If we want more evidence-based practice, we need more practice-based evidence.*


If we want more evidence-based practice, we need more practice-based evidence.*


Home   Endnotes and Links: Chap 1  Chap 2  Chap 3 Chap 5 Chap 6  Chap 7  Chap 8  Chap 9

Health Program Planning, 4th edition (2004)

Chapter 4 (formerly Chap. 5 in third edition)

Ecological and Educational Diagnosis of Factors Affecting Health-Related Environments and Behavior

Table of Contents (Click on the section to go to the new endnotes and references for that section)

Reciprocal Determinism     

Theoretical Themes Underlying this Part of the Model 

Predisposing Factors

Enabling Factors

Reinforcing Factors

Selecting Determinants of Behavioral and Environmental Change

Endnotes* (Besides the table of contents above, you can search this page for references by topic or by key words, theories, models, authors, journals, dates, etc. using the "Find" command in the Edit menu)

*Although many of the articles cited below are hyperlinked to their abstracts, you might need to copy the citation to a word processing document to be able to click on the title and get to the linked abstract.

Endnote numbers refer to 4th edition, unless followed by >, in which case the first number refers to the third edition, and the number after the > refers to the 4th edition.

1. Reciprocal determinism of behavior and environment: In previous editions, we have presented these concepts of predisposing, enabling, and reinforcing factors in separate sections for their influences on behavior and influences on the environment. As the ecological approach has taken hold in program planning, the artificial compartmentalization of these by the disciplines that have nurtured the theories and research on each factor's influence has given way to a transdisciplinary view of their interaction and reciprocal determinism, as reflected in this discussion. See also, Best, Stokols, et al., 2003; Halfon & Hochstein, 2002; Hertzman et al., 2001; IOM, 2001; Jamner & Stokols, 2000; Keating & Hertzman, 1999; King et al., 2002; Singer & Ryff, 2001; Stokols, 2000.

Best, A., Stokols, D., Green, L. W., Leischow, S., Buchholz, K., Holmes, B. (2003). Health promotion and community partnering: Translating theory into effective strategy. American Journal of Health Promotion, 18, 168-76.

Halfon, N., & Hochstein, M. (2002). Life course health development: An integrated framework for developing health, policy, and research. The Milbank Quarterly, 80, 433-79.

Hertzman, C., Power, C., Matthews, C., & Manor, O. (2001). Using an interactive framework of society and lifecourse to explain self-rated health in early adulthood. Social Science and Medicine,  53, 1575-85.

Institute of Medicine. (2001). Health and behavior: The interplay of biological behavioral, and societal influences. Washington, DC: National Academy Press.

Jamner,  M., & Stokols, D. (Eds.). (2000). Promoting human wellness:  New frontiers for research, practice, and policy.  Berkeley, CA: University of California Press.

Keating, D. P., & Hertzman, C. (Eds.). (1999). Developmental health and the wealth of nations: Social, biological and educational dynamics. New York: Guilford Press; 1999.

King, A. C., Stokols, D., Talen, E., Brassington, G. S., & Killingsworth, R. (2002). Theoretical approaches to the promotion of physical activity: Forging a transdisciplinary paradigm. American Journal of Preventive Medicine, 23(2 Suppl), 15-25.

Singer, B. H., & Ryff, C. D. (Eds.). (2001). New horizons in health: An integrative approach. Washington, DC: National Academy Press.

Stokols, D. (2000). Social ecology and behavioral medicine: implications for training, practice, and policy. Behavioral Medicine, 26, 129-38.

1>2. Theoretical themes underlying the Precede-Proceed model. See endnote 14 in Chapter 1, and Chapter 1 of previous editions for earlier published references. For a searchable bibliography of some 950 published applications of the model, go to http://lgreen.net/hpp/precede apps/preapps.htm. The theoretical grounding and evolution of the Model has been influenced as much from its various applications and the theories brought to bear in those applications as in the original theories and research that led to the formulation of the model.

3. Social learning, as distinct from formal educational process, and the individual as an agent of environmental change, not just a victim of the environment.  Bandura, 2001; 2002; Green, 2004.

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1-26.

Bandura, A. (2002). Social cognitive theory. In L. Breslow et al. Encyclopedia of public health, vol. 4. (pp. 1121-1122). New York, Macmillan Reference USA.

Green, L. W. (2004). Introduction of Albert Bandura to receive the Healthtrac Foundation Prize for Health Education at the Society for Public Health Education. Health Behavior and Education, 31, in press.

2>4. Stages of change applied to populations: Prochaska, 2001; Prochaska et al., 2001; Sarkin et al., 2001. For critiques of the theory and its application, see Bandura, 1997; Lechner, Brug, & Mudde, 1998. [Citations predating 1999 for which references are not listed here will be found in the 3rd edition of the book.]

Prochaska, J. O. (2001). Treating entire populations for behavior risks for cancer. Cancer Journal, 7, 360-8.

Prochaska JO, Velicer WF, Fava JL, Rossi JS, Tsoh JY. (2001). Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation. Addictive Behavior, 26, 583-602.

Sarkin, J. A., Johnson, S. S., Prochaska, J. O., & Prochaska, J. M. (2001). Applying the transtheoretical model to regular moderate exercise in an overweight population: Validation of a stages of change measure. Preventive Medicine, 2001 Nov;33(5):462-9.

3>5. St. Louis community asthma project with African-American low-income neighborhood: E. B. Fisher et al., 1996, p. 371. For other Precede analyses of educational and ecological determinants of behavior and environments influencing asthma, see W. C. Bailey et al., 1987; Barner et al., 1999; Bartholomew, Parcel, Kok, & Gottlieb, 2001, pp. 34-34 & Fig 2.5; Boulet, Belanger, & Lajoie, 1996; Boulet, Chapman, Green, & FitzGerald, 1994; Chiang et al., 2003; H. Cohen, Harris, & Green, 1979; Fireman, Friday, Gira, Vierthaler, & Michaels, 1981; Green, 1974; Green & Frankish, 1994; Hindi-Alexander & Cropp, 1981; Liu & Feekery, 2001; Maiman, Green, Gibson, & Mackenzie, 1979; Mesters, Meertens, Crebolder, & Parcel, 1993; Pujet et al., 1997; Taggart et al., 1991. New references since 3rd edition:

Bailey WC, Kohler CL, Richards JM Jr, Windsor RA, Brooks CM, Gerald LB, Martin B, Higgins DM, Liu T. (1999). Asthma self-management: do patient education programs always have an impact? Arch Intern Med. 159, 2422-8.

Barner, J. C., Mason, H. L., & Murray, M. D. (1999).  Assessment of asthma patients' willingness to pay for and give time to an asthma self-management program. Clinical Therapeutics, 21, 878-94.   

Bartholomew, L. K, Parcel, G. S.,  Kok, G.,  & Gottlieb, N. H. (2001). Intervention mapping: Designing theory- and evidence-based health promotion programs. Mountain View, CA: Mayfield Publishing Co. (now McGraw-Hill).

Chiang, L., Huang, J., & Lu, C.  (2003). Educational diagnosis of self-management behaviors of parents with asthmatic children by triagulation based on PRECEDE-PROCEED model in Taiwan.  Patient Education and Counseling, 49, 19-25.

Liu, C., & Feekery, C. (2001). Can asthma education improve clinical outcomes?  An evaluation of a pediatric asthma education program.  Journal of Asthma, 38, 269-78.

Pujet, J-C, Nejjari, C.,  Tessier, J-F, Sapene, M, Pasquet, S, & Racineux, J-L . (1997).  Diagnostic and education in asthma.  A description of the results of a survey by questionnaire.  Revue Des Maladies Respiratoires, 14, 209-17.

6. Bartholomew, Parcel, Kok, & Gottlieb, 2001, present a graphic summary of the determinants of behavioral factors in asthma outcomes that also lists a set of environmental factors that interact with the behavioral factors (Fig. 2.5, p. 35). We commend this to those planning asthma self-management programs, but would recommend directing the enabling and reinforcing factors listed under “educational diagnosis” at the environmental factors as well as the behavioral. Many of their enabling and reinforcing factors would influence behavior and health outcomes through the social and physical environmental determinants, whereas the graph as drawn implies that all of the direct effects of change in the enabling and reinforcing factors would be on behavioral change in the parents or children with asthma.

4>7. Psychographics. The use of marketing concepts and tools such as psychographics have found their way increasingly into health program planning, especially via social marketing and where the health program has a product or service to "sell" to the public, such as condoms (Gray et al., 2001) or nicotine replacement treatments (Ling, & Glantz, 2002). Some other recent examples of psychographics in health planning include Stephenson et al., 2002 in drug abuse prevention and Candel, 2001 in consumer orientation toward convenience in meal preparation.

Candel, M. (2001). Consumers' convenience orientation towards meal preparation: Conceptualization and measurement. Appetite, 36, 15-28.

Gray, B., Morgan, G. T., & Shirer, R. (2001). Condom use and partner characteristics among young adult males in urban Ghana, aged 15-24. Social Biology, 48, 234-55.

Ling, P. M., & Glantz, S. A. (2002). Using tobacco-industry marketing research to design more effective tobacco-control campaigns. Journal of the American Medical Association, 287, 2983-9.

Stephenson, M. T., Morgan, S. E., Lorch, E.P., Palmgreen, P., Donohew, L., & Hoyle, R. H. (2002). Predictors of exposure from an antimarijuana media campaign: Outcome research assessing sensation seeking targeting. Health Communication, 14, 23-43.

Predisposing Factors

5>8. Sociographics. Demographic characteristics that predict, moderate, and sometimes explain variations in health behavior serve in conjunction with psychographics to segment and target health communications and other program interventions. E.g., Espy, & Senn, 2003; Fernando et al., 2003; Green & Potvin, 2002; Shoenberg et al., 2003; Whaley, & Winfield, 2003.

Espy, K. A., & Senn, T. E. (2003). Incidence and correlates of breast milk feeding in hospitalized preterm infants. Social Science and Medicine, 57, 1421-8.

Fernando, D., Schilling, R. F., Fontdevila, J., & El-Bassel, N. (2003). Predictors of sharing drugs among injection drug users in the South Bronx: implications for HIV transmission. Journal of Psychoactive Drugs, 35, 227-36.

Green, L. W. &  Potvin, L. (2002). Education, health promotion, and social and lifestyle determinants of health and disease. In R. Detels, J. McEwen, R. Beaglehole, & H. Tanaka (Eds.). Oxford Textbook of public health: Vol 1: The scope of public health, 4th edition (pp. 113-130). New York: Oxford University Press.

Schoenberg, N. E., Amey, C. H., Stoller, E. P., & Muldoon, S. B. (2003). Lay referral patterns involved in cardiac treatment decision making among middle-aged and older adults.
Gerontologist, 43, 493-502.

Whaley, A. L., & Winfield, E. B. (2003). Correlates of African American college students' condom use to prevent pregnancy, STDs, or both outcomes. Journal of the National Medical Association, 95, 702-9.

6>9. PRECEDE examples of using socio-demographic information for health planning by examining cultural differences imbedded in the predisposing demographic variations. Airhihenbuwa, 1995, esp p. 152 ff.; Bird et al., 1996; Castro et al., 1999, esp. pp 139, 151; Dabbagh et al., 1991-92; Doyle et al., 1999; Doyle & Feldman, 1977; Farthing, 1994; Frankish, Lovato, & Shannon, 1999, esp. pp. 59-63, 67; Glanz, Grove, et al., 1999 (using Andersen's earlier classification in which reinforcing were part of enabling factors); Gutierrez & Le, 1999, esp. pp. 359-60, 367, 370; Hiatt et al., 1996; Huff & Kline, 1999, esp. pp. 482, 495, see also pp. 76-78, 81-91; . 383, 389-390, 504-506, 509, & 513; Maxwell et al., 1998; Pasick, D'Onofrio, & Otero-Sabogal, 1996; Turner et al., 1995; Ugarte et al., 1992. Some applications of Precede analyses for planning programs cross-culturally have used participatory research methods with native populations, which have tended to draw them to a closer examination of demographic variations within what had been treated as culturally homogeneous populations (Bruerd, Kinney, & Bothwell, 1989; Daniel & Green, 1995; Daniel, Green, et al., 1999; Kieth & Doyle, 1998; Macaulay, Paradis, et al., 1997; McGowan & Green, 1995).

Airhihenbuwa, C.O. (1995). Health and culture: Beyond the Western paradigm.  Thousand Oaks, CA, Sage Publications, 152 p., 1995.

Bird, J. A., Otero-Sabogal, R., Ha, N.-T., & McPhee, S. J. (1996).  Tailoring lay health worker interventions for diverse cultures: lessons learned from Vietnamese and Latina communities. Health Education and Behavior, 23 (Suppl.), S105-22.

Bruerd, B., Kinney, M. B., & Bothwell, E. (1989). Preventing baby bottle tooth decay in American Indian and Alaska Native communities: A model for planning. Public Health Reports 104, 631-40.

Castro, F. G.,  Cota, M. K., Vega, S. C. (1999).  Health promotion in Latino populations: A sociocultural model for program planning, development, and evaluation. In R. M. Huff, & M. V. Kline (Eds.). Promoting Health in Multicultural Populations: A Handbook for Practitioners (pp. 137-68).  Thousand Oaks, CA: Sage.

Dabbagh, L., Green, L. W., & Walker, G. M. (1991-92).  Case Study: Application of PRECEDE and PROCEED as a framework for designing culturally sensitive diarrhea prevention programs and policy in Arab countries. International Quarterly of Community Health Education, 12, 293-315.

Daniel, M., &  Green, L. W. (1995). Application of the Precede-Proceed model in prevention and control of diabetes: A case illustration from an aboriginal community. Diabetes Spectrum 8, 80-123.

Daniel, M., Green, L. W., Marion, S. A., Gamble, D., Herbert, C. P., Hertzman, C., &  Sheps, S. B. (1999).  Effectiveness of community-directed diabetes prevention and control in a rural Aboriginal population in British Columbia, Canada.  Social Science & Medicine, 48, 815-832.

Doyle, E. I., Beatty, C. F., Shaw, M. W. (1999). Using cooperative learning groups to develop health-related cultural awareness. Journal of School Health 69, 73-76.

Doyle, E. I., & Feldman, R. H. L. (1997). Factors affecting nutrition behavior among middle-class adolescents in urban area of Northern region of Brazil. Revue Saude Publica, 31, 342-50, 1997.

Farthing, M.  (1994).  Health education needs of a Hutterite Colony. The Canadian Nurse/L'Infirmiere Canadienne 90, 20-6.

Frankish, C. J., Lovato, C. Y., Shannon, W. J. (1999). Models, theories, and principles of health promotion with multicultural populations. In R. M. Huff, & M. V. Kline (Eds.), Promoting health in multicultural populations: A handbook for practitioners (pp. 41-72).  Thousand Oaks, CA: Sage.

Glanz, K., Grove, J., Lerman, C., Gotay, C., Le Marchand, L. (1999). Correlates of intentions to obtain genetic counseling and colorectal cancer gene testing among at-risk relatives from three ethnic groups. Cancer Epidemiology Biomarkers & Prevention, 8, 329-36.

Gutierrez English, J., & Le, A.  (1999).  Assessing needs and planning, implementing, and evaluating health promotion and disease prevention programs among Asian American population groups. In R. M. Huff & M. V. Kline (Eds.). Promoting health in multicultural populations: A handbook for practitioners (pp. 357-73)Thousand Oaks, CA: Sage.

Hiatt, R. A., Pasick, R. J., Perez-Stable, E. J., McPhee, S., Engelstad, L., Lee, M., Sabogal, F., D’Onofrio, C. N., & Stewart, S. (1996). Pathways to early cancer detection in the multiethnic population of the San Francisco Bay Area. Health Education Quarterly, 23 (Suppl.), S10-27.

Huff, R. M., & Kline, M. V. (1999). The cultural assessment framework. In R. M. Huff, & M. V. Kline (Eds.). Promoting health in multicultural populations: A handbook for practitioners (pp. 481-500). Thousand Oaks, CA: Sage.

Keith, S. E., & Doyle, E. I. (1998). Using PRECEDE/PROCEED to address diabetes within the Choctaw Nation of Oklahoma. American Journal of Health Behavior 22, 358-67.

Macaulay, A. C., Paradis, G., Potvin, L., Cross, E. J., Saad-Haddad, C., McComber, A., Desrosiers, S., Kirby, R., Montour, L. T., Lamping, D. L., Leduc, N., & Rivard, M. (1997). The Kahnawake schools diabetes prevention project: Intervention, evaluation, and baseline results of a diabetes primary prevention program with a native community in Canada.  Preventive Medicine, 26, 779-90.

Maxwell, A. E., Bastani, R., & Warda, U. S. (1998). Mammography utilization and related attitudes among Korean-American women.  Women and Health, 27, 89-107. 

McGowan, P., & Green, L.W.(1995). Arthritis self-management in Native populations of British Columbia: An application of health promotion and participatory research principles in chronic disease control. The Canadian Journal on Aging 14(Suppl.1), 201-12.

Pasick, R. J., D'Onofrio, C. N., & Otero-Sabogal, R. (1996). Similarities and differences across cultures: Questions to inform a third generation for health promotion research. Health Education Quarterly, 23 (Suppl.), S142-161.

