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136 Cultural Competence in Health Education and Health Promotion

(Table 7.1 continued)

Model Year of Creation Approach Phases

Intervention Developed Ecological • Consists of 6 steps:
mapping in 2001 by and social 1. Needs assessment
Bartholomew, approach 2. Matrixes

Parcel, Gerjo, and 3. Theory - based methods and
Gottlieb. practical strategies
4. Program
5. Adoption and implementation

plan
6. Evaluation plan

needs assessment phase, intervention mapping focuses on the development of theory -
based interventions, MATCH emphasizes the implementation process, and the CDC -
Cynergy and SMART models place the consumer at the center of the program design.
Each model segments and names the process phases or steps differently; however, three

general stages are present in all the models: (1) identification of the health problems,
(2) planning and development of the intervention, and (3) implementation. The follow-
ing sections describe what each of these three stages entails and how health education
professionals can combine the models for a more thorough planning process.
Health Problem Identifi cation
The fi ve models agree that the fi rst step in the process of creating a health promotion
program must be determination of the program focus. To identify this focus, health
education professionals must answer the following questions: What are the most rele-
vant health problems? Who are these problems affecting the most? Where and when
do the problems exist? What are the environmental, behavioral, and biological and
genetic factors associated with the problems? How do the problems affect the quality
of life of the target population? The models offer health education professionals differ-

ent ways to find the answers to these questions. All the models agree that one approach
is to use epidemiological data (Bartholomew, Parcel, Gerjo, & Gottlieb, 2001; Green
& Kreuter, 2005; McKenzie et al., 2005). However the PRECEDE - PROCEED,

SMART, and intervention mapping models are more specific and recommend con-
ducting other types of formative research to learn more about the needs, wants, and
strengths of the target population and of the subgroups within it (Bartholomew et al.,
2001; Green & Kreuter, 2005; McKenzie et al., 2005).
For all the models it is also crucial to conduct a thorough analysis of the etiological
factors that contribute to the health problems of the intended community ( Bartholomew
et al., 2001; Green & Kreuter, 2005; McKenzie et al., 2005). According to the SMART
and PRECEDE - PROCEED models, it is also relevant to identify the predisposing

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