Section 2.

PRECEDE/PROCEED
(http://ctb.ku.edu)

Learn how to develop a coherent plan that addresses necessary issues and actions using
the Precede-Proceed model.

WHAT IS PRECEDE-PROCEED?
WHY USE PRECEDE-PROCEED?
HOW DO YOU USE PRECEDE-PROCEED?
If you were a contractor setting out to build a wood-frame house, you wouldn’t just pick up
whatever wood you found lying around and begin. You’d consult first with the owner, and start
with an idea of the house she wanted – its size, its shape, its features. You’d want a picture of
the finished house, and a floor plan as well, with some notes on measurements and materials.
You’d plan the construction with her, and set out a process for getting it done. And you’d do all
this before you ever picked up a tool, because otherwise the process would be hit-or-miss: she
wouldn’t get the house she wanted, and your time would be wasted.

The same is true if you’re developing an intervention to address a health or community issue. It
makes no sense to pick an issue at random, and to use whatever service happens to be
available to try to address it. You have to consult with the community, understand and analyze
community information, your own and others’ observation, and the context of the issue to
create an intervention that will actually bring about the changes the community wants and
needs.

In the first section of this chapter (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/overview/models-for-community-health-and-development/logic-model-

development/main) , we introduced the need for a process for doing health and community work. In this

section, we’ll look at PRECEDE-PROCEED, the first of several specific models that may prove
helpful to you in carrying out your own work. We’ll examine other models in subsequent
sections of this chapter. Then in the last section, we’ll examine some ways in which elements of
various models can be combined to respond to your particular situation.

WHAT IS PRECEDE-PROCEED?
Like most of the other models we’ll examine in this chapter, PRECEDE-PROCEED was
developed for use in public health. Its basic principles, however, transfer to other community
issues as well. As a result, we’ll treat it as a model not just for health intervention, but for
community intervention in general. And in fact, PRECEDE/ PROCEED focuses on the community
as the wellspring of health promotion.

In the latter half of the 20th Century, as medical advances eliminated many infectious diseases,
the leading causes of disability and death in the developed world changed to chronic
conditions – heart disease, stroke, cancer, diabetes. The focus of health maintenance,
therefore, shifted from the treatment of disease to the prevention of these conditions, and,
more recently, to the active promotion of behaviors and attitudes – proper diet, exercise, and
reduction of stress, for instance – that in themselves do much to maintain health and improve
the length and quality of life.

Behind PRECEDE-PROCEED lie some assumptions about the prevention of illness and
promotion of health, and, by extension, about other community issues as well. These include:

Since the health-promoting behaviors and activities that individuals engage in

are almost always voluntary, carrying out health promotion has to involve
those whose behavior or actions you want to change. PRECEDE-PROCEED should
be a participatory process, involving all stakeholders – those affected by the issue or
condition in question – from the beginning.
Health is, by its very nature, a community issue. It is influenced by community
attitudes, shaped by the community environment (physical, social, political, and
economic), and colored by community history.
Health is an integral part of a larger context, probably most clearly defined as
quality of life, and it’s within that context that it must be considered. It is only
one of many factors that make life better or worse for individuals and the community as a
whole. It therefore influences, and is influenced by, much more than seems directly
connected to it.

AIDS has changed the way many people in the US view and practice sex, for instance. In
some other countries, it has affected the whole social structure because of the number
of orphans it has created, and its impact on the workforce. By the same token, youth
violence changes the views and actions of many people who are at no risk of being its
victims, and may put a community at an economic disadvantage by making it less
attractive to new business or industry. Almost any other issue could serve equally well as
an example of the broad reach of community problems (or assets, for that matter).

Finally, health is more than physical well-being, or than the absence of

disease, illness, or injury. It is a constellation of factors – economic, social, political,
ecological, and physical – that add up to healthy, high-quality lives for individuals and
communities.

This broad perspective on health extends to other community issues. We can define the health
of a community as its fitness in many areas, of which citizens’ physical health is only one.
Indications of a community’s overall health (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/overview/models-for-community-health-and-
development/healthy-cities-healthy-communities/main) include how well it:
 Contributes to the stability of families
Nurtures and supports children
Fosters lifelong learning
Provides meaningful work for its citizens
Invites involvement in the democratic process
Cares for those who need help
Protects and sustains the natural environment
Encourages the arts
Values and encourages racial and cultural diversity
Works to promote and maintain safety and physical well-being for its members

PRECEDE and PROCEED are acronyms (words in which each letter is the first letter of a word).
PRECEDE stands for Predisposing, Reinforcing, and Enabling Constructs in
Educational/Environmental Diagnosis and Evaluation. As its name implies, it represents the
process that precedes, or leads up to, an intervention.

PROCEED spells out Policy, Regulatory, and Organizational Constructs in Educational and
Environmental Development, and, true to its name as well, describes how to proceed with the
intervention itself.

PRECEDE has four phases, which we’ll explore in greater detail later in the section:
Phase 1: Identifying the ultimate desired result.
Phase 2: Identifying and setting priorities among health or community issues and their
behavioral and environmental determinants that stand in the way of achieving that result,
or conditions that have to be attained to achieve that result; and identifying the behaviors,
lifestyles, and/or environmental factors that affect those issues or conditions.
Phase 3: Identifying the predisposing, enabling, and reinforcing factors that can affect
the behaviors, attitudes, and environmental factors given priority in Phase 2.
Phase 4: Identifying the administrative and policy factors that influence what can be
implemented.

Another premise behind PRECEDE-PROCEED is that a change process should focus initially on
the outcome, not on the activity. (Many organizations set out to create community change
without stopping to consider either what effect their actions are likely to have, or whether the
change they’re aiming at is one the community wants and needs.) PRECEDE’s four phases,
therefore, move logically backward from the desired result, to where and how you might
intervene to bring about that result, to the administrative and policy issues that need to be
addressed in order to mount that intervention successfully. All of these phases can be thought
of as formative.