Satia-Abouta J., Patterson, R. E., Kristal, A. R., et al. (2002). Psychosocial predictors of diet and acculturation in Chinese American and Chinese Canadian women. Ethnic Health 7, 21-39.

Turner, L. W., Sutherland, M., Harris, G. J., & Barber, M. (1995). Cardiovascular health promotion in North Florida African-American churches. Health Values: The Journal of Health Behavior, Education & Promotion 19(2), 3-9, 1995.

Ugarte, C. A., Duarte, P., Wilson, K. M. (1992). PATCH as a model for development of a Hispanic health needs assessment: The El Paso experience. Journal of Health Education 23, 171-56.

7>10.  Use of demographic variation in predisposing factors to plan programs: e.g., motivation to quit smoking vs. weight gain. Males vs. females. Riedel et al., 2002. And further variation between African-American and white women, Pomerleau et al., 2001.

Pomerleau, C. S., Zucker, A. N., Namenek Brouwer, R. J., Pomerleau, O. F., & Stewart, A. J.. (2001). Race differences in weight concerns among women smokers: Results from two independent samples. Addictive Behavior 26, 651-63.

Riedel, B. W., Robinson, L. A., Klesges, R. C., & McLain-Allen, B. (2002). What motivates adolescent smokers to make a quit attempt? Drug and Alcohol Dependence, 68, 167-74.

10>11.  Examples of applied health-related awareness and knowledge acquisition, and relation of knowledge to behavior. E.g., Collins et al., 2003; Jardine, 2003; Jungers et al., 2003; some within the Precede-Proceed framework of predisposing, enabling, reinforcing factors: Canto, Goodman, et al., 1998; 2001; Chiou et al., 1998; Daltroy, et al., 1993.

Canto, M. T., Drury, T. F., Horowitz, A. M. (2001). Maryland dentists’ knowledge of oral cancer risk factors and diagnostic procedures. Health Promotion Practice 2(3): 255-262, July 2001.

*Canto, M. T., Goodman, H. S., Horowitz, A. M., Watson, M. R., & Duran-Medina C.  (1998).  Latino youths’ knowledge of oral cancer and use of tobacco and alcohol. American Journal of Health Behavior, 22, 411-20.

*Chiou, C. J.,  Huang, Y. H., Ka, J. K., Chun, F. J.  Huang, H. Y. (1998).  Related factors contributing to the healthy lifestyle of urban employees through the PRECEDE model.  (Chinese).  Kaohsiung Journal of Medical Sciences (Kao-Hsiung i Hsueh Ko Hsueh Tsa Chih), 14, 339-47.

Collins, R. L., Schell, T., Ellickson, P. L., & McCaffrey, D. (2003). Predictors of beer advertising awareness among eighth graders. Addiction, 98, 1297-306.

*Daltroy, L. H., Iversen, M. D., Larson, M.G., et al. (1993).  Teaching and social support: effects on knowledge, attitudes, and behaviors to prevent low back injuries in industry. Health Education Quarterly, 20, 43-62.

Jardine, C. G. (2003). Development of a public participation and communication protocol for establishing fish consumption advisories. Risk Analysis, 23, 461-71.

Jungers, E. A., Guenthner, S. T., Farmer, E. R., & Perkins, S. M. (2003). A skin cancer education initiative at a professional baseball game and results of a skin cancer survey. International Journal of Dermatology, 42, 524-9.

11>12. Knowledge requirements for asthma self-management actions. Bartholomew, Parcel, Kok, & Gottlieb, 2001, p. 35, do not include knowledge as necessary predisposing factor in asthma self-management, though they do include several skills needed by parents and children as enabling factors; Cf. Boulet, Chapman, Green, & FitzGerald, 1994; McLean et al., 2003; Meszaros et al., 2003.

Bartholomew, L. K, Parcel, G. S.,  Kok, G.,  & Gottlieb, N. H. (2001). Intervention mapping: Designing theory- and evidence-based health promotion programs. Mountain View, CA: Mayfield Publishing Co. (now McGraw-Hill).

*Boulet, L-P., Chapman, K. R., Green, L. W., & FitzGerald, J. M. (1994). Asthma education. Chest, 106, Suppl. 4: 184-96.

McLean, W., Gillis, J., & Waller R. (2003). The BC Community Pharmacy Asthma Study: A study of clinical, economic and holistic outcomes influenced by an asthma care protocol provided by specially trained community pharmacists in British Columbia. Canadian Respiratory Journal, 10, 195-202.

Meszaros A, Orosz M, Magyar P, Mesko A, Vincze Z. (2003). Evaluation of asthma knowledge and quality of life in Hungarian asthmatics. Allergy, 58, 624-8.

12>13.  Awareness or new knowledge sometimes appear to be the only thing required to get a change in behavior in those situations where the other predisposing, enabling, and reinforcing factors are already in place. A case study of the Ford Motor Company’s medical screening and surveillance program notes, “Although there is little evidence that information alone achieves behavior change...considerable evidence exists to indicate that, in some kinds of situations, information is all that is needed to provide behavior change....This was such a case.” Quotation from Ware, 1985, p. 321.

Ware, B. G. (1985). Occupational Health Education: A Nontraditional Role for a Health Educator," in Advancing Health Through Education: A Case Study Approach, H. P. Cleary, J. M. Kichen, and P. G. Ensor, eds. Palo Alto: Mayfield, pp. 319-23. 

13>14. Awareness and knowledge prevail over time in many cases because of the human drive for cognitive consistency.  The classic sources on this are Abelson, Aronson, McGuire, et al., 1968; and Festinger, 1957. Recent applications of the concept of cognitive consistency and cognitive dissonance in health include Gruber, 2003; Kiss, Richter-Mueksch, et al., 2004; Offir et al., 1993; Salovey, Schneider, & Apanovitch, 2000.

Festinger, L. (1957). A theory of cognitive dissonance. Stanford, CA: Stanford University Press.

Gruber M. (2003). Cognitive dissonance theory and motivation for change: a case study. Gastroenterology Nursing, 26, 242-5.

Kiss CG, Richter-Mueksch S, Stifter E, Diendorfer-Radner G, Velikay-Parel M, Radner W. (2004). Informed consent and decision making by cataract patients. Archives of Ophthalmology, 122, 94-8.

Offir, J. T., Fisher, J. D., Williams, S. S., et al. (1993). Reasons for inconsistent AIDS-Preventive behaviors among gay men. Jounral of Sex Research, 30, 62-69.

Salovey, P., Schneider, T. R., Apanovitch, A. M. (1999). Persuasion for the purpose of cancer risk reduction: A discussion. Journal of the National Cancer Institute Monographs, 25, 119-22, 1999.

14>15. For reviews of the various theories of intrapersonal or psychological dynamics in health behavior, see Glanz, Rimer, & Lewis, 2002, pp. 45-159; esp. Rimer, 2002; B. G. Simons-Morton, Greene, & Gottlieb, 1995; K. Tones & Tilford, 1994, esp. pp. 87–103.

Glanz, K., Rimer, B. K., & Lewis, F. M. (Eds.). (2002). Health behavior and health education: Theory, research, and practice. 3rd ed. San Francisco: Jossey-Bass.

Rimer, B. K. (2002). Perspectives on intrapersonal theories of health behavior. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.). Health behavior and health education: Theory, research, and practice. 3rd ed. (pp. 144-159). San Francisco: Jossey-Bass.

Simons-Morton, B. G., Greene W. H., & Gottlieb, N. H. (1995). Introduction to health education and health promotion, 2nd edition (Prospect Heights, IL: Waveland Press, Inc.).

Tones, K., & Tilford, S. (1994).Health education: Effectiveness, efficiency and equity, 2nd edition. London: Chapman & Hall.

15>16. The classic study that put the Health Belief Model on the map was reported in Hochbaum, 1956, 1959 to explain why people sought screening X-rays for tuberculosis. The model soon changed shape when applied to seeking  immunization. Hochbaum's colleagues substituted belief in susceptibility for belief that one could have a disease and not know it, which he had found to be the most important belief accounting for getting screening examinations. See Rosenstock, 1974; Rosenstock, Derryberry, & Carriger, 1959.

Hochbaum, G. M. (1956). "Why people seek diagnostic X-Rays. Public Health Reports, 71, 377-80.

 Hochbaum, G. M. (1959). Public participation in medical screening programs: A social-psychological study. Washington, DC: Public Health Service, PHS-572.

Rosenstock, I. M., M. Derryberry, and B. Carriger (1959).  Why people fail to seek poliomyelitis vaccination. Public Health Reports, 74, 98-103.

 Rosenstock, I. M. (1974). “The historical origins of the Health Belief Model. Health Education Monographs, 2, 354-95.

16>17.  For a more recent review of the origins, components, and applications of the Health Belief Model, see Janz, Champion, & Strecher, 2002. For a review and critique of studies testing the model, see J. A. Harrison, Mullen, & Green, 1992. For a validation of its predictive power in relation to other models, including PRECEDE, which encompasses the Health Belief Model, see P. D. Mullen, Hersey, & Iverson, 1987.

Harrison, J. A., Mullen, P. D., & Green, L. W. (1992). A meta-analysis of studies of the Health Belief Model. Health Education Research, 7, 107-16.

Janz, N. K., Champion, V. L., & Strecher, V. J. (2002). The Health Belief Model. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.). Health behavior and health education: Theory, research, and practice. 3rd ed. (pp. 45-66). San Francisco: Jossey-Bass.

Mullen, P. D., Hersey, J., & Iverson, D. C. (1987). Health behavior models compared. Social Science and Medicine 24, 973-81.

17>18. Most recent examples of Health Belief Model applications are cited in the series of endnotes (19- 30) to follow, by health issue, settings or populations. For more extensive and earlier bibliographic references on applications and tests of the Health Belief Model in each of these and other areas, see the previous editions of this book (Green & Kreuter, 1991, pp.156-7; 1999, pp. 162-3), or Harrison, Mullen, & Green, 1992; and Janz, Champion, & Strecher, 2002. For a critique of this and several other social cognition models used widely in health planning (theory of reasoned action, theory of planned behavior, and protection motivation theory), see Ogden, 2003.

Green, L. W., & Kreuter, M. W. (1991). Health promotion planning: An educational and environmental approach, 2nd ed. Mountain View, CA: Mayfield Publishing Co.

Green, L.W., & Kreuter, M.W. (1999b). Health promotion planning: An educational and ecological approach, 3rd ed. Mountain View, CA: Mayfield Publishing Co. 

Ogden, J. (2003). Some problems with social cognition models: a pragmatic and conceptual analysis. Health Psychology, 22, 424-8.

    19. Breast cancer screening and mammography (Allen, Bastani, et al., 2002; Oliver-Bazquez et al., 2002; Parten & slater, 2003).

Allen, B., Jr., Bastani, R., Bazargan, S., & Leonard, E. (2002). Assessing screening mammography utilization in an urban area. Journal of the National Medical Association, 94, 5-14.

Oliver-Vazquez, M., Sanchez-Ayendez, M., Suarez-Perez, E., Velez-Almodovar, H., & Arroyo-Calderon, Y. (2002). Breast cancer health promotion model for older Puerto Rican women: Results of a pilot programme. Health Promotion International, 17, 3-11.

Partin, M. R., & Slater, J. S. (2003). Promoting repeat mammography use: Insights from a systematic needs assessment. Health Education and Behavior, 30, 97-112.

    20.  Cervical cancer screening (Austin et al., 2002; Kahn et al., 2001; Lee, 2000; Michielutte et al., 2001).

Austin, L. T., Ahmad, F., McNally, M. J., & Stewart, D. E. (2002). Breast and cervical cancer screening in Hispanic women: A literature review using the Health Belief Model. Women's Health Issues, 12, 122-128.

Kahn, J. A., Goodman, E., Slap, G. B., Huang, B., & Emans, S. J. (2001). Intention to return for Papanicolaou smears in adolescent girls and young women. Pediatrics. 108(2, Part 1), 333-41.

Lee, M. C. (2000). Knowledge, barriers, and motivators related to cervical cancer screening among Korean-American women: A focus group approach. Cancer Nursing, 23, 168-75.

*Michielutte, R., Cunningham, L. E., Sharp, P. C., Dignan, M. B., & Burnette, V. D. (2001). Effectiveness of a cancer education program for women attending rural public health departments in North Carolina. Journal of Prevention and Intervention in the Community, 22, 23-42.

    21. Colorectal cancer screening exams (Jacobs, 2002; Manne et al., 2002; 2003; Rawl et al., 2002).

Jacobs, L.A. (2002). Health Beliefs of First-degree Relatives of Individuals With Colorectal Cancer and Participation in Health Maintenance Visits: A Population-based Survey
Cancer Nursing, 25, 251-65.

Manne, S., Markowitz, A., Winawer, S., Guillem, J., Meropol, N. J., Haller, D., Jandorf, L., Rakowski, W., Babb, J., & Duncan, T. (2003). Understanding intention to undergo colonoscopy among intermediate-risk siblings of colorectal cancer patients: A test of a mediational model. Preventive Medicine, 36, 71-84.

Manne, S., Markowitz, A., Winawer, S., Meropol, N. J., Haller, D., Rakowski, W., Babb, J., & Jandorf, L. (2002). Correlates of colorectal cancer screening compliance and stage of adoption among siblings of individuals with early onset colorectal cancer. Health Psychology, 21, 3-15.

Rawl, S. M., Menon, U., & Champion, V. (2002). Colorectal cancer screening: An overview of current trends. Nursing Clinics of North America, 37, 225-245.

    22. Prostate cancer screening exams (Clark-Tasker & Wade, 2002).

Clarke-Tasker, V. A., & Wade, R. (2002). What we thought we knew: African American males' perceptions of prostate cancer and screening methods. ABNF Journal, 13, 56-60.

    23. Skin cancer, sun exposure, and sun-protection behavior (Cokkinides et al., 2001; Grubbs & Tabano, 2000).

Cokkinides, V.E.; Johnston-Davis, K.; Weinstock, M.; O'Connell, M.C.; Kalsbeek, W.; Thun, M.J.; Wingo, P.A. (2001). Sun exposure and sun-protection behaviors and attitudes among U.S. youth, 11 to 18 years of age. Preventive Medicine, 33, 141-51.

Grubbs, L. M., & Tabano, M. (2000). Use of sunscreen in health care professionals: The Health Belief Model. Cancer Nursing, 23, 164-7.

    24. Cardiovascular disease prevention, risk reduction (Ali, 2002; Docherty, 2001).

Ali, N. S. (2002). Prediction of coronary heart disease preventive behaviors in women: A test of the Health Belief Model. Women and Health, 35, 83-96.

Docherty, B. (2001). Education campaigns in coronary heart disease. Professional Nurse, 16, 1048-51.

    25. Diabetes prevention (Burnet, Plaut et al., 2002; Wdowik, Kendall et al., 2000).

Burnet, D., Plaut, A., Courtney, R., & Chin, M. H. (2002). Practical model for preventing type 2 diabetes in minority youth. Diabetes Educator. 28, 779-95.

Wdowik, M. J., Kendall, P. A., Harris, M. A., & Keim, K. S. (2000). Development and evaluation of an intervention program: Control on campus. Diabetes Educator, 26, 95-104.

    26. Diet, exercise, physical activity, weight control, usually related to the two previous categories of cardiovascular disease prevention, risk reduction, and diabetes control (Ali, 2002; Burnet, Plaut, et al., 2002; Chew, Palmer, et al. 2002; Murimi, 2001; Rosal, Ebbeling, et al., 2001; Shephard, 2002; Soto Mas et al., 2000).

Chew, F., Palmer, S., Slonska, Z., & Subbiah, K. (2002). Enhancing health knowledge, health beliefs, and health behavior in Poland through a health promoting television program series. Journal of Health Communication, 7, 179-96.

Murimi, M. (2001). Short-term nutrition intervention increases calcium intake among 45-54 year old women. Journal of Nutrition for the Elderly, 20(3):1-12.

Rosal, M. C., Ebbeling, C. B., Lofgren, I., Ockene, J. K., Ockene, I. S., & Hebert, J. R. (2001). Facilitating dietary change: The Patient-centered Counseling Model. Journal of the American Dietetic Association. 101,  332-38,341.

Shephard, R. J. (2002). Whistler 2001: A Health Canada/CDC Conference on Communicating Physical Activity and Health Messages: Science Into Practice. American Journal of Preventive Medicine, 23, 221-5.

Soto Mas, F. G., Kane, W. M., Going, S., Ford, E. S., Marshall, J. R., Staten, L. K., & Smith, J. E. (2000). Camine con Nosotros: Connecting theory and practice for promoting physical activity among Hispanic women. Health Promotion Practice, 1, 178-87.

    27. Immigrants, minority, and cross-cultural health (Burnet et al., 2002; Hyman & Guruge, 2002; Lee, 2000; Poss, 2001; Soto Mas, Kane, et al., 2000).

Hyman, I., & Guruge, S. (2002). Review of theory and health promotion strategies for new immigrant women. Canadian Journal of Public Health. 93, 183-7.

Poss, J. E. (2001). Developing a new model for cross-cultural research: Synthesizing the Health Belief Model and the Theory of Reasoned Action. Advances in Nursing Science, 23, 1-15.

