Utilization and Effectiveness of the PRECEDE-PROCEED Model as a Tool in Public Health Interventions: A Systematic Review
a systematic review
-
Mingyu Yang
,
Zhiyun Hu
,
Xiaohan Qu
,
Meng Li
,
Wei Du
,
Lijun Fan
Abstract
Background: The PRECEDE-PROCEED Model (PPM) is a theoretical tool for comprehensively assessing population health priorities and practically guiding the planning, implementation, and evaluation of interventions. We aimed to analyze systematically the extent of PPM utilization in the development and evaluation of public health interventions and to appraise the effectiveness of PPM-based interventions.
Methods: PUBMED, Web of Science, ELSEVIER, EBSCO, and SCOPUS were systematically searched to identify relevant peer-reviewed studies from inception to June 2024. Data were extracted on study objectives, design, population, PPM utilization, interventions, and outcomes. Qualitative synthesis was performed to analyze how PPM was applied, to identify recurring themes, and to assess intervention effectiveness.
Results: A total of 54 studies were included, of which 51 reported effective outcomes. These studies spanned 11 domains including disease prevention and control, healthy behaviors, preventing domestic violence, and so on. Education and ecological assessment was most frequently adopted (96%) in the PRECEDE stage, and outcome assessment was most commonly adopted (94%) in the PROCEED phase. All studied interventions incorporated health education. Nine key intervention elements were identified including sustained implementation, adequate duration, multiple educational topics, diverse formats, social support, providing educational materials, participant interaction, intervention monitoring, and practice support. Participant interaction was most frequently utilized (85%), whereas practice support was least frequently used (54%).
Conclusion: Our findings highlight the importance of educational and ecological assessment in the PRECEDE stage and outcome evaluation in the PROCEDE phase for effective intervention design and assessment. Future PPM-based interventions should consider the nine identified core elements, with emphasis tailored to the specific health domain.
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3. Baker MT, Lu P, Parrella JA, et al (2022). Consumer acceptance toward functional foods: A scoping review. Int J Environ Res Public Health. Int J Environ Res Public Health, 19(3): 1217.
4. Sun D, Han YT, Lyu J, et al (2024). Current major public health challenges. Zhonghua Liu Xing Bing Xue Za Zhi, 45(1): 1-10.
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9. Gielen AC, McDonald EM, Gary TL, et al (2008). Using the PRECEDE-PROCEED model to apply health behavior theories. In: Health behavior and health education: The-ory, research, and practice. ED, Glanz K, Rimer BK, Viswanath K.CA: Jossey-Bass. San Francisco, pp. 407-29.
10. Green LW (1974). Toward cost-benefit eval-uations of health education: some con-cepts, methods, and examples. Health Educ Monogr, (2):34-64.
11. Roussin M, Lowe J, Hamilton A, et al (2021). Factors of sexual quality of life in gy-naecological cancers: a systematic litera-ture review. Arch Gynecol Obstet, 304(3): 791-805.
12. James TG, Varnes JR, Sullivan MK, et al (2021). Conceptual Model of Emergency Department utilization among deaf and hard-of-hearing patients: A critical re-view. Int J Environ Res Public Health, 18(24): 12901.
13. Handyside L, Warren R, Devine S, et al (2021). Utilisation of the PRECEDE-PROCEED model in community phar-macy for health needs assessment: A narrative review. Res Social Adm Pharm, 17(2): 292-9.
14. Porter CM (2016). Revisiting Precede-Proceed: A leading model for ecological and ethical health promotion. Health Educ J, 75: 753-764.
15. Wyatt S (2023). What is 'agency' in torture and trauma recovery? An inquiry into the properties and explanations of the concept of agency and its impacts. Tor-ture, 33(2): 17-44.
16. Neubeck T, Elg M, Schneider T, et al (2014). Prospects and problems of transferring quality-improvement methods from health care to social services: Two case studies. Perm J, 18(2): 38-42.
17. Stranford SA, Owen JA, Mercer F, et al (2020). Active Learning and Technology Approaches for Teaching Immunology to Undergraduate Students. Front Public Health, (8): 114.
18. Moher D, Shamseer L, Clarke M, et al (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev, 4(1):1.
19. Sinha SK, Bessman ES, Flomenbaum N, et al (2011). A systematic review and qualita-tive analysis to inform the development of a new emergency department-based geriatric case management model. Ann Emerg Med, 57(6): 672-682.
20. Fan L, Lukin W, Zhao J, et al (2015). Inter-ventions targeting the elderly population to reduce emergency department utilisa-tion: A literature review. Emerg Med J, 32(9): 738-743.
21. Effective Public Health Practice Project (EPHPP). Quality assessment tool for quantitative studies. 2010. Retrieved 10 December 2013.
22. Bahadori F, Ghofranipour F, Zarei F, et al (2021). Application of the PRECEDE-PROCEED model in prevention of brucellosis focused on livestock vaccination process. BMC Vet Res, 17(1): 384.
23. Khani Jeihooni A, Hoshyar S, Afzali Harsini P, et al (2021). The effect of nutrition education based on PRECEDE model on iron deficiency anemia among female students. BMC Womens Health, 21(1): 256.
24. Moradi A, Soltani R, Shamsi M, et al (2023). Effects of online social media on improving mothers' behaviors towards preventing their children's otitis media based on the PRECED model: a randomized educational intervention trial. BMC Pediatr, 23(1): 216.
