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Define and explain the difference among theory, concept, construct, variable and
2. Explain the importance of theory to the health education discipline.
3. Distinguish between models of implementation and change process theories
4. Distinguish between planning models and the theories and models focusing on
behavior change.
5. Identify the planning models and their components used in health / health
promotion an briefly explain each:
b. Model for Health Education Planning (MHEP)
c. Comprehensive Health Education Planning and Resource Development (MHEPRD)
d. Generic Health and Fitness Delivery System (GHFDS)
e. Generalized Model for Program Planning (GMPP)
6. Identify the theories and models focusing on behavior (change process theories)
and their components used in health / promotion and briefly explain each:
a. . Health belief model
b. Transtheoretical model or stages of change
c. Theory of planned theory
d. Social cognitive theory
c. Theory of diffusion

Glanz, Lewis and Rimer
It is a set of interrelated concepts, definitions and
propositions that presents a systematic view of events or
situations by specifying relations among variables in
order to explain event and predict the events of the
Mckenzie and Smelter
It is a systematic arrangement of fundamental principles
that provide a basis for explaining certain happenings of
Health Education
It is a general explanation of why people act or do not
act to maintain and / or promote the health of
themselves, their families, organizations and

CONCEPT it is the primary elements of
CONSTRUCT - when a concept has been
developed, created or adopted for use with a
specific theory
VARIABLE - the operational form of a
MODEL - it is a subclass of a theory
- It provides health educators with a framework on
which to create plans for programs.
Example: safety belt use
- It helps guide the practice of health educators.

- It can help during the various stages of planning,
implementing, and evaluating program.

- It can provide answers to program developers
questions regarding why people arent already
engaging in a desirable behavior of interest, how to
go about changing their behaviors, and what factors
to look for when evaluating a programs focus.

- Provides direction and justification for program
activities and serves as a basis for processes that are
to be incorporated into health promotion program.
models of implementation change process theories
- This is also called as planning
models which are used in
planning, implementing, and
evaluating health education /
promotion programs
-Focus on behavior change
- These help explain, through their
constructs, how change process
theories help explain, through
their constructs, how change takes

Ex: non exerciser to exercise

PRECEDE stands for Predisposing,
Reinforcing, and Enabling Constructs in
Educational / Environmental Diagnosis and

PROCEED stands for Policy, Regulatory, and
Organizational Constructs in Educational and
Environmental Development

Phase 5 Phase 4 Phase 3 Phase 2 Phase 1
Administrative Educational Behavioral and Epidemiological Social Diagnosis
and Policy and organizational Environmental Diagnosis
Diagnosis Diagnosis Diagnosis

g Factors




of life
Phase 8 impact evaluation
Phase9 outcome
Phase 6 implementation
Phase7 process evaluation
It was first developed in 1966 by Mico and
has been periodically updated since. It has
been comprised of six phases: initiate, needs
assessment, goal setting, planning and
programming, implementation, and
evaluation. Within each phase, the model
focuses on the three dimensions of content
(subject matter), method (steps and
techniques), and process (interactions).

Phase Content Dimension Method Dimension Process Dimension
6. Evaluation Understand evaluation;
know problem and target
Clarify measures; collect
and analyze data; provide
feedback, redefine
Come to agreement;
communicate; reduce
threat results
5. Implementation Know plan; subject, and
content and problem
solving; writing skills
Initiate activity; problem
solve; report
Communicate with and
help others; resolve
4. Planning programming Understand planning
techniques, system
analysis, and political
Develop an
implementation plan;
design management
systems; negotiate
commitments; create
Understand and commit
clarify roles;
communicate; negotiate
3. Goal setting Role of goals; nature of
policy; manage by
objectives; understand
theory of change
Establish criteria for and
set goals and objectives;
link to policy
development; determine
strategies for
Set agreement;
understand process and
2. Needs assessment Identify standards,
criteria, and needed data
Review criteria; collect
and analyze data;
describe problem
Select starting point; open
communication with
appropriate people
1. Initiate Gain knowledge of the
problem and target
Gain entry to the
community; organize
those concerned
Reduce threat of the
unknown; build trust
The CHEM like the MHEP, has six major
components. However, these components are
referred to as steps and use different labels;
involve people, set goals, define problems,
design plans, conduct activities, and evaluate

