Foundations

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Precede- Procede

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a step by step process used by health educators to assess, plan implement and evulate health programs

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used in health diciplines
a model, like theory
not a theory of health behavior which focuses only on how behavoor change

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precede proceed

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step by step model to guide the entire health ed process, assesss, plan implement, evualte,

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precede procede

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starts with final consequences of behavior conditions and works backward to origional cause

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precede-procede

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prec/pro
Asks the ____ before ___

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why before HOW

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What does precede stand for?

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predisposing
reinforcing and
enabling
consturcts in
Education/ecologial
diagnosis and
evaluation

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what does proceede stand for

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Policy
regulatory and
organizatinal
consturcts in
educational and
environment
development

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list the 3 phases

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social assesment
epidemoligical asessment
behavioral and envimental assesment

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2nd 3 phases

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Educatinal and ecological assessment
Administrative and policy assessment
implementation

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last 3 phases

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process evaluation
impact evaluation
outcome evaluation

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What precede procede phase do you determine the quality of life concerns?

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social assesment

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Which PRECEDE-PROCEED phase is the following goal associated with?
The survival rate of mothers, infants, and children will be raised through optimal growth/ development
of children.

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The EPIDEMIOLOGICAL DIAGNOSIS identifies the specific health problems in terms of morbidity, disability, or mortality, which may contribute to the social goals or problems in Phase 1, ranks them, and then selects the most deserving specific health problem

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In what PRECEDE-PROCEED phase do you determine the health issues related to quality of life
concerns

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Phase 2 - Epidemiological DiagnosisThis phase helps determine health issues associated with the quality of life. It helps identify behavioral and environmental factors related to the quality of life issues. The focus of this phase is to identify specific

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In what PRECEDE-PROCEED phase do you determine the health/program objective

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The EPIDEMIOLOGICAL DIAGNOSIS identifies the specific health problems in terms of morbidity, disability, or mortality, which may contribute to the social goals or problems in Phase 1, ranks them, and then selects the most deserving specific health problem

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Which PRECEDE-PROCEED phase is the following goals/objectives associated with?
The infant mortality rate within Duval County will be reduced by 10% within 2 years

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The EPIDEMIOLOGICAL DIAGNOSIS

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In what PRECEDE-PROCEED phase do you determine the major causes of the health problem?

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Behavioral & Environmental Assessment:

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In what PRECEDE-PROCEED phase do you determine and rate the importance and changeability of the
related behaviors and environmental factors?

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Behavioral and environment
assessment

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In the Beh/Env Phase, eating and exercise are examples of what type of factors? ``

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behavioral

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In the Beh/Env Phase, access to health care is an example of what type of factor?

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environmental

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In the Beh/Env Phase, age and ethnicity are examples of what type of factors?

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non behavioral

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In what PRECEDE-PROCEED phase do you determine the behavioral/environmental objectives?

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behavioral and environmental
assessment

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Which PRECEDE-PROCEED phase is the following objective associated with?
Pregnant teens in Duval County will show a 15% increase in obtaining prenatal care within 2 years of
program implementation.

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behavioral and environmental
assessment

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In what PRECEDE-PROCEED phase do you determine predisposing, reinforcing, enabling factors for
the behavioral and environmental factors

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Phase 4: Educational & Organizational (Ecological) Assessment

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In what PRECEDE-PROCEED phase do you determine and rate the importance and changeability of the
factors causing the behavior?
15. In what PRECEDE-PROCEED phase do you determine learning/resource objectives?

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Phase 4: Educational & Organizational (Ecological) Assessment

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Ed/Eco phase, ability, skills, and resources are examples of what types of factors?

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enabling

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In Ed/Eco phase, life experiences, values, attitudes, knowledge, and beliefs are examples of what types
of factors?

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predisposing

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In Ed/Eco phase, support from family and friends, feedback, encouragement, and rewards are examples
of what types of factors?

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reinforcing

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Which PRECEDE-PROCEED phase is the following objective associated with?

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In Ed/Eco phase

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In what PRECEDE-PROCEED phase do you determine the organizational barriers/facilitators that
can effect program implementation?
21. In what PRECEDE-PROCEED phase do you determine the resources needed and available to launch
and sustain your program

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Phase 5: Administrative & Policy Assessment:

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In what PRECEDE-PROCEED phase do you determine the policies you can use to support your
program or that need to be changed to enable the program to proceed?

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Phase 5: Administrative & Policy Assessment

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In what evaluation phase are you measuring program elements such as instructor training, materials,
implementation, program acceptance and staff

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Process

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answers the question: “Is the program being carried out as intended

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process eval

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Was the program’s attendance good?” is an example of

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process evaluation

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In what evaluation phase are you measuring immediate effect of the program on target behaviors and
predisposing, reinforcing, enabling factors

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impact

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Can the women correctly demonstrate how to perform a breast self-examination on a model” is an
example of

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impact

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In what evaluation phase are you measuring program effect on the health status and quality of life
indicators?

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outcome

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“Have breast cancer deaths decreased by 15 percent in Anywhere, USA as a result of the program?” is
an example

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outcome

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More important and more changeable factors are considered what type of priority for health programs?

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high

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In phase 6 when implementing programs, it is important to match

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implementation (strategies, activities,
methods) with objectives (planning)

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Use the importance/changeability grid

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to prioritize the focus of a program

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-Based on comparison of the survey data that
you collected before and after the program
(pre and post), were the objectives
(behavioral, environmental, and learner)
met?

