifying working group for implementation of your selected strategies (Phase 4)

In this phase, the major identified working groups for the implementation of the strategies

would include the School found in the community, this will take into consideration all the

teachers, the heads of the schools, the education officers among others. The second working

group would include the hospitals and the community. In this regard therefore, this phase will

focus mainly on the identification of the various required resources, policies, supports, as well as

various facilities required for the implementation as well as the evaluation of this health

education program. In this regard therefore, the assessment of the place, timetable for activities,

budgeting, personnel, organizational barriers, facilitators, policies, responsibilities, necessary

supports as well as the coordination that would help in the implementation of the strategies. The

factors are identified mainly by interview methods.

Phase 5: Implementation

How the strategies would be adopted, implemented, and maintained in the

community.

The strategies will be adopted, implemented and maintained in the community in various

ways. However, the important thing to note is that the change theories to be utilized in designing

the intervention after the assessment will include individual, interpersonal as well as community-

level theories. The intervention that will be addressing the predisposing factors will be to assess
 PRECEDE-PROCEED MODEL 13

the skills which the teens have about the use of protection during sex. The interventions that will

address the enabling factors will focus on assessing the existing programs as well as resources

that may assist in reducing the rate of unprotected intercourse among the teens. Another

intervention based on reinforcing factors will focus on analyzing the impact of advice as well as

social support which will then focus on reducing the rate of unprotected sex among the teens. In

this regard therefore, after planning the intervention, the proposed program will be implemented

among teenager’s intervention group. This is intended to increase the teen’s awareness regarding

the dangers of unprotected sex.

To ensure that the strategies are maintained , various means will be used such as regular

holding of lectures for life skills education as well as colloquy sessions regarding unprotected

sex at least thrice a week until the intended objectives are met distribution ,of the circulation of

the educational pamphlets associated with how to reduce, avoid and manage unprotected sex

students. Additionally, changing the attitude of the students, the strategies will focus at holding

various focus group discussions particularly with the high school teens about sex, this will be

done continuously until the students may change their behavior attitude. Promotion of o

reinforcing factors will be facilitated by advocating as well as training the school counselors who

will be actively guiding the school teens on the right path to reduce the rate of unprotected sex

among the teens.

The distributed educational booklets to the parents are meant to involve the parents in the

process as they can help in advising their children so that they can avoid the unprotected sex

behavior. In this regard therefore, promoting of the enabling factors various strategies will also

be used and they include: coordinating with the available counseling centers so that they can be
 PRECEDE-PROCEED MODEL 14

able to provide guidance and counseling to the school teens. Additionally, the teachers in this

regard are considered the key enabling factors to the students. The teachers will also help in

providing the necessary information that will help in increasing the teen’s awareness about the

dangers of the unprotected sex among the teens.

Phase 6: Process Evaluation

This process will take place during the implementation of the program, it will be helpful

in the evaluation of the process though which the program takes place. Therefore, the

achievement of the educational objectives will be evaluated or measured, the process will take

into consideration the evaluation of the program components for example the program staff,

methods, the various materials used, as well as activities.

Phase 7: Impact Evaluation

In this phase, determination of the instant impacts of the program on the Unprotected

sexual behavior will take place after the end of the program. Therefore, the impact evaluation

will take into consideration the evaluation of the changes in predisposing, reinforcing, enabling,

as well as behavioral factors after the intervention activities.

Phase 8: Statistical Analysis

In this regard, the data will be analyzed though the use of various statistical software

including Excel and SPSS statistical software. To determine the effects of the intervention,

repeated measures analyses of variance will be done. The goal of this phase is determining the

long-term effect of the program.

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The results of the first assessment are important as it will help in determining the

responsibilities as well as the timescale of the sexual education as well as drug abuse services

which have to be offered to the students in the institution. Additionally, the results were utilized

in the formulation of the strategic plans which will assist to tackle the apprehensions (Brookover,

2016). Moreover, the results of the second assessment were utilized in the development of the

action plan which will also be key in the modernization of the health improvement of prisoners at

the Durham institutions.

Conclusion

This paper has focused on the Application of the PRECEED-PROCEED Model to

address unprotect sex among teens as the major health behavior selected. This is a major health

problem because various studies and are showing the rise in the rate of unprotected sex among

teens and this is causing an alarm. The paper has therefore, followed all the eight phases of the

PRESEED-PROCEED Model to create a health promotion plan for the selected health behavior

which in this case is the Unprotected sex among the teens. Unprotected sex is a major concern

because it is the root cause of various health issues or problems such as STDs, HIV/AIDS, early

unwanted teen pregnancy among another awful incidences. The rising rat of the unprotected sex

among the teens was the propelling factor that made it possible for the determination of the need

to address this risk health behavior among the teens.

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