PROCEED has four phases (also to be discussed in more detail later) that cover the actual
implementation of the intervention and the careful evaluation of it, working back to the original
starting point – the ultimate desired outcome of the process.

Phase 5: Implementation – the design and actual conducting of the intervention.

Phase 6: Process evaluation. Are you actually doing the things you planned to do?
Phase 7: Impact evaluation. Is the intervention having the desired impact on the target
 population?
Phase 8: Outcome evaluation. Is the intervention leading to the outcome (the desired
result) that was envisioned in Phase 1?

A word about logic models: Although most formal models, like PRECEDE-PROCEED
present themselves as the way to structure an intervention or other activity, the word
“logic” implies that you should carefully consider your own situation as well as the model.
If there are reasons why a particular part of a model might not work for you, it’s
reasonable (logical) to change it. While PRECEDE-PROCEED presents a structure that
could conceivably work well (and has worked well) in a variety of situations, it’s still
important to think about whether all parts of it will work for you.

A flow chart of the model (see Fig. 1), developed by its originators, shows a circular process. It
starts (on the upper right) with a community demographic and quality-of-life survey, and goes
counterclockwise through PRECEDE’s four phases that explain how to conceive and plan an
effective intervention. PROCEED then picks up with the intervention itself (described here as a
health program), and works back through the first five phases, evaluating the success of the
intervention at addressing each one (The process evaluation in Phase 6 looks at whether the
intervention addressed the concerns of Phase 3 as planned. The impact evaluation of Phase 7
examines the impact of the intervention on the behaviors or environmental factors identified in
Phase 2. And the Outcome evaluation of Phase 9 explores whether the intervention has had
the desired quality of life outcome identified in Phases 1 and 2). Eventually, the process arrives
back at the beginning, either having achieved the desired quality of life outcome, or to start
over again, incorporating the lessons of the first try. The arrows in the flow chart demonstrate
the effects of each phase’s issues on the next one to the right. Since you’re working backwards
from the ultimate outcome, effects move to the right. If the chart was demonstrating the
direction of analysis, the arrows would point in the opposite direction.
FIGURE 1. GENERIC REPRESENTATION OF THE PRECEDE-PROCEED MODEL. FROM L. GREEN
AND M. KREUTER. (2005). HEALTH PROMOTION PLANNING: AN EDUCATIONAL AND
ECOLOGICAL APPROACH (4 TH ED.). MOUNTAIN VIEW , CA : MAYFIELD PUBLISHERS.

The PRECEDE-PROCEED model applies a medical perspective to public health, even

though its focus is health promotion, rather than treatment of disease. Just as a medical
diagnosis precedes treatment, the model assumes that a far-reaching diagnosis should
precede a public health intervention. A diagnosis suggests a treatment (an intervention),
which is closely monitored for process (Is the patient getting the treatment prescribed?),
impact (Is the treatment having the hoped-for impact on the symptoms?), and outcome
(Does the treatment cure the patient, or have the desired effect on her overall health?). A
premise of the model is that a diagnosis should start with the desired end result and work
backwards to determine what needs to be done to bring about that result.
Another basic premise of the model is that the purpose of a health program – and by
extension, the purpose of any proactive type of community intervention – is to improve
the quality of life for individuals and their community, and that the two are largely
inseparable. Thus, any intervention should be community-based, and should look at the
needs of the community, even if the intervention is aimed at a more specific target group.
A final premise of any community-based model for intervention is that planning and
implementing a community intervention calls for a joint effort among (health and other)
professionals and organizations, policy makers, community officials, community leaders,
and community members at large, including members of the target population. In order to
 ensure accurate information and community support, all elements of the community
should be involved in the process from the beginning.

WHY USE PRECEDE-PROCEED?

First, there are good reasons for using some kind of logic model or theoretical framework for
any intervention:

It provides a structure within which to plan your work, so that you’re not simply grasping
at straws. As a result, you’re more likely to develop a coherent plan that addresses the
necessary issues.
Most models give you either a guide or a foundation for critical analysis of the issues at
hand. That doesn’t guarantee that your analysis will be complete or accurate, but it
significantly increases the chances. (See Analyzing Community Problems and Solutions
(http://ctb.ku.edu/node/664) , for more on logical analysis.)

This is not to say that you have to use a logic model (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/where-to-
start) . There are other ways (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/structure/strategic-planning) to approach

developing an intervention (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/choose-and-adapt-community-interventions) , many

of them outlined in the Community Tool Box. The advantage of PRECEDE-PROCEED and
similar models (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/analyze-community-problems-and-solutions) is that they tell you
exactly what to do: you follow directions, and you have a procedure for developing an
intervention. The disadvantage of these models is that they tell you exactly what to do: if
some part of the model isn’t appropriate for your setting or your circumstances, you’ll
have to realize that, and change it to fit, or risk a problem. PRECEDE-PROCEED now
offers a flow chart or algorithm to facilitate decisions for skipping some steps or phases,
thereby tailoring the model to different local situations (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-
contents/analyze/analyze-community-problems-and-solutions) .

Usually, the originators of the model will tell you that you have to follow it exactly. In fact,
that’s rarely the case. If you like the model, you can be sure to include all its elements,
but you can still change some of them, change the timing, even change the order to
better match the needs of your community. You might also find yourself taking some
pieces of one model and grafting them on to another, or reinterpreting a model in light of
a particular theoretical framework.

