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Toward Cost-Benefit Evaluations of Health Education: Some Concepts, Methods, and Examples

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... The unique and personal implications of health behaviors and decisions on one's body, health and physiological state, which refer to humans' most basic set of considerations and needs (Maslow, 1943), suggest that health behavior decision processes are likely to be different than other types of behaviors, such as tax-compliance or pro-environmental behavior. Indeed, while classic policy compliance and law obedience scholarships stress the role of perceived legitimacy of the government or sense of moral duty or obligation in compiling with governmentally desired behavior (Fine & van Rooij, 2021;Levi, 1988;Murphy, 2004;Scholz & Lubell, 1998;Thomassen et al., 2017;Tyler, 1990), health behavior theories highlight a complex set of cognitive perceptions and evaluations regarding the promoted behaviors, as behavioral determinants (Green, 1974;Hayden, 2022;Irwig‫‬ et al., 2008;Janz & Becker, 1984;Prochaska & DiClemente, 1982;Rosenstock, 1974). This emphasizes the likelihood that decision-making processes regarding health-behavior-related instructions are different than those operated in other domains. ...
... While the first stresses the effect of trusted sources of information on cognitive appraisals of promoted actions (Chaiken, 1980;Chetioui et al., 2021;P. Liu et al., 2019;O'Keefe, 2015;Petty & Cacioppo, 1986;Thaker et al., 2017;Visschers et al., 2011;Wallace et al., 2020), the latter, as mentioned above, and particularly the HBM, focus on cognitive appraisals of actions and their outcomes as a prominent factor in determining health behavior (Green, 1974;Hayden, 2022;Irwig‫‬ et al., 2008;Janz & Becker, 1984;Prochaska & DiClemente, 1982;Rosenstock, 1974). ...
... Furthermore, as will be elaborated in the next section, prominent theories on health behavior set their main focus on cognitive mechanisms of appraisal of the behavior of interest, at the heart of the health behavior decision-making process (Green, 1974;Hayden, 2022;Irwig‫‬ et al., 2008;Janz & Becker, 1984;Prochaska & DiClemente, 1982;Rosenstock, 1974). This differs from classic political and law obedience literature, which, as mentioned above, points at a different set of considerations when deciding to comply with laws and regulations in other realms, namely legitimacy and a sense of obligation and duty to comply (Fine & van Rooij, 2021;Levi, 1988;Murphy, 2004;Scholz & Lubell, 1998;Thomassen et al., 2017;Tyler, 1990). ...
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Trust in government is considered a prominent factor for enhancing public compliance with government policies and instructions. The Coronavirus pandemic demonstrates the crucial role public compliance with governmentally issued health guidelines has in mitigating the pandemic. However, the mechanism explaining the trust-compliance association, particularly in regard to health-behavior compliance, is unclear. This article develops a new theoretical model, the Mediated Trust Model (MTM), for explaining the relationship between trust in government and public compliance with health instructions. The model extends the classic Health Belief Model for predicting health behavior by claiming that the perceptions regarding the instructions' costs, benefits and one's ability to perform them are affected by trust in government and mediate the trust-compliance association. The MTM was tested in four cross-sectional studies performed during the first 20 months of the Coronavirus pandemic in Israel on 3732 participants, for various health instructions. Implications for public health literature, policy compliance theory and policy makers are discussed.
... Thesis Components of the intervention mapping approach Stage 1Bartholomew et al(201) recommend the use of a modified Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model(393) to guide the logic model of the problem. In the PRECEDE model, health behaviour is regarded as being influenced by both individual and environmental factors, and the model is based on the premise that a diagnosis of a problem is essential before developing and implementing the intervention plan(393).Diagnosing the problem involves identifying a number of factors or determinants of behaviour. ...
... Thesis Components of the intervention mapping approach Stage 1Bartholomew et al(201) recommend the use of a modified Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model(393) to guide the logic model of the problem. In the PRECEDE model, health behaviour is regarded as being influenced by both individual and environmental factors, and the model is based on the premise that a diagnosis of a problem is essential before developing and implementing the intervention plan(393).Diagnosing the problem involves identifying a number of factors or determinants of behaviour. Personal determinants that can predispose the desired behaviour include knowledge, attitudes, beliefs, personal preferences, skills, and self-efficacy towards the desired behaviour(393). ...
... In the PRECEDE model, health behaviour is regarded as being influenced by both individual and environmental factors, and the model is based on the premise that a diagnosis of a problem is essential before developing and implementing the intervention plan(393).Diagnosing the problem involves identifying a number of factors or determinants of behaviour. Personal determinants that can predispose the desired behaviour include knowledge, attitudes, beliefs, personal preferences, skills, and self-efficacy towards the desired behaviour(393). External factors can prevent or reinforce the desired behaviour, including social support and availability and accessibility of resources(393). Behavioural factors include the overt actions that can lead to the desired behaviour(393).The logic model of the problem reads from left to right, however, formation of this logic model begins from right to left, starting with a description of the health problem (201). ...
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Adolescents with long-term conditions (LTCs) often adopt a marginal role during healthcare consultations, which does not reflect their role in condition self-management. Shared decision-making (SDM) gives adolescents a voice in their healthcare and treatment plans, improving the likelihood of selecting the best possible option for them. Literature in this area is limited, and much of the research to date has focused primarily on the views of parents and clinicians, with little attention to the adolescents’ perspectives. The work in this thesis describes the development and user-testing of an intervention informed by adolescents and relevant theory, which aims to prepare and support adolescents with LTCs to participate in SDM. Development and user-testing was guided by the MRC’s framework for developing complex interventions and the Person-Based Approach. A systematic review revealed that preferences of adolescents with LTCs around involvement in decision-making can vary substantially, but often go unmet. Reasons for the discrepancy between adolescents’ preferences and experiences were further explored in qualitative participatory interviews, and perceived barriers to, and facilitators for SDM were identified. The Intervention Mapping Approach was used to develop a theory and evidence-based intervention in the form of a 12-page booklet titled “It’s my body, I can have a say” which aimed to address the identified barriers. User-testing with adolescents with LTCs and clinicians revealed positive responses to the booklet’s key messages and design. Suggested changes were made to improve acceptability of the booklet, which included the addition of a short video and electronic format. Design for further feasibility testing was proposed. Overall, preliminary findings suggest that the intervention could be a useful tool for preparing and supporting adolescents with LTCs to be involved in SDM, and for addressing the perceived barriers to involvement. However, preparation for SDM must be paired with willing and skilled clinicians, supported by parents, and delivered within a supportive environment.
... Among them, the NIH Stage model was created to be relevant for clinical sciences [58] and the CONSORT statement was created for nonpharmacologic treatments for all nonpharmacological interventions [44]. Out of 46 frameworks, 3 (7%) aimed to validate health promotion programs [29,32,38]. A total of 23 of 46 (50%) were targeted to validate health behavior change interventions: of these 23, 15 (65%) were aimed at eHealth interventions in general [12,41,43,48,49,52,59,61,[64][65][66][71][72][73][74], 2 (9%) at Internet interventions [55,57], and 6 (26%) at mobile interventions [17,56,60,67,69,70]. ...
... Finally, 13 frameworks out of 46 (28%) were intended for all stakeholders: professionals, researchers, users, clinicians, and other health helpers [42,46,[55][56][57]59,65,67,[68][69][70]72,73]. In 6 out of 46 cases (13%), the target of the framework was not mentioned; however, the reading of these articles was directed toward software designers [28,34,40], researchers, stakeholders, and health program planners [29,31,37]. Out of 46, 25 frameworks (54%) were created for software designers and 24 (52%) were created for researchers. ...
... A total of 15 out of 46 frameworks (33%) were also associated with an evolutive process, creating a cyclic organization to improve the product progressively [30,34,35,[37][38][39]43,[47][48][49]51,58,60,67,68]. Finally, 11 out of 46 frameworks (24%) also integrated a parallel process [29,36,40,41,46,57,59,64,65,71,74]; 1 of those was the Agile software management framework, which aims for a high degree of adaptability to satisfy the clients [40]. ...
... Therefore, having a model as a conceptual framework to identify factors affecting QoL in TDT patients is an advantage. particular behavior [10]. The predisposing factors within the scope of this research were anxiety-depression, perceived self-efficacy, perceived barriers, and knowledge. ...
... The predisposing factors within the scope of this research were anxiety-depression, perceived self-efficacy, perceived barriers, and knowledge. Reinforcing factors refer to factors that reward or strengthen the desired behavior [10]. The reinforcing factors within the scope of this research were social supports from family members, friends, and significant others. ...
... The reinforcing factors within the scope of this research were social supports from family members, friends, and significant others. Enabling factors are resources and skills that facilitate health behavior change [10]. The enabling factors within the scope of this research were the degree of availability and accessibility of resources and services for TDT patients. ...
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Abstract This study aimed to determine the predictors of Quality of Life (QoL) in Transfusion-Dependent Thalassemia (TDT) patients based on PRECEDE (Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) model. This cross-sectional analytical study was performed on 389 TDT patients who were under treatment in four thalassemia centers in Tehran, Iran. Data gathering instrument consisted of three parts: socioeconomic and demographic information, the Persian version of the six standardized questionnaires for measuring some of the potential predictive factors of QoL in TDT patients based on the PRECEDE model constructs, and a researcher-made questionnaire to assess knowledge of patients about health- and QoL-promoting behaviors and enabling factors involved in health- and QoL-promoting behaviors. Using AMOS 23.0, the structural equation modeling with maximum likelihood estimation was conducted to test the proposed hypotheses. Associations of QoL with all of the PRECEDE model constructs, including anxiety–depression, self-efficacy, perceived barriers, knowledge, enabling factors, and reinforcing factors were significant (all p < 0.001). Anxiety–depression and perceived barriers were the significant negative predictors of QoL in TDT patients, whereas health-promoting lifestyle was the significant positive predictor of QoL in TDT patients. The final conceptual model of the study was adequately fit and can be applied as a framework for future educational-supportive programs aimed at improving the QoL in TDT patients.
... Among them, the NIH Stage model has been created to be relevant for clinical sciences [54] and CONSORT Statement for Nonpharmacologic Treatments for all non-pharmacological interventions [44]. Three frameworks aim to validate health promotion programs [29,32,38]. Nineteen targeted to validate health behavior change interventions, 11 of them aim at the eHealth interventions in general [12,17,41,43,47,48,51,55,[58][59][60]. ...
