HLTH 5493 Module 1 Planning Model Application Example

Half a Mile and Still Driven: Applying PRECEDE-PROCEED to Low Rates of Walking to School at a Composite Title I Elementary School

Student Name

American College of Education

HLTH5493: Health and Wellness Program Design and Implementation

Module 1 Assignment

Instructor Name

August 3, 2026

Introduction

Linden Park Elementary is a composite kindergarten through fifth grade school of about 430 students in a small Midwestern city. It qualifies for Title I funding, and roughly seven in ten of its students receive free or reduced-price meals. Every school morning, a line of cars stretches around the block while the principal and two teachers wave children out of vehicles in a narrow drop-off lane. Yet the school sits in a compact neighborhood of older houses, and most families live close enough to walk. As the county health department's school health educator, I was asked by the school's wellness committee to find out why so few children walk and whether a program could change that. This paper applies the PRECEDE-PROCEED planning model to that question. It works through the four assessment phases that precede any program decision and closes by previewing the implementation and evaluation phases that later modules will develop.

Why PRECEDE-PROCEED

Green and Kreuter (2005) designed PRECEDE-PROCEED to make planners begin with the outcome a community values and work backward to its causes before choosing an intervention. The model's first half, PRECEDE, moves from social assessment through epidemiological, behavioral and environmental assessment to the educational and ecological factors behind behavior and, finally, to the administrative and policy conditions a program must fit. Its second half, PROCEED, covers implementation and three levels of evaluation. The model suits this problem for two reasons. First, walking to school depends on parents' decisions and on streets, schedules and school rules, not only on children's knowledge, and the model's ecological phase is built for problems with causes at several levels. Second, the wellness committee had already proposed three solutions, a fun run, a pedometer contest and a poster campaign, before anyone had asked families why they drive. Working backward from causes protects the committee from choosing a program that addresses the wrong barrier.

Phase 1: Social Assessment

The social assessment asked what families and staff care about, in their own words. I held two listening sessions, one in the evening and one after morning drop-off, attended by 31 parents and grandparents, and interviewed the principal, the physical education teacher and the school nurse. Parents did not begin with physical activity. They talked about the morning rush, the stress of the drop-off line, children arriving hungry or wound up and the cost of gas for a trip of a few blocks. Several said their children were restless in the evening and spent little time outside because the neighborhood felt unsafe after dark. Staff raised tardiness, which the principal linked partly to the drop-off line backing up, and the number of children who reach recess already tired of sitting. The quality-of-life concerns that emerged were calmer mornings, safer streets and children who have more chances to move. A program that promised only fitness would miss what these families value; one that also eased the morning rush would speak to them directly.

Phase 2: Epidemiological, Behavioral and Environmental Assessment

The health issue behind those concerns is children's low daily physical activity. Federal guidance calls for school-age children to build up an hour or more of moderate-to-vigorous activity each day, with muscle- and bone-strengthening activity on three days a week (Piercy et al., 2018). Walking to school is one of the few ways to add activity to a child's day without taking time from anything else, which is why it matters to this plan.

Nationally, active travel to school is now uncommon. Analyzing the 2017 National Household Travel Survey, Kontou et al. (2020) found that 9.6% of students aged 5 to 17 usually walked to school and 1.1% biked, and that most walking trips were shorter than a mile. Linden Park's pattern is similar. A hand-raise travel tally taken in every classroom on two mornings in May found that 11% of students walked, 18% rode a district bus and 71% arrived by car. The district's address file showed that 64% of students live within one mile of the school, the zone in which the district provides no bus. The central behavioral finding, then, is that hundreds of children who live within an easy walk are driven anyway.

The environmental assessment walked each likely route with the city's traffic engineer. The neighborhood grid has sidewalks on most blocks, but two blocks on the school's west side have none, and children coming from the apartment complexes east of the school must cross a four-lane arterial where traffic is signed for 35 miles per hour at a signal staffed by a crossing guard only in the afternoon. Morning drop-off traffic itself creates hazards on the streets nearest the school.