Over and above the use of logic models in general, there are some good reasons for using
PRECEDE-PROCEED specifically:

PRECEDE-PROCEED provides a template for the process of conceiving, planning,

implementing, and evaluating a community intervention.
PRECEDE-PROCEED is structured as a participatory model, to incorporate the ideas and
help of the community. That means that its use will provide you with more, and more
accurate, information about the issues in question, and with a better understanding of
their history and context in the community.
Community involvement is also a means of building community ownership of the
 intervention, leading to more community support and a greater chance of success.
PRECEDE-PROCEED considers the ways in which administrative and policy guidelines
can limit or shape an intervention, an area of planning too often ignored.
PRECEDE-PROCEED incorporates evaluation of the process, the intervention itself, and
the final outcome. That allows the intervention to be monitored and adjusted to respond
to community needs and changes in the situation, and checks that its accomplishments
actually lead to the projected goal.
Although PRECEDE-PROCEED sets out a strict process, it says much less about content. It
leaves plenty of leeway for adapting your intervention’s design and methods to the
situation, the needs of the community, etc.

Although these are good reasons to use PRECEDE-PROCEED, they are also good
reasons to use some of the other models in this chapter. This is the reason we are
presenting several – so that you can decide which among them, if any, makes the most
sense to you, and would be best for your circumstances and community. PRECEDE-
PROCEED’s greatest strength may be its comprehensive and rigorous structure – it
covers all the bases.

HOW DO YOU USE PRECEDE-PROCEED?

Logic models don’t really mean much unless you actually use them in the community. Once
you’ve decided that PRECEDE-PROCEED provides a good model for your intervention, how do
you translate it into action? We’ll look at each of the nine phases of the model with that
question in mind.

PRECEDE: Doing the groundwork. PRECEDE starts by determining the desired outcome for the
community, and then works back to what has to be done to obtain that outcome. Each phase
moves one step closer to the actual intervention.

Our presentation of the model assumes that, although it was developed for use in public health,
it can be used by activists or organizations concerned with any issues that affect the quality of
life in a community, as seen in some of the 950 published applications.

Phase 1: Defining the ultimate outcome. The focus here is on what the community wants
and needs, which may seem unrelated to the issue you plan to focus on. What outcome does
the community find most important? Eliminating or reducing a particular problem
(homelessness)? Addressing an issue (race)? >Improving or maintaining certain aspects of the
quality of life (environmental protection?) Improving the quality of life in general (increasing or
creating recreational and cultural opportunities)?

This phase starts with the collection of demographic data, which is then presented to the
community to help citizens decide on priorities. The way to determine what citizens want for
their community is to ask them. There are a number of options here, which can be used
individually or in combination, including:

Community surveys
Focus groups
 Phone interviews
Face-to-face interviews
Questionnaires in public places

Rather than just asking them for their opinions about what would improve the
community, it’s far more powerful to involve community members in the whole process
from the beginning (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/where-to-start/participatory-approaches/main) , including
them in all phases of the PRECEDE-PROCEED model. While actual applications of the
model often tend to be top-down, it is likely to work better if the community has
significant input and decision-making power from the beginning.

Phase 2: Identifying the issue. In Phase 2 of PRECEDE, you look for the issues and factors
that might cause or influence the outcome you’ve identified in Phase 1 (including supports for
and barriers to achieving it), and select those that are most important, and that can be
influenced by an intervention. (One of the causes of community poverty, for instance, may be
the global economy, a factor you probably can’t have much effect on. As important as the
global economy might be, you’d have to change conditions locally to have any real impact.)

It’s important to analyze these issues carefully, and to make sure that you’ve chosen the right
ones. What would the elimination of a particular factor make possible, for instance, that isn’t
possible already? How does a particular issue create a barrier to the desired outcome? What
else do these issues affect, besides the desired outcome?

Which are the issues with the most drastic effects? (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/analyze-community-
problems-and-solutions/social-determinants-of-health/main) And how do you define “the most drastic effects?” Are they

economic? Social? Physical?

An industry responsible for pollution that actually or potentially causes health problems
may also be the local economic mainstay. Even if the industry has the best of intentions,
it may be unable to afford to clean up its operation. The town may be faced with the
choice of either losing the jobs and tax base that the industry provides, or continuing to
live with a health hazard. What’s more important here (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-
contents/analyze/analyze-community-problems-and-solutions/think-critically/main) , and how do you decide what to focus on

(http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/analyze-community-problems-and-solutions) ? (And is there an answer that isn’t

either-or ?)

This kind of situation is by no means universal...but it isn’t particularly unusual, either.

In some cases, the issues you choose to focus on may be directly related to the outcome
you’re seeking – building more affordable housing as a way to address homelessness, for
instance. In others, you may be trying to affect factors that have just as great an impact on the
outcome, but seem further removed from it – e.g., addressing safe streets by providing
parenting courses and other services for at-risk families.
Once again, involving stakeholders and other community members here is likely to get you the
best information possible about which issues to emphasize, and to keep you from making
mistakes based on ignorance of the community’s history or of the relationships among
community members.

Phases 1 and 2 are where you develop the long-term goals for your intervention. They
tell you what your ultimate desired outcome should be, and what the issue(s) or
associated factors may be that influence it. Those are the things you’re ultimately aiming
to change.

Most of the factors influencing the issues or outcomes can be classified as behavioral, lifestyle,
or environmental.

The behavior referred to here is a specific, observable, often measurable – and usually
customary – action. Some behaviors put people or communities at more or less risk for health
or other problems.

Needle-sharing is a behavior that puts heroin addicts at high risk for hepatitis and AIDS.
Consistent studying usually lessens the risk of school failure for a student.
If littering is a common individual behavior, it may have community consequences that
range from the aesthetic (piles of trash creating an unattractive scene) to health (breeding
of mosquitoes in garbage-strewn lots, water pollution, etc.) to the economic (businesses
unwilling to locate in the community because of its physical condition). It may also have
social consequences, with neighborhood conditions affecting residents’ self-image, and
leading eventually to a breakdown of civic responsibility.