... In six cases, the target of the framework was not mentioned. The reading of the articles in question directs towards software designers [28,34,40] and researchers, stakeholders and health program planners [29,31,37]. 23 frameworks (70%) were created for software designers and 13 for researchers (39%). ...
... 13 frameworks (39%) also associated an evolutive process, creating a cyclic organization to progressively improve the product [30,34,35,[37][38][39]43,[46][47][48]50,54,60]. Finally, 6 (18%) integrate also a parallel process [29,36,40,41,45,58]. The Agile software management that aims a high degree of adaptability to satisfy the clients, is one of those [40]. ...
Preprint
BACKGROUND Changing health behaviors such as smoking, unhealthy diet, inactivity and alcohol abuse may have a greater impact on population health than any curative strategy. One of the suggested strategy is the use of Behavioral Intervention Technologies (BIT). They open up new opportunities in the area of prevention and therapy and begin to show benefits in durable change of health behaviors in patients or at-risk people. A consensual and international paradigm has been adopted by health authorities for drugs 50 years ago. It guides their development from research units to their authorization and surveillance. BITs’ generalization brings their upstream evaluation before being placed on the market and their downstream monitoring once on the market into question, particularly in view of the marketing information of the manufacturers, the scarcity and the methodological limits of the scientific studies on these tools. OBJECTIVE To register, characterize and categorize BITs’ validation and monitoring frameworks, in order to reach their underlying paradigm. METHODS We have conducted a narrative literature review using Medline, PsychInfo and Web of Science. Analysis criteria were: name, publication year, name of the creator, country, funding organization, health focus, target group, design (linear, iterative, evolutive and/or concurrent). The frameworks were then categorized based on (1) the translational research thanks to a linear continuum of steps that we called here Prototyping, Mechanisms, Concept, Evidence, Surveillance (P-MCES) steps and (2) the three paradigms that may have inspired the frameworks: biomedical, engineering and/or behavioral. RESULTS We identified 33 frameworks, 39% created in the 2010s. 45% involved the final user in an early and systematic way. 6% had a linear only sequence of their phases, 33% a linear and iterative structure, 39% added an evolutive structure and 18% frameworks also associated a parallel process. Only 7 covered the full P-MCES spectrum, 7 frameworks relied on the 3 paradigms. CONCLUSIONS To date, 33 frameworks of BITs’ validation and surveillance coexist, without the predominance of one of them or a convergence to a consensual model. Their number has increased exponentially the three last decades. Two dangers are possible, an anarchic continuous development of BITs depending of companies, amalgaming health benefits and usability (user experience, data security, ergonomics) and limiting implementation to several countries, or the absence of clinical research before the access to market trusting bigdata analyses and self-regulation. The paper recommends the convergence to an international validation and surveillance framework based on specificities of BITs (not equivalent to medical devices) to guarantee their effectiveness and safety for users.
... Treatments aux interventions non médicamenteuses de façon générale (Boutron et al., 2008). 3 visent à la validation de programmes de promotion de la santé (Green, 1974 ;Flay, 1986 ;Bartholomew et al., 1998). 19 ciblent la validation d'interventions visant au changement de comportement de santé dont 11 sur la conception d'interventions basées sur la e-santé de façon générale (Mohr et al., 2014 ;Whittaker et al., 2012 ;Kukafka et al., 2003 ;Pagliari, 2007 ;Catwell & Sheikh, 2009 ;Van Gemert-Pijnen et al., 2011 ;Eysenbach et al., 2011 ;Yardley et al., 2015 ;Salisbury et al., 2015 ;Mummah et al., 2016 ;Wilhide et al., 2016). 2 sont plus particulièrement déployés à destination de la mHealth et ont été créés à partir de 2012 (Whittaker et al., 2012 ;Wilhide et al., 2016). ...
... Dans six cas, la cible n'est pas précisée. La lecture des articles en question oriente néanmoins vers des développeurs de logiciel et des responsables de développement (Royce, 1970 ;Boehm, 1988 ;Beck et al, 2001) et vers des chercheurs, des décideurs politiques et des planificateurs de programme de santé (Green, 1974 ;Greenwald & Cullen, 1985 ;Onken et al., 1997). Le nombre total de frameworks développés pour les développeurs de logiciel et les responsables de développement de logiciel est de 23 (70%) et de 13 pour les chercheurs (39%). ...
... 14 modèles (42%) lui associent également un processus évolutif, formant une organisation cyclique visant au développement progressif du produit vers des versions de plus en plus abouties (Floyd, 1984 ;Boehm, 1988 ;Harston & Hix, 1989 ;Onken et al., 1997 ;Bartholomew et al., 1998 ;Mayhew, 1999 ;Pagliari, 2007 ;Craig et al., 2008 ;Catwell & Sheikh, 2009 ;Van Gemert-Pijnen et al., 2011 ;Michie et al., 2011 ;Onken et al., 2014 ;Wilhide et al., 2016). Enfin, six (18%) intégrent également un processus parallèle (Green, 1974 ;Martin, 1991 ;Beck et al., 2001 ;Kukafka et al., 2003 ;Cockburn, 2008 ;Salisbury et al., 2015). C'est le cas du développement Agile (Agile software management) qui vise à une grande adaptabilité pour satisfaire le client (Beck et al., 2001). ...
Thesis
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Face à la multiplication exponentielle du nombre de personnes souffrant d’une maladie chronique d’origine comportementale (e.g., tabagisme, alcoolisme, mauvaise alimentation, sédentarité), des interventions non médicamenteuses (INM) agissant sur ces comportements modifiables sont devenues incontournables en prévention et en complément des traitements. Parmi ces INM, les interventions numériques santé (INS) ouvrent un champ prometteur de changement durable de comportement de santé (e.g., objet connecté santé, application pour le téléphone, jeu vidéo). La thèse s’intéresse, au-delà de leur ergonomie et de leur fonctionnalité, à leur évaluation santé, de leur validation à leur surveillance. La première étude recense les modèles proposés dans le monde pour évaluer ces INS et les catégorise selon leurs paradigmes épistémologiques sous-jacents. Les résultats montrent une augmentation exponentielle de ces modèles et une absence de consensus ou de convergence vers un modèle comme cela a été le cas dans le médicament à la fin du XXème siècle. La deuxième étude s’appuie sur une revue systématique ayant identifié 90 essais interventionnels publiés testant les bénéfices et les risques de solutions numériques visant à lutter contre le tabagisme. Les résultats montrent une efficacité de certaines INS sur le tabagisme mais issue d’un corpus méthodologique très hétérogène limitant la portée des conclusions. Cette hétérogénéité est liée aux caractéristiques intrinsèques des INS (e.g., technologies utilisées et combinaison entre elles, multiplicité des théories du changement de comportement utilisées), aux méthodes d’évaluation utilisées (e.g., type de groupe contrôle, durée de suivi) et aux critères de jugement choisis (e.g., réduction du tabagisme ou arrêt). La discussion porte sur les limites actuelles dans la mise en évidence de l’efficacité et des risques des INS à cause d’approches paradigmatiques parallèles, le paradigme biomédical, le paradigme d’ingénierie et le paradigme comportemental. Le manque de consensus limite la comparabilité et la reproductibilité des résultats des études testant ces solutions numériques de santé. Elles restent pour la plupart à ce jour des solutions gadgets malgré un potentiel prometteur et promis par les industriels. La thèse encourage à la convergence vers un modèle consensuel de détermination du bénéfice/risque santé fondé sur la science de chaque INS et fait des propositions en ce sens.
... Green sejak tahun 1974 menyatakan bahwa perilaku seseorang dipengaruhi oleh tiga faktor, yaitu faktor prediposisi, faktor pendukung dan faktor pendorong. 4 Faktor predisposisi mencakup pengetahuan, sikap, kepercayaan, keyakinan, nilai-nilai, dan lain sebagainya. Faktor pendukung adalah ketersediaan dan kemudahan akses untuk mendapatkan obat yang aman dan bermutu. ...
... ini menggunakan desain deskriptif dengan rancangan potong lintang yang mengacu kepada kerangka konsep dari Green Lawrence. 4 Studi dilakukan pada bulan April sampai Desember 2015 di beberapa kabupaten/kota pada tiga provinsi terpilih yaitu Jawa Barat memiliki cluster tinggi, yaitu human development index (HDI) tinggi dan memiliki sangat banyak sarana produksi; DKI Jakarta memiliki cluster sedang, yaitu HDI tinggi dan memiliki cukup banyak sarana produksi, dan Sulawesi Tenggara memiliki cluster rendah, yaitu HDI tinggi dan memiliki sangat sedikit sarana produksi. ...
... Bila dikaitkan dengan teori Green, dapat ditafsirkan bahwa kesadaran masyarakat terhadap obat yang aman masih kurang baik. 4 Oleh karena itu, pemerintah harus melakukan intervensi komunikasi, edukasi, dan informasi (KIE) mengenai obat dan makanan yang aman dan bermutu bagi masyarakat di media informasi (televisi, leaflet, koran, dll) untuk meningkatkan PSP masyarakat. 14 Hasil analisis indeks menunjukkan indikator perilaku lebih rendah dari indikator pengetahuan dan sikap sehingga bila melakukan intervensi dengan KIE maka metode yang digunakan harus menyeluruh dan terus menerus dengan penekanan pada perubahan perilaku. ...
Article
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Medicine is an important component that cannot be replaced in health service. Indonesia National Agency of Drug and Food Control conducted survey to assess knowledge, attitude, and practice (KAP) of communities on selecting safe and quality medicines. The aim of the study is to get description KAP of community in choosing a safe medicine. Data were collected in West Java, DKI Jakarta, and South East Sulawesi. Sampling calculation use probability proportional to size sampling and census block. There were 1271 households as samples that analysed. Data results were analysed using descriptive and index analysis. Knowledge relates to criteria of quality medicines, rules for antibiotics use, and medicines logo. Attitude relates to how to select over the counter medicines, reasons of taking traditional medicines, and opinion about giving half dose of adults medicines to children. Practice relates to source of medicines information, the way to buy prescribe medicines, and reading label information. The results showed that KAP of communities on selecting safe and quality medicines close to 50%. According to score of index analysis are 4.65 (1 to 10 scale), it is recommended that information, education, and communication has to be delivered to communities intensively and continuously by the government.
... De acuerdo con el esquema propuesto por Green et al. (1982) y adaptándolo a la situación que nos ocupa, la evaluación de programas de educación nutricional debe contemplar los tres procedimientos que se observan en la figura 1.5 Green, 1982 (Green et al., 1982). ...
