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Case Report

PRECEDE: A Conceptual Model to Assess Immigrant Health

Archives of Healthcare [2023; 3(1):40-47]
Received: 03 July 2023, Accepted: 25 July 2023, Published: 31 July 2023

Immigration to anew country is one of the most important stress-producing event in a person’s or a family’s life. There are over 40 million immigrants in the United States,. This constitutes 13.7% of the United States [US] population. The majority live in large cities of border states, such as New York, Los Angeles, Texas. Immigrants bring with them strengths as well as maladies associated with smoking, infectious diseases and lack of preventive care in their country of origin. It is therefore important to assess and evaluate the health status and health related practices of the immigrant population to determine areas that need intervention to protect the host country as well as improve the health of the immigrants.

The PRECEDE model provided a comprehensive theoretical framework to develop the Health Status Assessment Questionnaire (HSAQ) to evaluate the health of Armenian immigrant population (AIP) in the US. The word PRECEDE is an acronym where each letter stands for the following concepts of the theoretical framework: Predisposing, Reinforcing, Enabling, Causes in Educational Diagnosis Evaluation.

Behavioral causes of the problem are contextual, and they fall into three categories: Predisposing, Enabling and Reinforcing. Predisposing Factors consisted of all the demographic information of the HSAQ including knowledge, attitudes and their willingness to do self-care. The Enabling Factors dealt with the availability, adequacy, accessibility and the skills of the immigrant to access preventive health care such as health insurance, social support, communication systems, and skills of the immigrant to do self-care to comply with his/her diabetic and /or hypertension compliance regiments. Reinforcing Factors dealt with the attitudes and behaviors of the health care workers and helpers within the person’s social support system.

The next step of the PRECEDE model is intervention. They are the medical, nursing and other provision of resources by the community, such as social support examples of interventions. Evaluation is the last step of the PRECEDE model. It consists of [1] Process factors such a as immigrant taking responsibility for completing planned activities for his/her health promotion, e.g., going to the doctor to get immunization, or following directions to evaluate blood sugar levels for diabetic. [2] Impacting Factors refer to the achievement of desired behaviors. For example, seeking social support system [3]. Outcome factors: They refer to the end result as to what is good for the =immigrants as a whole. For example, lower blood pressures, reduced numbers of acute and chronic illnesses, low depression levels, compliance with diabetic and hypertension compliance. These are all the areas that the HSAQ measured.

In conclusion, The PRECEDE model provides a very useful conceptual framework to develop assessment tools to measure the health status of any immigrant groups and plan and intervention strategies.

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