A lifestyle is a collection of related behaviors that go together to form a pattern of living. Some
lifestyles may put people and communities at risk of health and other problems.

An example of a high-risk lifestyle that is often mentioned in the popular media is one that
includes very little exercise, a diet high in calories and saturated fats, and lots of stress.
Such a lifestyle can lead to heart attack, stroke, cardiovascular disease, and other
problems associated with obesity, including diabetes.
A lifestyle that involves gang membership and regular participation in violent acts has
both individual consequences (the constant risk of serious injury or death, an arrest
record, detachment from others’ humanity) and consequences for the community (people
afraid to use the streets, reduced economic activity, scarce resources spent on extra law
enforcement, etc).

The environment of a particular issue or problem can refer to the natural, physical
environment – the character and condition of the water, air, open space, plants, and wildlife, as
well as the design and condition of built-up areas. But it can also refer to the social environment
(influence of family and peers; community attitudes about gender roles, race, childrearing, work,
etc.), the political environment (policies and laws, such as anti-smoking ordinances, that
regulate behavior or lifestyle; the attitudes of those in power toward certain groups or issues),
and the economic environment (the availability of decent-wage jobs, affordable housing, and
health insurance; the community tax base; global economic conditions).

In general, behaviors, lifestyles, and environmental factors are what an intervention sets out to
change. The changes in these areas in turn affect the crucial issues, and lead to the
achievement of the final outcome that was identified in Phase 1 of the model.

So how do you choose which behaviors, lifestyles, or environmental factors to focus on?
That’s where analysis comes in. What are people doing – or what are the factors in the
environment – that lead to, maintain, or prevent the issue or condition you want to
change? Using critical thinking (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/analyze-community-problems-and-solutions/think-
critically/main) and the “But why?” technique (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/analyze/analyze-community-problems-and-

solutions/define-analyze-problem/main) , you should be able to narrow it down to a handful. The criteria for

choosing a particular target for your intervention are: (a) Is the potential target an
important enough factor to have a real effect on the issue, and thus on the quality of life
in the community? and (b) Is it likely that the potential target can actually be changed by
an intervention that you have the resources to mount?

A classic example of community change through behavior change is that of reducing the
incidence of lung cancer and heart disease in a community by convincing smokers to
change their behavior – i.e. quit. Fewer smokers mean less secondhand smoke, less
time lost from work because of smoke breaks and smoking-related illnesses, fewer low-
birth-weight babies, fewer children with asthma and other respiratory ailments, and lower
health insurance costs. Altogether, changing smokers’ behavior adds up to an
improvement in the overall quality of life for the community.

Changing smokers’ behavior fits both criteria described above. It has a profound effect
on the issue and on the general quality of life; and it is often responsive to change,
because of many smokers’ desire to quit, general knowledge about the dangers of
smoking, the cost of tobacco products, community support, and already-existing
strategies and smoking-cessation groups that can be incorporated relatively cheaply into
an intervention.

Phase 3: Examining the factors that influence behavior, lifestyle, and responses to
environment. Here, you identify the factors that will create the behavior and environmental
changes you’ve decided on (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/sustain/social-marketing/promote-behavior-change/main) in Phase 2.

The terms “healthful behavior” and “risky behavior” below refer not only to physical
health, but to any behavior that’s advantageous or harmful to the individual and/or the
community, and is likely to have a significant effect on their quality of life.

Predisposing factors are intellectual and emotional “givens” that tend to make individuals
more or less likely to adopt healthful or risky behaviors or lifestyles or to approve of or accept
particular environmental conditions. Some of these factors can often be influenced by
educational interventions. They include:

Knowledge. You’re more likely, for instance, to avoid sunburn if you know it can lead to
skin cancer than if you don’t.
Attitudes. People who have spent their youth as athletes often come to see regular
exercise as an integral part of life, as necessary and obvious as regular meals.
Beliefs. These can be mistaken understandings – believing that anything low in fat is also
low in calories – or closely held beliefs based on religion or culture – the Bible says
“Spare the rod and spoil the child,” so it’s important to physically punish your children for
mistakes or misdeeds.
Values. A value system that renounces violence would make a parent less likely to beat a
child, or to be physically abusive to a spouse or other family member.
Confidence. Many people fail to change risky behavior simply because they don’t feel
capable of doing so.

Enabling factors are those internal and external conditions directly related to the issue that
help people adopt and maintain healthy or unhealthy behaviors and lifestyles, or to embrace or
reject particular environmental conditions. Among them are:

Availability of resources. People with mental health problems, for instance, are much
more likely to get help if services are readily available.
Accessibility of services (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/implement/improving-services/access-health-and-community-services/main)
. Services do no good if they have waiting lists that run into years, or aren’t physically
accessible to those who need them.
Community and/or government laws, policies, priority, and commitment to the issue
(http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/implement/changing-policies/overview/main) . Government laws and policies can

both force changes in behavior or environment (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/advocacy/direct-action) ,

and underline the importance of those changes (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/advocacy/media-advocacy) .
Issue-related skills. People who start out with a work ethic and an understanding of the
workplace, for instance, are apt to benefit from job placement programs.

Reinforcing factors
factors, are the people and community attitudes that support or make difficult
adopting healthy behaviors or fostering healthy environmental conditions. These are largely the
attitudes of influential people: family, peers, teachers, employers, health or human service
providers, the media, community leaders, and politicians and other decision makers. An
intervention might aim at these people and groups – because of their influence – in order to
most effectively reach the real target group.