... De acuerdo con el esquema propuesto por Green et al. (1982) y adaptándolo a la situación que nos ocupa, la evaluación de programas de educación nutricional debe contemplar los tres procedimientos que se observan en la figura 1.5 Green, 1982 (Green et al., 1982). ...
... De acuerdo con el esquema propuesto por Green et al. (1982) y adaptándolo a la situación que nos ocupa, la evaluación de programas de educación nutricional debe contemplar los tres procedimientos que se observan en la figura 1.5 Green, 1982 (Green et al., 1982). ...
Thesis
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En esta tesis se realiza un exhaustivo estudio nutricional en 38 sujetos (23 hombres y 15 mujeres) discapacitadas intelectuales con síndrome de Down con edades comprendidas entre los 16 y 38 años. Los sujetos estudiados pertenecen a dos centros ocupacionales de la Región de Murcia. Debido a la alta prevalencia de sobrepeso y obesidad en este colectivo especial, se realizó una evaluación nutricional inicial (bioquímicas, antropométricas y de ingesta alimentaria) y una valoración del grado de actividad física que realizaban. Posteriormente se realizó un programa de educación nutricional, tanto en el colectivo de personas con síndrome de Down, como en los familiares y profesionales de los centros implicados. Los resultados de la valoración nutricional inicial, mostraron unos valores indicadores de ingestas alimentarias inadecuadas del colectivo estudiado para los micronutrientes vitamina E, Zn y Cu. Además, se evaluó la posible relación entre la actividad física, factores sociales, económicos y culturales del entorno del individuo con síndrome de Down y su estado nutricional. Tras la realización del programa de intervención dietética con la finalidad de disminuir los grados de obesidad observados en la evaluación inicial, la población estudiada mostró unos mejores indicadores bioquímicos (vit. C, E, folato, Cu, Zn), antropométricos (IMC, % de grasa corporal, perímetro de la cintura, relación cintura/cadera), grado de actividad física y conocimientos dietéticos alimentarios que en la situación inicial. Por otra parte, también se mejoraron los hábitos alimentarios tanto de la población con síndrome Down como de los familiares y profesionales de los centros. En esta tesis doctoral se muestra la importancia de los factores socio culturales del entorno de la persona con síndrome de Down así como de las características de los centros estudiados en el estado nutricional del colectivo.
... The Precede-Proceed Model [8] was the theoretical framework for the study. Precede-Proceed model provides a comprehensive structure for assessing health and quality-of-life. ...
... Precede-Proceed model provides a comprehensive structure for assessing health and quality-of-life. It was proposed in 1974 by Dr. Lawrence W. Green, it is a cost-benefit evaluation framework that that can help health program planners, policy makers, and other evaluators to analyze situations and design health programs efficiently [8]. The theory was used to assess health related behaviours and environments that affect health and quality of life. ...
... According to Fuller [18], there were some gender differences in knowledge and attitudes, with boys more likely to agree with the positive statements about smoking; that smoking helps people relax if they are stressed, that smoking is not dangerous if you do not smoke a lot and that smoking helps people cope with life. In the study, 8.9% of the participants strongly agreed that smoking helps in relaxation. Also there were also differences by age, with younger participants more likely to think that smoking is not dangerous if you do not smoke a lot while older participants were more likely to agree with the statements that smoking helps people to relax, that smokers stay slimmer than non-smokers, that smoking gives people confidence and that smoking helps people cope [18]. ...
... The widespread use of this framework in RCT (randomized controlled trials) studies confirms the predictive validity of this model as a planning tool. The PRECEDE-PROCEED planning model is comprised of 4 planning stages, which include 1 implementation stage and 3 evaluation stages (24). ...
... Findings of articlesThis model was first developed by Lawrence W.Green, et al (1974). This model is influenced by both individual and environmental factors and has 2 distinct parts. ...
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Background: Clinical education is a vital part of occupational therapy education process. High clinical education quality in fieldwork settings leads to higher clinical competency and occupational proficiency. One of the most effective clinical education methods in equalizing the conditions of clinical education to students is the correct use of educational models related to each field of medical sciences. In the field of clinical education, various models have been designed with a specific subject. However, limited research has been done on the introduction of the usability of these models in occupational therapy settings. This study was conducted to determine which models have the potential to be used as clinical education models in occupational therapy. Methods: A scoping review was conducted and studies published in English between 2000 and 2018 that examined clinical education models were selected. Results: A total of 8 articles were entered in the review, and a central theme of implementing clinical education models in occupational therapy was determined by thematic analysis. This central theme consisted of 3 categories: (1) evaluative models, (2) acting models, and (3) evaluative/acting models. Conclusion: Occupational therapists, especially who work as educators should be aware of the different types of clinical education models and try to use these models in clinical education process and minimize the variation of teaching methods in fieldwork settings to promote the clinical education quality. However, more research should be done to improve evidence-based occupational therapy practice in clinical education.
... For example, cost-benefit logic models like PRECEDE (an acronym for predisposing, reinforcing, and enabling causes in educational diagnosis and evaluation) were shaped by the ethos of Western academic and scientific thought. 10,11 PRECEDE represents a linear approach that relies on a biomedical perspective to diagnose and address public health issues. However, health interventions are increasingly needed to consider more social determinants of health, which may have a greater influence on health and prevention, especially regarding obesity in Indian Country. ...
... Earp and Ennet's focused approach is preferable to multicausal models like PRECEDE for a number of reasons. 10,11 Multicausal models seek to show all causes, and can imply a need to address all the causes at once. Earp and Ennet 1 suggest that it is more effective in research and practice to delimitate a desired outcome and select relevant phenomena instead of an entire causal chain. ...
Article
Background: American Indian childhood obesity rates are among the highest and rising. Obesity Prelated chronic diseases (i.e., diabetes type II and cardiovascular disease) rates far exceed other US racial groups. Health interventions are drastically needed to halt this epidemic within Indian Country; yet, few effective interventions exist. Some studies show success with health interventions that center within an American Indian worldview and approach rather than centering on the individual. Photovoice serves as one methodology that can be utilized to design an effective health intervention. The authors discuss one such study which utilized a CBPR photovoice methodology to define health through an American Indian perspective and the applicably to food and exercise intervention. Methods: After developing a strong community partnership and utilizing a CBPR framework and photovoice-methodology, an obesity prevention study was analyzed to determine the disconnect between American Indian and western frameworks of health. Lessons learned are outlined and guide an innovative approach to health intervention design. Results As a result of dissemination and feedback, the authors have developed a Tribal health sovereignty framework to guide future American Indian interventions that are embedded within tribal culture. Photovoice had high utility among children and illuminated varying worldviews between American Indian and western views. Photovoice provided contextual barriers and facilitators for health and an effective community dissemination and public policy awareness increasing propensity for community change embedded within tribal culture. Conclusions. Through utilizing a tribal health sovereignty framework, tribal communities can be engaged in identifying barriers and facilitators for health to lower childhood obesity.
... It has been used to promote health programs for more than 30 years [3]. Green [5] developed the PRECEDE section for health diagnosis and education needs and later added the PROCEED section to the framework by adding elements of policy, regulation, organization, and the environment to emphasize the effects of ecological aspects in the modified model [4]. The model consists of eight phases: social assessment, epidemiological assessment, educational/ecological assessment, administrative/policy assessment and intervention planning, implementation, process evaluation, impact evaluation, and performance evaluation. ...
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Background The predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation policy, regulatory, and organizational constructs in educational and environmental development (PRECEDE-PROCEED) model has been used as a theoretical framework to guide health promotion strategies to prevent chronic diseases and improve the quality of life. However, there is a lack of evidence as to whether applying the PRECEDE-PROCEED model effectively improves health outcomes. This study aimed to systematically review intervention studies that applied the PRECEDE-PROCEED model and examine its effectiveness. Methods In December 2020, seven databases were systematically searched. The quality of studies was assessed using the Mixed Methods Appraisal Tool. The outcome of interest for the meta-analysis was knowledge. Results In total, 26 studies were systematically reviewed. Most studies provided educational programs as the main intervention for various population groups. Symptom or disease management and health-related behavior promotion were the most common topics, and education was the most frequently used intervention method. The PRECEDE-PROCEED model was applied in the planning, implementation, and evaluation of the intervention programs. Eleven studies were included in the meta-analysis, which showed that interventions using the PRECEDE-PROCEED model significantly improved knowledge. Conclusions This study indicated that individuals are more likely to engage in health-related behaviors with better knowledge. Thus, the PRECEDE-PROCEED model can be used as the theoretical framework for health promotion interventions across population groups, and these interventions are particularly effective with regard to knowledge improvement.
... However, according to reports, current clinical problems in nursing are limited to incomplete, nonstandard, unsystematic, and too simplistic forms of publicity and education [9]. The Precede-Proceed model is a planned intervention model proposed by Green and is widely used in many fields [10]. Based on this model, researchers can make multilevel health intervention plans which could intervene with all social, behavioral, and environmental factors [11]. ...
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Objective: This study's objective is to establish a nurse-led pain management model for neurointensive care based on the Precede-Proceed model to provide a theoretical basis for clinical pain management in neurointensive care. Methods. ICU nurses were randomly divided into a control group (giving conventional routine pain care) and an experimental group (managed pain based on the Precede-Proceed model). The nurses from the experimental group were trained in the Precede-Proceed-based management. The nurses then treated a total of 410 critically ill patients, and the patients were randomly divided into a control and an intervention group (205 cases/nursing group), and the data were prospectively recorded. Before and after the intervention, the pain assessment ability, discomfort level, satisfaction degree, usage of the analgesic drug, and the incidence of delirium of the patients from the two groups were evaluated. Nurses from both groups also assessed their knowledge of pain, attitude, and pain nursing behaviors using indicated self-designed questionnaires. Results: Before the intervention, there was no statistical difference between the two groups of nurses in their baseline characteristics, pain knowledge, attitude, pain nursing behavior, and pain assessment ability for the patients. After the intervention, the nurses in the experimental group had better pain knowledge, attitude, pain nursing behavior, and pain assessment ability to patients than the nurses in the control group. Patients in the intervention group felt less discomfort, a higher satisfaction degree, reduced use of analgesics, and a lower incidence of delirium than patients in the control group. Conclusion. Pain management based on the Precede-Proceed model was beneficial in improving the care of neurointensive patients.
... High quality evaluation that encourages accountability will be more easily integrated into programs if a robust framework is used. Elements from public health evaluation frameworks, such as the 'PRECEDE-PROCEED' model, first proposed by Green (1974) and widely used in programs intended to enhance the determinants of health, may be beneficially applied to community development program evaluation (Clendon and Munns, 2018). Another framework is Results-Based Accountability (RBA) (Friedman, 2005). ...
