Question Description

I’m working on a health & medical multi-part question and need an explanation to help me understand better.

Demonstrate knowledge of Chapters 13-16 by completing Part V Discussion (Review Questions).Review Questions: Chapter 13 (2, 9)2. Identify and describe the planning phases of the PRECEDE-PROCEED model.9. Describe the purpose of each of the three evaluation phases in the PRECEDE-PROCEED model.Chapter 14 (3, 8)3. What is quasi-experimental research? Why would researchers choose this type of research over experimental research.8. What is bias? How can bias occur when conducting research? What are some steps that can be taken to eliminate bias?Chapter 15 (6, 8)6. What is probability sampling? How does it differ from nonprobability sampling?8. Why would a researcher utilize a convenience sample to collect data? Why would a researcher use a purposive sample?Chapter 16 (10)10. Why is it necessary for the profession of health education to evolve as tends in science and technology progress?Module discussions are graded discussions. Your posts must be professional, well organized, grammatically correct, and free of misspellings. Additionally, any content quoted, paraphrased, or gleaned from references must be properly cited (see APA & Resources). Internal Citations included Please.



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Chapter 13
“He who has health, has hope; and he who has hope, has everything”
~ Thomas Carlyle
structure for applying theories so the most
appropriate intervention strategies can be
identified and implemented
• Not considered a theory, but rather a planning
model or conceptual framework for practice
• One of the most widely used program
planning frameworks
• Unlike other theories, PPM does not attempt
to predict or explain the relationship among
factors thought to be associated with an
outcome of interest
P = predisposing
R = reinforcing
E = enabling
C = constructs
E = educational/ecological
D = diagnosis
E = evaluation
P = policy
R = regulatory
O = organizational
C = constructs
E = educational
E = environmental
D = development
• The PPM contains 8 Phases:
• Phase 1: Social Assessment
• Phase 2: Epidemiological Assessment
• Phase 3: Educational and Ecological
• Phase 4: Administrative and Policy
Assessment and Intervention Alignment
• Phase 5: Implementation
• Phase 6: Process Evaluation
• Phase 7: Impact Evaluation
• Phase 8: Outcome Evaluation
• Phase 1 – Social Assessment: Identify social
problems that impact quality of life, health
care, and priorities of individuals or
• Primary Data – information collected
• Planners expand understanding of the community
by conducting multiple data collection activities,
such as interviews with key opinion leaders, focus
groups with members of the community,
observations, and surveys
• Example: unemployment, absenteeism, crime,
crowding, overall population health
• Phase 2 – Epidemiological Assessment:
determine health issues associated with quality
of life
• Secondary Data – data which have previously
been collected by other researchers, such as
vital statistics, state and national health
surveys, medical and administrative records
• Subgroups may be characterized by age,
gender, ethnicity, occupation, education,
income, family structure, geographical
location, etc.
• Example: morbidity, mortality, risk factors,
disability, longevity, intensity, incidence,
• Phase 2 – Epidemiological Assessment:
• Behavioral determinants of health exist on three
• Physical – behaviors which contribute to the
presence and severity of health problems
(smoking, poor nutrition, and sedentary
• Social – behaviors of individuals who can
influence the actions of the person at risk
(parents, spouses, or friends)
• Environmental – external factors beyond the
control of the individual (policies and law
• Phase 2 – Epidemiological Assessment:
• Prioritization Matrix – a tool which program
planners utilize to help prioritize the physical,
social, and environmental determinants
• Phase 3 – Educational & Ecological
Assessment: Predisposing, reinforcing, and
enabling factors all influence the likelihood that
health behavior change will occur
• Predisposing Factors: Antecedents to behavior that
provide the rationale or motivation for the behavior
(knowledge, attitudes, existing skills, values, beliefs)
• Reinforcing Factors: Reward or incentive for the
persistence or repetition of the behavior (attitudes and
beliefs of others, social support, peer influence, vicarious
• Enabling Factors: Antecedents to behavioral or
environmental change that allow motivation or policy to
be realized (resources, programs, services, accessibility,
• Phase 4 – Administrative & Policy
Assessment & Intervention Alignment:
Policies, resources, and circumstances
prevailing that could facilitate or hinder
program implementation
• The resources needed to launch and sustain the
• The organizational barriers that effect
• Policies that support the program or need to be
• Phase 5 – Implementation:
• The act of converting planning, goals, and
objectives into action through administrative
structure, management activities, policies,
procedures, regulations, and organizational
actions of new programs
• When a program planner reaches this phase,
the program should be finalized and ready to be
put into action
• Phase 6 – Process Evaluation: An evaluation
designed to document the degree to which
replicable program procedures were
implemented with fidelity by trained staff
according to a written plan
• How well and how much of the assessment
and intervention procedures were provided,
to whom, when, and by whom?
• The extent to which the program was
implemented according to the set protocol
• Appropriateness of content, methods,
materials, media, instruments
• Phase 7 – Impact Evaluation:
• The extent of change in the predisposing,
reinforcing, and enabling factors in addition to
the behavioral and environmental factors
• An evaluation designed to produce qualitative
and quantitative data and insight during the early
developmental phase of an intervention,
including the assessment of:
• Immediate (1-hour to 1-week) or short-term
(1-week to 6-months) cognitive, psychosocial,
psychomotor (skill), and/or behavioral impact
of an intervention for a well-defined population
at risk
• Phase 8 – Outcome Evaluation:
• The effectiveness of the program and whether
the program reached its goals and objectives
• An evaluation using an experimental or quasiexperimental design to document program
feasibility, efficacy, or effectiveness, and costeffectiveness or cost-benefit in producing longterm changes (ex: 1 to 10 years) in the
incidence or prevalence of a morbidity or
mortality rate or other health status indicator
for a clinically diagnosed medial condition
among a well-defined population at high risk
Application of the
• Compass Strategy – concerned with the early
detection and treatment of mental disorders
among adolescents
• Phase 1 & 2 – researchers utilized focus groups of
adolescents and parents who were affected by
mental health disorders to generate appropriate
media messages to stress the importance of early
detection and treatment
• Phase 3 & 4 – predisposing, reinforcing, and
enabling factors were identified; resources and
policies were analyzed to determine the success of
the Compass Strategy
Application of the
• Compass Strategy – concerned with the early
detection and treatment of mental disorders
among adolescents
• Phase 5 – Compass Strategy was implemented over
a three-year period; a media campaign evolved
from the first four phases of the PPM
• Phase 6, 7, & 8 – Process evaluation used a 65-item
survey; impact evaluation used telephone
interviews; and outcome evaluation was used to
determine the overall success of the mental
disorder social media campaign