   28. Multiple risk behaviors (Chew, Palmer, et al., 2002; Docherty, 2001; Strecher, Wang, et al., 2002).

Strecher, V., Wang, C., Derry, H., Wildenhaus, K., & Johnson, C. (2002). Tailored interventions for multiple risk behaviors. Health Education Research, 17, 619-26.

    29. Osteoporosis (Murimi, 2001; Wallace, 2002).

Wallace, L. S. (2002). Osteoporosis prevention in college women: Application of the expanded Health Belief Model. American Journal of Health Behavior, 26, 163-72.

    30. School and college health programs (Wdowik et al., 2000; Winnail et al., 2002).

Winnail, S. D., Geiger, B. F., & Nagy, S. (2002). Why don't parents participate in school health education? American Journal of Health Education, 33, 10-4.

44>31. Use of Health Belief Model as a guide to needs assessment in relation to the predisposing factors within the Precede-Proceed Model (e.g., Lux & Petosa, 1993; Wong & Seet, 1997).

45>32. Ways of integrating the Health Belief Model and other specific cognitive and affective models with PRECEDE-PROCEED. Neumark-Sztainer & Story, 1996; Skinner & Kreuter, 1997, esp. pp. 56–59. Street, Gold, & Manning  recommend “an integrative framework for health promotion” such as Precede-Proceed to organize and expand the more specific theories and models, including Health Belief Model, Efficacy Theory (Social Cognitive Theory), Attribution Theory, the Theory of Reasoned Action and the Transtheoretical Model. Some of these will be discussed from this perspective later in this chapter.

Street, R. L., Jr., Gold, W. R., & Manning T. (1997). Health promotion and interactive technology: Theoretical applications and future directions. Mahwah NJ & London: Lawrence Erlbaum Associates, esp. pp.54-65.

(19)>33. The Health Belief Model and other predisposing factors are sometimes incorporated into other needs assessment, communication, or patient education and counseling models (Airhihenbuwa, 1995; Burnet et al., 2002; Rosal et al., 2001; Strecher, Wang, et al., 2002; Wong & Seet, 1997), although the use of the term "model" varies across these applications, where one model is often seen as a subset or component of another model, as with the Health Belief Model within the predisposing component of the Precede-Proceed Model. Some are mainly conceptual models to explain or predict, as with the Health Belief Model, others are that plus procedural or stage models for systematic application of the concepts, as with Precede-Proceed, Airhihenbuwa's PEN-3 (Person- model, and the Patient-Centered Counseling Model (Poss, 2001; Rosal et al., 2001).

Airhihenbuwa, C. O. (1995). Health and culture: Beyond the Western paradigm. Thousand Oaks, CA, Sage Publications, 152 p., 1995.

Rosal, M. C., Ebbeling, C. B., Lofgren, I., Ockene, J. K., Ockene, I. S., & Hebert, J. R. (2001). Facilitating dietary change: The Patient-centered Counseling Model. Journal of the American Dietetic Association. 101,  332-38,341.

Wong, T. Y., & Seet, B. (1997)  A behavioral analysis of eye protection use by soldiers.  Military Medicine, 162, 744-8.

45>34 Relating beliefs to other predisposing factors in the Precede model without using the Health Belief Model (H. Becker, Hendrickson, & Shaver, 1998), e.g., using Protection Motivation Theory introduced by R. W. Rogers (1975) and recently applied to genetic counseling by  (Helmes, 2003), amblyopia (Norman et al., 2003), and HIV-AIDS (Bengel et al., 1996). This theory contains the same essential elements as the Health Belief Model, but added a dimension of self-efficacy to the original HBM. Some of the architects of the evolving HBM later suggested adding self-efficacy to that Model as well (Rosenstock, Strecher, & Becker, 1988).

Bengel, J., Belz-merk, M., Farin, E.(1996). The role of risk perception and efficacy cognitions in the prediction of HIV-related preventive behavior and condom use. Psychology and Health, 11, 505-25.

Helmes, A.W. (2002). Application of the protection motivation theory to genetic testing for breast cancer risk. Preventive Medicine, 35, 453-62.

Norman, P., Searle, A., Harrad, R., & Vedhara, K. (2003). Predicting adherence to eye patching in children with amblyopia: An application of protection motivation theory. British Journal of Health Psychology, 8(Pt 1), 67-82.

Rogers, R. W. (1975). A protection motivation theory of fear appeals and attitude change. Journal of Psychology, 91, 93-114.

Rosal, M. C., Ebbeling, C. B., Lofgren, I., Ockene, J. K., Ockene, I. S., & Hebert, J. R. (2001). Facilitating dietary change: The Patient-centered Counseling Model. Journal of the American Dietetic Association. 101,  332-38,341.

Rosenstock, I. M., Strecher, V., & Becker, M. H. (1988). Social Learning Theory and the Health Belief Model. Health Education Quarterly, 15, 175-83.

47>35. Fear as motivation, or as barrier to action if belief in self-efficacy is lacking (Cho, 2003; Helmes, 2002; Norman et al., 2003; van der Pligt, 1998).

Cho, H. (2003). Communicating risk without creating unintended effects. American Journal of Health Studies, 18, 104-10.

48>36. Competing values, pro-health vs. non-health. (Lalonde, 1974, p. 8; see also Resnicow, Braithwaite, et al., 2002, esp. pp. 494-495 on differing core values of cultural or ethnic groups, and pp. 500-502 on core values of individualism vs. communalism, and of religiosity; Franzini et al., 2002, esp. pp 302-304, and Aguirre-Molina et al., 2001, pp. 77-178; and Gordon-Larsen et al., 2003, on how these values vary within Hispanic populations depending on their degrees of acculturation and stage of life; and Huff & Kline, 1999, for cultural assessment frameworks and tools to gauge values within cultural or multicultural settings). For variations in physical activity within African-American and other ethnic populations, for example, see several analyses in a special issue of American Journal of Preventive Medicine: Eyler, Matson-Koffman, & Macera, 2003.

Aguirre-Molina, M., Molina, C. W., & Zambrana, R. E. (Eds.). (2001). Health issues in the Latino community. San Francisco: Jossey-Bass.

Eyler, A. A., Matson-Koffman, D., & Macera, C. (Eds.). (2003). Physical activity in women from diverse racial/ethnic groups: Environmental, policy, and cultural factors. American Journal of Preventive Medicine, 25, Whole issue 3, Supplement 1: 1-105.

Franzini, L., Ribble, J. C., & Keddie, A. M. (2002). Understanding the Hispanic paradox. In T. A. LaVeist (Ed.). Race, ethnicity, and health: A public health reader (pp. 280-310). San Francisco: Jossey-Bass.

Gordon-Larsen, P., Mullan Harris, K., Ward, D. S., & Popkin, B. M. (2003). Acculturation and overweight-related behaviors among Hispanic immigrants to the US: the National Longitudinal Study of Adolescent Health. Social Science & Medicine, 57, 2023-34.

Huff, R. M., & Kline, M. V. (Eds.). The cultural assessment framework. In R. M. Huff, & M. V. Kline (Eds.). Promoting health in multicultural populations: A handbook for practitioners (pp. 481-499). Thousand Oaks, CA: Sage Publications, Inc.

Resnicow, K., Braithwaite, R. L., Dilorio, C., & Glanz, K. (2002). Applying theory to culturally diverse and unique populations. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.). Health behavior and health education: Theory, research, and Practice. 3rd ed. (pp. 485-509). San Francisco: Jossey-Bass.

49>37. This approach to audience segmentation and analysis is central to the marketing and social marketing fields. For examples of this application within the Precede model, see Bonaguro & Miaoulis, 1983; De Pietro, 1987; esp. pp. 105–107; Glanz & Rimer, 1995; Hall & Best, 1997; Kotler & Roberto, 1989, pp. 282–94; Lefebvre et al., 1995; Miaoulis & Bonaguro, 1980–1981; Sleet, 1987; J. A. Smith & Scammon, 1987. Recent reviews show a growing convergence in the use of social marketing methods of formative research with the traditions of community health in participatory research and planning, e.g., Bryant, et al., 2000; CDC, 1999; Neiger, et al., 2003.

Bryant, C. A., Forthofer, M. S., McCormack Brown, K. R., Landis, D. C., McDermott, R. J. (2000). Community-based prevention marketing: The next steps in disseminating behavior change. American Journal of Health Behavior, 24, 61-68.

CDC (1999). CDCynergy content and framework workbook. Atlanta: Office of Communication, Centers for Disease Control and Prevention, U. S. Department of Health and Human Services.

Hall, N., & Best, J. A. (1997).  Health promotion practice and public health: Challenge for the 1990sCanadian Journal of Public Health, 88, 409-15.

Neiger, B. L., Thackeray, R., Barnes, M. D., McKenzie, J. F. (2003). Positioning social marketing as a planning process for health education. American Journal of Health Studies, 18, 75-80.

Sleet, D. A. (1987). Health education approaches to motor vehicle injury prevention. Public Health Reports, 102, 606-8.   

Wechsler, H., Basch, C. E., Zybert, P. & Shea, S. (1998). Promoting the selection of low-fat milk in elementary school cafeterias in an inner-city Latino community: Evaluation of an intervention.  American Journal of Public Health, 88, 427-33. 

50>38. Definition of attitude in psychology. Mucchielli, 1970, p. 30.

51>39. Relation of attitude to beliefs. Kirscht, 1974.

52>40. Relation of attitudes and beliefs to values. Rokeach, 1970.

53>41. The Semantic Differential as a tool to measure attitudes. Osgood, Cuci, & Tannenbaum, 1961.

54>42. Self-efficacy applied in health, Baranowski, Perry, & Parcel, 2002; from some of the earliest applications in patient self-care education (e.g., Bowler & Morisky, 1983; Green, Levine, & Deeds, 1975; Lorig & Laurin, 1985); and broader school and community health education (Parcel & Baranowski, 1981; Strecher, DeVillis, Becker, & Rosenstock, 1986), to recent applications in chronic disease self-management (e.g., Lorig & Holman, 2003), risk-reduction and health promotion (Petosa et al., 2003).

Baranowski, T., Perry, C. L., & Parcel , G. S. (2002). How individuals, environments, and health behavior interact: Social Cognitive Theory. In K. Glanz, F. M. Lewis, and B. K. Rimer (Eds.). Health behavior and health education: Theory, research, and practice. 3rd edition (pp. 165-84). San Francisco: Jossey-Bass.

Lorig K. R., Holman, H. (2003). Self-management education: history, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26, 1-7.

Petosa R. L., Suminski, R., Hortz, B. (2003). Predicting vigorous physical activity using social cognitive theory. American Journal of Health Behavior, 2003, 27, 301-10.

57>43. Ottawa Charter declaration of health promotion's purpose, consistent with self-efficacy as a central mediator, if not outcome, for health promotion. First International Conference on Health Promotion, 1986.

58>44. Albert Bandura's concept of self-efficacy from his original Social Learning Theory, later named Social Cognitive Theory. Bandura, 1977; 1982; 1986; 2001; 2002; 2003. For a commentary on the significance of Bandura’s work for the health field, see Green, 2004.

Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall. 

Bandura, A. (1982). Self-efficacy mechanisms in human agency. American Psychologist 37, 122-47. 

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs: Prentice-Hall.

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1-26.

Bandura, A. (2002). Social cognitive theory. In L. Breslow, et al. (Eds.). Encyclopedia of public health, vol. 4. (pp. 1121-1122). New York, Macmillan Reference USA.

Bandura, A. (2004). ... Health Education and Behavior, 31, --[in press, title & pp to follow]

Green, L. W. (2004). Introduction of Albert Bandura for the Healthtrac Foundation Prize in Health Education. Health Education and Behavior, 30, --[in press, final title & pp to follow]

59>45. Self-efficacy's cognitive dimensions in coping with relapse in complex behavioral changes. E.g., Ausems et al., 2003; Dijkstra, & Borland, 2003; Fiorentine, & Hillhouse, 2003; McAuley et al., 2003; Mermelstein, 2003; Scholes et al., 2003.

Ausems, M., Mesters, I., van Breukelen, G., & De Vries, H. (2003). Do Dutch 11-12 years olds who never smoke, smoke experimentally or smoke regularly have different demographic backgrounds and perceptions of smoking? European Journal of Public Health, 13, 160-7.

Dijkstra A, Borland R. (2003). Residual outcome expectations and relapse in ex-smokers. Health Psychology, 22, 340-6.

Fiorentine, R., & Hillhouse, M. P. (2003). Replicating the Addicted-Self Model of recovery.
Addictive Behavior, 28, 1063-80.

McAuley, E., Jerome, G. J., Elavsky, S., Marquez, D. X., & Ramsey, S. N. (2003). Predicting long-term maintenance of physical activity in older adults. Preventive Medicine, 37, 110-8.

Mermelstein, R., Hedeker, D., & Wong, S. C. (2003). Extended telephone counseling for smoking cessation: Does content matter? Journal of Consulting and Clinical Psychology, 71, 565-74.

Scholes, D., McBride, C. M., Grothaus, L., Civic, D., Ichikawa, L. E., Fish, L. J., & Yarnall, K. S. (2003). A tailored minimal self-help intervention to promote condom use in young women: results from a randomized trial. AIDS, 17, 1547-56.

63>46. Self-efficacy variable in planning media-based programs. E.g., Levin et al., 2002; Mermelstein et al., 2003; Renger et al., 2002.

Levin, S., Martin, M. W., McKenzie, T. L., & DeLouise, A. C. (2002). Assessment of a pilot video's effect on physical activity and heart health for young children. Family and Community Health, 25, 10-7.

Renger, R., Steinfelt, V., & Lazarus, S. (2002). Assessing the effectiveness of a community-based media campaign targeting physical inactivity. Family and Community Health, 25, 18-30.

64,65,66>47. Measurement instruments for self-efficacy in health areas. E.g., Lorig, Stewart, Ritter, Gonzalez, et al., 1996 (including Spanish translations); Love, Davoli, & Thurmon, 1996.

48. Expectations and expectancies, other predisposing factors in Social Cognitive Theory. Bandura, 1986, as defined by Baranowski, Perry, & Parcel, 2002, p. 169; see their table showing implications of each of these and the other elements of Social Cognitive Theory for the design of health program interventions.

66>49. Behavioral intention and other predisposing factors from the Theory of Reasoned Action and the Theory of Planned Behavior. First introduced by Fishbein (1967)  in the face of growing discontent with the inconsistencies of "attitude" as a construct to predict and explain behavior (e.g., Green, 1970b). He and Ajzen distinguished between attitude toward an object of behavior and attitude toward the behavior itself, which they reframed as "evaluation of behavioral outcomes" and "behavioral beliefs" (Fishbein & Ajzen, 1975). In the Theory of Planned Behavior, Ajzen and colleagues added a dimension akin to self-efficacy, which they called "perceived behavioral control," a product of "control beliefs and "perceived power," to account for situations over which people do not have complete volitional control (Ajzen & Madden, 1986). For reviews of the evolution and earlier applications of this pair of theories in health, see Godin & Kok, 1996; Montano & Kasprzyk, 2002.

Ajzen, I., & Madden, J. T. (1986). Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22, 453-74. 

Fishbein, M. (Ed.). (1967). Readings in attitude theory and measurement. New York: Wiley.

Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.

Godin, G., & Kok, G. The Theory of Planned Behavior: A review of its applications to health-related behaviors. American Journal of Health Promotion, 80, 467-8.

67-73>50. Applications in health programs of the concepts from the Theory of Reasoned Action and Theory of Planned Behavior. See previous edition (Green & Kreuter, 1999, p. 167), for a range of applications prior to 1999. Armitage & Conner, 2001, conducted a meta-analysis of 185 studies that had applied the broader Theory of Planned Behavior and were published before 1997. More recent applications in health studies and programs, besides those on HIV and STD prevention reviewed in detail by Albarracin et al., 2001 and by Montano & Kasprzyk, 2002,  include breastfeeding (Gosken, 2002); drug abuse (Morrison et al., 2002) oral health (Syrjala et al., 2002); physical activity (Mummary et al., 2000; Trost et al., 2002); smoking prevention (McGahee et al., 2000).

Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychological Bulletin, 127, 142-61.

Armitage CJ, Conner M. (2001). Efficacy of the Theory of Planned Behaviour: a meta-analytic review. British Journal of Social Psychology, 40(Pt 4), 471-99.

Goksen, F. (2002). Normative vs. attitudinal considerations in breastfeeding behavior: Multifaceted social influences in a developing country context. Social Science and Medicine, 54, 1743-53.

McGahee, T. W., Kemp, V., & Tingen M. (2000). A theoretical model for smoking prevention studies in preteen children. Pediatric Nursing, 26, 135-8, 141.

Morrison, D. M., Golder, S., Keller, T. E., & Gillmore, M. R. (2002). The theory of reasoned action as a model of marijuana use: tests of implicit assumptions and applicability to high-risk young women. Psychology and Addictive Behavior, 16, 212-24.

Mummery, W. K., Spence, J. C., & Hudec, J. C. (2000). Understanding physical activity intention in Canadian school children and youth: An application of the theory of planned behavior. Research Quarterly of Exercise and Sport, 71, 116-24.