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This paper presents an eight-step evidence cycle conceptual framework for helping communities ensure evidence is foundational to all stages of their programs. The steps are recognize, gather, appraise, integrate, use, create, manage, and share evidence. Each step is described, and example approaches applicable to both descriptive and intervention evidence are provided. A tool (specifically, a rubric) for program managers to self-assess their work against the cycle, informed by UK-based development network, Bond’s five principles for evidence use in community development (voice/inclusion, appropriateness, triangulation, contribution, and transparency), is also provided.
... These principles have been applied in targeting cybersecurity awareness initiatives [90]. Also within the health domain, the PRECEDE-PROCEED intervention framework [54] emphasises the development of targeted interventions for a particular group and behaviour, including attention to factors which promote or prevent a behaviour. Here we argue that the need for such precision should be similarly emphasised in the design of cybersecurity interventions. ...
Article
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Cybersecurity controls are deployed to manage risks posed by malicious behaviours or systems. What is not often considered or articulated is how cybersecurity controls may impact legitimate users (often those whose use of a managed system needs to be protected, and preserved). This oversight characterises the ‘blunt’ nature of many cybersecurity controls. Here we present a framework produced from consideration of concerns across methods from cybercrime opportunity reduction and behaviour change, and existing risk management guidelines. We illustrate the framework and its principles with a range of examples and potential applications, including management of suspicious emails in organizations, and social media controls. The framework describes a capacity to improve the precision of cybersecurity controls by examining shared determinants of negative and positive behaviours in a system. This identifies opportunities for risk owners to better protect legitimate users while simultaneously acting to prevent malicious activity in a managed system. We describe capabilities for a novel approach to managing sociotechnical cyber risk which can be integrated alongside elements of typical risk management processes. This includes consideration of user activities as a system asset to protect, and a consideration of how to engage with other stakeholders in the identification of behaviours to preserve in a system.
... The PRECEDE-PROCEED model is often used in health education and health promotion. This model is a cost-benefit evaluation framework proposed in 1974 by Lawrence W. Green that can help health program planners, policymakers, and other evaluators, analyze situations and design health programs efficiently [22]. Based on the study by Green and Kreuter, analyzing situations and designing and implementing educational programs efficiently can be classified in enabling factors and administrative and policy diagnoses. ...
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Background Nurses play an important role in health promotion, prevention strategies, and care. Therefore, nurses need to obtain and update their knowledge and skills via appropriate strategies. This study aimed to explore nurses’ experiences of receiving social media and in-person education to integrate the findings into practice. Methods This was a qualitative study using the directed content analysis approach. A sample of nurses with previous experiences of receiving social media and in-person education participated in the study. They were asked to express their experiences and indicate their preferences. The data were collected based on individual semi-structured interviews. Results In total 15 participants took part in the study with a mean age of 40.6 ± 8.93 years and work experiences of 15.3 ± 9.21 years. During the process of content analysis, three main themes emerged: Approaches to nursing education and its adoption in the health system, Achieving effectiveness and efficiency in nursing education, and Health care policy and facilitating pathways for nursing education. Participants indicated several barriers to attending an educational program, including motivation, workload, time and place, and hospital politics. Conclusion Overall the findings suggest that regardless of any methods of education nurses cannot actively engage in the educational interventions while on duty. However, the findings suggest that nurses believe that the social media approach might be superior in reducing barriers and making the educational interventions work better.
... Green's proceed-precede model was first published as an evaluation framework in 1974 [52], as Precede in 1980 [53], and as a full framework in 1991 [54]. Precede-Proceed framework comprises eight phases to guide professionals to develop, implement and evaluate health promotion programmes [55], using socio-ecological model to assess individual characteristics and sociopolitical conditions [56]. ...
Article
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Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study was to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo, and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2001—2022. Results The online search yielded 1,682 articles, however, only 44 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism ( n = 1) or phenomenology ( n = 2) philosophies and theories of self-efficacy ( n = 10), theory of planned behaviour ( n = 13), social cognitive theories ( n = 18) and represented 16 countries. Theories of self-efficacy and planned behaviour were the most used theories. Conclusions This review suggests that theories and models are increasingly being used to promote exclusive breastfeeding. Orienting exclusive breastfeeding programmes within theoretical frameworks is a step in the right direction because theories can sensitize researchers and practitioners to contextually relevant factors and processes appropriate for effective exclusive breastfeeding strategies. Future research should examine the efficacy and effectiveness of theory-informed exclusive breastfeeding programmes over time. Such information is important for designing cost-effective EBF programmes.
... The primary purpose of the Andersen Model is to describe factors associated with these constructs to develop appropriate research questions and inform statistical model-building approaches. Inspired by the Andersen Model, the PRECEDE-PROCEED model (PPM) was developed for planning and evaluating health education and promotion interventions [43,47]. Like the Andersen Model, the PPM includes predisposing and enabling constructs with similar definitions; however, the PPM also includes reinforcing constructs. ...
Article
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Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients.
... The widespread use of this framework in RCT (randomized controlled trials) studies confirms the predictive validity of this model as a planning tool. The PRECEDE-PROCEED planning model is comprised of 4 planning stages, which include 1 implementation stage and 3 evaluation stages (24). ...
... So, it's like, if they give us the time to do it, we're going to do it." [player] The PRECEDE-PROCEED model is an eight-part framework used to provide a standard structure for designing, implementing, and evaluating public health programs [28][29][30][31][32][33][34]. The PRECEDE stage of the model includes four phases of intervention planning: (1) social diagnosis; (2) epidemiological, behavioral, and environmental diagnosis; (3) educational and ecological diagnosis; and (4) administrative and policy diagnosis. ...
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Background: While participation in sports-related activities results in improved health outcomes, high school athletes are at risk for lower extremity injuries, especially ankle, knee, and thigh injuries. Efforts to promote the adoption and implementation of evidence-driven approaches to reduce injury risk among school-aged athletes are needed. However, there is limited research regarding the perceived barriers, facilitators, and adherence factors that may influence the successful implementation of effective warm-up routines among this population. Methods: We conducted a qualitative study using semi-structured interviews and focus groups to assess high school basketball coach and player current practices, knowledge, and perspectives about warm-ups and lower-extremity injuries (LEIs). We interviewed coaches (n = 12) and players (n = 30) from May to October 2019. Participants were recruited from public high schools in a joint school district in Southern California. Multiple coders employed thematic analysis of the data using validated methods. Results: Coaches and players reported regular engagement (e.g., daily) in warm-up routines, but the time dedicated (range 5-45 min), types of exercises, and order varied substantially. Players often co-lead the warm-up practice with the coach or assistant coach. Despite regular engagement in warm-up, players and coaches report multiple challenges, including (1) limited time and space to warm-up effectively at games, (2) a perception that young players are not prone to injury, (3) competing demands for coaches' time during practice, and (4) coaches' lack of knowledge. Coaches and players perceive that warming up before practice will result in fewer injuries, and many players are motivated to warm up as a result of their personal injury experience; however, they desire guidance on the ideal exercises for preventing injury and training on the proper form for each exercise. Conclusions: Regular involvement in basketball warm-up routines is common among high school teams, but the methods and time dedicated to these practices varied. Players and coaches are eager for more information on warm-up programs shown to reduce LEIs.
... Again looking to the health domain, the PRECEDE-PROCEED intervention framework [41] includes a PRECEDE phase, which diagnoses factors critical to an intervention, including behavioural and environmental factors. This phase includes identifying the activities of actors which can affect the environment. ...
Conference Paper
Background. Cybersecurity controls are deployed to manage risks posed by malicious behaviours or systems. What is not often considered or articulated is how cybersecurity controls may impact legitimate users (often those whose use of a managed system needs to be protected, and preserved). This characterises the ‘blunt’ nature of many cybersecurity controls. Aim. Here we present a synthesis of methods from cybercrime opportunity reduction and behaviour change. Method. We illustrate the method and principles with a range of examples and a case study focusing on online abuse and social media controls,relating in turn to issues inherent in cyberbullying and tech-abuse. Results. The framework describes a capacity to improve the precision of cybersecurity controls, identifying opportunities for risk owners to better protect legitimate users while simultaneously acting to prevent malicious activity in a managed system. Conclusions. We describe capabilities for a novel approach to managing sociotechnical cyber-risk, which can be integrated into typical risk management processes, to allow for side-by-side consideration of efforts to prevent and preserve different behaviours in a system, by examining their shared determinants.
... The PRECEDE-PROCEED framework was first designed and applied in health promotion in the 1970s to provide a structure for applying theories and concepts in a systematic way to plan and evaluate programs [29,30]. The initial stages of the model are designed to develop a deeper understanding of a community and to better design interventions that strategically and accurately address needs. ...
Article
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Since 2012, the Alberta Parks division in the Province of Alberta, Canada has been engaged in a process of building scientific, research, and evidence-informed capacity and practices across the parks system. Following a series of priority-setting workshops and agreements with the research, Parks management, and local communities, Alberta Parks has adopted a working group approach and subsequent framework, to support the research and decision-making goals of parks and protected areas management, and the research communities. This Social Science Framework is an innovative way to support evidence-informed decision-making in the public sphere by explicitly linking data-specific needs (benchmark data in social, natural, and applied sciences) with both established and emerging policy and research priorities. It is also a way to situate those needs within a broader goal of inter-organizational collaboration. This paper presents the background and developmental context to the framework, and its structure and desired functionality. The paper concludes with an assessment of the anticipated benefits and potential liabilities of this direction for linking academic and policy agents and organizations in a more formalized structure for environmental policy.
... Thus, analysing a behaviour in this context would assist in reaching definite solutions to problems originating from individual behaviours and long-term prevention of such. Using the PRECEDE-PROCEED Model as was postulated by Green Lawrence; 22 the predisposing (antecedent) factors provides the rationale for the behaviour. They refer to those intrinsic factors that are unique to the research participants and make them liable of practicing healthy eating. ...
