.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.
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 outc