PRECEDE-PROCEED Model (PPM) is one of the
most widely used program planning models in health
promotion programs
PPM contains 8 Phases – (1) Social Assessment;
(2) Epidemiological Assessment; (3) Educational and
Ecological Assessment; (4) Administrative and Policy
Assessment and Intervention Alignment;
(5) Implementation; (6) Process Evaluation;
(7) Impact Evaluation; (8) Outcome Evaluation
PRECEDE-PROCEED Model (PPM) is a cost-benefit
evaluation framework that helps health program
planners, policy makers, and other evaluators analyze
situations and design health programs efficiently
Chapter 15
Design, Sampling, and Evaluation
“Research is to see what everybody else has seen,
and to think what nobody else has thought”
~ Albert Szent-Gyorgyi
Research Design
• The primary purpose of conducting
research is to develop new knowledge
• The best and most powerful means of
generating new facts is through the use of
scientific experimentation
• Research performed using experimental
methods attempt to minimize threats to
internal and external validity and other
extraneous variables or biases that may
contaminate the study
Research Design
• Extraneous Variables – Contaminants
controlled for by using random assignment

Example: ethnicity, sex, age, fitness level,
health status, race, and socioeconomic status
• Cause-and-Effect Relationship –
Determined using experimental methods in
that one factor demonstrates a predictable
influence on another

Experimental research is the most robust way
for researchers to determine if there is a true
cause-and-effect relationship between two (or
more) variables
Research Design
• Research Design – Overall plan for the study