Article
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Unhealthy eating, which is quite prevalent among the adult population globally, is a major risk factor for Non-Communicable Diseases. Men have the tendency to visit food vendors without recourse to body nutrients requirement, health and expectations as potential change agents. The study was thus designed to investigate the knowledge and practices of healthy eating among male public health students in a Nigerian tertiary institution. Data was collected from 161 consenting respondents. Knowledge of healthy eating was assessed on a 25-point knowledge scale; score �19 was rated good, <19�12 fair and <12 poor. Practices of healthy eating were assessed using a 34-point practice scale; score �26 was rated good and <26 poor. Patterns of eating was determined using food frequency questionnaire; descriptive and inferential statistics were carried out at a¼0.05. Respondents’ age was 28.9 � 5.5 years; they were mostly Christian (87.0%), Yoruba (69.6%) and 21.1% were married. Their body mass index was 23.1 � 3.1kg/m2, monthly income ranged between N5000 and N300,000, 2.5% smoked tobacco/cigarette and 28.0% consumed alcohol. Good knowledge was observed among 52.2% of the respondents, 37.9% had good healthy eating practices, 49.7% did not eat breakfast everyday while only 13.7% consumed fruits and vegetables daily. The most reported factors influencing choice of food included health maintenance and food availability. Respondents’ knowledge and practices relating to healthy eating was significant. Knowledge of healthy eating was average and practice was poor among the study population. Strategic health education and behaviour change communication could motivate male students for healthy eating.
... As a commonly used example in health-related interventions, the PRECEDE model was originally developed by (Green, 1974) and stands for 'Predisposing, Reinforcing and Enabling Constructs in Education Diagnosis and Evaluation'. Constructs or determinants in this approach are personal, meaning they function at the individual level (Green & Kreuter, 1999). ...
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Through this paper, a thorough understanding was gained by partly encompassing the three first steps of an intervention programme. Among them, the interplay of individual and socio-ecological factors with all their level of complexity involves inherently a difficult endeavour. However, it has been experienced that a systematic and evidence-based approach can guide the planner to overcome these hurdles and to progressively focus from complex to more specific aspects of the problem and ultimately on practical solutions. Thus, a challenging part of this approach is to determine until which level of specificity the model should extend, since broader factors could be deconstructed in more precise determinants and interrelate between both individual and environmental dimensions. Concerning the needs assessment, the overriding principle is not found to be how to elaborate a psychosocial model but more regarding how to consider the level of participation and involvement of stakeholders from different hierarchies. The provision of tangible conceptions of behavioural influences is approached by conveniently dichotomising behavioural factors into the misperception and disregard of speed limits, related to unintentional and intentional behaviours. While explicit on-road limits provide the maximum speed allowed, it is emphasised that, in certain occasions, this is not enough to guarantee a safe driving and further speed adaptations may be required. Further, proximal behavioural influences external to the YND have been identified through environmental factors such as peer-pressure and moral norms. Though requiring a closer investigation, a link to their corresponding agents (parents and the driving license authority) has been set, in order to be cognisant of their perspectives and developing specific objectives. The practical application of theoretical methods consists on a general description of the steps that should be strategically followed in order to achieve the expected results. Nevertheless further developments on this structure would make it more concrete by addressing specific stages and aspects of the intervention, such as the elaboration of materials in terms of content and design. It will be necessary to communicate and consult with the different target groups in order to make sure that their needs are addressed through the considered programme applications. In brief, the developments of steps one to three of the intervention mapping methodology provided an opportunity to appreciate the challenging but rewarding process of developing a health-promoting intervention strategy. YNDs are at particular risk, and this report demonstrates the need for long-term and community based solutions. The knowledge and practice gained is therefore ready to be dispensed when developing a programme that evolves through the further steps and lead to the implementation of a final intervention programme.
... Dans un environnement légèrement di érent, une intervention pour inciter au port du gilet de sauvetage dans les activités nautiques dans l'État de Washington s'est révélée e cace à terme. Elle s'appuyait sur du marketing social, le modèle PRECEDE-PROCEED 1 (Green 1974) et quelques éléments de théories cognitives sociales, de théorie de la motivation à la protection (protection motivation theory), de notion d'auto-e cacité (self e cacy) et de role modelling (modèle d'exemples) (O'Leary 1985 ;Rogers 1975 (Wilks 2017). Les messages de prévention pouvaient rester e caces à 6 mois, les personnes interrogées étaient plus à même de se baigner sur les plages surveillées, mais pas forcément entre les drapeaux. ...
Thesis
Les côtes girondines, dans le Sud-Ouest de la France, sont façonnées par les conditions océaniques. Les plages de sables y présentent des dangers tels que les courants d'arrachement et les vagues de bord. Ces phénomènes sont la cause de noyades et de traumatismes potentiellement graves, nécessitant des dispositifs de surveillance et de secours.Les objectifs de cette thèse étaient d'enrichir les connaissances utiles à l'intervention sur les noyades et traumatismes liés aux vagues selon plusieurs axes : en décrivant la population des victimes, en modélisant les risques et en déterminant les actions nécessaires à leur prévention.Dans un premier temps, les caractéristiques démographiques et la gravité des noyades et des traumatismes ont été décrites. En analysant les appels au Service d'Aide Médicale d'Urgence de la Gironde, 652 noyades et 814 traumatismes ont été recensés. À partir de ces données et en intégrant les observations météorologiques, un modèle de prévision du risque de noyade sur le littoral océanique girondin a été créé. Il a été ensuite validé, sur les données météorologiques prévisionnelles. Le risque de noyade liée aux courants d'arrachement peut ainsi être anticipé trois jours à l'avance. Les risques de traumatismes liés aux vagues de bord ont également fait l'objet de modélisation.Un cadre théorique de modélisation de l'histoire naturelle de la noyade à l'aide d'un processus de Markov à temps continu a été proposé. Il a permis, entre autre, de quantifier l'impact théorique d'une réduction du délai des secours sur la gravité des noyades. Une réduction du délai de médian des secours de 15 à 10 minutes permettrait une diminution de moitié des cas de noyade graves.Enfin, l'utilisation des prévisions du risque dans une action de prévention a été discuté à partir de concepts issus d'une revue de la littérature. Ces travaux permettront de mettre en place et d'évaluer une action de prévention de la traumatologie océane en Gironde.
... Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) and the Consolidated Framework for Implementation Research (CFIR) are useful frameworks for intervention development. The crux of PRECEDE is that an intervention must be strategically planned before implementation (Green, 1974). It begins with a focus on the desired outcome. ...
Article
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An estimated 17-year lag exists between evidence generation and its integration into routine clinical care. The field of implementation science has emerged to close this gap by applying rigorous methods to systematically study the obstacles and facilitators of the uptake of evidence-based practices. However, implementation science has not gained wide traction in dermatology. In this narrative review, we use literature and expert input to introduce implementation science and key frameworks for implementing interventions and evaluating their uptake. We then highlight opportunities for dermatology-specific interventions at the patient-, provider-, system-, and population-levels, and advocate for the field's expansion into dermatology.
... Phase I: formative phase A systematic approach was used to develop the intervention of diabetes and CVD screening. 23 The formative phase commenced with identifying the needs for diabetes and CVD risk screening programme. After identifying the suitability of community pharmacies for providing screening services, a literature review of pharmacist-delivered screening models was conducted to identify useful and effective approaches to screening. ...
Article
Objectives This study aimed to develop an evidence-based community pharmacist-delivered screening model for diabetes and cardiovascular disease (CVD), and assess its feasibility to identify and refer patients with elevated risk. Design A feasibility study. Setting A purposive sample of 12 community pharmacies in three cities in the United Arab Emirates (UAE). Participants Adults 40 years of age and above who have not been previously diagnosed with either diabetes or CVD. Intervention Pharmacist screening of adults visiting pharmacies involved history, demographics, anthropometric measurements, blood pressure and point-of-care testing including glycated haemoglobin (HbA1c) levels and lipid panel. Participants with a 10-year CVD risk ≥7.5%, HbA1c level ≥5.7% or American Diabetes Association (ADA) risk score ≥5 points were advised to visit their physician. Primary and secondary outcome measures The primary outcomes were (1) development of UAE pharmacist-delivered screening model, (2) the proportion of screened participants identified as having high CVD risk (atherosclerotic CVD 10-year risk defined as ≥7.5%) and (3) the proportion of participants identified as having elevated blood glucose (high HbA1c level ≥5.7% (38.8 mmol/mol)) or high self-reported diabetes risk (ADA risk score ≥5 points). Secondary outcome is participants’ satisfaction with the screening. Results The first UAE pharmacist-delivered screening model was developed and implemented. A total of 115 participants were screened, and 92.3% of the entire screening process was completed during a single visit to pharmacy. The mean duration of the complete screening process was 27 min. At-risk individuals (57.4%) were referred to their physicians for further testing, while 94.5% of participants were at least satisfied with their screening experience. Conclusions The community pharmacist-delivered screening of diabetes and CVD risk is feasible in the UAE. The model offers a platform to increase screening capacity within primary care and provides an opportunity for early detection and treatment. However, pathways for the integration of the pharmacist-delivered screening service with physicians in primary care are yet to be explored.
... RE-AIM has been widely applied to evaluate behavioral health interventions including weight loss, nutrition curricula, and disease management (Gaglio et al., 2013). Another widely used framework, conceptualized by Green (1974) and expanded by Green and Kreuter (1991), the PRECEDE-PROCEED Framework describes a two-part process of planning (i.e., Predisposing, Reinforcing and Enabling in Constructs in Educational Diagnosis and Evaluation) and evaluation (Policy, Regulatory, and Organization Constructs in Educational and Environmental Development) that facilitates identifying outcomes and targeted, backwards planning to facilitate intervention and evaluation. PRECEDE-PROCEED has been widely applied to facilitate health promotion interventions and related evaluations (see Porter, 2016). ...
Article
Many evidence-based practices have not achieved their potential to broadly impact student outcomes as schools struggle with their adoption and implementation. This costly and consequential implementation gap must be addressed within school psychology through the focused study of implementation processes and outcomes. Implementation science is a multidisciplinary, translational field focused on increasing the usage and implementation of evidence-based practices into typical practice to improve outcomes. Despite the rapid development of the field of implementation science over the past decade it has been underexamined in school psychology research. As a step toward decreasing the implementation gap, the purpose of this introductory article is to increase school psychology researchers' implementation literacy. Specifically, this article provides an overview of implementation science, including (a) key terminology; (b) theories, models, and frameworks designed to explain, describe, or illustrate implementation processes or constructs; (c) strategies to support implementation across levels (e.g., provider, organization); (d) measures to capture implementation and related context; and (e) utilized research designs. By increasing school psychology researchers' implementation literacy, it is hoped that future research will attend to and evaluate implementation process and outcomes and thus facilitate the adoption and implementation of evidence-based practices to improve student outcomes.
