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Theories and Models of Program Planning

There are several theories and models that maintain human behavior and support the activity of health promotion and diseases prevention. These theories and models are used and applied for program planning to guide health promotion to be successful.

These theories include:

1. The Ecological Model. This is a group of models identify several levels of influence into a person’s health. These levels or factors include the intrapersonal factors which include attitude, beliefs and personality.

1. Interpersonal factors, which refer to the way people interact with other people creating support or barriers.

2. Institutional factors. These include rules, regulations and ultimately policies for health promotion.

3. Community factors. These include formal and informal social norms among individuals and organizations.

4. Public policy. These refer to regional, state, and federal policies that ultimately try to regulate human behavior.

Even though this model could become attractive towards the National Diabetes Prevention Plan, it seems to me that, implementing policies about strong regulations and enforcement about healthy food could be too harsh and perhaps a strong attempt towards the liberty of choosing food.

1. The Health Belief Model. This model focusses its attention on the understanding of the person on what it means to be healthy. Based on the person’s understanding and beliefs about health, will determine the individual’s behavior towards attaining or maintaining health. In order to promote a behavior change, the program or model should convey clear information to the individuals about their collective and individual risk, the consequences of a risky behavior, what step are needed to take action towards health and their benefits, provide assistance on overcoming the possible barriers there are between taking action and execution and assisting with the development of possible needed skills to attain goals. See below.

2. The PRECEDE-PROCEED Model. This model is primarily used for community-based program planning and implementation. For its best results and success, the entire community should participate. Its name is actually an acronym for, Predisposing, Reinforcing, Enabling, Constructs in Educational Diagnosis and Evaluation. Through a social assessment a common goal is established. Then the community is assessed about their behaviors, way of living, environmental characteristics, to then identify the predisposing factors and enable the behavior that will be needed to be developed. The second part of this model is the PROCEED phase which also contains 4 phases. These four phases are based on the previous 4. Here, the conduct desired is going to be Designed, the process will be Evaluated, the Impact is going to be contemplated and measured, and the Outcomes will be evaluated.

3. The Social Support Theory. This Theory bases its results on social networks and social support among the members of the community. By assessing the Structure, Interaction and the Function of the groups, this model will evaluate the results o program may have.

4. The Diffusion of Innovations Theory. This is based on the degree the individuals of a community have to adopt a new conduct. It recognizes that, among the community there are different levels of adoption such as the Innovators, who are those that try to embrace the latest technology. The Early Adopters, who are attracted by innovations but are not the ones that take the first step to adopt it. The Early Majority, who wait until more motivation is available. The Late Majority, who are those who need more encouragement from seeing others make the change, and the Laggards who are the last to adopt a change. The degree of energy to involve he population is key for the success of these model.

5. The RE-AIM Model. This model has a major purpose, the evaluation of the program to determine or measure the impact of it. First it measures its Reach, which determines the percentage of the population reached. Then it measures the Adoption of the program by the different locations and places. Then it measures the Implementation impact and finally the Maintenance, which in most programs is the most difficult stage.

When it comes to implementing a program. Choosing the best model is key towards the success of that program. In some instances, there may be situations or programs that may appear to have interactions among the different models, however there is a central model for any given program.

In the case of the program chosen; National Prevention of Diabetes, I believe the best program to be utilized is the Health Belief Model. In this model, as explained above, the Individual is informed about the risk of a given disease, i.e. Diabetes, its consequences expecting the person to feel the fear this risk may provoke a motivation needed to act. Specifically, the patient should understand the severity of the consequences of suffering diabetes and the possible complications. Key risk factors should be explained, in which case, if the person being informed has some of these risk factors the sensed fear may be stronger. The person needs to be perceive a susceptibility to a given degree, and the higher the degree the more likely the person will finally put actions into play. The person should perceive the potential benefits of changing attitude and the positive results of his or her acts. In this model, the individual will also identify the possible barriers towards implementing those actions to finally decide whether to act or not. For the program to be successful, the addition of help to overcome these barriers should be included.