Selected before the study is conducted
Determines relationships between the independent
and dependent variables
• Provides structure and determines the statistical
analyses used to test the hypotheses
• Allows the researcher to conduct the program
while minimizing extraneous variables and bias
• Selection depends on many factors:
• Purpose of the study
• Threats to validity controlled by the researcher
• Resources
• Time
• Accessibility to participants
Research Design
• Research Design – Three categories:
• Experimental Design
• Quasi-Experimental Design
• Nonexperimental Design
• Measurements used in evaluation designs can be
collected at three different times:
• After the intervention
• Both before and after the intervention
• Several times before, during, and after the
Experimental Design

Experimental Design – Involves random
assignment of participants to experimental and
control groups and the measurement of both

Allows for the greatest control over the factors
that may influence the results

Minimizes threats to validity to the greatest
extent possible and produces the most robust
evidence of program effectiveness

Common experimental designs in health
education include:

Posttest-Only Design
Pretest-Posttest Design
Time Series Design
Experimental Design

Posttest-Only Design

Posttest only design is based on the randomization
of participants into either an experimental or
control group, introducing the independent
variable to the experimental group, and then
testing for the differences of treatment and no
Pretest-Posttest Design

Pretest-posttest design differs from the posttest
only design due to the addition of a pretest
The use of a pretest allows the researcher to
assure that both the treatment and control groups
are similar and provides a baseline measurement
Experimental Design

Time Series Design

Used to examine differences in program
effects over time
In an experimental time series design, several
measurements are taken over time both before
and after the program for both treatment and
control groups
This process helps to identify other factors that
may account for change between the pretest
and posttest measurements, and is useful for
measuring delayed effects of a program
Quasi-Experimental Design

Quasi-Experimental Design

Involves the use of experimental and control
groups; however, there is no random
assignment to the groups
These designs result in interpretable and
supportive evidence of program effectiveness
Premise of a quasi-experimental design is to
investigate the participant in a real-world
setting, introduce the independent variable,
and then measure its effect
Quasi-Experimental Design

Pretest-Posttest Design

Quasi-experimental pretest-posttest design is
one of the more common types of research
designs found in health promotion programs
Used when the treatment or control group
cannot be formed by random assignment
Time Series Design

A quasi-experimental time series design is
the same as an experimental time series
design, only there is no randomization of
participants to groups
Quasi-Experimental Design

Repeated Measures Design

The experimental group is exposed to more
than one level of the independent variable

In a repeated measures design, participants
have repeated measures gathered from them

Thus, participants serve as their own
control group, which makes this a fairly
sound research design

This design works best when there is little
interaction among the levels of the
independent variable and little time in between
data collection measurements
Nonexperimental Design

Nonexperimental Design

Involves the use of a treatment group, but
does not use a control group or randomization
Classified as experimental designs only
because there is a manipulation of an
independent variable
Weakest degree of experimental control over
the factors affecting the validity of the results
Nonexperimental designs offer poor control
and it is difficult to draw any meaningful
conclusions about a cause-and-effect
relationship between variables
It is imperative that researchers avoid using
nonexperimental research designs
Nonexperimental Design

Pretest-Posttest Design

Used when participants cannot be assigned to
groups, as no comparison group can be identified
or it is not warranted
This type of research are of limited significance,
as changes in the participants could be due to
other events and not due to results of the program
Time Series Design

A single experimental group serves as its own
control and is assessed on a dependent variable
several times over a specified period of time

Establishes a baseline for the variable of interest

Examples: Stress, hormone levels, sleeping
patterns, nutritional habits, medication use, etc.
Nonexperimental Design

Static Group Comparison Design

No randomization of participants into groups

This is the only factor that makes it different
from the posttest only experimental design

The experimental group receives the independent
variable and is compared with an nonequivalent
control group on the dependent variable

One-Shot Design

Least acceptable of all the experimental designs
The experimental group receives a treatment and
is tested on its effect on the dependent variable
The results of the treatment are compared against
what the researcher “expected to occur” if the
treatment was not given
Based on previous knowledge and/or observation
of the participants on the part of the researcher