Phases 2 and 3 comprise the part of the model where the real planning of an
intervention has to take place. What are you trying to change, and what are the factors
that will help to bring that change about? Answering these questions should bring you to
an understanding of whom and what an intervention should target, who best might
conduct the intervention, and what it should look like in order to hit its targets effectively.
Phase 4: Identifying “best practices” and other sources of guidance for intervention
design, as well as administrative, regulation, and policy issues that can influence
the implementation of the program or intervention. Phase 4 helps you look at
organizational issues that might have an impact on your actual intervention. It factors
in the effects on the intervention of your internal administrative structure and policies, as well as
external policies and regulations (from funders, public agencies, and others).

Design issues: “Matching, mapping, pooling, and patching.” or “Selecting, designing, blending,
and supporting interventions.”

The discussion of the ways in which organizational issues, particularly internal ones, interact
with a proposed intervention is one that all too often never takes place. For that reason, Phase
4 is particularly important. Such a discussion can avoid mismatches between an organization
and its proposed intervention (a strictly hierarchical organization attempting to implement an
intervention meant to empower a group with no voice, for instance), or to alert an organization
to an internal or external regulation or policy that needs to be changed or circumvented for an
intervention to proceed as planned.

Administrative issues include organizational structure, procedures, and culture; and the
availability of resources necessary for the intervention.

The organizational structure may be hierarchical, democratic, collaborative, or some

combination, and may be more or less rigid or flexible within each of those categories. It
should be appropriate to the design of the intervention (e.g., allowing for staff decisions in
the field in a gang outreach program), and flexible enough to make adjustments when
necessary.
Organizational procedures are the ways in which the organization actually carries out its
work. In order for an intervention to be successful, those procedures have to focus on its
goals, rather than on internal convenience or traditional methods. An intake procedure,
for instance, should be designed to be as easy and un-embarrassing for participants as
possible – otherwise it can be a barrier to participation.
The organizational culture. Organizations are social groups that develop cultures of their
own. Those cultures often dictate, among other things, how staff members interact with
one another, how program participants are treated, and how the organization views its
work and its mission. (Is it just a job, or is it God’s work?) They also usually determine the
fit between an organization and an intervention.
The resources available for the intervention include not only money – although that’s
certainly important – but time, personnel, skills, and space. Now is the time to pinpoint
any gaps in resources beforehand, and work to close them. Thus, finding funding and/or
the right staff people may be a good part of this phase.

Policy and regulatory issues have to do with the rules and restrictions – both internal and
external – that can affect an intervention, and their levels of flexibility and enforcement.

Internal policies:
Staff members. Organizational policy may treat staff as employees who take orders, as
colleagues who contribute to the work of the organization, or as collaborators who jointly
 own it. The amount of freedom they have to exercise their creativity and to take initiative
probably depends on that policy, which may be unstated.
Participants. Does organizational policy see participants as “clients” that the organization
is doing something to or for, or as partners in a change effort? Does it treat participants
respectfully, as equals, or does it condescend or act authoritative?

How does the organization treat relationships among participants and staff? In some
organizations, they may be friendly; in others, strictly professional. (Romantic or sexual
relationships raise some ethical questions, and probably need to be considered
separately. See “Professional ethics” below.)

Specific practices, methods, or programs. Many organizations maintain policies that

suggest or mandate certain ways of carrying out their work.
Collaboration. Some non-profits make it a point of policy to collaborate as much as
possible, while others rarely, if ever, work with other organizations.
Professional ethics. Many organizations expect staff members to adhere to a code of
professional ethics – either an internal one, or one set out by a professional association –
that governs confidentiality, inappropriate relationships, abuse of position, reporting (or
non-reporting) of specific kinds of illegal behavior, etc. There may be organizational
regulations about these areas as well.

External policies and regulations that might affect an intervention can come in a variety of
forms:
Funders’ requirements. These may apply to the intervention itself, or they may place
restrictions on anything the organization can do, even those areas – such as, perhaps,
this intervention – that aren’t funded directly by the funder in question.
Oversight agency regulations. The organization may be subject to the authority of a state
or federal agency whose regulations affect the intervention.
State or federal laws, or local ordinances
Unstated community policies. Certain actions may simply be unacceptable to the majority
of the community, to coalition partners, etc.

PROCEED: Implementing and evaluating the intervention .

Phase 5: Implementation. At this point, you’ve devised an intervention (largely in Phases 3
and 4), based on your analysis. Now, you have to carry it out. This phase Involves doing just
that – setting up and implementing the intervention you’ve planned.

The final three phases take place as the intervention continues, and serve to help you
monitor and adjust your work to make it as effective as possible.

Phase 6: Process Evaluation. This phase isn’t about results, but about procedure. The
evaluation here is of whether you’re actually doing what you planned. If, for instance, you
proposed to offer mental health services three days a week in a rural area, are you in fact
offering those services?

Phase 7: Impact Evaluation. Here, you begin evaluating the initial success of your efforts. Is the
intervention having the desired effect on the behavioral or environmental factors that it aimed
at changing – i.e., is it actually doing what you expected?

Phase 8: Outcome Evaluation. Is your intervention really working to bring about the outcome
the community identified in Phase 1? It may be completely successful in every other way – the
process is exactly what you planned, and the expected changes made – but its results may
have no effect on the larger issue. In that case, you may have to start the process again, to see
why the factors you focused on aren’t the right ones, and to identify others that might work.

Some outcomes may not be apparent for years or decades. Lifestyle changes made by young
people to stave off heart disease and stroke, for instance, usually won’t reveal their health
benefits until those people are well into middle age. If you know that an outcome may not show
itself for a long time, you may just have to be patient and continue to monitor the process and
impact of your intervention, with the belief that the eventual outcome will become apparent in
time.

