Empirical Testing of the PRECEDE-PROCEED Model
The Minnesota Wood Dust Study
Purpose of study: To develop an intervention to reduce exposures to wood dust using the PRECEDE-PROCEED model, and assess its effectiveness in a randomized controlled trial conducted with 48 small woodworking businesses Minnesota.
Methods (to address phases 3 and 4):
- Planning Committee of key informants - gave insight into the characteristics of small woodshop owners and barriers to dust control
- Focus groups - validated planning committee knowledge
- Pilot test of outcome measures - provided info on the variety of controls to lower dust levels and range of exposure
Results: An intervention was designed using data from the planning committee, focus groups, and pilot test.
- 48 shops (24 control/24 intervention)
- Random selection of 10 workers sampled for dust exposure
- Control group received a letter in the mail with sampling results and recommendations to lower dust levels
- Intervention group received: preliminary recommendations, intervention activities, technical assessment and recommendations, worker training, priority setting with owners, education sessions
Conclusion: The PRECEDE-PROCEED model was a useful framework for this study.
Women with Abnormal Mammograms
Purpose of study: To examine the interval time between breast cancer screening and diagnosis among multicultural women with abnormal mammograms using the PRECEDE-PROCEED model.
Participants: 436 women with abnormal mammogram results and 58 clinicians (one administrator at each of the clinics)
Methods (to address phase 4):
- Clinical site interviews - covered characteristics of the organization, patient characteristics, logistical information (i.e., parking, public transportation, safety), outreach and education methods, communication methods, and environment
- Patient interviews - covered demographics, health practices and beliefs, access to health care, provider communication, satisfaction, treatment
- Medical record review
Results
- A larger gap between screening and diagnosis was associated with Spanish speakers and having clinical staff set up appointments.
- The time to diagnosis was shortened by
- Better access to health care
- The provision of early morning screening services
- Higher levels of patient anxiety
Conclusion: The PRECEDE-PROCEED model is valuable in outlining structural and personal efforts that influence timely diagnosis.