25. Wen M, Chen Y, Yu J, et al (2024). Effects of a PRECEDE-PROCEED model-based intervention on fatigue in patients with coronary heart disease: A randomized controlled trial. West J Nurs Res, 46(2): 68-80.
26. Al-Delaimy AK, Al-Mekhlafi HM, Lim YA, et al (2014). Developing and evaluating health education learning package (HELP) to control soil-transmitted hel-minth infections among Orang Asli children in Malaysia. Parasit Vectors, 7:416.
27. Sezgin D, Esin MN (2018). Effects of a PRECEDE-PROCEED model based ergonomic risk management programme to reduce musculoskeletal symptoms of ICU nurses. Intensive Crit Care Nurs, 47: 89-97.
28. Han HR, Mendez KJW, Perrin N, et al (2023). Community-based health literacy focused intervention for cervical cancer control among Black women living with human immunodeficiency virus: A randomized pilot trial. Health Expect, 26(1): 172-82.
29. Barasheh N, Shakerinejad G, Nouhjah S, et al (2017). The effect of educational program based on the precede-proceed model on improving self-care behaviors in a semi-urban population with type 2 diabetes referred to health centers of Bavi, Iran. Diabetes Metab Syndr, 11 Suppl 2:S759-S765.
30. Jeihooni AK, Kashfi SM, Hatami M, et al (2019). The Effect of educational program based on PRECEDE Model in promoting prostate cancer screening in a sample of Iranian men. J Cancer Educ, 34(1): 161-172.
31. Khani Jeihooni A, Moradi M (2019). The effect of educational intervention based on PRECEDE Model on promoting skin cancer preventive behaviors in high school students. J Cancer Educ, 34(4): 796-802.
32. Khani Jeihooni A, Afzali Harsini P (2020). The effect of an educational intervention based on PRECEDE model on oral cancer prevention behaviors in hookah users. J Cancer Educ, 35(6): 1250-1260.
33. Khani Jeihooni A, Ghasemi M, Mobaraei AH, et al (2021). The application of PRECEDE model on preventing osteoporosis in women. Clin Nurs Res, 30(3): 241-252.
34. Jajarmi H, Tavakoli Sani SB, Pourtaheri A, et al (2024). A community based intervention to modify preventive behaviors of cutaneous leishmaniasis in children: A randomized controlled trial based on PRECEDE PROCEED model. BMC Public Health, 24(1): 1304.
35. Rakhshani T, Limouchi Z, Daneshmandi H, et al (2024). Investigating the effect of education based on PRECEDE-PROCEED model on the preventive behaviors of musculoskeletal disorders in a group of nurses. Front Public Health, 12: 1371684.
36. Rezaei M, Solaimani L, Mohammadinia N (2022). Effect of educational intervention based on PRECEDE model on improving menstrual health behaviors among female students. Shiraz E-Medical Journal, 23(12):e123461.
37. Ghahremani L, Azizi M, Moemenbellah-Fard MD, et al (2019). Malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, south of Iran: Interventional design based on PRECEDE model. Pathog Glob Health, 113(1): 32-38.
38. Brown B, Young J, Smith DP, et al (2018). A multidisciplinary team-oriented intervention to increase guideline recommended care for high-risk prostate cancer: A stepped-wedge cluster randomised implementation trial. Implement Sci, 13(1): 43.
39. Hosseini N, Amini A, Alamdari A, et al (2016). Application of the PRECEDE model to improve sexual function among women with hysterectomy. Int J Gynaecol Obstet, 132(2): 229-233.
40. Ranjbaran S, Dehdari T, Sadeghniiat HK, et al (2015). Poor sleep quality in patients after coronary artery bypass graft sur-gery: An intervention study using the PRECEDE-PROCEED model. J Tehran Heart Cent, 10(1): 1-8.
41. Kashfi SM, Khani JA, Rezaianzadeh A, et al (2014). The effect of mothers' education program based on the precede model on the mean weight in children (6-12 months) at health centers in Shiraz, Fars Province. Med J Islam Repub Iran, 28: 95.
42. Salinero-Fort MA, Carrillo-de SPE, Arrieta-Blanco FJ, et al (2011). Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabe-tes mellitus. BMC Public Health, 11: 267.
43. Yang Y, Wang Y, Chen Q, et al (2025). Pre-cede-Proceed model-dominant nursing combined with nutrition support for pa-tients discharged after hepatobiliary surgery with T tube. Altern Ther Health Med, 31(3):92-99.
44. Bozorgi A, Hosseini H, Eftekhar H, et al (2021). The effect of the mobile "blood pressure management application" on hypertension self-management enhancement: A randomized controlled trial. Trials, 22(1): 413.
45. Li F, Guo S, Gong W, et al (2023). Self-management of diabetes for empty nest older adults: A randomized controlled trial. West J Nurs Res, 45(10):921-931.
46. Nejhaddadgar N, Darabi F, Rohban A, et al (2019). The effectiveness of self-management program for people with type 2 diabetes mellitus based on PRECEDE-PROCEDE model. Diabetes Metab Syndr, 13(1):440-3.
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| Files | ||
| Issue | Vol 54 No 10 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v54i10.20121 | |
| Keywords | ||
| The PRECEDE-PROCEED model Public health interventions Effectiveness Systematic review | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Yang M, Hu Z, Qu X, Li M, Du W, Fan L. Utilization and Effectiveness of the PRECEDE-PROCEED Model as a Tool in Public Health Interventions: A Systematic Review. Iran J Public Health. 2025;54(10):2073-2088.
