PRECEDE-PROCEED MODEL
BSN 2A Group 4
I. Theorist/s
• Lawrence Green first developed Precede in
1974.
o Former Director of the Office of
Science and Extramural Research
for CDC.
o Has published several books and
over 300 articles on topics including
health promotion and public health.
o Awarded with the highest distinction
of the American Public Health
Association
• Later, Green and Marshall Kreuter added
Proceed in 1991.
II. The PRECEDE-PROCEED Model
• A 9-phase, community-oriented,
participatory model for creating successful
community health promotion interventions.
• Process begins at the end, focusing on the
health-related outcomes of interest.
• Works backwards to determine best
intervention strategy to best achieve goals.
III. Concept and Definition
PRECEDE-PROCEED are actually acronyms.
1. PRECEDE (Predisposing, Reinforcing, and
Enabling Constructs in Educational Diagnosis
and Evaluation)
• Provides the structure for planning a
targeted and focused public health program.
o Educational diagnosis of the
problem is very essential before
developing and implementing the
intervention plan.
• It involves 5 phases:
Phase 1: Social Assessment:
o Determine people’s perceptions of
their own health-related needs and
quality of life.
o Broadens community health
workers of their understanding of
the community
o Considers the community’s
problem solving capacity, its
strengths, resources, and its
readiness to change.
Ex (1): Brgy. X had “poor” quality of
life according to the residents
because they think safety of their
children is not observed.
Phase 2: Epidemiological Assessment:
o Identify specific health problems linked
to the issues related to the quality of
life in Phase 1.
o Identify target groups
o Planners can conduct secondary data
analyses using existing data sources
such as vital statistics, census data,
etc.
Ex (2):
▪ Pedestrian injury main cause of
injury death for Western
Australian children (rate =
3.2/100,000)
▪ Child pedestrian injuries are
usually severe (severe head
injuries in 80% of critically injured)
▪ Target Groups:
a) Primary children aged 5-
9, teachers, parents
b) Secondary school
administrators, city
officials, legislators,
police, road safety
advisory committee,
residents
**In Phases 1 & 2, you create the objectives for your
intervention.**
Phase 3: Behavioral & Environmental
Assessment:
o Identify specific health behaviors
that need to be changed
o Be aware of environmental factors
that already influence these
behaviors.
o Factors Contributing to the Health
Problems
a) Behavioral- compliance,
consumption patterns,
coping, self-care
b) Environmental- social,
economic, physical
Ex (3):
Behavioral risk factors
▪ Inappropriate road crossing
▪ Children not seeking help to
cross
▪ Inappropriate road crossing
by parents (bad role
models)
Environmental risk factors
▪ Traffic volume and speed
▪ Road design
Phase 4: Educational & Ecological
Assessment:
o Identify the predisposing, enabling,
and reinforcing factors that act as
supports for or barriers to changing
the behaviors and environmental
factors you identified in Phase 3.
o Are categorized into 3 factors:
a) Predisposing- provides
 rationale of behavior
b) Reinforcing- provides
continuing reward for
persistence of behavior
c) Enabling- allows motivation
to be realized
Ex (4):
Predisposing factor
▪ Lack of knowledge regarding
safe road crossing behavior
Enabling factor
▪ Poorly developed road
crossing skills
Reinforcing factors
▪ Parents allowed children to
cross roads alone
**In Phases 3 & 4, you plan the
intervention.**
Phase 5: Administrative & Policy
Assessment
o Identify “best practices” for designing
intervention
o Are capabilities and resources
enough?
o Determine which policies or laws
can positively or negatively affect
implementation of intervention
Ex (5):
a) School-based classroom
lessons, home activities, teacher
training
b) Community-based newspapers
and other local media, monthly
community advisory meetings,
newsletters to parents
____
NOW THAT WE ARE DONE WITH THE PRECEDE
(Assessment, Diagnosis, Planning) STAGE, WE
NOW GO TO PROCEED STAGE (Implementation,
Evaluation)
____
2. PROCEED- (Policy, Regulatory, and
Organizational Constructs in Educational and
Environmental Development)
• Provides the structure for implementing
and evaluating the public health program.
and focused public health program.
• It involves 4 phases:
Phase 6: Implementation:
o You carry out the intervention you
planned out during the PRECEDE
stage
Ex (6): You conduct a school-based
lecture/lesson on the kids regarding proper
crossing of streets
Phase 7: Process Evaluation:
o You evaluate the process of the
intervention
o Monitor your implementation
process to make sure you are
doing what you said you would do
during the PRECEDE Stage
▪ Not about outcomes, but
about the PROCESS
Ex (7):
Was the lecture/lesson on proper
crossing of streets conducted, or
postponed?
Did the program classroom lesson
start on time?
Were the learning materials
enough for the students?
Phase 8: Impact Evaluation:
o You measure whether the
intervention is having your intended
impact on the behavioral and
environmental factors it’s aimed at
o Adjust accordingly the process of
the intervention after evaluation
Ex (8):
Are the kids/parents changing their
behavior? How?
Has the environment changed in the
way we thought it would?
Phase 9: Outcome Evaluation:
o You evaluate whether the
intervention’s effects are in turn
producing the outcome(s) the
community identified in Phase 1.
o You measure if you are having a
larger impact on the QOL factor
you wanted to improve in Phase 1
Ex (9):
Is the safety of the children observed
better? How?
IV. PRECEDE-PROCEED Framework
Sources: Bedoya, D. (2020, Sept 16). Precede Proceed model for health promotion.
Youtube. https://www.youtube.com/watch?v=EruALRW-lBU&t=134s
Community Toolbox (n.d.). Precede Proceed. University of Kansas.