... For instance, in a observational cohort where PrEP was provided free to young, African-American men who have sex with men (MSM) in Atlanta, high cumulative HIV incidence was demonstrated (6.2 % in one year), with 13 of 14 individuals who seroconverted having previously stopped PrEP or contemplated, but not started, PrEP [10]. Conversely, predisposing factors (e.g., positive PrEP attitudes or concern for HIV risk), enabling factors (e.g., ease at attending follow-up or contacting providers), and reinforcing factors (e.g., outreach from clinic staff) may support PrEP retention [11][12][13][14]. For PrEP to help bend the curve of the HIV epidemic, primary care will need to keep individuals engaged on PrEP [6]. ...
Article
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Background Maintaining retention in pre-exposure prophylaxis (PrEP) care among diverse patient populations will be needed to support PrEP’s efficacy. We characterized patterns of PrEP care retention in a U.S. municipal primary care health network and examined whether missed visits, a metric of care retention that is easy to evaluate in clinic, are associated with subsequent discontinuation. Methods We included individuals on PrEP from July 2012 until August 2017 in the San Francisco Primary Care Clinics (SFPCC), a 15-clinic municipal health network. We categorized PrEP usage patterns as follows: early discontinuation (<90 days), later discontinuation (after ≥90 days), and continuing use at the end of follow-up. We first examined early discontinuation using adjusted Poisson regression. In those who remained on PrEP for at least 90 days, we examined factors associated with late discontinuation. Results Of the 364 individuals who initiated PrEP, 16% discontinued PrEP before 90 days, 46% discontinued later, and 38% were retained in care over a median 12 months of observation. Transgender women were more likely to discontinue PrEP early [adjusted risk ratio (aRR) 2.16 (1.36-3.49)], younger users were more likely to discontinue late (aRR 0.82 per ten-year increase in age; 0.70-0.96), as were people who use illicit drugs (aRR 1.59; 1.02-2.47). Missed visits while using PrEP were associated with future discontinuation (aRR 1.52; 1.14-2.03). Later year of current PrEP use was associated with both early and late discontinuation. Conclusion Diverse populations may require differentiated care to remain on PrEP. Missed visits should trigger tailored interventions to maximize PrEP’s impact.
... Before planning a theory-based intervention, it is necessary to select the appropriate and target-oriented models and theories that best suit the study objectives. PRECEDE-PROCEED model is one of the useful behavior change theories which is introduced by Green in 1970 [14]. Since this model provides a comprehensive framework, health planners can apply this model to successfully design health behavior change interventions. ...
Article
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Aims: Diabetes mellitus (DM) is one of the most common chronic diseases worldwide that requires a person with diabetes to make a multitude of daily self-management decisions. This study sought to evaluate the effectiveness of a self-management program based on PRECEDE-PROCEDE model on self-management behaviors in patients with type 2 diabetes. Methods: This experimental study was conducted on 86 diabetic patients referred to the diabetes clinics in Ardabil, Iran, in 2017. From a total of 326 patients with diabetes medical records in those clinics, 86 (26.3%) patients agreed to participate in this study. They were then randomly divided into two groups; intervention (n = 43) and control (n = 43). The intervention group received eight sessions of PRECEDE model-based self-management education program while the control group did not receive any education program. Both groups were assessed at baseline and six months after the intervention. Results: The mean age of the participants was 55.69 ± 12.04 years (range 32–86 years). 41 patients were men, and 45 were women. The mean time since the first diagnosis of diabetes was 8.6 years (SD = 5.2), and the mean BMI of the patients was 31.63 (SD = 4.20). At baseline, 35.01% of patients had poor self-management behaviors. All PRECEDE variables, including predisposing factors (knowledge, attitude, and self-efficacy), enabling factors, and reinforcing factors, as well as self-management behaviors, were significantly improved in those of intervention group after the education program. Conclusion: Self-management education program substantially enhances the self-management behaviors in patients with type two diabetes.
... Before planning a theory-based intervention, it is necessary to select the appropriate and target-oriented models and theories that best suit the study objectives. PRECEDE-PROCEED model is one of the useful behavior change theories which is introduced by Green in 1970 [14]. Since this model provides a comprehensive framework, health planners can apply this model to successfully design health behavior change interventions. ...
Article
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Aims: Diabetes mellitus is a chronic and progressive disease which requires ongoing medical care as well as patient's self-care skills to prevent acute complications. The purpose of this study is to determine the effect of the PRECEDE-PROCEED model combined with self-management theory on self-care behaviors in type 2 diabetic patients. Methods: In this semi-experimental study, 86 type 2 diabetic patients referred to the diabetes clinic of Ardabil were randomly selected and divided into two groups (n = 43). Patients in group 1 received educations based on PRECEDE-PROCEED model combined with self-management theory while patients in group 2 received only educations based on PRECEDE-PROCEED model. The self-made questionnaire was used to measure demographic information and PRECEDE-PROCEED model variables at baseline and one month after the intervention. Results: The mean scores of knowledge, attitude, self-efficacy (p = 0.001), self-care (p = 0.001), enabling factors, and reinforcing factors had significant differences in both groups before and after the intervention (p < 0.05). In addition, one month after the intervention, the mean scores of attitude, self-efficacy, self-care, and reinforcing factors were significantly higher in group 1 compared to group 2. Conclusion: The results indicate the effectiveness of an educational intervention based on PRECEDE-PROCEED model combined with self-management theory to improve self-care behaviors in patients with type 2 diabetes.
... The PRECEDE model assesses predisposing, enabling and reinforcing factors. 20 According to this model, a person's behavior results from predisposing factors preceding behavioral changes which motivate behavior, knowledge, attitude, beliefs, values, and perceptions. Enabling factors that change behavior or the environment and allow the realization of a motivation or environmental policy are resource acquisition, availability, rules, regulations, and skills. ...
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Introduction: Maternal mental health during pregnancy has a major impact on fetal growth and consequently, child health. The objective of this study was to assess the effect of "Cooperative-Supportive" Intervention Program on Pregnancy. Methods: The present before and after interventional research was conducted on 114 pregnant women referring to Khoy health centers in 2014. Pregnant women were randomly divided into intervention (n=57) and control groups (n=57). The data collection tool in this research was the researcher-made questionnaire based on the Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model which assessed the participants’ predisposing, enabling, and reinforcing factors. The educational interventions for enhancing pregnant women’s stress controlling skills were conducted and also practical pacifying lessons were held for the intervention group during five weeks with relaxation exercises. In order to assess health status among pregnant women, knowledge, attitude, depression, anxiety and self-efficacy were investigated by applying different scales and questioners. The questionnaires were completed before and after the interventional program. The data were analyzed, using suitable statistical tests. Results: After the intervention, the mean score of PRECEDE major components significantly increased and the total anxiety and depression scores decreased in the intervention group in comparison to those of the control group. Conclusion: The present study showed the positive impact of educational intervention programs based on PRECEED model and major components on reducing anxiety and depression, and finally mental health promotion in the studied population.
... START-ART, a stepped-wedge cluster randomized trial, was conducted between May 2013 and August 2015. The START-ART intervention consisted of three components informed by PRECEDE framework concepts of predisposing, enabling and reinforcing factors [12] to address barriers to ART initiation ( Figure 1). First, we used opinion leader-led interactive training sessions with HIV care providers, which conveyed recent scientific evidence regarding effects of rapid ART initiation on patient survival, and introduced a revised counselling approach. ...
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Introduction: The Streamlined Antiretroviral Therapy Initiation Strategy (START-ART) study found that a theory-based intervention using opinion leaders to inform and coach health care providers about the risks of treatment delay, provision of point of care (POC) CD4 testing machines (PIMA) and reputational incentives, led to rapid rise in ART initiation. We used qualitative research methods to explore mechanisms of provider behaviour change. Methods: We conducted in-depth interviews (IDIs) with 24 health care providers and nine study staff to understand perceptions, attitudes and the context of changes in ART initiation practices. Analyses were informed by the Theoretical Domains Framework. Results: Rapid dissemination of new practices was enabled in the environmental context of an existing relationship based on communication, implementation and accountability between Makerere University Joint AIDS Program (MJAP), a Ugandan University-affiliated organization that provided technical oversight for HIV service delivery at the health facilities where the intervention was implemented, and a network of health facilities operated by the Uganda Ministry of Health. Coaching carried out by field coordinators from MJAP strengthened influence and informal accountability for carrying out the intervention. Frontline health workers held a pre-existing strong sense of professional identity. They were proud of attainment of new knowledge and skills and gratified by providing what they perceived to be higher quality care. Peer counsellors, who were not explicitly targeted in the intervention design, effectively substituted some functions of health care providers; as role models for successful ART uptake, they played a crucial role in creating demand for rapid ART initiation through interactions with patients. Point of care (POC) CD4 testing enabled immediate action and relieved providers from frustrations of lost or delayed laboratory results, and led to higher patient satisfaction (due to reduced costs because of ability to initiate ART right away, requiring fewer return trips to clinic). Conclusions: Qualitative data revealed that a multicomponent intervention to change provider behaviour succeeded in the context of strong institutional and individual relationships between a University-affiliated organization, government facilities, and peer health workers (who acted as a crucial link between stakeholders) and the community. Fostering stable institutional relationships between institutional actors (non-governmental organization (NGOs) and ministry-operated facilities) as well as between facilities and the community (through peer health workers) can enhance uptake of innovations targeting the HIV cascade in similar clinical settings.
... PRECEDE uses cues, prompts, and reinforcements to alter behavior (Skinner 1953). This framework is a cost-benefit evaluation that provides a comprehensive structure for assessing health and quality of life needs for designing, implementing, and evaluating health promotion programs (Green 1974). Social learning theory proposes that behavior change is affected by environmental influences, personal factors, and attributes of the behavior itself (Bandura 1977). ...
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Thousands of young children die or sustain life changing disabilities every year because of unintentional child injury (UCI) at home. Many injuries could be prevented if parents and caregivers were more aware of risks and accident-avoidance strategies. The aim of this review was two-fold. First, we explored whether health education modified parent or caregiver knowledge, attitudes, or behaviour related to injury awareness and prevention. Our secondary aim was to describe strategies used when delivering health education. Intervention studies using quantitative methods published after 2010 were included. The participants were caregivers or parents of children younger than six years of age. A systematic search of multiple databases yielded twelve studies. The risk of bias (ROB) was assessed using the Cochrane ROBINS-I for non-randomised and ROB-2 for randomised studies. Data synthesis was performed following the steps described in the SWiM guideline. We followed PRISMA guidelines to report the process and results. Interventions were usually one-off, multifaceted, and interactive using printed materials, discussion, didactic teaching, video, and games. Improvement of knowledge ranged from 12.5% to 85%. Attitude improvement was noted in five studies and ranged from 6.6% to 28%. Self-reported behavioural change was noted in six studies. Follow up duration varied from less than one month to six months. The observed changes have not been linked to the numbers or severity of UCI. Health education is beneficial, but the true long-term impact has yet to be fully explored. Studies that provided the greatest improvements used theories of behaviour change and interventions that were designed for the specific needs of the target population. Our review provides health care professionals with evidence of the potential benefits of health education in enhancing parents’ awareness regarding preventing UCI and information about how to deliver health education, that can guide the review of prevention practices of UCI.