Syrjala, A. M., Niskanen, M. C., & Knuuttila, M. L.. (2002). The theory of reasoned action in describing tooth brushing, dental caries and diabetes adherence among diabetic patients.
Journal of Clinical Periodontology, 29, 427-32.

Trost, S. G., Pate, R. R., Dowda, M., Ward, D. S., Felton, G., & Saunders R. (2002). Psychosocial correlates of physical activity in white and African-American girls.Journal of Adolescent Health, 31, 226-33.

74,75>51. Combination of the Theory of Reasoned Action with PRECEDE, DeVries & Kok, 1986.  Other applications of the behavioral intention concept within PRECEDE include DeVries, Dijkstra, & Kuhlman, 1988; Keintz et al., 1988; Kraft, 1988; Liburd & Bowie, 1989; P. D. Mullen, Hersey, & Iverson, 1987; Ostwald & Rothenberger, 1985; Padilla & Bulcavage, 1991; Salazar, 1985; J. A. Smith & Scammon, 1987.

DeVries, H., Dijkstra, M. & Kuhlman, P. (1988). Self-efficacy: The third factor besides attitude and subjective norm as a predictor of behavioral intentions. Health Education Research, 3, 273-82.

Keintz, M. K., Rimer, B. K., Fleisher, L., & Engstrom, P. (1988). Educating older adults about their increased cancer risk. Gerontologist, 28, 487-90.

Kraft, D. P. (1988). The prevention and treatment of alcohol problems on a college campus. Journal of Alcohol and Drug Education, 34, 37-51.

Liburd, L. C. & Bowie, J. V. (1989). Intentional teenage pregnancy: A community diagnosis and action plan. Health Education, 20, 33-8.

Mullen, P. D., Hersey, J., & Iverson, D. C. (1987). Health behavior models compared. Social Science and Medicine 24, 973-81.

Ostwald, S. K., & Rothenberger, J. (1985). Development of a testicular self-examination program for college men. Journal of the American College Health, 33, 234-9.

Padilla, G. V., & Bulcavage, L. M. (1991). Theories used in patient / health education.  Seminars in Oncology Nursing, 7, 87-96.

Salazar, M. K. (1985). Dealing with hypertension: Using theory to promote behavioral change. AAOHN Journal, 43, 313-8.

Smith, J. A., & Scammon, D. L. (1987). A market segment analysis of adult physical activity: Exercise beliefs, attitudes, intentions and behaviors, Advances in Nonprofit Marketing, vol. 2. Greenwich, CT: JAI Press Inc.

52. Origins of the theories of change and psychotherapy initially reviewed for the Transtheoretical Model. Prochaska, 1979.

Prochaska, J. O. (1979). Systems of psychotherapy: A transtheoretical analysis. Pacific Grove, CA: Brooks-Cole.

53. Empirical studies of smokers to derive stages of change for the Transtheoretical Model. DiClemente & Prochaska, 1982; Prochaska & DiClemente, 1983.

DiClemente, C. C., & Prochaska, J. O. (1982). Self-change and therapy change of smoking behavior: A comparison of process of change in cessation and maintenance. Addictive Behaviors, 7, 133-42.

Prochaska, J. O. &DiClemente, C. (1983). Stages and processes of self-change in smoking: towards an integrative model of change. Journal of Consulting and Clinical Psychology, 5, 390-5.

54. Applications of the Stages of Change constructs with PRECEDE. Grueniger, 1995; Grueninger, Duffy, & Goldstein, 1995; Haber, 1994; Hubball, 1996; Koivula & Paunonen, 1998; Neumark-Sztainer, & Story, 1996.

Grueninger, U. J. (1995). Arterial hypertension: Lessons from patient education, Patient Education and Counseling, 26, 37-55. , 1995.

Grueninger, U. J., Duffy, F. D., & Goldstein, M. G. (1995). Patient education in the medical encounter: How to facilitate learning, behavior change, and coping. In M. Lipkin, Jr., S. M. Putnam, A. Lazare  (Eds.). The medical interview: Clinical care, education, and research (pp. 122-33). Bern: Mack Lipkin, Jr., MD.

Haber, D. (1994). Medical screenings and health assessments.  In D. Haber (Ed.), Health promotion and aging (pp.41-76).  New York, NY: Springer Publishing Company.

Hubball, H.  (1996).  Development and Evaluation of a Worksite Health Promotion Program: Application of Critical Self-Directed Learning for Exercise Behaviour Change.  Unpublished doctoral dissertation. Vancouver, B. C.: University of British Columbia, Faculty of Graduate Studies, Institute of Health Promotion Research.

Koivula, M., & Paunonen, M  (1998). Smoking habits among Finnish middle-aged men: experiences and attitudes.  Journal of Advanced Nursing, 27: 327-334.

Neumark-Sztainer, D, Story, M. (1996). The use of health behavior theory in nutrition counseling.  Topics in Clinical Nutrition, 11, 60-73.

55. Other recent applications of the Transtheoretical Model in health behavior studies or program planning. For a description of the model and recent reviews of its application in health, see Prochaska, Redding, & Evers, 2002. More recent applications include condom use in HIV prevention (Gullete & Turner, 2003); hypertension control (Chang, McAlister, et al., 2003), mammography adoption (Champion, & Skinner, 2003); physical activity (Schumann, Estabrooks, et al., 2003); self-management of pain (Habib, Morrissey, & Helmes, 2003); smoking cessation (Andersen, Keller, & McGowan, 1999).

Andersen, S., Keller, C., & McGowan, N. (1999). Smoking cessation: The state of the science. Online Journal of Knowledge Synthesis in Nursing, 22, 6-9.

Champion, V. L., & Skinner, C. S. (2003). Differences in perceptions of risk, benefits, and barriers by stage of mammography adoption. Journal of Women's Health, 12, 277-86.

Chang, L., McAlister, A. L., Taylor, W. C., & Chan, W. (2003). Behavioral change for blood pressure control among urban and rural adults in Taiwan. Health Promotion International, 18, 219-28.

Gullette, D. L., & Turner, J. G. (2003). Pros and cons of condom use among gay and bisexual men as explored via the internet. Jounal of Community Health Nursing, 20, 161-77.

Habib, S., Morrissey, S. A., & Helmes, E. (2003). Readiness to adopt a self-management approach to pain: evaluation of the pain stages of change model in a non-pain-clinic sample.
Pain, 104, 283-90.

Schumann, A., Estabrooks, P. A., Nigg, C. R., & Hill, J. (2003). Validation of the stages of change with mild, moderate, and strenuous physical activity behavior, intentions, and self-efficacy.
International Journal of Sports Medicine, 24, 363-5.

56. Stages of Change applied to organizational change.  J. M. Prochaska, Prochaska, & Lavesque, 2001.

Prochaska, J. M., Prochaska, J. O., & Levesque, D. A. (2001). A transtheoretical approach to changing organizations. Administration and Policy in Mental Health, 28, 247-61.

57. Existing skills in resisting peer pressure can predispose to not smoking, e.g., Engels, Knibbe, & de Haan, 1997; but success in changing these skills with resulting reduction in susceptibility to taking up drinking or other substance abuse is mixed (Clayton et al., 1996; Dedobbeleer, & Desjardins, 2001; Donaldson, Graham, et al., 1995).

Clayton, R. R., Cattarello, A. M., & Johnstone, B. M. (1996). The effectiveness of Drug Abuse Resistance Education (project DARE): 5-year follow-up results. Preventive Medicine, 25, 307-18.

*Dedobbeleer, N., & Desjardins, S. (2001). Outcomes of an ecological and participatory approach to prevent alcohol and other drug "abuse" among multiethnic adolescents. Substance Use and Misuse, 36, 1959-91.

Donaldson, S. I., Graham, J. W., Piccinin, A. M., & Hansen, W. B. (1995). Resistance-skills training and onset of alcohol use: Evidence for beneficial and potentially harmful effects in public schools and in private Catholic schools. Health Psychology, 14, 291-300.

58.  Programs that seek to build new health-related social skills in youth. D. R. Black, Tobler, & Sciacca, 1998. For reviews of the studies in this vein, see Allott, Paxton, & Leonard, 1999; Flay, 1987; Gerstein & Green, 1993, pp. 76–117; Midford, Munro, et al., 2002.

Allott, R., Paxton, R., & Leonard, R. (1999). Drug education: a review of British Government policy and evidence on effectiveness. Health Education Research, 14, 491-505.

Black, D.R., Tobler, N., & Sciacca, J. P. (1998).  Peer helping/involvement: An efficacious way of meeting the challenge of reducing illicit drug use?  Journal of School Health, 68, 87-93. 

Flay, B. R. (1987). Social psychological approaches to smoking prevention: Review and recommendations. In W. B. Ward and P. D. Mullen (Eds.). Advances in Health Education and Promotion, vol. 2 (pp. 121-80). Greenwich, CT: JAI Press.

Midford, R., Munro, G., McBride, N., Snow, P., & Ladzinski, U. (2002). Principles that underpin effective school-based drug education. Journal of Drug Education, 32, 363-86.

Enabling Factors

78>59. Skills as enabling factors. See, for example, the 12 behavioral outcomes described as skills needed by an asthmatic child, in Bartholomew, Parcel, Kok, & Gottlieb, 2001, Fig. 2-5, p. 35; or the 22 skills contributing to self-management ability in children and adolescents outlined by Thoresen & Kirmil-Gray, 1983. Some applications of PRECEDE in assessing needs for enabling skills include projects in asthma and chronic obstructive pulmonary disease (Bailey, Richards, et al., 1987; Fireman, Friday, et al., 1981; Taggart et al., 1991; Windsor, Green, & Roseman, 1980); cystic fibrosis (Bartholomew, Seilheimer, et al., 1989); preventing back pain (Daltroy, Iversen, et al., 1993); professional continuing education and training for health practitioners (Bennett, 1977; Hubball, 1996; Lomas, 1993; Mann & Putnam, 1989, 1990; Mann, Putnam, et al., 1990; McKell, 1996; Ottoson, 1995); childbirth and parenting skills (O'Meara, 1993); child health and survival (Schumann & Mosley, 1994); alcohol (Villas, Mottinger, & Cardenas, 1996); smoking cessation in pregnant women (Windsor, 1986); increasing condom use among sex workers (M. L. Wong, Chan, Koh, & Wong, 1994–95, 1996; 1998; 2000), and breast self-examination skills (Worden, Solomon, et al., 1990).

Bailey, W. C.,  Richards, J. M., Manzella, B. A., Windsor, R. A., Brooks, C. M., &  Soong, S. J. (1987). Promoting self-management in adults with asthma--An overview of the UAB program. Health Education Quarterly, 14, 345-55.

Bartholomew, L. K.,  Seilheimer, D. K., Parcel, G. S., Spinelli, S. H., &  Pumariega, A. J. (1989). Planning patient education for cystic fibrosis: Application of a diagnostic framework. Patient Education and Counseling, 13, 57-68.

Daltroy, Iversen, et al., see endnote 11 above.

Mann, K.V., & Putnam, R.W. (1989). Physicians' perceptions of their role in cardiovascular risk reduction. Preventive Medicine, 18, 45-58.

O'Meara, C. (1993). An evaluation of consumer perspectives of childbirth and parenting education. Midwifery 9, 210-9.

Ottoson, J. M. (1995).  Use of a conceptual framework to explore multiple influences on the application of learning following a continuing education program. Canadian J. of Adult Education 9(2): 1-18.

Schumann,  D. A., & Mosley, W. H. (1994).  The household production of health: Introduction. Social Science and Medicine 38(2): 201-204, 1994.

Taggart, V. S., Zuckerman, A. E., Sly, R. M., Steinmueller, C., Newman, G., O'Brien, R. W., Schneider, S., &  Bellanti, J. A.(1991). You can control asthma: evaluation of an asthma education program for hospitalized inner-city children. Patient Education and Counseling, 17, 35-47.

Villas, P.,  Mottinger, S. G., & Cardenas, M. (1996).  PRECEDE model utilization in differentiating users and nonusers of alcohol.  Journal of Wellness Perspectives, 12, 113-122.

Windsor, R. A. (1986). An application of the PRECEDE Model for planning and evaluating education methods for pregnant smokers. Hygie: International Journal of Health Education 5 (3): 38-43.

Windsor, R. A., Green, L. W., & Roseman, J. M. (1980). Health promotion and maintenance for patients with chronic obstructive pulmonary disease: A review. Journal of Chronic Disease, 33, 5-12.

Wong, M. L.,  Chan, K. W. R., & Koh, D.  (1998).  A sustainable behavioral intervention to increase condom use and reduce gonorrhea among sex workers in Singapore: 2-Year follow-up.  Preventive Medicine, 27, 891-900.

Wong M. L., Chan, R., Wee, S. (2000). Sex workers’ perspectives on condom use for oral sex with clients: a qualitative study. Health Education and Behavior 27, 502-16.

Worden, J. K., Flynn, B. S. Geller, B. M., et al. (1988). Development of a smoking prevention mass-media program using diagnostic and formative research. Preventive Medicine, 17, 531-58.

Worden, J. K., Soloman, L. J., Flynn, B. S., Costanza, M. C., Foster, R. S., Dorwaldt, A. L., & Weaver, S. O. (1990). A community-wide program in breast self-examination training and maintenance.  Preventive Medicine, 19, 254-69.

79>60. Social-action or collective action skills and capacity. See Chapters 5, 7, and 8 for more on these social-action skills.

61. Enabling factors at the population level expressed as collective efficacy, community capacity, and social capital. See, e.g., Chaskin et al., 2001; Crisp et al., 2000; Poland, 2000, and others cited in endnote 40 of Chapter 2.

Chaskin, R.J., Brown, P., Venkatesh, S., & Vidal, A. (2001). Building community capacity. New York: Aldine de Gruyter.

Crisp, B. R., Swerissen, H., & Duckett, S. J. (2000). Four approaches to capacity building in health: consequences for measurement and accountability. Health Promotion International, 15, 99-107.

Poland, B. D. (2000).  Social capital, social cohesion, community capacity, and community empowerment:  Variations on a theme?  In Poland, B.D., Green, L.W., & Rootman, I. (Eds.).  Settings in health promotion:  Linking theory and practice (pp. 301-307).  Thousand Oaks, CA:  Sage Publications.

62. Andersen’s original weighting of family and community resources as enabling factors for utilization of services for different healthcare needs. Andersen, 1969.  For some of his more recent studies of healthcare utilization, where enabling factors typically consist of income, insurance, and a regular source of care, see Andersen, Yu, et al., 2002; Barkin et al., 2003; Dobalian, Andersen, et al., 2003; Goodwin & Andersen, 2002; Heslin, Andersen, & Gelberg, 2003a,b.

Andersen, R. M., Yu, H., Wyn, R., Davidson, P. L., Brown, E. R., & Teleki S. (2002). Access to medical care for low-income persons: how do communities make a difference? Medical Care Research Reviews, 59, 384-411.

Barkin, S. L., Balkrishnan, R., Manuel, J., Andersen, R. M., & Gelberg, L. (2003). Health care utilization among homeless adolescents and young adults. Journal of Adolescent Health, 32, 253-6.

Dobalian, A., Andersen, R. M., Stein, J. A., Hays, R. D., Cunningham, W. E., & Marcus, M. (2003). The impact of HIV on oral health and subsequent use of dental services.
Journal of Public Health Dentistry, 63, 78-85.

Goodwin, R., & Andersen, R. M. (2002). Use of the Behavioral Model of Health Care Use to identify correlates of use of treatment for panic attacks in the community. Social Psychiatry and Psychiatric Epidemiology, 37, 212-9.

Heslin K. C., Andersen, R. M., & Gelberg, L. (2003a). Case management and access to services for homeless women. Journal of Health Care for the Poor and Underserved, 14, 34-51.

Heslin, K. C., Andersen, R. M., & Gelberg, L. (2003b). Use of faith-based social service providers in a representative sample of urban homeless women. Journal of Urban Health, 80, 371-82.

81>63. Center for Health Promotion and Education, 1987; D. G. Simons-Morton, Parcel, Brink, Harvey, & Tiernan, 1991. This and the other CDC Handbooks listed in subsequent citations each applied the Precede model to the assessment of needs and the planning of interventions for selected health problems and target populations. They provide detailed procedural guidelines on collecting and analyzing the data necessary to arrive at efficient judgments about the behavioral determinants and the predisposing, enabling, and reinforcing factors for behavioral change. Other applications of PRECEDE-PROCEED in assessing enabling factors in tobacco control include studies and program descriptions in adolescents and school-aged children (C. Boyd, 1993; Canto, Drury, & Horowitz, 2001; Canto, Goodman, et al., 1998; Dovell, 2001; Fawcett et al., 1997; Lipnickey, 1986; Parcel, Eriksen, et al., 1989, Parcel, O'Hara-Tompkins, et al., 1995; Polcyn, Price, Jurs, & Roberts, 1991; Reid, Harris, et al., 1983; Younoszai, & Lohrmann, 1999); college students (Hofford & Spelman, 1996); disabled clients of rehabilitation workers (Glenn, 1994); clinical counseling on smoking (Heywood, Firman, et al., 1996; Kientz, Rimer, et al., 1988; Kientz, Fleisher, & Rimer, 1994);  pregnant women (Lelong, Kaminski, et al., 1995); adult male populations (Koivula, & Paunonen, 1998); community programs (Paradis et al., 1995; Sanders-Phillips, 1996); with mass media (Secker-Walker, Flynn, & Worden, 1996; Secker-Walker, Worden, et al., 1997; Tillgren, Haglund, et al., 1995); worksites (Bertera, 1990; Bertera, Oehl, & Telepchak, 1990; Gottlieb, Eriksen, et al., 1990; Gottlieb, Lovato, et al., 1992; Gottlieb, & Nelson, 1990; Pucci, & Haglund, 1994; Sun, & Shun, 1995); and developing countries (Smith, & Alpers, 1984; Sun & Shun, 1995; Zhang & Qiu, 1993).

