PRECEDE-PROCEED Model Applied to Oral Health Planning
This paper examines the application of the PRECEDE-PROCEED planning model to the development of an oral health intervention for adults with intellectual and developmental disabilities (IDD) living in group home settings. Developed by Larry Green and Marshall Kreuter, the model's eight phases are traced from social and epidemiological assessment through educational, ecological, administrative, and policy assessment, culminating in implementation and outcome evaluation. The paper highlights barriers to oral health care in this population — including Medicaid limitations, caregiver knowledge gaps, and environmental constraints — and outlines enabling and reinforcing factors that can improve oral hygiene outcomes. Statistical approaches including hierarchical linear modeling and multilevel structural equation modeling are also discussed.
- Introduction to the PRECEDE-PROCEED Model: Origins, principles, and overview of the model
- Phase 2: Epidemiological, Behavioral, and Environmental Assessment: Oral health barriers and risk factors for adults with IDD
- Phase 3: Educational and Ecological Assessment: Predisposing, enabling, and reinforcing factors for behavior change
- Phase 4: Administrative, Policy Assessment, and Intervention Alignment: Policy, institutional endorsement, and contextual moderators
- Phases 5–8: Pilot Study, Implementation, and Evaluation: Trial design, data collection, and statistical modeling approaches
- Summary of the Model and Its Application: Phase-by-phase recap of the full planning process
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What makes this paper effective
- Systematically maps every phase of the PRECEDE-PROCEED model onto a single, concrete health problem, making the framework tangible and easy to follow.
- Integrates multiple levels of assessment — epidemiological, behavioral, environmental, and policy — demonstrating how the model captures complexity in real-world health planning.
- Connects theoretical constructs (self-efficacy, outcome expectancies, reinforcing factors) to specific caregiver behaviors, grounding abstract theory in practice.
Key academic technique demonstrated
The paper exemplifies model application writing: it takes a well-established theoretical framework and works through each component sequentially, linking scholarly citations to each phase. This technique shows evaluators that the writer can operationalize theory rather than merely describe it.
Structure breakdown
The paper opens with a conceptual overview of the PRECEDE-PROCEED model and its historical origins, then moves phase by phase through the eight-stage planning process. A concise summary table at the end recaps each phase's purpose. The references section cites primary empirical sources alongside the foundational model literature, reflecting graduate-level engagement with the field.
Introduction to the PRECEDE-PROCEED Model
The PRECEDE-PROCEED model, like any other planning model, is used in public health; however, its primary principles connect to broader community issues as well. During the 20th century, as medical advances eliminated most infectious diseases, the leading causes of death and disability shifted to chronic conditions such as stroke, diabetes, cancer, and heart disease. Health maintenance efforts then changed focus from disease treatment to prevention of such conditions (Morgan et al., 2012). More recently, active promotion of healthy attitudes and behaviors — including exercise and stress minimization — has improved both the span and quality of life.
The PRECEDE-PROCEED model is one of the most detailed and widely used frameworks guiding the development of population health interventions. Larry Green and Marshall Kreuter established the framework, which is primarily used within the Western world, where it has been applied to multiple health issues. It is also one of the oldest frameworks for health education and planning initiatives (Binkley & Johnson, 2013). The framework is founded on the critical principle of participation, which stipulates that change is enhanced through the active participation of targeted audiences in identifying their health-related issues and in implementing and developing solutions. Accordingly, applying any particular stage of the model should encompass attempts to gather input from the priority populations that the intervention is designed to help.
One of the unique features of the PRECEDE-PROCEED model is its eight-stage planning process that begins at the end, centralizing on health-associated outcomes of interest. The model then works backward to establish the combination of intervention strategies that can best achieve those objectives. At this stage, population health planners broaden their understanding of the community in which they work by carrying out several data collection activities — including focus group interviews, interviews with key opinion leaders and community members, surveys, and observational data gathering (Binkley & Johnson, 2013). "Community," as used in this context, refers to a group or geographical area with shared values, norms, and characteristics.
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