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

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 hypotheticalcausal relationships (effect, or how-it-works models) and theother, sequences of activities or events (stage, or how-to-do-itmodels). A selection of such models, with their roots in differenttheories of social change, health education and health promotion,are reviewed in the light of this distinction. Both types ofmodel are important. Existing stage models for health promotion programmes implyan ordered or cyclical set of activities, in which preparationis followed by implementation, maintenance, evaluation and revision.In the second part of the paper a new and more detailed typeof stage model is presented for the preparatory phase. In practice,this phase involves a series of parallel but interdependentactivity streams. These add up to a complex process that needsto be carefully planned and managed. In such circumstances itis important to be able to convey to the various people andorganisations involved how their different contributions meshtogether. The new model is designed to help with this. It hasbeen developed in the light of experience of planning community-baseddisease prevention programmes in Stockholm and elsewhere, withthe objective of making the lessons learned available for othersin a compact and accessible form.