Phases 6-8 call for formal evaluations of each phase, with controlled studies and detailed
findings, but most Community Tool Box users probably don’t have the resources for that,
and shouldn’t expect to do it. That doesn’t mean you shouldn’t evaluate, however.

It’s a relatively simple matter, for instance, to keep records and to examine them to find
out whether your process was carried out as planned, or simply to look at what you are
doing to see whether it matches what you intended to do. The same is true for the other
stages of evaluation (http://ctb.ku.eduhttp://ctb.ku.edu/en/table-of-contents/evaluate/evaluate-community-initiatives) . Don’t worry if you
can’t do a formal study...but don’t let evaluation go, either. It’s an important part of the
process.

Remember also that evaluation is ongoing throughout the work. It takes place while the
intervention is being implemented, not afterwards. The whole point of evaluation of each
phase of the model is to adjust or change what you’re doing in that phase, if necessary,
to make it more effective.

At any point in the PROCEED continuum, you should be prepared to revisit your analysis. If you
find a gap between your planning and reality, or if you realize that your intervention isn’t
achieving the results you aimed at, you should go back to the PRECEDE part of the model, try
to determine what needs to be changed, and adjust what you’re doing accordingly. The point
of evaluation is not to see whether you pass some kind of test – it’s to make sure that your
intervention brings about the outcome that the community wanted or needed in the first place.

IN SUMMARY
PRECEDE-PROCEED provides a logic model that can serve as the basis for an individual, one-
time intervention or a decades-long community development program or project. Although
designed for health programs, it’s adaptable to other community issues as well. As with many
models, it’s meant to be a guide, not a prescription.

PRECEDE-PROCEED is community-based and participatory, founded on the premise that

changes promoting health (and other community issues) are largely voluntary, and therefore
need the participation of those needing to change and others who might influence them or be
influenced by them.

A major reason to use PRECEDE-PROCEED is that it is a logic model. As a result, it will provide
a structure within which to plan your work, and organize both your thinking and your actions, so
that your intervention will be a carefully-planned, coherent whole, rather than cobbled together.
As a logic model, it also provides a guide for analyzing the issues involved, and choosing both
the most likely areas to address and the most likely avenues to address them.

There are also reasons to use PRECEDE-PROCEED specifically. First, it’s a participatory model.
By involving the community, it will both bring more and better ideas about issues and resolving
them, and build community ownership of the intervention. Second, since it includes multi-level
(ecological) planning and evaluation, PRECEDE-PROCEED builds in monitoring of the
intervention, allowing for adjustment and greater effectiveness. And finally, the model allows
the freedom to adapt the structure to whatever content and methods meet the needs of your
community.

PRECEDE is the diagnostic portion of the model. It starts with the idea that the focus of change
must be on its desired outcome, and works backward from that outcome to construct an
intervention that will bring it about. It has four phases:

Phase 1: Social diagnosis – determine what the community wants and needs to improve its
quality of life.

Phase 2: Epidemiological diagnosis – determine the health problems or other issues that
affect the community’s quality of life. Include also the behavioral and environmental factors that
must change in order to address these problems or issues. Behavioral factors include patterns
of behavior that constitute lifestyles. In considering environmental factors, you should include
the physical, social, political, and economic environments.

Phases 1 and 2 identify the goals of the intervention.

Phase 3: Educational and organizational diagnosis – determine what to do in order to change

the behavioral and environmental factors in Phase 3, taking into account predisposing factors
(knowledge, attitudes, beliefs, values, and confidence); enabling factors (availability of
resources, accessibility of services, government laws and policies, issue-related skills), and
reinforcing factors (largely the influence of significant others in the social environment).

Phase 4: Designing programs or interventions and the support for them through administrative
and policy diagnosis – determine (and address) the internal administrative and internal and
external policy factors that can affect the success of your intervention. The former include
organizational structure, procedures, culture, and resources; the latter encompass both internal
policies and funders’ requirements, oversight agency regulations, state or federal laws, or local
ordinances, and unstated community policies.
Phases 3 and 4 set the structure and targets for the planning and design of the intervention.

PROCEED is, in medical terms, the treatment portion of the model, and comprises the
implementation and evaluation of the intervention. It consists of four phases:

Phase 5: Implementation – conduct the intervention.

Phase 6: Process evaluation – determine whether the intervention is actually taking the
actions intended.

Phase 7: Impact evaluation – determine whether the intervention is having the intended
effects on behaviors and/or environment.

Phase 8: Outcome evaluation – determine whether the intervention ultimately brings about
the improvements in quality of life identified by the community as its desired outcome.

An unstated but important part of the model is that, at any point, your plan or intervention can
and should be revisited and revised, based on continued analysis and the results of the various
evaluations.

Online Resources

A Framework for Planning and Evaluation: Precede-Proceed Evolution and

Application of the Model ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////jjaasspp..iinnssppqq..qqcc..ccaa//DDaattaa//SSiitteess//11//SShhaarreeddFFiilleess//pprreesseennttaattiioonnss//22000066//JJAASSPP22000066--OOttttaawwaa--
G
Grreeeenn--O DFF)) by Lawrence W. Green and Judith M. Ottoson of Montreal, Quebec.
Ottttoossoonn1144--11..PPD

An explanation of the PRECEDE-PROCEED model from the Interdisciplinary Student

Community-Oriented Prevention ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ssmmhhss..ggwwuu..eedduu//iissccooppeess//lleeaarrnniinnggccoommmmuunniittiieess)) .

The website of Lawrence Green ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////llggrreeeenn..nneett//pprreecceeddee..hhttmm)) , originator of the PRECEDE-

PROCEED model and co-author of the main text describing it. Includes a description of and
ordering information for EMPOWER software, developed as a teaching tool for the model

Using the Precede-Proceed Model ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////wwwwww..ssffuu..ccaa//uuppllooaaddss//ppaaggee//2233//GGEERROO882200__22001122FFAALLLL__PPRREECCEEDDEE--

PPRRO
OC D..ppddff)) is a short resource with visual examples of program planning as well as case studies.
CEEEED

Phase 1: Defining the ultimate outcome.