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Background: Suboptimal Anti-Retroviral adherence is an advancing global issue. Methodology: One-Group Pre-and Post-Test Integrated Home-Based Care intervention program with control was adopted. The validated questionnaire was used to gather information from 60 PLWHA following ethical approval and informed consent. Descriptive statistics and frequency distributions are employed in data analysis. One-tailed independent sample T-test was used to determine the impact of the intervention using percentage-change and Cohen's Effect Size with a 5% level of significance. Validity and reliability of Instrument tested with Cronbach Alpha, 0.795. Results: Respondents mean age was 35.38 ± 9.061, married (37.61%), females (66%) and self-employed (41.1%). Mumuye ethnic group (28.3%), Christians, 71.7% with lower educational attainments (56.6%). Control group reported predispos-ing factors in HIV treatment (137-point scale), = 82.17(2.18) ±11.92 and = 86.50(1.69) ±9.23; Reinforcing factors on 15-points scale, scored = 9.00(0.65) ±3.65 and = 8.87(0.69) ±3.78; Enabling factors on 15-points scale, = 8.23(0.46) ±2.50 and = 8.00 (0.51) ±2.77 and Self-Reported Adherence on 24-points scale, = 16.23(0.82) ±4.49 and = 17.87(0.91) ±4.99 at baseline and post intervention respectively for each group and adherence prevalence rate of 60. Experimental group at baseline reported predisposing factors on 137-points scale, = 80.90(2.77) ±15.15 and = 97.13(8.12) ±1.48; Reinforcing factors on 15-points scale, = 8.87(0.47) ±2.50 and = 9.33(0.48) ±2.60; Enabling factors on 15-points scale, = 7.23(0.41) ±2.24and = 7.40(0.41) ±2.25 and Self-reported Adherence on 24-points scale, = 15.98(0.57) ±4.39 and = 23.13(0.43) ±2.37 at baseline and post intervention respectively for each group and adherence prevalence rate of 96%.
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Health care decision-makers are interested in using rational approaches to allocating resources among patients with chronic disease. Some policy-makers may view cost-effectiveness analyses as a means to justify rationing, but others embrace economic evaluation methods for improving decision-making about, for example, limits on insurance coverage for specific interventions, formulary development, quality improvement programs, and appropriate utilization of services. Before sound decisions can be made on appropriate selection and use of interventions, however, more comparative data on the economic value of the treatments and management strategies are needed. Too few studies as yet adequately characterize the economic impact of the large number of interventions currently being used to manage asthma. There is no standard approach to evaluating the economic costs and benefits of medical treatments used to treat asthma or for comparing the clinical and economic benefits of alternative treatments. Researchers conduct studies with varying lengths of follow-up, use different outcome measures, include different costs in the calculation of total cost, and evaluate different mixes of patients. These inconsistencies hinder efforts by decision-makers to compare clinical and economic benefits. Despite the many shortcomings, economic evaluations of asthma treatments need to be encouraged and nurtured. Substantial improvements and standardization are needed in the study design, study duration, sample size determination based on economic and health status endpoints, selection of appropriate comparison therapies, and selection and evaluation of costs and outcomes.
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Objectives: Inclusive and equitable research is an ethical imperative. Community-based participatory research (CBPR) as well as human-centered design are approaches that center partnership between community members and academic researchers. Together, academic-community research teams iteratively study community priorities, collaboratively develop ethical study designs, and co-create innovations that are accessible and meaningful to the community partners while advancing science. The foundation of the CBPR approach is reliant on its core principles of equity, colearning, shared power in decision-making, reciprocity, and mutual benefit. While the CBPR approach has been used extensively in public health and other areas of healthcare research, the approach is relatively new to audiology, otolaryngology, and hearing health research. The purpose of the present article is to advance an understanding of the CBPR approach, along with principles from human-centered design, in the context of research aimed to advance equity and access in hearing healthcare. Design: The literature is reviewed to provide an introduction for auditory scientists to the CBPR approach and human-centered design, including discussion of the underlying principles of CBPR and where it fits along a community-engaged continuum, theoretical and evaluation frameworks, as well as applications within auditory research. Results: Recent applications of CBPR have been framed broadly within the theoretical positions of the socioecological model for a systems-level approach to community-engaged research and the Health Services Utilization model within health services and disparities research using CBPR. Utilizing human-centered design strategies can work in tandem with a CBPR approach to engage a wide range of people in the research process and move toward the development of innovative yet feasible solutions. Conclusions: Leveraging the principles of CBPR is an intricate and dynamic process, may not be a fit for some topics, some researchers' skillsets, and may be beyond some projects' resources. When implemented skillfully and authentically, CBPR can be of benefit by elevating and empowering community voices and cultural perspectives historically marginalized in society and underrepresented within research. With a focus on health equity, this review of CBPR in the study of hearing healthcare emphasizes how this approach to research can help to advance inclusion, diversity, and access to innovation.
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Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of an infant’s life and continued breastfeeding for 2 years. The global rate of exclusive breastfeeding is low at 33%. Thus, it is important to identify philosophical and theory-based strategies that can promote exclusive breastfeeding. The aim of the study is to identify philosophical schools of thought and theories used in research on promoting the practice of exclusive breastfeeding. Methods A scoping review using Arksey and O'Malley's framework explored the phenomenon of exclusive breastfeeding practice promotion. Searches were conducted using CINAHL Plus full-text, PubMed, APA PsycInfo and Academic Search Premier. Search terms included theory, philosophy, framework, model, exclusive breastfeeding, promotion, support, English, and publication between 2000 - 2020. Results The online search yielded 877 articles, however, only 40 met the inclusion criteria for the scoping review. The articles promoting exclusive breastfeeding used pragmatism (n=1) or phenomenology (n = 2) philosophies and theories of self-efficacy (n = 10), theory of planned behaviour (n = 10) and social cognitive theories (n = 17). Theories of self-efficacy and planned behaviour were the most effective theories that increased exclusive breastfeeding rates. Conclusions Theory-based exclusive breastfeeding promotion strategies are effective to increase the rates of exclusive breastfeeding. Theory of planned behaviour is better compared with theories of self-efficacy for program content development and implementation in Randomized Controlled Trial studies. Future breastfeeding interventions should be based on relevant philosophies and guided by theories of self-efficacy and planned behaviours.
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Aim of research. 1. Presenting the position taken by Poland in the international Active Healthy Kids Global Alliance (AHKGA) ranking of the potential physical activity determinants among children and adolescents aged 10-18. 2. Evaluating the implementation of the ecological model of physical activity according to international criteria. 3. Assessing the effectiveness of implementing the ecological model of physical activity in the world, taking the criteria of its functioning into account. Research methods. In obtaining materials and analysing them, the following methods were used in our research: non-reactive research (research and secondary analysis). In accordance with the methodology of social sciences, in non-reactive research, 2 techniques were used: desk research and content analysis). Research results. The physical activity/behaviour of Polish children can be considered average compared to their peers living in various parts of the world. This means that only a small percentage of children in Poland meet the WHO recommendations for daily physical activity (at a combined moderate and vigorous level) in order to counteract the negative effects of a sedentary lifestyle. The best performing area in this respect is school, where activities are focused on improving school infrastructure and physical education classes. There are no representative studies regarding the physical activity of children under the age of 9, and there is a complete lack of scientific analyses in the area of active play. The evidence for a change concerning the methodological paradigm in the approach to building a model of physical activity determinants is the already widespread use of the ecological model, proposed by Sallis et al. in 2002. Conclusions: The conclusions proposed the experts regarding the first Polish Charter of Physical Activity for Children and Youth indicate a need to disseminate activities supporting physical activity and to undertake constant monitoring of changes taking place in the areas of individual domains of the ecological model of physical activity determinants.
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Introduction: Travelers may transmit diseases due to their behavior of travel, consequently travelers should consider preventive measurement through pre-travel health consultation seeking behavior. Pre-travel health consultation is a particular preparation ideally conducted by international travelers to obtain risk assessment and management to prevent the transmission of diseases. This study investigates the relationship of socio-demographic characteristics and itinerary on pre-travel health consultation behavior among international travelers in Badung, Bali.Methods: A descriptive-correlative design using a cross-sectional approach employed 125 participants determined by a purposive sampling technique performed in the ten tourist destinations of Badung Regency. Data collection was conducted on February 15th until March 5th, 2020. Data demography, travel plan, and anonymous questionnaires regarding pre-travel health consultation behavior are used in this research. The Gamma coefficient correlation and Kruskal-Wallis statistic tests were performed in the study for bivariate analysis.Results: The results showed that age (p<0.0001; r=-0.650) and past-travel history to Bali (p=0.004; r=-0.475) were significantly correlated with pre-travel health consultation behavior among international travelers in Badung, Bali. Meanwhile sex, nationality, last education, travel duration, and types of the destination visited were not significantly associated with pre-travel health consultation behavior among international travelers in Badung, Bali (p>0.05).Conclusion: The age and past-travel history to Bali seem to be predictors for travelers to uptake pre-travel health consultation, thus nurses should be able to promote the implementation of pre-travel health consultation by utilizing the media promotion appropriately adjusted to the age of travelers and travel experience.
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Background. Cybersecurity controls are deployed to manage risks posed by malicious behaviours or systems. What is not often considered or articulated is how cybersecurity controls may impact legitimate users (often those whose use of a managed system needs to be protected, and preserved). This oversight characterises the ‘blunt’ nature of many cybersecurity controls.