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impact

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-Among teens participating in program,
increase teen contraceptive use by 50%
within 6 months.
- Among teens participating in program,
increase teen abstinence by 10% within 6
months.

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example behavioral objectives

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Increase health educational programs
offered to teens in Duval County by 25% at
the initiation of the program.
-Increase condom distribution sites in schools
by 75% at the initiation of the program

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example environmental

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-Improve health and wellbeing
of UNF students

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epi assesment

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-Reduce negative health
consequences associated with
alcohol use (as measured by
DUI) by 25% among UNF
students by 2010.

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epi ass

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-List 3 immediate health consequences related to
binge drinking.
-Describe 3 social alternatives to drinking in
Jacksonville.
-Role play 3 refusal/alternatives explanations

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example of learner objectives/
edu-eco ass

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patch
guiding principals

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-Community members participate in the process
-data guide the developement of programs
-participants develop a comprehansive health promotion strategy
-evaluation emphasizes feedback and promgram improvement
-community capicity for health promothion

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Patch goals
#1

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creating a practical mechanism which effective community health education action could be targeted to address local level health priorites

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patch goals #2

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providing a means wherin statehealh education agencies would work with local leaders to establish community health educaitn programs through a
skills basesd program of technical assistances
community intervention

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6 phases bottom to top

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Mico's model for Health Education planning

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phase 1 micro

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Initiation of the planning activity

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2 phase mirco

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needs assessment

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phase 3 micro

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goal setting

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phase 4 micro

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planning or programming the activity

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phase 5 micro

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implementing the activity

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phase 6 micro

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evaluating the activitys effectivness

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micros colums identify:
activitys ___ and ___

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content or subject matter

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micros colums
___ and ____ associated with each horizonal phase

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steps and techniques

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micros colums
___ or ____

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process of interactions involved in each phases

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____ or ____ of acticity depends on what happends depends on phase ___

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success or failure
1

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Match

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a sociaecological health promotion framework- a conceptual model

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match usefu where?

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in situatins where extensive local needs assessments are not possible du to the rapid pace of contemperary health education and health promotion practice

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Match - 5 levels intervention

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individual
interpersonal
organizational
societal
governmental

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individual level

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level behaviors, while substantially controlled by the individual are also influencd by environmental factors

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interpersonal level

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freinds family and healt care providers

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organizational factors

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policies resources and pograms to affect health and behavior churches schools and buisnesses are influental organizationans

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societal

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trends and support for programs practices policies can be serious influences on health. any group of people often to the target population whith whom that population interacts

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governmental

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resources programs policies legislation and environmental controls

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Delphi Process

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technique which is a special multistep survey method that uses a series of questionaires to generate a consensus on an isssue

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how Delphi process used?

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to identify goals and objectives, examine possible alternatives, establish priorities, reveal group values, educate a responadant group,

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Delphi

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questionaire consisting a few broad questions usually sent by mail to small goup of participates, 10-15. After responces are analized thea second questionaire is developed this time with more specific questions. the same respondents feedback is alalyzed

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Delphi

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3-5 questionaires are necessary to arrive at consensus

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Delphi advantage

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of being useful in obtaining opinions from specific groups such as experts or victims of a health problem when assembling peple in one location is difficult

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Delphi disavantages

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a large amount of administrative time and cost are necessary
participants commit large amount of time
vague results no face to face dissucssion

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Nomial group process

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highly structured group process allows reseachers to qualify and quantify specific needs of a target group/ ROUND ROBIN fashion

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Nomial group process

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highly structured group process allows reseachers to qualify and quantify specific needs of a target group/ ROUND ROBIN fashion

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Answers to a question without discussing it/ vote on importance

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Nomial group process

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Nomial avantages

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people most effected by a health or social problem can participate in its identification
+all participants ave equal opportunity to sar ideas
Common ground discovery
minority opinions are tolerated

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nomial disavantages

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requires commiment of an hour
finiding enough willing participants is difficult
biases enter bc it encourages age expression of personal opinions beliefs and experionces
direction shift of origional issues

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Focus group

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group depth interview developed to form group therapy

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focus advantage

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low cost
easy to arrange group
no more than 2 hours of participation time
focus leads to insights that are relevan to issues

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Data collection must include

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validity
relialiity
representativesness of sample
generalizability

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Governing principals usually accompanied by written by limitations on employee behavior and organizational action.

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policy formation

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at this point administratiors may be added temporarily to the planning committee or at least consulted

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policy formation

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should be examined so prorams plans can work within the exisitin policies when possible

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policy formation

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establishing new policies or altering existing ones may be necessary

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policy formation

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the planner should not assume that a policy is cast in stone and cannot be changed
--may require educating administrators

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policy formation

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policies should be

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fair
nondiscriminatory
developed to flexibility
creativity

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policies should

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include a mechanism for altering the policies themselves if they are later found to be detrimental to the program

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implentation of plan varies according to

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scope of program
characteristics of target pop
institutions or organizations involved and number of
resource requirments

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implentation

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small scale beginnings helplful as a part of the plan

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implentation

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small scale can reveal gaps that can realeved before project is put in place

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health educational instruct. programs be tried at schools at different age levels before impleneting them in the entire district

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implentation

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program is plausble if it tends to bring

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change

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plausable if

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intentions are clear

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prgm is plausble if

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planned activites are reasonalbe
( right nature to influence out come)

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prgm is plausble if activites are suffieecnt in ______ and _____ to EXPERT that influence

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quality and quanitiy

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pgm is plausable if _____ are present in suffienct amount and type for the activies to be implented as planned

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resources