The first phase is to involve the community in prioritizing the issues on which they want to
focus. This involves collecting demographic data in the form of interviews, questionnaires, and
focus groups. The entire community can then be involved in using those data to prioritize their
outcomes.

Community Tool Box links related to Phase 1:

Assessing Community Needs and Resources ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//99))

Conducting Public Forums and Listening Sessions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//112266))
Conducting Focus Groups ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//114400))
Conducting Needs Assessment Surveys ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//114455))
Conducting Concerns Surveys ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//115599))
 Conducting Interviews ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//116699))
Conducting Surveys ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//117744))
Creating and Using Community Report Cards ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//119977))
Developing a Plan for Identifying Local Needs and Resources ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//111188))
Leading a Community Dialogue on Building a Healthy Community
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//119933))

Qualitative Methods to Assess Community Issues ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//118844))

Understanding and Describing the Community ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//112222))

Phase 2: Identifying the issue.

In this phase, the community must involve all stakeholders in the process of identifying issues
related to the outcome and determining what to influence. It must be decided what could
prevent the desired outcome or aid in achieving it, which factors are the most significant, and
which can be influenced by intervention.

Community Tool Box links related to Phase 2:

Analyzing Community Problems ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//113366))

Assessing Community Needs and Resources ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//99))
Collecting Information About the Problem ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//113311))
Conducting Focus Groups ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//114400))
Conducting Interviews ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//116699))
Conducting Needs Assessment Surveys ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//114455))
Conducting Public Forums and Listening Sessions ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//112266))
Conducting Surveys ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//116699))
Developing a Plan for Identifying Local Needs and Resources
((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//111188))

Leading a Community Dialogue on Building a Healthy Community

((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//119933))

Understanding and Describing the Community ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//112222))

Phase 3: Examining the factors that influence behavior, lifestyle, and responses to
environment.

Phase three involves deciding what factors to manipulate in order to create the changes
agreed upon in Phase 2. This requires analysis of the predisposing, enabling, and reinforcing
factors including the knowledge, beliefs and values of members of the community, availability
and accessibility of resources, and the attitudes of influential people.

Community Tool Box links related to Phase 3:

A ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//113366)) nalyzing Community Problems ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//113366))
Assessing Community Needs and Resources ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//99))
Collecting Information About the Problem ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//113311))
Conducting Focus Groups ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//114400))
Conducting Interviews ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//116699))
Conducting Surveys ((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//116699))
 Developing a Plan for Identifying Local Needs and Resource
((hhttttpp::////ccttbb..kkuu..eedduuhhttttpp::////ccttbb..kkuu..eedduu//nnooddee//111188))

Developing Baseline Measures of Behavior ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//115555))

Determining Service Utilization ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//116644))
Identifying Community Assets and Resources ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//115500))
Qualitative Methods to Assess Community Issues ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//118844))
SWOT Analysis: Strengths, Weaknesses, Opportunities, and Threats
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//117799))

Phase 4: Identifying "best practices" and other sources of guides to intervention

design and the administrative regulation, and policy issues that can influence the
implementation of the intervention.

In Phase four, an organization must consider its own structure, policies and history in order to
ensure that there are no internal factors that might act as barriers when trying to implement
changes. Issues that must be considered include the group's organizational structures,
procedures, culture and resources as well as policies regarding staff members, participants,
specific practices, community laws, and issues related skills.

Community Tool Box links related to Phase 4:

Assessing Community Needs and Resources ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//99))

SWOT Analysis: Strengths, Weaknesses, Opportunities, and Threats
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//117799))

Administrative Issues

Creating and Gathering a Group to Guide Your Initiative ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//442211))

Developing an Organizational Structure for the Initiative ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//441144))
Developing a Plan for Staff Hiring, Orientation, and Trainin ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//445588))
Developing Multisector Task Forces or Action Committees for the Initiative
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//442266))

Developing an Ongoing Board of Directors ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//443300))

Developing Personnel Policies ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//447744))
Hiring and Training Key Staff of Community Organizations ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//445566))
Maintaining a Board of Directors ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//443399))
Maintaining Ethical Leadership ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//557755))
Managing Finances ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11440033))
Orienting Ideas in Leadership ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//554422))
Organizational Structure: An Overview ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//22443388))
Planning and Writing an Annual Budget ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11440055))
Understanding and Writing Contracts and Memoranda of Agreement
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//445533))

Welcoming and Training New Members to a Board of Directors ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//443344))

Writing Bylaws ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//444444))

External Policies and Regulations

 Adapting Community Interventions for Different Cultures and Communities
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//773311))

Analyzing Community Problems and Solutions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//666644))

Choosing and Adapting Community Interventions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//771166))
Criteria for Choosing Promising Practices and Community Interventions
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//771188))

Deciding Where to Start ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//669966))

Defining and Analyzing the Problem ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//667744))
Designing Community Interventions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//669988))
Ethical Issues in Community Interventions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//773355))
Generating and Choosing Solutions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//668899))
Identifying Strategies and Tactics for Reducing Risks ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//772277))
Identifying Targets and Agents of Change: Who Can Benefit and Who can Help
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//770033))

An Introduction to the Problem Solving Process ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//666666))

Participatory Approaches to Planning Community Interventions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//770033))
Putting Your Solution into Practice ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//669933))
Thinking Critically ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//667700))
Understanding Risk and Protective Factors: Their Use in Selecting Potential
Targets and Promising Strategies for Interventions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//772222))
Using Community Sectors to Reach Targets and Agents of Change
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//771133))

Phase 5: Implementing and evaluating the intervention

At this point, the interventions devised must be carried out. This phase involved setting up and
implementing the intervention as planned.