Step Description
1. Involve people Identifying the target population and those needed
to carry out the program; determining the roles of
those involved; establishing the necessary
relationships among the people
2. Set goals Creating the ultimate goals related to health
status, personal action, health education practices,
and health education resources
3. Define problems Conducting a needs assessment; determining the
gaps between what is and what ought to be;
deciding what problem to tackle
4. Design plans Identifying the most appropriate approach for
reaching the goals; setting operational objectives;
defining timetables, activities, and resources;
piloting the plans; developing evaluation
procedures; getting approval for the plans;
obtaining commitments for resources
5. Conduct activities Obtaining the resources to implement; creating
policies and procedures for implementation;
carrying out the implementation
6. Evaluate results Determining the overall worth of the program by
comparing the results with the program objectives
and goals in the context of the activities and
resources used
The developers of this model have indicted that it
can be distinguished from others because it
separates process from end results, and because of
the continuous evaluation, which tests and validates
program assumptions throughout the planning

Each of the five major components of the model -
- health education plans, demonstration programs,
operational programs, research programs, and
information and statistics - - represents an end
result of the planning process.

This model was not developed specifically for
health education/promotion programs; however,
it can easily be adapted to them.

This goal-oriented planning model is
compromised of five steps - - needs assessment,
goal setting, planning, program implantation,
and evaluation. Each of the steps has an
education and a service component. The
education component focuses on a cognitive
experience, while the service component has a
more psychomotor emphasis.


Education component

Service component

Needs assessment

Input / feedback

Goal setting




Program implementation



Educational needs

Learning goals and objectives

Learning intervention

Of learning intervention

Educational assessments

Behavioral needs

Behavioral goals and objectives

Behavioral intervention

Of behavioral intervention

Behavioral Assessments
Each of the five models previously presented revolves
around the six primary tasks incorporated in the
Generalized Model for Program Development such as:

1. Assessing the needs of the largest population
2. Identifying the problem (s)
3. Developing appropriate goals and objectives
4. Creating an intervention that considers the peculiarities of
the setting
5. Implementing the intervention
6. Evaluating the results

Example: A health educator was hired to develop health
promotion programs in a corporate setting.
II. Theories and Models Focusing on Health
(Change Process Theories)

As with planning models, there are a number of theories and models
that health educators can use to design appropriate health education
interventions to help those in the target populations with behavior change.
And, as with planning models, each of these theories and models works
better in some situations than in others depending on which level of
influence the health education program is being planned.

The concept of level of influence is included in the ecological
perspective. This perspective includes five levels of influence on health-
related behaviors and conditions:

1. Intrapersonal, or individual, factors
2. Interpersonal factors
3. Institutional, or organizational, factors
4. Community factors
5. Public policy factors

Focused on factors within individuals such
as knowledge, attitudes, beliefs, self-
concept, and mental history, past
experiences, motivation, skills, and behavior.

The three theories that are useful in
changing these factors are the health belief
model, the transtheoretical model or stages
of change, and the theory of planned

It addresses a persons perceptions of the threat of a
health problem and the accompanying appraisal of a
recommended behavior for preventing or managing
the problem.

It was developed in the 1950s by a group of
psychologists to help explain why people would or
would not use health services.

Example: Why a person may or may not do
self-screening for cancer.
The transtheoretical model revolves around
an individuals readiness to change or
attempt to change toward healthy behaviors.
Example: chain smoker

Individuals intention to perform a given
behavior is a function of their attitude toward
performing the behavior, their beliefs about
what relevant others think they should do,
and their perception of the ease of difficulty
of performing the behavior.

Example: of the use of spit tobacco
The category of interpersonal theories is
comprised of theories that include factors
related to individuals experience and
perceptions of their environments in
combination with their personal

Example: The social cognitive theory (SCT)
describes learning as a reciprocal interaction
among an individuals environment, cognitive
processes, and behavior.
This group of theories includes three categories of factors
from the ecological perspective institutional, community,
and public policy.

Institutional factors include such things as rules,
regulations, and policies of an organization that can impact
health behavior.

Community factors include social networks and norms,
while public policy includes legislation that can impact
health behavior.

Example: The diffusion theory provides an explanation for
the diffusion of innovations in populations. In health
education/promotion, innovations come in the form of new
ideas, techniques, behaviors, and programs. When people
become consumers of an innovation, they are referred to
as adopters.