Start at the end, then walk back

Green's PRECEDE-PROCEED model is one of the most widely used frames for planning health education and health-promotion programs. PRECEDE, as Green published it, is the diagnostic half: Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation, used to set aims and to decide what comes first. PROCEED, added with Kreuter, is Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development, and it carries the work through implementation and evaluation. The point is less 'what program shall we deliver' than 'what result do we want, and what would have to change to get there.' Health and risk come from many factors, so the effort has to be many-sided. Responsibility sits with the person and with the conditions they live in. Quality of life is the outcome the model keeps in view, and the same frame can be used in a school, a community, a clinic, or a workplace.

The worked example is a thirteen-year-old at a school in Seoul's Gangdong-gu. In the source, smoking started in the fifth grade, after a friend offered a cigarette, and also out of curiosity. The amount is two or three cigarettes a day. The father and an older brother also smoke. That student is a planning example, not a named real child. It also cites a youth smoking survey report for its local planning assumptions. Those rates are not dated in the source, and they are not treated here as a current official national count.

Nine steps, and a plan dated 2021

The stages, as the account fills them in, run like this. Social assessment looks at a report the plan is using and at a sense that children are meeting cigarettes earlier. Epidemiological diagnosis sets a goal of lowering elementary smoking, and it names environmental ideas the account wants to challenge, including a fading alertness to harm and a notion that smoking looks grown-up or masculine. Behavioral and environmental assessment points to pressure from friends and older students, to smoking at home, and to a thin smoking-cessation offering at the school and in the neighborhood. Educational and ecological assessment divides predisposing gaps (little sense of harm or of illness), reinforcing gaps (inattention from family and teachers, weak local limits), and enabling gaps (thin publicity for cessation programs, and smoking scenes in the mass media). Administrative and policy assessment looks at thin programs, thin community resources, and thin publicity.

The intervention it then writes is dated 1 July to 1 December 2021: an after-school hour in the school health room, with posters and the school's social accounts as publicity, aimed at sixth-graders in that local school whom the plan treats as its participants. Implementation is an elementary cessation program. Process evaluation looks at participation, at the support system, and at satisfaction. Impact evaluation looks at whether smoking among those students falls and whether alertness to harm rises. Outcome evaluation looks at cessation, and at whether cessation lasts after someone has tried to stop. The plan is a classroom working-out of Green's model, dated to that 2021 calendar, not a claim about official smoking rates this year.

Sources

1. A PRECEDE-PROCEED health-education plan for elementary students, using a worked example set in Seoul's Gangdong-gu and an intervention calendar dated July to December 2021.

Last updated: 14 November 2026