Community Tool Box links related to Phase 5:

Acting as a Watchdog ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11005588))

Advocacy Over and For the Long Term ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11118822))
Conducting Advocacy Research ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11002255))
Conducting a Direct Action Campaign ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11009933))
Conducting a Petition Drive ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11113322))
Conducting a Public Hearing ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11115500))
Conducting Research to Influence Policy ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11006666))
Conducting Studies of the Issue ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11003311))
Changing the Media's Perspective on Community Issues ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11221100))
Creating News Stories the Media Wants ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11119977))
Criticizing Unfavorable Action ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11110055))
Demonstrating Economic Benefit or Harm ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11005500))
Developing and Maintaining Ongoing Relationships with Legislators and Their
Aides ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11114411))
Developing a Plan for Advocacy ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11002222))
Developing a Proposal for Change ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11007777))
Documenting Complaints ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11005544))
Electronic Advocacy ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11117777))
Encouraging Involvement of Potential Opponents as well as Allies
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11001177))

Establishing Formal Communications and Requesting Participation

((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11008811))

Establishing Lines of Communication within the Opposition's Traditional Allies

((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11112288))

Filing a Complaint ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11110099))

Gathering Data on Public Opinion ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11003366))
General Rules for Organizing for Legislative Advocacy ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11113377))
How to Conduct Research: An Overview ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11002277))
How to Respond to Opposition Tactics ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11222200))
Identifying Opponents ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11001133))
Initiating Legal Action ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11116633))
Lobbying Decisionmakers ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11112233))
Making Friends with the Media ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11119933))
Meeting the Media ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11220066))
Media Advocacy ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11118855))
Overview Getting an Advocacy Campaign Off the Ground ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//999955))
Organizing Audits of Consumer Services ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11006622))
Organizing a Boycott ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11116688))
Organizing a Strike ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11117733))
Organizing Public Demonstrations ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11115555))
Organizing Study Circles ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11007711))
Overview of Opposition Tactics: Recognizing the Ten D's ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11221166))
Principles of Advocacy ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//999955))
Providing Encouragement and Education ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11007755))
Providing Corrective Feedback ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11008855))
Recognizing Allies ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11000099))
Registering Voters ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11114455))
Recognizing Allies ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11000099))
Reframing the Issue ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11008899))
Responding to Counterattack ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11221133))
Requesting Accountability ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11004466))
Seeking Enforcement of Existing Laws or Policies ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11111144))
Seeking a Negotiator, Mediator, or Fact-Finder ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11115599))
Studying the Opposition ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11004411))
Survival Skills for Advocates ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11000011))
Understanding the Issue ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11000055))
Using Paid Advertising ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11220022))
Using Personal Testimony ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11111188))
Working with the Media ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11118888))
Writing Letters to Elected Officials ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11009955))
 Writing Letters to the Editor ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11110000))

Phase 6: Process evaluation

In phase six, the organization must review the interventions underway to determine if the
procedures are being carried out as planned. It must be determined if the specific tasks within
the interventions are being carried out as intended.

Phase 7: Impact evaluation

In phase seven the effects of the interventions are reviewed. A basic analysis must be
conducted to ensure that the interventions are having the desired effect.

Phase 8: Outcome evaluation

Even in you are implementing everything you planned, you may still not be having an impact on
the larger issues. In phase eight the outcomes are examined to see if the direct effects of the
interventions being made are effecting the bottom line, or if a focus on different factors is
needed.

Community Tool Box links related to Phase 6, Phase 7, and Phase 8

Behavioral Surveys ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11331100))

Communicating Information to Funders for Support and Accountability
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11333344))

Community-Level Indicators: Some Examples ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11332244))

Collecting and Analyzing Data ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11227700))
Collecting and Using Archival Data ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11227744))
Conducting Interviews with Key Participants to Analyze Critical Events
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11331144))

Choosing Evaluators ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11224411))

Constituent Survey of Outcomes: Ratings of Importance ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11330011))
Designing an Observational System ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11225599))
Developing an Evaluation Plan ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11224455))
Developing and Testing a Prototype Intervention ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11226633))
A Framework for Program Evaluation: A Gateway to Tools ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11222277))
Gathering Information: Monitoring Your Progress ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11228877))
Information Gathering and Synthesis ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11225555))
Introduction to Evaluation ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11222255))
Intervention Research with Communities: A Gateway to Tools ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11223311))
Measuring Success: Evaluating Comprehensive Community Health Initiatives
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11228833))

Providing Feedback to Improve the Initiative ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11332299))

Rating Community Goals ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11229922))
Rating Member Satisfaction ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11229966))
Reaching Your Goals: The Goal Attainment Report ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11330066))
Some Operations in Evaluating Community Interventions ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11225533))
Selecting an Appropriate Experimental Design ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11226677))
 Some Methods for Evaluating Comprehensive Community Initiatives
((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11228811))

Understanding Community Leadership, Evaluators, and Funders: What Are

Their Interests? ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11223366))
Using Evaluation to Understand and Improve the Initiative ((hhttttpp::////ccttbb..kkuu..eedduu//nnooddee//11332277))
Print Resources
Gielen, A. C., & Eileen M. M. (1996). The PRECEDE-PROCEED Planning Model. In Health
Behavior and Health Education , edited by Glanz, K, Lewis, F., & Rimer, K. B. San Francisco :
Jossey-Bass.
Green, Lawrence W., & Marshall W. Kreuter. Health Promotion and Planning: An Educational
and Environmental Approach. (1999) (4th edition). Mountain View , CA : Mayfield Publishing Co.

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