Census – Data from all target participants

Example: An entire school district
Sample – Data from only some participants

Example: One school in the district
Sampling Unit – Elements considered for
selection as part of a chosen sample
Sampling – Chosen from the target
population of interest

Using a sample rather than an entire
population saves researchers both time and
Appropriate sample size is determined by
how many individuals are needed for the
researchers to feel confident valid
conclusions can be drawn from the data

One of the most critical determinants of external
validity, which is the ability to generalize study findings
to the population of individuals who possess similar
characteristics as those represented in the study sample

The correct selection of a sample is critical to
the success of any program evaluation

Example: Does the information gained
from the sample reflect the knowledge,
attitudes, and behaviors of the survey

Sampling bias can be minimized by selecting
the appropriate sampling procedures

Sampling procedures are categorized into:

Probability Samples

Nonprobability Samples
Probability Sample

Probability Sample

Random selection increases the chance
the study sample is representative of the
survey population
Random Sampling – An unbiased procedure
by which all members of a population have an
equal chance of being selected, and all samples
of a given size have the same chance of being
Probability Sample – Random selection is
employed, and every individual in the survey
population has an equal chance or probability of
being selected
Probability Sample

Simple Random Sample – Individuals,
elements, or scores are selected from a
population in such a way that each sample
of size N has an equal chance of being

Sampling Frame – List of all
sampling units in the survey
Systematic Sample – Every nth person is
Cluster Sample – A naturally occurring
heterogeneous group
Probability Sample

Stratified Random Sample – Utilized when
researchers want certain groups to be represented
in a sample

Proportional Stratified Random Sample –
Proportions in the sample represent the survey

Example: Sample of 100 – selection of 60
small, 35 medium, and 5 large health clubs
Nonproportional Stratified Random Sample –
Equal representation from different strata within
the survey population

Example: Sample of 200 – selection of 50
students from all ranks of freshman,
sophomores, juniors, and seniors
Nonprobability Sample
• Nonprobability Sample – Sample in which all
individuals in the survey population do not have an
equal chance or probability of being selected
• Utilized when a probability sample is not needed or
cannot be obtained, due to lack of resources or being
unable to identify or contact all those in the survey
• Cannot be generalized to the total survey population
• Some form of bias occurs in nonprobability samples,
as those who are not included in the sample may
differ in some way from those who are included in
the study
• Common types of nonprobability samples include:
• Convenience Sampling
• Purposive Sampling
Nonprobability Sample

Convenience Sample – Selected as is
accessible and relatively representative of
the population of interest

Examines the relationships among variables
Purposive Sample – Selected in a
deliberative and non-random fashion based
on the purpose of the study

Involves studying the entire population of a
specific group (College Professors at
Florida Atlantic University) or a subset of a
population (Tenured College Professors at
Florida Atlantic University)
Evaluation of Research

Evaluation – A process of reflection whereby
the value of certain actions in relation to
projects, programs, or policies are assessed
against a standard of acceptability

Without the evaluation of a program,
researchers cannot be certain of its impact
and whether or not it was successful in
achieving its targeted objectives and goals

Two main methods for categorizing evaluations:

Formative Evaluation (Process Evaluation)

Summative Evaluation (Impact Evaluation
and Outcome Evaluation)

Evaluation of Research
Formative Evaluation – Any combination of
measurements obtained and judgments made
before or during the implementation of materials,
methods, activities, or programs to control, assure
or improve the quality of performance or delivery

Designed to produce data and information used
to improve a health promotion program during
the developmental phase and document the
feasibility of program implementation

Considered a method for judging the worth of a
program while activities are being developed

Often used in pretesting or pilot testing an
intervention program
Evaluation of Research
• Process Evaluation – Any combination of
measurements obtained during the
implementation of program activities to
control, assure, or improve the quality of
performance or delivery
• Considered to be a type of formative
• Measures the extent to which an intervention
was delivered or implemented as intended
• Designed to assess how much of …
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Florida Atlantic University

Precede Proceed Model

Quasi Experimental Research

social assessment

process evaluation

Health behavioral determinants

shortterm cognitive

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