SECTION 4 Public Health PRECEDE STEP 5 STEP 4 STEP 2 STEP 1 Educational and and Policy Assessmen Diagnosis Assessment Health Behavior and lifestyle Environment STEP 6 STEP 7 STEP 8 STEP 9 Implementation Outcome Evaluation Evaluation Evaluation PROCEED Figure 26-1 The PRECEDE/PROCEED modeL (Redrawn and modified from Green L, Kreuter M: Health program planning: An educational and ecological approached4,NewYork,2005,Mcgraw-hIll.SlIde8fromhttp://www.lgreen.net/hpp/chapters/chapterolhtm) Step VIl: Process evaluation. Evaluating the process for their health problems and to set measurable health priorities implementing the interventions for health promotion and disease prevention, communities Step VIll: Impact evaluation. Evaluating the impact of the have additional leverage to strengthen their requests for interventions on the factors supporting behavior and on resources. With more data becoming available online(see behavior itself Chapter 25), this step may become less demanding in the Step IX: Outcome evaluation, Determining the ultimate future ffects of the interventions on the health and quality of life of the population 3. Mobilizing for Action through Planning In reality, when implemented in a program, PRECEDE and Partnerships and PRoceed interact as a continuous cycle, since feedback data from the PROCEEd steps indicate how programs m Mobilizing for Action through Planning and Partnerships be modified to more closely reach their goals and targets (MAPP)is a program sponsored by the National Association for County and City Health Officials(NACCHO)in coop 2. Planned Approach to Community Health eration with the Public Health Practice Program Office of he CDC. It is a community-driven strategic planning process The Planned Approach to Community Health(PATCH)was for improving community health. The seven principles of developed by the CDC in the mid-1980s. The primary goal MAPP are as follows: of PATCH was to create a practical mechanism through which effective community health education action could be tar- 1. Systems thinking-to promote an appreciation for the geted to address local-level health priorities. A secondary goal dynamic interrelationship of all components of the local was to offer a practical, skills-based program of technical public health system required to develop a vision of a assistance in which health education leaders in state health healthy community. agencies could work with their local counterparts to establish 2. Dialogue-to ensure respect for diverse voices and per- ffective community health education progran pectives during the collaborative proce interventions included mobilizing the community, collecting 3. Shared vision--to form the foundation for building a and organizing data, choosing health priorities, developing healthy future(visioning a comprehensive intervention plan, and evaluation 4. Data-to inform each step of the process Historically, the most demanding and time-consuming 5. Partnerships and collaboration-to optimize perfor step in patCh has often been the gathering and analysis of mance through shared resources and responsibility local area data to facilitate program planning and evaluation. 6. Strategic thinking-to foster a proactive response to the On average, communities spent about a year collecting and issues and opportunities facing the system nalyzing data. This energy appears to be well spent, however. 7. Celebration of successes-to ensure that contributions With information to document the magnitude and extent of are recognized and to sustain excitement for the process