Bertera, R. L. (1990). Planning and implementing health promotion in the workplace: A case study of the Du Pont Company experience. Health Education Quarterly, 17, 307-27.

Bertera, R. L.,  Oehl, L. K., &  Telepchak, J. M. (1990). Self-help versus group approaches to smoking cessation in the workplace: Eighteen-month follow-up and cost analysis. American Journal of Health Promotion, 4, 187-92.

Canto, M. T., Drury, T. F., Horowitz, A. M. (2001). Maryland dentists’ knowledge of oral cancer risk factors and diagnostic procedures. Health Promotion Practice, 2, 255-62.

Canto, M. T., Goodman, H. S.,  Horowitz, A. M.,  Watson, M. R., & Duran-Medina, C.  (1998).  Latino youths’ knowledge of oral cancer and use of tobacco and alcohol.  American Journal of Health Behavior, 22,  411-20.

Center for Health Promotion and Education (1987). Smoking control among women: A CDC community intervention handbook (145 pp.). Atlanta, GA: Centers for Disease Control and Prevention, Department of Health and Human Services.1987.

Dovell, R. (2001). Cigarette Smoking by Adolescents: Exploring a Hypothesis of Social Marginalization. Vancouver, BC: University of British Columbia, Institute of Health Promotion Research.

Gottlieb, N. H., Eriksen, M. P.,  Lovato, C. Y., et al. (1990). Impact of a restrictive work site smoking policy on smoking behavior, attitudes, and norms. Journal of Occupational Medicine, 32, 20-3. 

Gottlieb, N. H., Lovato, C. Y., Weinstein, R., Green, L. W., & Eriksen, M. P. (1992). The implementation of a restrictive worksite smoking policy in a large decentralized organization. Health Education Quarterly, 19, 77-100.

Gottlieb, N. H., & Nelson, A. (1990). A systematic effort to reduce smoking at the worksite. Health Education Quarterly, 17, 99-118.

Heywood, A., Firman, D., Sanson-Fisher, R., & Mudge, P. (1996). Correlates of physician counseling associated with obesity and smoking.  Preventive Medicine, 25, 268-76.

Keintz, M. K., Rimer, B. K., Fleisher, L., Fox, L., & Engstrom, P. F. (1988). Use of multiple data sources in planning a smoking cessation program for a defined population. In P. F. Engstrom, P. N. Anderson, & L. E. Mortenson (Eds.). Advances in Cancer Control: Cancer Control Research and the Emergence of the Oncology Product Line (pp. 31-42). New York: Alan R. Liss, Inc.

Keintz, M. K., Fleisher, L., & Rimer, B. K. (1994). Reaching mothers of preschool-aged children with a targeted quit smoking intervention. Journal of Community Health, 19, 25-40. [Results from Keintz et al., 1988].

Koivula, M., & Paunonen, M. (1998). See endnote 54 above.

Lelong, N.,  Kaminski, M., Chwalow, J., Bean, K. & Subtil, D. (1995). Attitudes and behavior of pregnant women and health professionals towards alcohol and tobacco consumption.  Patient Education and Counseling, 25: 39-49.

Lipnickey, S. C. (1986). Application of the PRECEDE Model to a school-based program of drug, alcohol and tobacco education. [microform] ERIC database ED281126 Gov't Publications / Microforms Div. 12pp. Paper presented at the Annual Meeting of the American Public Health Association (114th, Las Vegas, NV, Sept. 28-Oct. 2, 1986). 

Polcyn, M. M., Price, J. H., Jurs, S. G., & Roberts, S. M. (1991). Utility of the PRECEDE Model in differentiating users and nonusers of smokeless tobacco. Journal of School Health, 61, 166-71.

Reid, D., Harris, J., Jacob, M., Davis, A. M., Randell, J. (1983). Smoking education in the United Kingdom with special reference to England, Wales, and Northern Ireland. In W.F. Forbes, R.C. Frecker, D. Nostbakken (Eds.). Proceedings of the Fifth World Conference on Smoking and Health, Winnipeg, Canada, 1983, Volume 1 (pp. 355-360). Ottawa, Ontario, Canada: Canadian Council on Smoking and Health.

Secker-Walker, R. H., Flynn, B. S., Solomon, P. M. (1996). Helping women quit smoking: baseline observations for a community health education project.  American Journal of Preventive Medicine, 12, 367-77.

Secker-Walker, R. H., Worden, J. K., Holland, R. R., Flynn, B. S., Detsky, A. S. (1997). A mass media program to prevent smoking among adolescents:  costs and cost effectivenessTobacco Control, 6, 207-12.

Smith, D. E., Alpers, M. P. (1984). Cigarette smoking in Papua New Guinea. Papua New Guinea Institute of Medical Research Monograph No. 7  Papua New Guinea Institute of Medical Research, Dec. 1984, 83pp.

Sun, W. Y., & Shun, J. (1995). Smoking behavior amongst different socioeconomic groups in the workplace in the People's Republic of China. Health Promotion International, 10, 261-6.

Tillgren, P., Haglund, B. J. A., Ainetdin, T., Thornqvist, E., Uhrbom, E. & Holm, L-E. (1995). Effects of different intervention strategies in the implementation of a nationwide tobacco “Quit and Win” contest in Sweden.  Tobacco Control, 4, 344-50.

Younoszai, T. M., Lohrmann, D. K., Seefeldt, C. A., & Greene, R.  (1999). Trends from 1987 to 1991 in alcohol, tobacco, and other drug (ATOD) use among adolescents exposed to a school district-wide prevention program.  Journal of Drug Education, 29, 77-94.

64. Measures of enabling and other factors (predisposing and reinforcing) determining smokeless tobacco use. Polcyn, Price, Jurs, & Roberts, 1991.

82>65. B. G. Simons-Morton, Brink, Parcel, et al., 1989. Other applications of PRECEDE-PROCEED in assessing enabling factors and other determinants of alcohol-related behavior in youth include Canto, Goodman, et al., 1998; Dedobbeleer & Desjardins, 2001; Donovan, 1991; Fawcett, Lewis, et al., 1997; Higgins & MacDonald, 1992; Hunnicutt, Perry-Hunnicutt, Newman, Davis, & Crawford, 1993; Hofford & Spelman, 1996; Kraft, 1988; Newman, Martin, & Weppner, 1982; Stivers, 1994; Vertinsky & Mangham, 1991; Villas, Cardenas, & Jameson, 1994. New to 4th edition:

Canto, M. T.,  Goodman, H. S.,  Horowitz, A. M.,  Watson, M. R., & Duran-Medina, C.  (1998).  Latino youths’ knowledge of oral cancer and use of tobacco and alcohol.  American Journal of Health Behavior, 22, 411-20.

Dedobbeleer, N., & Desjardins, S. (2001). Outcomes of an ecological and participatory approach to prevent alcohol and other drug abuse among multiethnic adolescents.  Substance Use and Misuse 36, 1959-91. 

Fawcett, S. B., Lewis, R. K., Paine-Andrews, A., Francisco, V. T., Richter, K. P., Williams, E. L., & Copple, B. (1997). Evaluating community coalitions for prevention of substance abuse: The case of project freedom.  Health Education and Behavior, 24, 812-28.

Hofford, C. W., & Spelman, K. A. (1996). The community action plan: incorporating health promotion and wellness into alcohol, tobacco and other drug abuse prevention efforts on the college campus.  Journal of Wellness Perspectives, 12, 70-9.

83>66. Project Graduation demonstrated reduction in teen alcohol-related vehicle fatalities following provision of enabling factor of alcohol-free graduation parties. Mowatt, Isaly, & Thayer, 1985.

Mowatt, C., Isaly, J., & Thayer, M. (1985). Project Graduation—Maine. Morbidity and Mortality Weekly Report 34, 233-5.

67. Laws enabling and reinforcing environmental controls on alcohol consumption before or during driving have reduced drunk driving, alcohol-related crashes, injuries and fatalities. Holder, Gruenewald, et al., 2000; Senserrick, 2003; Shults, Elder, et al., 2001; Shults, Sleet, et al., 2002; Treno & Lee, 2002. For an overview of theories applicable to injury prevention and the use of the Precede-Proceed Model to organize and integrate them, see Gielen & Sleet, 2003.

Gielen, A. C., & Sleet, D. (2003). Application of behavior-change theories and methods to injury prevention. Epidemiologic Reviews, 25, 65-76.

Holder, H. D., Gruenewald, P. J., Ponicki, W. R., et al. (2000). Effect of community-based interventions on high-risk drinking and alcohol-related injuries. Journal of the American Medical Association, 284, 2341–7.[Abstract/Free Full Text]

Senserrick, T. M. (2003). Graduation from a zero to.05 bac restriction in an Australian graduated licensing system: a difficult transition for young drivers? Annual Proceedings of the Association of Advanced Automotive Medicine, 47, 215-31.

Shults R. A., Elder, R. W., Sleet, D. A., Nichols, J. L., Alao, M. O., Carande-Kulis, V. G., Zaza, S., Sosin, D. M., Thompson, R. S., & Task Force on Community Preventive Services (2001). Reviews of evidence regarding interventions to reduce alcohol-impaired driving. American Journal of Preventive Medicine, 21, (4 suppl), 66–88.[Medline]

Shults, R. A., Sleet, D. A., Elder, R. W., Ryan, G. W., & Sehgal, M. (2002). Association between state level drinking and driving countermeasures and self reported alcohol impaired driving.
Injury Prevention, 8, 106-10.

Treno, A. J., & Lee, J. P. (2002). Approaching alcohol problems through local environmental interventions. Alcohol Research and Health, 26, 35-40.

68. Dramatic decline in alcohol-related fatalities from 1982-2001. Elder & Shults, 2002.

Elder, R. W., &  Shults, R. A. (2002). Involvement by young drivers in fatal alcohol-related motor-vehicle crashes--United States, 1982-2001. MMWR Morbidity and Mortality Weekly Report, 6;51(48), 1089-91.

New Figure 5-4 [replacing "Project Graduation" chart, p. 71]:

Figure 1

Source: Elder & Shults, 2002. MMWR, 6;51(48), 1091.

69. Enabling factors related to legislation and regulation usually depend on building the predisposing and reinforcing factors of an informed electorate and a favorable social climate. E. g., Bashford, 2003; Halperin, & Rigotti, 2003; Lorence & Richards, 2003.

Bashford, K. (2003). Going green more easily. Health Estate, 57(6), 27-30.

Halperin, A. C., & Rigotti, N. A. (2003). US public universities' compliance with recommended tobacco-control policies. Journal of American College Health, 51, 181-8.

Lorence, D. P., & Richards, M. C. (2003). Adoption of regulatory compliance programmes across United States healthcare organizations: a view of institutional disobedience. Health Services Management Research, 16, 167-78.

84>70. Enabling factors contributing to physical activity. Bauman, Smith, et al., 1999; Centers for Disease Control and Prevention, 2001; Craig, Brownson, et al., 2002; Ewing, Schmid, et al., 2003. Simons-Morton, Parcel, O'Hara, 1988 and their colleagues demonstrated substantial diet and physical activity changes in the first year following the implementation of organizational changes in school lunch programs and other aspects of the school environment in their "Go for Health" project, based partially on the Precede-Proceed Model.

Bauman, A., Smith, B., Stoker, L., et al. (1999). Geographical influences upon physical activity participation: evidence of a 'coastal effect.' Australia and New Zealand Journal of Public Health, 23, 322-4.

Centers for Disease Control and Prevention (2003). Increasing physical activity: A report on recommendations of the Task Force on Community Preventive Services. Morbidity and Mortality Weekly Report, RR-18, 50.

Craig, C. L., Brownson, R. C., Craig, S. E., & Dunn, A. L. (2002). Exploring the effect of the environment on physical activity: A study examining walking to work. American Journal of Preventive Medicine, 23(Suppl 2), 36-43.

Ewing, R., Schmid, T., Killingsworth, R., Zlot, A., & Raudenbush, S. (2003). Relationship between urban sprawl and physical activity, obesity, and morbidity. American Journal of Health Promotion, 18, 47-57.

*Simons-Morton, B. G., Parcel, G. S., O'Hara, N. M. (1988). Implementing organizational changes to promote healthful diet and physical activity at school. Health Education Quarterly, 15, 115-30.

71. The "built environment" of cities, suburbs, parks, schools, and transportation enable more or less physical activity, and can be designed to enable more.  Dannenberg, Jackson, et al., 2003; Hoehner, Brennan, et al., 2003; Killingsworth, Earp, & Moore, 2003; Saelens, Sallis, et al., 2003; Stokols, Grzywacz, et al., 2003.

Dannenberg, A. L., Jackson, R. J., Frumkin, H., Schieber, R. A.., Pratt, M., Kochtitzky, C., & Tilson, H. H. (2003). The impact of community design and land-use choices on public health: A scientific research agenda. American Journal of Public Health, 93, 1500-8.

Hoehner, C. M., Brennan, L. K., Brownson, R. C., Handy, S. L., & Killingsworth, R. (2003). Opportunities for integrating public health and urban planning approaches to promote active community environments. American Journal of Health Promotion, 18, 14-20.

Killingsworth, R., Earp, J., & Moore, R. (2003). Supporting health through design: Challenges and opportunities. American Journal of Health Promotion, 18, 1-2.

Saelens, B. E., Sallis, J. F., Black, J. B., & Chen, D. (2003). Neighborhood-based differences in physical activity: An environment scale evaluation. American Journal of Public Health, 93, 1552-8.

Stokols, D., Grzywacz, J. G., McMahan, S., & Phillips, K. (2003). Increasing the health promotive capacity of human environments. American Journal of Health Promotion, 18, 4-13.

72. Measures of the various enabling environmental factors that affect physical activity. Emery, Crump, & Bors, 2003; Moudon, & Lee, 2003.

Emery, J., Crump, C., & Bors, P. (2003). Reliability and validity of two instruments designed to assess the walking and bicycling suitability of sidewalks and roads. American Journal of Health Promotion, 18, 38-46.

Moudon, A. M., & Lee, C. (2003). Walking and bicycling: An evaluation of environmental audit instruments. American Journal of Health Promotion, 18, 21-37.

73. Skills as enabling factors in asthma self-management. Bartholomew, Parcel, Kok, & Gottlieb, 2001, p. 35, list several skills needed by parents and children as enabling factors; Boulet, Chapman, Green, & FitzGerald, 1994; McLean et al., 2003; Meszaros et al., 2003. [See references above in endnote 12].

85>74. Skills to enable resistance to peer pressure to experiment with alcohol, tobacco and other drugs. Recent studies of this enabling factor, related to the reinforcing factor of peer pressure, include Crone, Reijneveld, et al., 2003; Holm, Kremers, & de Vries, 2003; Wang, Tsai, et al., 2003. For measurement and evaluation of these dimensions in youth, see Frauenknecht & Black, 2003.

Crone, M. R., Reijneveld, S. A., Willemsen, M. C.,  van Leerdam, F. J., Spruijt, R. D., & Sing R. A. (2003). Prevention of smoking in adolescents with lower education: a school based intervention study. Journal of Epidemiology and Community Health, 57, 675-80.

Holm K, Kremers SP, de Vries H. (2003). Why do Danish adolescents take up smoking? European Journal of Public Health, 13, 67-74.

Wang, S. C., Tsai, C. C., Huang, S. T., & Hong, Y. J. (2003). Betel nut chewing and related factors in adolescent students in Taiwan. Public Health, 117, 339-45.

Frauenknecht, M., & Black, D. R. (2003). Social problem-solving inventory for adolescents (SPSI-A): A manual for application, interpretation and psychometric evaluation. Morgantown, WV: PNG Publications. 


86>75. Skills in goal-setting as an enabling factor in physical activity and obesity control. Conn, Minor, et al., 2003; Nies, & Kershaw, 2002; Ory, Jordan, & Bazzarre, 2002. A recently validated instrument for measurement of goal-setting and other psychosocial and enabling factors in physical activity is presented in Nies, Hepworth, et al., 2001. Applications incorporating goal-setting in analyses and program planning using PRECEDE include Bush, Zuckerman, et al., 1989; Cheng, DeWitt, et al., 1999; Mann, 1989; Mann & Sullivan, 1987; McMurry, Hopkins, et al., 1991; D. G. Simons-Morton, Parcel, et al., 1988.

Cheng, T. L., DeWitt, T. G., Savageau, J. A., & O’Connor, K. G.  (1999).  Determinants of counseling in primary care pediatric practice. Archives of Pediatrics & Adolescent Medicine, 153, 629-35.

