Abstract
Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEED Model at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
Highlights
Over the past decade there has been increasing recognition of the need for effective management of chronic and complex conditions and less dependence on acute care services [1, 2]
The purpose of this paper is to demonstrate the applicability of the PRECEDE-PROCEED Model (“Model”) to the development of specific chronic care interventions for two distinct Australian populations: a rapidly growing and ageing rural population with unmet palliative care needs (RPAC Project) and an urban community at higher risk of cardiovascular disease (APRICA 2 Project)
In the R-PAC Project, focussing the intervention on increasing the competencies of aged care personnel was identified as likely to have the greatest impact on delivery of an evidence-based palliative approach to older people in aged care, while the APRICA 2 Project focussed on improving the outcomes for people undergoing percutaneous coronary interventions (PCIs) by improving postdischarge care and increasing access to cardiovascular disease (CVD) secondary prevention initiatives
Summary
Over the past decade there has been increasing recognition of the need for effective management of chronic and complex conditions and less dependence on acute care services [1, 2] Achieving this magnitude of reform has been difficult because it requires reorientation of health services, a greater focus on primary health care, and an enduring commitment to the delivery of best evidence-based practice. Identifying the priority health problem and analysing the problem is often the catalyst that enables services to reorientate care delivery from being institutionally focused to addressing populations needs [6]. This systematic process facilitates appraisal of a population’s.
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