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Aim. The aim of the report is to draw attention to the studies not included in system reviews and meta-analyzes which are important in the opinion of the authors of the paper - for: 1. estimating the size of the obesity phenomenon and its correlates on a global scale, 2. assessing the effectiveness of promoting physical activity and the approach to changing pro-health behaviors, with particular emphasis on the sedentary and inactive behavior. Material and methods. The effect of the preliminary literature search in the preparation of a systematic review of publications documenting the existence of regional differences in both the level of obesity and its growth rate in the last decades of the 21st century and assessing the effectiveness of interventions aimed at behavioral changes, mainly in the field of nutrition and physical activity in children and adolescents. Unobtrusive research, content analysis. Results. The report highlights the results of the research conducted as part of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). They were compared to other European and global results of solving the problem of overweight and obesity in school-age children and adolescents, and to assessing the potential of the determinants of physical activity in several dozen countries around the world. In addition, the American proposals to solve the obesity problem were indicated, with particular emphasis on the theoretical assumptions and practical implications of the NCOOR organization, included in the American four-volume study. Conclusions. 1.Each country and geographic jurisdiction has its own limited variation in the prevalence of obesity and each of the potentially modifying factors at different levels of prevalence but the international research is able to minimize variability in these factors. 2. The ecological approach to solving the determinants of physical activity and the methods of its evaluation based on the SEM model should be treated with greater interest in the social policy of the individual countries on different continents. 3. The theoretical assumptions of American behavioral epidemiology and solutions to the problem of obesity and the practical implications based on them, resulting from many years of experience in the approach to eliminating the obesity epidemic, should be more widely disseminated and used in the programming of the health promotion outside the United States and in shaping health-oriented physical fitness in children and adolescents Health Related Fitness (H-RF).
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Objective: Health behaviors shape more than 30% of one's physical and mental health, as well as overall well-being. Yet, changing behavior is difficult. This paper aims first at operationalizing the concept of health behavior by focusing on its main components and determinants. Second, it gives insights into how to influence health behavior by providing an overview of some of the most commonly used approaches to the design of behavioral interventions. Methods: This is a position paper that presents a selection of evidence-based theories, models and approaches to understand and address behavior. Results: A health behavior broadly refers to every individual action affecting health, disease, disability, or mortality. Behavior is shaped by factors within the skin (biological, psychological) and outside the skin (interpersonal, environmental, policy). Behavior change has therefore to be addressed from an ecological perspective. Specifically, behavior change can be influenced by changing capability, opportunity and motivation. Depending on the specific determinants of the behavior at stake, there are numerous approaches that can be taken. The main steps to design interventions are: defining the problem, selecting and analyzing the target audience, setting objectives, designing the intervention, planning and implementing an evaluation. Conclusion: Behaviors should not be targeted in isolation but within a socio-ecological approach that accounts for both their individual and environmental determinants. Practice implications: This paper provides practitioners with the bases of behavior change. It offers a road-map of the main factors to consider and shows how to address behavior by planning an intervention in all its main steps.
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Introduction: Obesity is a serious chronic disease that damages both physical and mental health. The global prevalence and trends of overweight and obesity among adolescents and children had increased. Aim: This study was aimed to investigate the prevalence and determinants of PRECEDE Framework and health literacy associated with overweight and obesity among adolescents (12-19 years of age) in the Northeast of Thailand. Materials and Methods: This cross-sectional analytical study was conducted among 1,129 samples selected through multistage random sampling among 4 provinces from 20 provinces of the Northeast of Thailand, between September 2017 to March 2018 after they which completed constructive questionnaires using the PRECEDE Framework Model including three factors; predisposing factors, enabling factors and reinforcing factors and health literacy including cognitive, access, communication, self-management, media literacy and decision. Multiple logistic regression was administered to determine the association using the PRECEDE Framework Model and health literacy to find associated with overweight and obesity. Results: It was found that the prevalence of overweight and obesity was 10.63% (95% CI: 8.89-12.57) and 10.45% (95% CI: 8.72-12.38), respectively. Multivariate analysis suggests that the factors that were statistically significant in association with overweight and obesity included watching television ≥3 hours per day (Adjusted OR=1.94; p5 hours per day (Adjusted OR=1.82; p=0.007), the PRECEDE Framework Model including low levels of attitude (Adjusted OR=2.61; p=0.001) and low levels of reinforcing factors (Adjusted OR=1.79; p=0.030), health literacy including: low levels of media literacy skills (Adjusted OR=3.64; p
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Background Changing health behaviors, such as smoking, unhealthy eating, inactivity, and alcohol abuse, may have a greater impact on population health than any curative strategy. One of the suggested strategies is the use of behavioral intervention technologies (BITs). They open up new opportunities in the area of prevention and therapy and have begun to show benefits in the durable change of health behaviors in patients or those at risk. A consensual and international paradigm was adopted by health authorities for drugs 50 years ago. It guides their development from research units to their authorization and surveillance. BITs’ generalization brings into question their upstream evaluation before being placed on the market and their downstream monitoring once on the market; this is especially the case in view of the marketing information provided by manufacturers and the scarcity and methodological limits of scientific studies on these tools. Objective This study aims to identify and categorize the frameworks for the validation and monitoring of BITs proposed in the literature. Methods We conducted a narrative literature review using MEDLINE, PsycINFO, and Web of Science. The review items included the following: name, publication year, name of the creator (ie, first author), country, funding organization, health focus, target group, and design (ie, linear, iterative, evolutive, and/or concurrent). The frameworks were then categorized based on (1) translational research thanks to a continuum of steps and (2) the three paradigms that may have inspired the frameworks: biomedical, engineering, and/or behavioral. Results We identified 46 frameworks besides the classic US Food and Drug Administration (FDA) five-phase drug development model. A total of 57% (26/46) of frameworks were created in the 2010s and 61% (28/46) involved the final user in an early and systematic way. A total of 4% (2/46) of frameworks had a linear-only sequence of their phases, 37% (17/46) had a linear and iterative structure, 33% (15/46) added an evolutive structure, and 24% (11/46) were associated with a parallel process. Only 12 out of 46 (26%) frameworks covered the continuum of steps and 12 (26%) relied on the three paradigms. Conclusions To date, 46 frameworks of BIT validation and surveillance coexist, besides the classic FDA five-phase drug development model, without the predominance of one of them or convergence in a consensual model. Their number has increased exponentially in the last three decades. Three dangerous scenarios are possible: (1) anarchic continuous development of BITs that depend on companies amalgamating health benefits and usability (ie, user experience, data security, and ergonomics) and limiting implementation to several countries; (2) the movement toward the type of framework for drug evaluation centered on establishing its effectiveness before marketing authorization to guarantee its safety for users, which is heavy and costly; and (3) the implementation of a framework reliant on big data analysis based on a posteriori research and an autoregulation of a market, but that does not address the safety risk for the health user, as the market will not regulate safety or efficacy issues. This paper recommends convergence toward an international validation and surveillance framework based on the specificities of BITs, not equivalent to medical devices, to guarantee their effectiveness and safety for users.
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Interprofessional education (IPE) is a learning process or framework to ensure that different health professionals work together effectively to meet the health needs of patients. This chapter provides a brief history of IPE and offers definitions of some key terms, including community care, uniprofessional education (UPE), POLY‐professionals, multiprofessional education (MPE), and interprofessional collaboration (IPC). Also included are the definitions of a number of generic educational, health and social care terms that are particularly relevant for IPE. The historical perspective of the term profession is explored together with broader concepts such as care in the community, partnership working, team working and human factors. The key concept in IPE is to learn with, from and about each other to enhance collaborative practice to improve the quality of care to patients. IPE programmes can have many different types of aims and each learning experience has to be tailored with the learning outcomes in mind, as with any learning.
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Introduction: The Fitness-to-Drive Screening Measure is a free online screening tool that detects at-risk older drivers, however, it's 20 min administration time may render the 54-item tool less than optimal for clinical use. Thus, this study constructed and validated a 21-item FTDS Short-Form (FTDS-SF). Method: This mixed methods study used 200 proxy rater responses and older driver on-road assessments. We conducted a Rasch analysis to examine information at the level of the item and used content validity index scores to select items. Using a receiver operator characteristics curve we determined the concurrent validity of the FTDS-SF to on-road outcomes. Results: Twenty-one items were selected for the FTDS-SF. The area under the curve = 0.72, indicated the FTDS-SF predicted on-road outcomes with acceptable accuracy. Still, 68 drivers were misclassified. Conclusion: The FTDS-SF may reduce administration time, while still yielding acceptable psychometric properties. Yet, caution needs to be executed in clinical decision making as the measure is overly specific.
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This reflection on the academic and practice careers—my own and some notable health promotion professors’—supports my suggestions about what makes good teaching and research faculty members in professional schools seeking to prepare next generations of practitioners for health education and health promotion careers. From the perspective of pedagogy in health promotion, the preparation of students for their roles in practice—in whatever blend of policy, planning, management, delivery, or evaluation of programs—should emanate, where possible, from field experience and reality-tested theoretical and evidence-based precepts. Just as usable evidence-based practices need to include practice-based evidence, so too must usable pedagogy for practitioners be built on periodic exposure and experience of instructors in contemporary practice. The concept of “turnstile careers” is introduced to address this need for periodic immersion of faculty in practice positions with responsibility for programs.
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Traducción de: Communication of Innovations. A Cross-Cultural Approach
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A preliminary cost benefit analysis for a program of urging middle-aged men to take annual Multiphasic Health Checkups has suggested a net savings of more than $800 per man over a 7-year period among men urged to take the checkups as compared to men not so urged. This difference principally reflects the lower disability and mortality rates observed for the men who were urged to receive the checkups.Similar differences have not been demonstrated for women or younger men.
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A $330,000 multimedia advertising campaign was undertaken in 4 U.S. cities (Columbus, Ohio; Memphis, Tennessee; Altoona, Pennsylvania; Jackson, Mississippi) November 1970-May 1971 by the Family Planning Evaluation project (University of North Carolina) to evaluate the cost and effectiveness of commercial advertising in increasing contraceptive utilization among active fertile individuals. The ads ran on radio, television, in special editions of Life and Look, and in local daily, ethnic, and community newspapers. The level of complaints was below what had been anticipated, and there was no unacceptable community opposition even in the saturation cases. The level of awareness was higher during the campaign for television and radio advertising but not for newspaper and magazine advertising (interviews). The number of "new" patients to family planning clinics was low (ranging from 24 to 444) and it appears that mass media advertising is not an effective recruitment technique. No differences were found in new prescription sales of oral contraceptives or sales of condoms between the media sites and their controls during the 6-month campaign. Mass media campaigns might be more effective in non-US settings where contraceptive knowledge is not great and usage is not widespread.
The economic aspects of preventing disease and promoting health
  • G Teeling-Smith
Interviewing and the Health Professions
  • L Bernstein
  • R H Dana