Health Promotion and Dr. Green’s Precede-Proceed Model
Using Dr. Green’s Precede-Proceed Model, the Healthy People 2020 objective of promoting physical activity can be developed into a strategy. The target population of this particular objective consists of adults at a behavioral health clinic located in a low income area. My plan is to execute a 7-week exercise class with health education to promote physical activity. The goal of the plan is to embed physical activity in the daily lives and routines of the adult clients at the clinic. This paper will examine the 7 phases of the Precede-Proceed Model and show how they apply to the Healthy People 2020 objective described above.
Phase 1: Social Assessment and Situational Analysis
The health status of the low income community in which our behavioral health clinic is situated is not the best. A windshield survey indicates that few people are outdoors exercising, playing sports in parks, walking, jogging, bicycling, or taking in part in any sort of physical activity whatsoever. As Berlin and Colditz (1990) pointed nearly three decades ago, physical activity is crucial to the prevention of so many health related issues, such as coronary heart disease. There is a lack of awareness of the benefits of physical activity among the adult clients at the behavioral health clinic, which indicates a need for an educational intervention, in accordance with the model recommended by Green, Kreuter, Deeds and Partridge (1980).
Phase 2: Epidemiological Diagnosis
Lack of physical activity is especially harmful for individuals with behavioral or mental health problems (Vancampfort et al., 2011). It can reduce the quality of life for such patients and impair their ability to improve their conditions overall. Additionally, excess weight and lack of physical exercise lead to an increased risk of cancer development in the pancreas and kidney (Ehem et al., 2012). There is also an economic cost, which was measured at the end of the 20th century at $24 billion or 2.4% of money paid on health care per year (Colditz, 1999). There is also the problem that this particular population is from a low income community, an environment that can cause people to want to stay indoors and not get outside an exercise for fear of being attacked, assaulted or just from a fear of feeling unsafe in the community (Molnar, Gortmaker & Buka, 2004). Thus, part of the problem of addressing this issue is helping people to find ways to overcome insecurities about being outdoors in a low income community so that they can engage in physical exercise on a routine basis.
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The intervention selected to help address this issue is the 7-week exercise class with health education to promote physical activity. The class will teach basic physical exercises that clients can do on a regular basis. It will also include health education that will teach them the value and importance of maintaining this routine. Lastly, it will include steps that adults can take to feel more secure in their community, such as exercising (running, walking) in pairs or in a group, maintaining contact with others so that one always knows when one is out, and so on.
Phase 3: Educational and Ecological Assessment
Motivating behaviors for this population include improving their health and feeling better physically. As they are patients at the clinic, they are already motivated to improve their health. This is another step in the right direction for them, and as they are already predisposed to learning about ways to improve their health, they should welcome the class. Enabling factors include the patients’ ability to develop a support group or network so that they can assist one another in getting out and exercising—whether it is by carpooling to a park where they can walk or bicycling as a group. Reinforcing factors include the feeling of improved health that they will enjoy by engaging in physical activity. Just from personal experience alone, one can sense how much better one feels after exercising for a short amount of time: one’s energy level, attitude, and overall physical feeling improves significantly.
Phase 4: Intervention, Alignment and Administrative/Policy Assessment
The intervention is designed to take place over a 7-week course, with one class per week at the clinic in the evening. The resources required for the intervention are one workout room in the clinic where class can be conducted. One television screen and DVD player will also be used to assist in the educational portion of the course. An educational DVD on the benefits of physical activity will be used to help educate the class for 10 minutes before each session. This will explain the purpose of the exercise and how it can improve the person’s health. Educational materials in the form of fliers and brochures….....
Berlin, J. A., & Colditz, G. A. (1990). A meta-analysis of physical activity in the prevention of coronary heart disease. American Journal of Epidemiology, 132(4), 612-628.
Colditz, G. A. (1999). Economic costs of obesity and inactivity. Medicine and Science in Sports and Exercise, 31(11 Suppl), S663-7.
Eheman, C., Henley, S. J., Ballard?Barbash, R., Jacobs, E. J., Schymura, M. J., Noone, A.M., ... & Jemal, A. (2012). Annual Report to the Nation on the status of cancer, 1975?2008, featuring cancers associated with excess weight and lack of sufficient physical activity. Cancer, 118(9), 2338-2366.
Molnar, B. E., Gortmaker, S. L., Bull, F. C., & Buka, S. L. (2004). Unsafe to play? Neighborhood disorder and lack of safety predict reduced physical activity among urban children and adolescents. American journal of health promotion, 18(5), 378-386.
Vancampfort, D., Probst, M., Scheewe, T., Maurissen, K., Sweers, K., Knapen, J., & De Hert, M. (2011). Lack of physical activity during leisure time contributes to an impaired health related quality of life in patients with schizophrenia. Schizophrenia Research, 129(2-3), 122-127.