Conn, V. S., Minor, M. A., Burks, K. J., Rantz, M. J., & Pomeroy, S. H. (2003). Integrative review of physical activity intervention research with aging adults. Journal of the American Geriatric Society, 51, 1159-68.

Mann, K. V. (1989). Promoting adherence in hypertension: a framework for patient education. Canadian Journal of Cardiovascular Nursing, 1, 8-14.

McMurry, M. P., Hopkins, P. N., Gould, R., Engelbert-Fenton, K., Schumacher, C., Wu, L. L., & Williams, R. R. (1991). Family-oriented nutrition intervention for a lipid clinic population.  Journal of the American Dietetic Association, 91, 57-65.

Nies, M. A., Hepworth, J. T., Wallston, K. A., & Kershaw, T. C. (2001). Evaluation of an instrument for assessing behavioral change in sedentary women. Journal of Nursing Scholarship,  33, 349-54.

Nies, M. A., & Kershaw, T. C. (2002). Psychosocial and environmental influences on physical activity and health outcomes in sedentary women. Journal of Nursing Scholarship, 34, 243-9.

Ory, M. G., Jordan, P. J., & Bazzarre, T. (2002). The Behavior Change Consortium: Setting the stage for a new century of health behavior-change research. Health Education Research, 17, 500-11.

87>76. Assessing individual and community capacity or developmental skills for management of personal environments, or for community organization and community mobilization to collaborate in changing the environment. Atkins, Oman, et al., 2002; Carr, 2000; Green & Shoveller, 2000; National Alliance of State and Territorial AIDS Directors, 2000. A survey instrument to measure some of these skills in adolescents has been validated by Oman, Vesley, et al., 2002, and applied variously to their management of risks related to tobacco (Atkins, Oman, et al., 2002) and sexual activity (Oman, Vesley et al., 2003). Participatory research approaches to developing these skills while assessing them in youth and others have been described in recent reports (e.g., Cargo, Grams, et al., 2003; Minkler & Hancock, 2003).

Atkins, L. A., Oman, R. F., Vesely, S. K., Aspy, C. B.,&  McLeroy, K. (2002). Adolescent tobacco use: the protective effects of developmental assets. American Journal of Health Promotion, 16, 198-205.

Cargo, M., Grams, G. D., Ottoson, J. M., Ward, P., & Green, L. W. (2003). Empowerment as fostering positive youth development and citizenship. American Journal of Health Behavior, 27, Suppl. 1, S66-79.

Carr, M. (2000). Social capital, civil society, and social transformation. In R. F. Woollard, & A. S. Ostry (Eds.). Fatal consumption: Rethinking sustainable development (pp. 69-97). Vancouver, BC: UBC Press.

Green, L. W. & Shoveller, J. A. (2000). Local versus central influences in planning for community health. In R. F. Woollard, & A. S. Ostry (Eds.). Fatal consumption: Rethinking sustainable development (pp. 166-196). Vancouver, BC: UBC Press.

Minkler, M., & Hancock, T. (2003). Community-driven asset identification and issue selection. In M. Minkler, & N. Wallerstein (Eds.). Community-based participatory research for health (pp. 135-54). San Francisco: Jossey-Bass.

National Alliance of State and Territorial AIDS Directors. (2000). HIV Prevention and Community Planning. Washington, DC: National Alliance of State and Territorial AIDS Directors. http://www.nastad.org.

Oman,  R. F., Vesely, S. K., Kegler, M., McLeroy, K., & Aspy, C. B. (2003). A youth development approach to profiling sexual abstinence. American Journal of Health Behavior, 27, Suppl. 1, S80-93.

Oman, R. F., Vesely, S. K., McLeroy, K. R., Harris-Wyatt, V., Aspy, C. B., Rodine, S., & Marshall, L. (2002). Reliability and validity of the youth asset survey (YAS). Journal of Adolescent Health, 31, 247-55.

Reinforcing Factors

88>77. Seeking social support while trying to quit smoking. E.g., Franks, Pienta, & Wray, 2002; . This effect can work against the behavior change when the source of social support is negatively inclined toward the change, such as a spouse who smokes, e.g., McLeod, Pullon, & Cookson, 2003. The influence of spouses and other family and peer support on quitting appears to be more positive for men than for women (Westmaas, Wild, & Ferrence, 2002), and women's perceptions of support from partners also tended to be less positive than the support male partners perceived themselves giving (Pollak, McBride, et al., 2001). These reinforcing factors could account for part of the difference in quit rates between men and women (Monso, Campbell, et al., 2001).

Franks, M. M., Pienta, A. M., & Wray, L. A. (2002). It takes two: marriage and smoking cessation in the middle years. Journal of Aging and Health, 14, 336-54.

McLeod, D., Pullon, S., & Cookson, T. (2003). Factors that influence changes in smoking behaviour during pregnancy. New Zealand Medical Journal, 116, U418.

Monsó, E., Campbell, J., Tønnesen, P., G Gustavsson, G., & Morera, J. (2001). Sociodemographic predictors of success in smoking intervention. Tobacco Control, 10, 165-69.

Pollak, K. I., McBride, C. M., Curry, S. J., Lando, H., Pirie, P. L., & Grothaus, L. C. (2001). Women's perceived and partners' reported support for smoking cessation during pregnancy. Annals of Behavioral Medicine, 23, 208-14.

West, R., McEwen, A., Bolling, K., Owen, L. (2001). Smoking cessation and smoking patterns in the general population: a 1-year follow-up. Addiction, 96, 891-902.

Westmaas, J. L., Wild, T. C., & Ferrence, R. (2002). Effects of gender in social control of smoking cessation. Health Psychology, 21, 368-76.

89>78. Reinforcing influence of role models in product advertising on alcohol and tobacco consumption, violence, food choices, and other health-related behavior: Green, Murphy & McKenna, 2002; Hackbarth, et al., 2001; Ribisl, Lee, et al., 2003; Stebbins, 2001; Villani, 2001; Wakefield, Flay, et al., 2003).

Green, L.W., Murphy, R.L., McKenna, J.W. (2002). New insights into how mass media works for and against tobacco. Journal of Health Communications, 7, 245-48.

Hackbarth, D. P., Schnopp-Wyatt, D., Katz, D., Williams, J., Silvestri, B., Pfleger, M. (2001). Collaborative research and action to control the geographic placement of outdoor advertising of alcohol and tobacco products in Chicago. Public Health Reports, 116, 558-67.

Ribisl, K. M., Lee, R. E., Henriksen, L., & Haladjian, H. H. (2003). A content analysis of Web sites promoting smoking culture and lifestyle. Health Education and Behavior, 30, 64-78.

Stebbins, K. R. (2001). Going like gangbusters: transnational tobacco companies "making a killing" in South America. Medical Anthropology Quarterly, 15, 147-70.

Villani S. (2001). Impact of media on children and adolescents: a 10-year review of the research. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 392-401.

Wakefield, M., Flay, B., Nichter, M., & Giovino, G. (2003). Role of the media in influencing trajectories of youth smoking. Addiction, 98, Suppl. 1, 79-103.

90>79. Reinforcement of physical activity by family, peers, and health care providers. E.g., Burke, Mori, et al., 2002; Mercer, Green, et al., 2003; Neumark-Sztainer, Story, et al., 2003; Painter, 2003; Satariano, Haight, & Tager, 2002. For examples of the assessment of reinforcing factors for physical activity within the context of the Precede-Proceed model, see Allegrante, Kovar, et al., 1993; Furst, Gerber, et al., 1987; Hill, 1996; Hopman-Rock, 2000; Lian, Gan, et al., 1999; Nguyen, Grignon, et al., 1995; Paradis, O’Loughlin, et al., 1995; Singer, Lindsay, & Wilson, 1991; Sjostrom, Karlsson, et al. One that found the reinforcing factor of "need for social support" to be  unimportant relative to predisposing factors in the adoption of a physical activity regimen was Hill, 1996. This supports the theoretical grounding of the reinforcing factors in maintaining a behavioral change more than in the initial adoption of the behavior.

*Allegrante, J. P., Kovar, P. T.,  Ronald MacKenzie, C.,  Peterson, M. G. E., & Gutin, B. (1993). A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies.  Health Education Quarterly, 20, 63-81.

Burke, V., Mori, T. .A, Giangiulio, N., Gillam, H. F., Beilin, L. J., Houghton, S., Cutt, H. E., Mansour, J., & Wilson, A. (2002). An innovative program for changing health behaviours. Asia Pacific Journal of Clinical Nutrition, 11, Suppl 3, S586-97.

*Furst, G. P., Gerber, L. H, Smith, C. C., Fisher, S., & Shulman, B.(1987).  A program for improving energy conservation behaviors in adults with rheumatoid arthritis. American Journal of Occupational Therapy, 41, 102-11.

*Hill, A. J. (1996). Predictors of regular physical activity in participants of a Canadian health promotion program. Canadian Journal of Nursing Research, 28, 119-41.

*Hopman-Rock, M. (2000). Towards implementing physical activity programmes:  The health promotion approachScience and Sports, 15, 180-6.

*Lian, W. M., Gan, L., Pin, C. H., Wee, S., & Ye, H. C. (1999). Determinants of leisure-time physical activity in an elderly population in Singapore. American Journal of Public Health, 89,  1578-80.

Macaulay, et al., 1997 [see endnote #9 above]

Mercer, S. L., Green, L. W., Rosenthal, A. C., Husten, C. G., Khan, L. K., & Dietz, W. H. (2003). Possible lessons from the tobacco experience for obesity control. American Journal of  Clinical Nutrition, 77(4 Suppl), 1073S-82S.

*Nguyen, M. N., Grignon, R., Tremblay, M., & Delisle, L. (1995).  Behavioral diagnosis of 30 to 60 year-old men in the Fabreville Heart Health Program. Journal of Community Health, 20, 257-69.

*Paradis, G., O’Loughlin, J., Elliott, M., Masson, P., Renaud, L., Sacks-Silver, G., & Lampron, G. (1995). Coeur en santé St-Henri - a heart health promotion programme in a low income, low education neighbourhood in Montreal, Canada: theoretical model and early field experience.  Journal of Epidemiology and Community Health, 49, 503-12.

*Neumark-Sztainer, D., Story, M., Hannan, P. J., Tharp, T., & Rex, J. (2003). Factors associated with changes in physical activity: a cohort study of inactive adolescent girls. Archives of Pediatric and Adolescent Medicine 157, 803-10.

Painter, P. (2003). Exercise for patients with chronic disease: physician responsibility. Current Sports Medicine Reports, 2, 173-80.

Satariano, W. A., Haight, T. J., & Tager, I. B. (2002). Living arrangements and participation in leisure-time physical activities in an older population. Journal of Aging and Health, 14, 427-51.

*Singer, J., Lindsay, E. A., & Wilson, D.M.C. (1991). Promoting physical activity in primary care: Overcoming the barriers. Canadian Family Physician, 37, 2167-73.

*Sjostrom, M., Karlsson, A. B., Kaati, G., Yngve, A., Green, L. W., Bygren, L. O. (1999). A four week residential program for primary health care patients to control obesity and related heart risk factors: effective application of principles of learning and lifestyle change. European Journal of Clinical Nutrition, 53 Suppl. 2, S72-7.

80. Vicarious reinforcement and learning of behavior.  Brown, Basil, & Bocarnea, 2003; Dye, Haley-Zitlin, & Willoughby, 2003; Peel & Dansereau, 1998; Thombs, Olds, & Ray-Tomasek, 2001; Tripp, Herrmann, et al., 2000.

Brown, W. J., Basil, M. D., & Bocarnea, M. C. (2003). The influence of famous athletes on health beliefs and practices: Mark McGwire, child abuse prevention, and Androstenedione. Journal of Health Communication, 8, 41-57.

Dye, C. J., Haley-Zitlin, V., Willoughby, D. (2003). Insights from older adults with type 2 diabetes: making dietary and exercise changes. Diabetes Educator, 29, 116-27.

Peel, J. L., & Dansereau, D. F. (1998). Management and prevention of personal problems in older adolescents via schematic maps and peer feedback. Adolescence, 33, 355-74.

Thombs, D. L., Olds, R. S., & Ray-Tomasek, J. (2001). Adolescent perceptions of college student drinking. American Journal of Health Behavior, 25, 492-501.

Tripp, M. K., Herrmann, N. B., Parcel, G. S., Chamberlain, R. M., & Gritz, E. R. (2000). Sun Protection is Fun! A skin cancer prevention program for preschools. Journal of School Health, 70, 395-401.

81. Role models as source of reinforcement and vicarious learning by professionals and other staff. Elnicki, Kolarik, & Bardella, 2003; Kern, Thomas, et al., 1998; Wright & Carrese, 2003.

Elnicki, D. M., Kolarik, R., & Bardella, I. (2003). Third-year medical students' perceptions of effective teaching behaviors in a multidisciplinary ambulatory clerkship. Academic Medicine,  78, 815-9.

*Kern, D. E., Thomas, P. A., Howard, D. M., & Bass, E. B. (1998). Curriculum development for medical education: A six-step approach. Baltimore: Johns Hopkins University Press.

Wright, S. M., & Carrese, J. A. (2003). Serving as a physician role model for a diverse population of medical learners. Academic Medicine, 78, 623-8.

91&92>82 Role models--peers and parents--for adolescent health-related behavior. Galambos, Barker, & Almeida, 2003; Gerstein, & Green, 1993; Musher-Eizenman, Holub, & Arnett, 2003; Urberg, Luo, et al., 2003.  Olds & Thombs (2001) find that adolescent perception of peer influence on cigarette and alcohol use outweighs perceived parental influence across all the grade levels. In a review of the literature on peer influence on teen smoking, Kobus (2003) views the data through the various theoretical lenses of social learning theory, primary socialization theory, social identity theory and social network theory, and notes that both peer and family influence work to stimulate use in some, and to deter it in others.

Galambos, N. L., Barker, E. T., & Almeida, D. M. (2003). Parents do matter: trajectories of change in externalizing and internalizing problems in early adolescence. Child Development, 74, 578-94.

Kobus, K. (2003). Peers and adolescent smoking. Addiction, 98, Suppl. 1, 37-55.

Musher-Eizenman, D. R., Holub, S. C., & Arnett, M. (2003). Attitude and peer influences on adolescent substance use: the moderating effect of age, sex, and substance. Journal of Drug Education, 33, 1-23.

Olds, R. S., & Thombs, D. L. (2001). The relationship of adolescent perceptions of peer norms and parent involvement to cigarette and alcohol use. Journal of School Health, 71, 223-8.

Urberg, K. A., Luo, Q., Pilgrim, C, & Degirmencioglu, S. M. (2003). A two-stage model of peer influence in adolescent substance use: individual and relationship-specific differences in susceptibility to influence. Addictive Behavior, 28, 1243-56.

Selecting Determinants of Behavioral and Environmental Change

83. Informal methods of data collection on factors influencing behavior and environment. Gilmore and Campbell, 2004.

Gilmore, G. D., & Campbell, M. D. (2004).  Needs assessment strategies for health education and health promotion.  (3rd ed.).  Madison, WI: Brown and Benchmark Publishers.

84. Focus group methods in identifying perceived causes of behavioral and environmental problems. Basch, 1987; Gilmore & Campbell, 2004. See Chapter 2 for more detail on focus-group methods and applications. For recent examples in the context of applications of the Precede-Proceed Model, including issues of nutrition, Balch, Loughrey, et al., 1997; Doyle & Feldman, 1997; Lefebvre, Doner, et al., 1995; Reed, Meeks, et al., 1998; occupational health, Brosseau, Parker, et al., 2002; dental health, Canto, Goodman, et al., 1998; cancer screening, Danigelis, Roberson, et al., 1995; Dignan, Michielutte, et al., 1990; infectious disease control, Larson, Bryan, et al., 1997; M. Taylor, Coovadia, et al., 1999; primary care behavior of physicians,  Mirand, Beehler, et al., 2002; Mahloch, Taylor, et al., 1993; V. Taylor, Taplin, et al., 1994.

*Balch, G. I., Loughrey, K. A., Weinberg, L., Lurie, D., & Eisner, E. (1997). Probing consumer benefits and barriers for the national 5 A Day Campaign: Focus group findings. Journal of Nutrition Education, 29, 178-83.

*Brosseau, L. M., Parker, D. L., Lazovich, D., Milton, T., & Dugan, S.  (2002).  Designing intervention effectiveness studies for occupational health and safety:  The Minnesota wood dust studyAmerican Journal of Industrial Medicine, 41, 54-61.

*Canto, Goodman, et al., 1998. See endnote # 11.

*Danigelis, N. L.,  Roberson, N. L., Worden, J. K., Flynn, B.,  Dorwaldt, A. L.,  Ashley, J. A.,  Skelly, J. M., & Mickey, R. M. (1995).  Breast screening by African-American women: Insights from a household survey and focus groups.  American Journal of Preventive Medicine, 11, 311-7.

*Dignan, M. B., Michielutte, R., Sharp, P., Bahnson, J., Young, L., & Beal, P. (1990).  The role of focus groups in health education for cervical cancer among minority women.  Journal of Community Health, 15, 369-75.

*Doyle & Feldman, 1997. See endnote # 9 above.

