Effect and stage models in community intervention programmes; and the development of the Model for Management of Intervention Programme Preparation (MMIPP)

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Abstract
Recent years have seen the development of a number of diagrammatic ‘models’ bearing on community intervention programmes. There have been two basic types, one involving actual or hypothetical causal relationships (effect, or how-it-works models) and the other, sequences of activities or events (stage, or how-to-do-it models). A selection of such models, with their roots in different theories of social change, health education and health promotion, are reviewed in the light of this distinction. Both types of model are important. Existing stage models for health promotion programmes imply an ordered or cyclical set of activities, in which preparation is followed by implementation, maintenance, evaluation and revision. In the second part of the paper a new and more detailed type of stage model is presented for the preparatory phase. In practice, this phase involves a series of parallel but interdependent activity streams. These add up to a complex process that needs to be carefully planned and managed. In such circumstances it is important to be able to convey to the various people and organisations involved how their different contributions mesh together. The new model is designed to help with this. It has been developed in the light of experience of planning community-based disease prevention programmes in Stockholm and elsewhere, with the objective of making the lessons learned available for others in a compact and accessible form.

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