Effect of the PRECEDE-PROCEED model on health programs: a systematic review and meta-analysis

Background: The predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation policy, regulatory, and organizational constructs in educational and environmental development (PRECEDE-PROCEED) model has been used as a theoretical framework to guide health promotion strategies to prevent chronic diseases and improve the quality of life. However, there is a lack of evidence as to whether applying the PRECEDE-PROCEED model effectively improves health outcomes. This study aimed to systematically review intervention studies that applied the PRECEDE-PROCEED model and examine its effectiveness. Methods: In December 2020, seven databases were systematically searched. The quality of studies was assessed using the Mixed Methods Appraisal Tool. The outcome of interest for the meta-analysis was knowledge. Results: In total, 26 studies were systematically reviewed. Most studies provided educational programs as the main intervention for various population groups. Symptom or disease management and health-related behavior promotion were the most common topics, and education was the most frequently used intervention method. The PRECEDE-PROCEED model was applied in the planning, implementation, and evaluation of the intervention programs. Eleven studies were included in the meta-analysis, which showed that interventions using the PRECEDE-PROCEED model significantly improved knowledge. Conclusions: This study indicated that individuals are more likely to engage in health-related behaviors with better knowledge. Thus, the PRECEDE-PROCEED model can be used as the theoretical framework for health promotion interventions across population groups, and these interventions are particularly effective with regard to knowledge improvement.