*Larson, E. L., Bryan, J. L., Adler, L. M., & Blane, C. (1997). A multifaceted approach to changing handwashing behavior. American Journal of Infection Control, 25, 3-10.

*Lefebvre, R. C., Doner, L., Johnston, C., Loughrey, K., Balch, G. I., & Sutton, S. M. (1995).  Use of database marketing and consumer-based health communication in message design: An example from the Office of Cancer Communications' "5 a Day for Better Health" program. In E. Maibach, & R. Louiselle Parrott (eds.). Designing health messages: Approaches from communication theory and public health practice (pp. 217-246). Thousand Oaks, London, New Delhi: Sage Publications Inc.

*Mahloch, J., Taylor, V., Taplin, S., & Urban, N. (1993). A breast cancer screening educational intervention targeting medical office staff. Health Education Research, 8, 567-79.

*Mirand, A. L., Beehler, G. P., Kuo, C. L., and Mahoney, M. C. (2002). Physician perceptions of primary prevention: qualitative base for the conceptual shaping of a practice intervention tool.  BioMed Central Public Health, 2(1): 16.

*Reed, D. B., Meeks, P. M., Nguyen, L., Cross, E. W., & Garrison, M. E. B. (1998). Assessment of nutrition education needs related to increasing dietary calcium intake in low income Vietnamese mothers using focus group discussions.  Journal of Nutrition Education, 30, 155-63.

*Taylor, M., Coovadia, H. M., Kvalsvig, J. D., Jinabhai, C. C., & Reddy, P. (1999).  Helminth control as an entry point for health-promoting schools in KwaZulu-Natal.  South African Medical Journal, 89, 273-9.

*Taylor, V. M., Taplin, S. H., Urban, N., Mahloch, J., & Majer, K. A. (1994).  Medical community involvement in a breast cancer screening promotional project. Public Health Reports, 109, 491-9.

4-85. Examples of brainstorming (Doyle, Beatty, & Shaw, 1999) and nominal group process (Adeyanju, 1987-88) to generate insight and ideas on predisposing, enabling, and reinforcing factors in behavioral and environmental problems.

*Taylor, V. M., Taplin, S. H., Urban, N., Mahloch, J., & Majer, K. A. (1994).  Medical community involvement in a breast cancer screening promotional project. Public Health Reports, 109, 491-9.

Doyle, E. I., Beatty, C. F., & Shaw, M. W. (1999). Using cooperative learning groups to develop health-related cultural awareness. Journal of School Health, 69, 73-6.

4-97>86. Tendency of informal methods to produce "victim blaming" or "system blaming," or "fate" and other unproductive and stereotyping explanations, e. g., De Moura, Harpham, & Lyons, 2003; Green, 1994; Johnson, Mullick, & Mulford, 2002; Ogden, Bandara, et al., 2001. Use of informal data to construct more formal questionnaire items to measure extent of misperceptions  and myths about causation, e. g., Walsh, Devellis, & Devellis, 2003.

De Moura S. L., Harpham, T., Lyons, M. (2003). The social distribution of explanations of health and illness among adolescents in Sao Paulo, Brazil. Journal of Adolescence, 26, 459-73.

Green, L.W. (1994). Refocusing health care systems to address both individual care and population health. Clinical and Investigative Medicine, 17, 133-41.

Johnson, L. M., Mullick, R., & Mulford, C. L. (2002). General versus specific victim blaming. Journal of Social Psychology, 142, 249-63.

Ogden, J., Bandara, I., Cohen, H., Farmer, D., Hardie, J., Minas, H., Moore, J., Qureshi, S., Walter, F., & Whitehead, M. A. (2001). General practitioners' and patients' models of obesity: whose problem is it? Patient Education and Counselling, 44, 227-33.

Walsh, J. F., Devellis, B. M., & Devellis, R. F. (1997). Date and acquaintance rape. Development and validation of a set of scales. Violence Against Women, 3, 46-58.

87. The stereotyping and victim-blaming tendencies extend beyond health professionals to policy makers and professionals in other sectors whose cooperation in addressing determinants of health will be needed, e.g., Bensberg, & Kennedy, 2002; de Almeida, Binder, & Fischer, 2000; Mittelmark, 1999; Raj, & Silverman, 2002. Attribution theory suggests a tendency for observers to overattribute the behavior of others to pre-dispositional variables and to underestimate the importance of situational or environmental determinants, but these tendencies diminish over time with greater familiarity (e. g., Truchot, Maure, & Patte, 2003).

Bensberg, M., & Kennedy, M. (2002). A framework for health promoting emergency departments. Health Promotion International, 17, 179-88.

de Almeida, I. M., Binder, M. C., & Fischer, F. M. (2000). Blaming the victim: aspects of the Brazilian case. International Journal of Health Services, 30, 71-85.

Mittelmark,  M. B. (1999). The psychology of social influence and healthy public policy. Preventive Medicine, 29, (6 Pt 2), S24-9.

Raj, A, & Silverman, J. G. (2002). Intimate partner violence against South Asian women in greater Boston. Journal of the American Medical Women's Association, 57, 111-4.

Truchot, D., Maure, G, Patte S. (2003). Do attributions change over time when the actor's behavior is hedonically relevant to the perceiver? Journal of Social Psychology, 143, 202-8.

99>88. For examples of analyses of demographic determinants of health-related behavior and environments, see Carpenter, 2003; N. H. Gottlieb & Green, 1987; O’Loughlin, Paradis, & Gray-Donald, 1999; Winkleby, Kraemer, & Varady, 1998.

Carpenter, C. (2003). Seasonal variation in self-reports of recent alcohol consumption: racial and ethnic differences. Journal of Studies in Alcoholism, 64, 415-8.

O’Loughlin, J. L., Paradis, G., Gray-Donald, K., & Renaud, L. (1999).  The impact of a community-based heart disease prevention program in a low-income, inner-city neighborhood. American Journal of Public Health, 89, 1819-26.

89. Diagnostic or assessment data as baseline data for subsequent program evaluation. E.g., Rossi, Lipsey, & Freeman, 2003, esp. chapters 4-6.

Rossi, P. H., Lipsey, M. W., & Freeman, H. E. (2003). Evaluation: A systematic approach. 7th edition. Thousand Oaks, CA: Sage Publications.

Figure 4-6.  Reasons people give for not being more active, with contrasts between the 43% of the overall population who are less active and the population of older adults over 60 years of age.

Source: President’s Council on Physical Fitness and Sports Medicine, U.S. Department of Health and Human Services. Online at http://www.fitness.gov/american_att.PDF, accessed September 28, 2003.

100>90. Examples of surveys constructed in line with PRECEDE's predisposing, enabling, and reinforcing factors to identify and assess determinants of behavioral and environmental changes related to asthma (Pujet, J-C., C Nejjari, et al., 1997); breast self-examination, clinical breast examination, and mammography screening (Danigelis, Roberson, et al, 1995; Desnick, Taplin, et al., 1999; Han, Baumann, & Cimprich, 1996; McPhee, Bird, et al., 1996; Morrison, 1995;  Lee, Lee, & Stewart, 1996; Taplin, Taylor, et al., 1994; Zapka, Costanza, et al., 1993; Zapka & Mamon, 1982; Zapka, Stoddard, et al., 1989); other cancer screening (McPhee, Bird, et al., 1996; Mercer, Goel, et al., 1997; Neef, Scutchfield, et al., 1991; Ngtuyen, McPhee, et al., 2002; Wismer, Moskovitz, et al., 1998; 2001; Zuckerman, Guerra, et al., 1996); cardiovascular diseases (Bailey, Rukholm, et al., 1994; Mann, & Putnam, 1989; McKell, Chase, & Balram, 1996); childbirth and parenting (O'Meara C., 1993); cystic fibrosis (Bartholomew, Seilheimer, et al., 1989); fetal alcohol syndrome (Donovan, 1991); diabetes (Daniel, 1997; Daniel, Green, et al., 1999);  gerontology (Rimer, Jones, et al., 1983); hospital infections (McGovern, Kochevar, et al., 1997; Michalsen, Delclos, et al., 1997), medication adherance (Opdycke, Ascione, et al., 1992); nursing and physician staff behavior related to prevention and health promotion (Berland, Whyte, & Maxwell, 1995; Cheng, DeWitt, et al., 1999; Clearie, Blair, & Ward, 1982; Desnick, Taplin, et al., 1999; Donovan, 1991; Han, Baumann, & Cimprich, 1996; Laitakari, Miilunpalo, & Vuori, 1997; Mann, & Putnam, 1989; Michalsen, Delclos, et al., 1997; Miilunpalo, Laitakari, & Vuori, 1995; Taplin, Taylor, et al., 1994); nutrition (Campbell, Denmark-Wahnefried, et al., 1999; Doyle & Feldman, 1997; Kristal, Patterson, et al., 1995; Lefebvre, Doner, et al., 1994; McKell, Chase, & Balram, 1996); physical activity (Lian, Gan, et al., 1999); school health (Cottrell, Capwell, & Brannan, 1995; Rubinson, & Baillie, 1981); sexuality education (Rubinson, & Baillie, 1981); tobacco control: adolescent smoking (Dovell, 2001; Flynn, Worden, et al., 1992; Sun & Ling, 1997); adult smoking (Koivula, & Paunonen, 1998; Secker-Walker, Flynn, et al., 1996); smokeless tobacco use (Canto, Goodman, et al., 1998); use of prosthetic devices (Gauthier-Gagnon, Grise& Potvin, 1998); skin cancer prevention (Glanz, Carbone, & Song, 1999; Miller, Geller, et al., 1999); genetic testing (Glanz, Grove, et al., 1999); general health risks related to ethnic and other disparities in health (Gottlieb & Green, 1984; 1987; McPhee, Bird, et al., 1996; Sanders-Phillips, 1991; Zuckerman, Guerra, et al., 1996); worksite health (Bertera, 1990; Daltroy, Iversen, et al., 1993; Kristal, Patterson, et al., 1995; McGovern, Kochevar, et al., 1997; Michalsen, Delclos, et al., 1997; Sun & Shun, 1995). Additional site-specific references to survey instruments using Precede-Proceed categories appear in latter chapters.

Bailey, P. H.,  Rukholm, E. E., Vanderlee, R., & Hyland, J. (1994). A Heart Health Survey at the worksite: The first step to effective programmingAAOHN Journal, 42, 9-14.

Bartholomew, Seilheimer, et al., 1989, see endnote 59 above.

Berland, A.,  Whyte, N. B., & Maxwell, L. (1995). Hospital nurses and health promotion.  Canadian Journal of Nursing Research, 27, 13-31.

Bertera, 1990, see endnote 63 above.

Campbell, M. K., Demark-Wahnefried, W., Symons, M., Kalsbeek, W. D., Dodds, J., Cowan, A., Jackson, B., Motsinger, B., Hoben, K., Lashley, J., Demissie, S., & McClelland, J. W. (1999). Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health Project. American Journal of Public Health, 89, 1390-6.

Canto, Goodman, et al., 1998, see endnote 63 above.

Cheng, DeWitt, et al., 1999, see endnote 75 above.

Clearie, A. F., Blair, S. N., & Ward, W. B. (1982).  The role of the physician in health promotion: Findings from a community telephone survey.  The Journal of the South Carolina Medical Association, 78, 503-5.

Cottrell, R. R.,  Capwell, E., & Brannan, J. (1995).  A follow-up evaluation of non-returning teams to the Ohio Comprehensive School Health Conference. Journal of Wellness Perspectives, 12, 1-6.

Daltroy, Iversen, et al. (1993), see endnote 11 above.

Daniel, Green, et al., 1999, see endnote 9 above.

Daniel, M. (1997). Effectiveness of Community-Directed Diabetes Prevention and Control in a Rural Aboriginal Population. Vancouver, BC: University of British Columbia, Faculty of Medicine and Faculty of Graduate Studies.

Danigelis, Roberson, et al, 1995, see endnote 84 above.

Desnick, L., Taplin, S., Taylor, V., Coole, D., & Urban, N.  (1999).  Clinical breast examination in primary care: Perceptions and predictors among three specialties.  Journal of Women’s Health, 8, 389-97.

Donovan, 1991, see endnote 65 above.

Dovell, R. (2001). Cigarette smoking by adolescents: Exploring a hypothesis of social marginalization. Vancouver, BC: University of British Columbia, Institute of Health Promotion Research, Faculty of Graduate Studies.

Doyle, & Feldman, 1997, see endnote 9 above.

Flynn B. S., Worden, J. K., Secker-Walker, R. H., Badger, G. J., Geller, B. M., & Costanza, M. C.  (1992). Prevention of cigarette smoking through mass media intervention and school programs. American Journal of Public Health, 82, 827-34.

Gauthier-Gagnon, C., Grise, M-C,  & Potvin, D. (1998).  Predisposing factors related to prosthetic use by people with a transtibial and transfemoral amputation. Journal of Prosthetics and Orthotics, 10, 99-109.

Glanz, K., Carbone, E., & Song, V.  (1999).  Formative research for developing targeted skin cancer prevention programs for children in multiethnic Hawaii. Health Education Research, 14, 155-66.

Glanz, Grove, Lerman, Gotay, & Le Marchand, 1999 (using Andersen's earlier classification in which reinforcing factors were part of enabling factors); see endnote 9 above.

Gottlieb, N. H., & Green, L. W. (1984). Life events, social network, life-style, and health: An analysis of the 1979 National Survey of Personal Health Practices and Consequences. Health Education Quarterly, 11, 91-105.

Gottlieb, N. H., & Green, L. W. (1987). Ethnicity and lifestyle health risk: Some possible mechanisms. American Journal of Health Promotion, 2, 37-45.

Han, Y., Baumann, L. C., & Cimprich, B. (1996). Factors influencing registered nurses teaching breast self-examination to female clients. Cancer Nursing, 19, 197-203.

Koivula, M., & Paunonen, M. (1998). See endnote 54 above.

Kristal, A. R., Patterson, R. E., Glanz, K., Heimendinger, J., Herbert, J. R.,  Feng, Z., & Probart, C. (1995). Psychosocial correlates of healthful diets: baseline results from the working well study. Preventive Medicine, 24, 221-8.

Laitakari, J., Miilunpalo, S., & Vuori, I. (1997). The process and methods of health counseling by primary health care personnel in Finland: a national survey.  Patient Education and Counseling30, 61-70.

Lee, M., Lee, F., & Stewart, S. (1996). Pathways to early breast and cervical detection for Chinese American women. Health Education and Behavior, 23 (Suppl.), S76-S88.

Lefebvre, Doner, et al., 1994, see endnote 84 above. 

Lian, Gan, Pin, Wee, & Ye, 1999, see endnote 79 above.

Mamon, J. A., & Zapka, J. G (1986). Breast self-examination by young women. I. Characteristics associated with frequency. American Journal of Preventive Medicine, 2, 61-9.

Mann, & Putnam, 1989, see endnote 59 above.

McGovern, P. M., Kochevar, L. K., Vesley, D., & Gershon, R. R. M. (1997). Laboratory professionals' compliance with universal precautions. Laboratory Medicine, 28, 725-30.

McKell, C. J., Chase, C., & Balram, C. (1996).  Establishing partnerships to enhance the preventive practices of dietitians. Journal of the Canadian Dietetic Association, 57, 12-7.

McPhee, S. J., Bird, J. A., Ha, N.-T., Jenkins, C. N. H., Fordham, D., & Le, B. (1996). Pathways to early cancer detection for Vietnamese women: Suc Khoe La Vang! (Health is Gold!). Health Education Quarterly, 23 (Suppl.), S60-S75.

Mercer, S. L., Goel, V., Levy, I. G., Ashbury, F. D., Iverson, D. C., & Iscoe, N. A. (1997). Prostrate cancer screening in the midst of controversy: Canadian men’s knowledge, beliefs, utilization, and future intentions. Canadian Journal of Public Health, 88, 327-32. 

Michalsen, A., Delclos, G. L., Felknor, S. A., Davidson, A. L., Johnson, P. C., Vesley, D., Murphy, L. R., Kelen, G. D., & Gershon, R. R. M. (1997). Compliance with universal precautions among physicians.  Journal of Occupational and Environmental Medicine, 39,  130-137.

Miilunpalo, S., Laitakari, J., & Vuori, I. (1995). Strengths and weaknesses in health counseling in Finnish primary health care. Patient Education and Counseling, 25, 317-28.

Miller, D. R., Geller, A. C., Wood, M. C., Lew, R. A., & Koh, H. K. (1999).  The Falmouth Safe Skin Project: Evaluation of a community program to promote sun protection in youth.  Health Education & Behavior, 26, 369-84.

Morrison, C. (1995). Breast cancer detection behaviors in low income women over forty: characteristics associated with frequency and proficiency of breast self examination. Dissertation Abstracts International [A] 55(10): 3101.

Morrison, C. (1996). Using PRECEDE to predict breast self-examination in older, lower-income women. American Journal of Health Behavior,  20, 3-14.

Neef, N., Scutchfield, F. D., Elder, J. & Bender, S. J. (1991). Testicular self examination by young men: An analysis of characteristics associated with practice. Journal of American College Health, 39, 187-90.

Ngtuyen, T. T., McPhee, S. J., Nguyen, T.; Lam, T., & Mock, J. (2002). Predictors of cervical pap smear screening awareness, intenetion, and receipt among Vietnamese-American women. American Journal of Preventive Medicine, 23, 207-14.

O'Meara C., 1993, see endnote 59 above.

Opdycke, R. A. C.,  Ascione, F. J., Shimp, L. A., Rosen, R. I. (1992). A systematic approach to educating elderly patients about their medications. Patient Education and Counseling, 19, 43-60.

Pujet, J-C., C Nejjari, et al., 1997, see endnote 5 above.

Rimer, B. K., Jones, W., Wilson, C., Bennett, D., Engstrom, P. (1983). Planning a cancer control program for older citizens. Gerontologist, 23, 384-9.

Rubinson, L., & Baillie, L. (1981). Planning school based sexuality programs using the PRECEDE Model. Journal of School Health, 51, 282-7.

Sanders-Phillips, K. (1991). A model for health promotion in ethnic minority families. Wellness Lecture Series. Oakland, CA: University of California President's Office.

Secker-Walker, Flynn, et al., 1996, see endnote 63 above.

Sun, & Shun, 1995, see endnote 63 above.

Sun W. Y., & Ling, T. (1997). Smoking behavior among adolescents in the city, suburbs, and rural areas of Shanghai.  American Journal of Health Promotion, 11, 331-6.

Taplin, S. H., Taylor, V., Montano, D., Chinn, R., & Urban, N. (1994). Specialty differences and the ordering of screening mammography by primary care physicians. Journal of the American Board of Family Practice, 7, 375-86.

Taylor, Taplin, et al., 1994, see endnote 84 above.

Wismer, B.A., Moskowitz, J.M., Min, K., Chen, A.M., Ahn, Y., Cho, S., Jun, S., Lew, A., Pak, Y.M., Wong, J.M., & Tager, I.B. (2001).  Interim assessment of a community intervention to improve breast and cervical cancer screening among Korean American WomenJournal of Public Health Management Practice, 7, 61-70.

Wismer, B. A., Moskowitz, J. M., Chen, A. M., Kang, S. H., Novotny, T. E., Min, K., Lew, R. & Tager, I. B. (1998). Rates and independent correlates of pap smear testing among Korean-American women.  American Journal of Public Health, 88, 656-60.

Zapka J. G., Costanza, M. E., Harris, D. R., Hosmer, D., Stoddard, A., Barth, R., & Gaw, V. (1993).  Impact of a breast cancer screening community intervention. Preventive Medicine, 22, 34-53.

Zapka & Mamon, 1982.

Zapka, J. G., Stoddard, A. M., Costanza, M. E., & Green, H. L. (1989). Breast cancer screening by mammography: Utilization and associated factors. American Journal of Public Health, 79, 1499-502.

Zuckerman, M. J., Guerra, L. G., Drossman, D. A., Foland, J. A., & Gregory, G. G.  (1996).  Health-care-seeking behaviors related to bowel complaints - Hispanics versus non-Hispanic whites.  Digestive Diseases and Sciences, 41, 77-82.

101>91. Formal surveys applying PRECEDE constructs of predisposing, enabling, and reinforcing factors in educational and ecological assessments usually are also used in subsequent surveys to evaluate progress. More or less standardized instruments are found in Green & Lewis, 1986; see esp. Chapter 6 for inventories and references on instrument selection and development, and Appendix C (pp. 331–341) for a questionnaire developed for the National Survey of Personal Health Practices and Consequences and adapted for community-level application. Other measures and exemplary survey instruments are found in Lorig et al., 1996. See also, Louis Harris and Associates, 1996; Lovato & Allensworth, 1989. Some of the PRECEDE measures have been adapted to various countries, languages and cultures, e.g., Australia (Cockburn, et al., 1989; 1997 on sunscreen protection behavior; Farr & Fisher, 1991, and Newman & Martin, 1982 on smoking; O'Meara, 1993, on childbirth and parenting preparation; Spillman, Harvey, et al., 1994 on nutrition; Stevenson & Jones, 1996, on child injury prevention); the Netherlands (deVries, Dijkstra, & Kok, 1992 on smoking; Hiddink, Hautvast, et al., 1995, 1997,on physicians' nutrition guidance to patients; Spruijt-Metz, 1995, on adolescent sleeping habits and snacking).  A Canadian national survey, based on the Precede factors, is described in Rootman, 1988.  Nozu et al. translated to Japanese the Alteneder, Price, et al. (1992) instrument for measurement of PRECEDE constructs in HIV-AIDS and tested its psychometric properties in a sample of senior high school students in Japan.

Alteneder, R. R., Price, J. H., Telljohann, S. K., Didion, J., & Locher, A. (1992). Using the PRECEDE model to determine junior high school students' knowledge, attitudes, and beliefs about AIDS. Journal of School Health, 62, 464-70.

Cockburn, J., D. Hennrikus, R. Scott, R., & Sanson-Fisher, R. (1989). Adolescent use of sun-protection measures. Medical Journal of Australia, 151, 136-40.

Cockburn, Jill (Discipline of Behavioural Science in Relation to Medicine, University of Newscastle, Locked Bag 10, Wallsend, NSW 2287, Australia), SC Tompson, R Marks, D Jolley, P Schofield & D Hill.  (1997).  Behavioural dynamics of a clinical trial of sunscreens for reducing solar keratoses in Victoria, Australia.  Journal of Epidemiology and Community Health, 51: 716-721.

de Vries, Hein, Margo Dijkstra, Gerjo Kok. (1992). A Dutch smoking prevention project: An overview. Hygie, 11(2), 14-18.

Farr, L. J., and L. J. Fisher (1991). 'Bring Your Body Back to Life': The 1990 Western Australian Quit Campaign.  Health Promotion Journal of Australia, 1:6-10.

Hiddink, Gerrit J. (Dutch Dairy Foundation on Nutrition & Health, Zonnenbaan 12D, 3606 CA Maarssen, The Netherlands), Hautvast JGAJ, van Woerkum CMJ, Fieren CJ, van’t Hof MA. (1995). Nutrition guidance by primary-care physicians: perceived barriers and low involvement. European Journal of Clinical Nutrition, 49, 842-51, 1995.

Hiddink, G. J. (Dairy Foundation on Nutrition and Health, P. O. Box 6017, 3600 HA Maarssen, The Netherlands), JGAJ Hautvast, CMJ van Woerkum, CJ Fieren, & MA van’t Hof.  (1997).  Driving forces for and barriers to nutrition guidance practices of Dutch primary care physicians.  Journal of Nutrition Education, 29 (1), 36-41.

Lorig, et al., 1996, see endnote 47 above.

Newman, I. M. and G. L. Martin (1982). Attitudinal and normative factors associated with adolescent cigarette smoking in Australia and the USA: A methodology to assist health education planning. Community Health Studies, 6, 47-56.

Nozu, Yuji (Assoc.Prof., 1-1 Tegata Gakuen, Akita Univ., Akita City, 010 Japan), Koichi Iwai, Motoi Watanabe (1995). AIDS-related knowledge, attitudes, beliefs and skills among high school students in Akita: Results from Akita AIDS education for Adolescent Survey (AAAS). Abstract No.234. Proceedings. Makuhari, Japan: Xvth World Conference of the International Union for Health Promotion and Education, Aug.

O'Meara C (Univ. of Canberra, PO Box 1, Belconnen, ACT 2616, Australia). (1993). An evaluation of consumer perspectives of childbirth and parenting education. Midwifery, 9, 210-219.

Rootman, I. (1988). Canada's Health Promotion Survey. In I. Rootman, R. Warren, T. Stephens, and L. Peters, (eds.). Canada's Health Promotion Survey: Technical Report. Ottawa: Minister of Supply and Services, for Health and Welfare Canada.

Spillman, D. A., Harvey, P. W. J., Gillespie, A. M., Heywood, P. F.  (1994).  Developing needs assessment for adolescent nutrition education.  Australian Journal of Nutrition & Dietetics, 51, 9-13.

Spruijt-Metz, Donna (Dept.Med.Ethics & Philos.of Med., Med.Faculty, Free Univ.of Amsterdam, Van der Boechorstastraat 7, 1081 BT Amsterdam, The Netherlands). Personal incentives as determinants of adolescent health behavior: the meaning of behavior. Health Education Research, Theory & Practice, 10, 355-64, 1995.

Stevenson, M., Jones, S. (Centre for Health Promotion Research, School of Public Health, Curtin University, GPO Box U1987 Perth WA 6001), D Cross, P Howat, M Hall (1996).  The child pedestrian injury prevention project.  Health Promotion Journal of Australia, 6, 32-6.

Zuilhof, W., & Maas Van der, P. (1998). HIV prevention for clients of male sex workers: an experiment in planned action. International Conference on AIDS, 12: 918 (abstract no. 29/43367).

102>92. Local sources of data, see Phillips, Morrison, & Aday, 1998; Vissandjee, Barlow, & Fraser, 1997. Such local sources of data can be most illuminating when contrasted with state or national data. A review of national data sources for the United States, organized according to the Precede model factors influencing behavior, is provided by R. W. Wilson & Iverson, 1982 and various websites (go to www.lgreen.net/precede).

103>93. CDC handbooks for conduct of community surveys and planning according to Precede-Proceed Model, e.g., Brink, Simons-Morton, Parcel, & Tiernan, 1988; Parcel, Simons-Morton, et al., 1987; B. Simons-Morton, Brink, et al., 1991; D. G. Simons-Morton, Parcel, et al., 1988. The Peace Corps also adapted the Precede Model for its overseas training of volunteers, and for work in specific health campaigns, e.g. Silverfine et al., 1990 on guinea worm eradication.

Brink, S. G., D. Simons-Morton, G. Parcel, and K. Tiernan (1988). "Community Intervention Handbooks for Comprehensive Health Promotion Programming," Family and Community Health 11: 28-35.

Parcel, G. S., D. G. Simons-Morton, S. G. Brink et al. (1987).  Smoking Control Among Women: A CDC Community Intervention Handbook (145 pp.). Atlanta: Center for Health Promotion and Education, Centers for Disease Control.

Silverfine, E., W. Brieger, and Churchill,  (1990). Community-Based Initiatives to Eradicate Guinea Worm: A Manual for Peace Corps Volunteers.  Washington, D.C.: U.S. Peace Corps and Agency for International Development.

Simons-Morton, B.G., Brink, S.G., Parcel, G.S., McIntyre, R.M., Chapman, M., Longoria, J. (1991). Preventing Acute Alcohol-related Health Problems Among Adolescents and Young Adults: A CDC Handbook for Community Interventions. Atlanta, GA: Centers for Disease Control.

Simons-Morton, D. G., Parcel, G. S.  Brink, S. G., et al. (1988). Promoting Physical Activity Among Adults: A CDC Community Intervention Handbook. Atlanta: Centers for Disease Control.

94. CDC's application of the PRECEDE Model in formulating the Planned Approach to Community Health (PATCH) program of technical support through states to community health planning with systematic local assessments of needs and resources. Green & Kreuter, 1992; Hanson, 1988-89; Liburd & Bowie, 1989; Nelson, Kreuter, et al., 1986; Steckler, Orville, et al., 1992. A similar application of PRECEDE by CDC's HIV-AIDS prevention programs was outlined in USDHHS, 1988. Although the PATCH program is no longer funded by CDC, many communities continue to apply its Guide for Local Coordinators (USDHHS, 1996; periodically updated at http://www.cdc.gov/nccdphp/patch/index.htm).

Green, L.W. and M.W. Kreuter. (1992).  CDC's Planned Approach to Community Health as an Application of PRECEDE and an Inspiration for PROCEED.  Journal of Health Education 23(3): 140-147.

Hanson, P. (1988-89). "Citizen Involvement in Community Health Promotion: A Rural Application of CDC's PATCH Model," International Quarterly of Health Education 9: 177-186.

Liburd, Leandris C. and Janice V. Bowie (CDC Center for Chronic Dis. Control and Health Promotion, Atlanta, GA 30333; & Virginia Dept.Health). "Intentional Teenage Pregnancy: A Community Diagnosis and Action Plan," Health Education 20(5):33-38, Dec. 1989.

Nelson, Charles F. (CDC), M. W. Kreuter, Nancy B. Watkins & Ronald R. Stoddard (1986).  "A Partnership Between the Community, State, and Federal Government: Rhetoric or Reality," Hygie (Paris) 5(3): 27-31.

Steckler, Allan, Kate Orville, Eugenia Eng, and Leonard Dawson, (1992). Summary of a Formative Evaluation of PATCH. Journal of Health Education, 23, 174-8.

U.S. Department of Health and Human Services (1988). CDC and Minority Communities Stopping the Spread of HIV Infection and AIDS (Atlanta: Office of the Deputy Director (AIDS), Centers for Disease Control, Public Health Service, National Conference on the Prevention of HIV Infection and AIDS among Racial and Ethnic Minorities in the United States), esp. section D.

U.S. Department of Health and Human Services (1996). Planned Approach to Community Health: Guide for the Local Coordinator. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996. ISBN 0-16-048399-9. Last updated 2003, see http://www.cdc.gov/nccdphp/patch/index.htm.

95. Health education and media raising public awareness, outrage, or demand as advocacy for the creation of community action or services, Chapman & Lupton, 1994; Entman, 1993; Wallack, Woodruff, et al., 1999); especially in breast cancer (Braun, 2003); HIV-AIDS (Sowell, 2003); tobacco (Chapman & Dominello, 2001; Chapman & Wakefield, 2001; Durrant, Wakefiled, et al., 2003);  cardiovascular disease prevention (Schooler, Sundar, & Flora, 1996); mainstreaming of the drug abuse problem (Fan, 1996); and alcohol (Holder Lopez-Escobar, Llamas, & McCombs, 1998; McCombs, Shaw, & Weaver, 1997; Wallack, Woodruff, et al., 1999).

Braun, S. (2003). The history of breast cancer advocacy. Breast Journal, 9, Suppl. 2, S101-3.

Chapman, S, & Lupton D. (1994). The fight for public health: principles and practice of media advocacy. London: BMJ Publishing Group.

Chapman, S., & Dominello, A. (2001). A strategy for increasing news media coverage of tobacco and health in Australia. Health Promotion International, 16, 137–43.[Abstract/Free Full Text]

Chapman, S., & Wakefield, M. (2001). Tobacco control advocacy in Australia: reflections on 30 years of progress. Health Education & Behavior, 28, 274–89.[Medline]

Durrant R, Wakefield M, McLeod K, Clegg-Smith K, Chapman S. (2003). Tobacco in the news: an analysis of newspaper coverage of tobacco issues in Australia, 2001. Tobacco Control, 12, Suppl 2:II75-II81.

Entman, R. M. (1993). Framing: toward clarification of a fractured paradigm. Journal of Communication, 43, 41–58.

Fan, D. P.. (1996). News media framing sets public opinion that drugs is the country’s most important problem. Substance Use & Misuse 1996;31:1413–21.[Medline]

Holder HD, Treno AJ. Media advocacy in community prevention: news as a means to advance policy change. Addiction 1997;92: S189–99.[Medline]

Lopez-Escobar E, Llamas JP, McCombs M. (1998). Agenda setting and community consensus: first and second level effects. International Journal of Public Opinion Research ;10:335–45.[Abstract]

McCombs, M. E., Shaw, D. L., Weaver D, (Eds.). (1997). Communication and democracy: exploring the intellectual frontiers of agenda-setting theory. Mahwah, NJ: Lawrence Erlbaum Associates,

Schooler, C., Sundar, S. S., Flora, J. (1996). Effects of the Stanford five-city project media advocacy program. Health Education Quarterly, 23,:346–64.[Medline]

Sowell RL.(2003). HIV/AIDS: mainstream or forgotten? Journal of the Association of Nurses and AIDS Care, 14, 16-7.

Wallack, L., Woodruff, K., Dorfman, L., & Diaz, I. (1999). News for a change: An advocate's guide to working with the media. Thousand Oaks, CA, Sage Publications.

96. A hierarchy of changeability among predisposing factors, Rokeach, 1970.

Rokeach, M. (1970). Beliefs, attitudes and values. San Francisco: Jossey-Bass.

97. Diffusion theory, Oldenburg, & Parcel, 2002; E. M. Rogers, 1995. More refined analyses of the rates of change and rates of diffusion for the successive stages of change and for specific health innovations are suggested in Crow et al., 1986; Green, 1975; 1976a. For examples of applying Rogers' classification of characteristics of an innovation as a framework for categorizing users' perceptions of a health-related product in the context of the Precede-Proceed Model, see Chiasson & Lovato, 2000; Farley, Haddad, & Brown, 1996.

Chiasson, M. W., & Lovato, C. Y. (2000). The health planning context and its effect on a user’s perceptions of software usefulness. Canadian Journal of Public Health 91(3): 225-228, May 2000.

Farley, C., Haddad, S., & Brown, B.(1996).  The effects of a 4-year program promoting bicycle helmet use among children in Quebec.  American Journal of Public Health, 86, 46-51.

Oldenburg, B., & Parcel, G. S. (2002). Diffusion of innovations. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.). Health behavior and health education: Theory, research, and practice (pp. 312-34). San Francisco: Jossey-Bass.


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