Phase 3: Educational and Ecological Assessment

Here the causes of the behavior are divided into predisposing, enabling and reinforcing factors (Green & Kreuter, 2005). Because young children do not decide how they travel, the behavior of interest is the parent's decision to let a child walk, and most factors belong to parents.

Predisposing Factors

In a short survey sent home in English and Spanish and returned by 188 families, the most common reason for driving was traffic danger, named by 72% of respondents, followed by fear of strangers at 54%, and distance or time at 38%. Parents of kindergarten through second grade students were far more likely than parents of older children to say their child was too young to walk without an adult. At the same time, 81% agreed that walking would be good for their child, and 60% said they would let their child walk if a trusted adult walked with a group. Parents' beliefs, in other words, favor walking; their confidence that it is safe does not. Children's attitudes were positive: in a quick classroom poll, most said they would like to walk with friends.

Enabling Factors

The enabling factors are mostly about adults and streets. Many parents work early shifts at a food processing plant and a regional hospital and cannot walk a child to school at 7:45. The missing sidewalks and the unstaffed morning crossing make the eastern and western routes harder than they need to be. The school has no program to organize walking, no designated gathering points and no adult assigned to walk with children. These barriers match those reported across the literature: a review of 12 walking school bus studies covering 9,169 children identified time constraints and difficulty recruiting volunteers as common obstacles, along with parents' worries about safety (Smith et al., 2015).

Reinforcing Factors

The reinforcing factors that currently operate favor driving. The drop-off line is the visible norm, and some parents reported feeling judged when their child walked alone. The school does not recognize walking in any way, and no teacher or staff member models it. On the positive side, children who do walk often walk with siblings or neighbors, and they described the walk as the best part of the morning. Recognition from the school, peer groups that walk together and visible support from the principal could reinforce walking if a program created them.

Priorities Among the Factors

Green and Kreuter (2005) advise ranking factors by importance and changeability. Parents' fear of traffic and strangers is highly important and moderately changeable if parents can see that children are supervised. The lack of an adult to walk with children is both important and changeable through organization. The missing morning crossing guard is important and changeable through the city. Missing sidewalks are important but slow to change, since construction requires capital funds. Children's attitudes are already favorable and need little work. This ranking points toward a program that supplies trusted adult supervision on fixed routes and pairs it with requests to the city for a morning crossing guard and, over time, sidewalk repairs. Evidence suggests such an approach can work in similar schools: in a controlled trial at low-income urban schools, a walking program run by a part-time coordinator and parent volunteers raised the share of students walking at the intervention school from 20% to 25% over a year, while walking at the comparison schools fell (Mendoza et al., 2009).

Phase 4: Administrative and Policy Assessment

The final PRECEDE phase asks what resources and policies stand in the way of a program or can support it. The district's wellness policy already encourages physical activity before and after school, which gives a walking program a policy home. District rules require any adult volunteering with students to pass a background check, which adds time and cost but also reassures parents. The school's insurance carrier requires that off-campus activities have a written supervision plan. The school has no budget line for the program, but the county health department can contribute my time, and the city's pedestrian safety office has small grants for school travel programs. The principal is willing to adjust the morning schedule so that walking groups arrive before the bell. No policy prohibits children from walking, though the handbook discourages kindergarten students from walking without an adult.

Looking Ahead to PROCEED

The assessment points to a clear program direction: adult-supervised group walking along set routes, supported by environmental requests and school recognition. The next module will review evidence-based options and select one to adapt. The PROCEED phases will then guide implementation and three levels of evaluation: process measures, such as how many walks run and how many children join; impact measures, such as parents' confidence and the share of children walking; and outcome measures, such as daily physical activity. This assessment has limits. The survey reached families who return school forms, the tally captured only two spring mornings and the route audit was done in dry weather. Even so, the consistency across sessions, surveys, tallies and street audits supports the conclusion that Linden Park's problem is not distance or interest but supervision and safety, and that is a problem a program can address.

References

Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill.

Kontou, E., McDonald, N. C., Brookshire, K., Pullen-Seufert, N. C., & LaJeunesse, S. (2020). U.S. active school travel in 2017: Prevalence and correlates. Preventive Medicine Reports, 17, Article 101024. https://doi.org/10.1016/j.pmedr.2019.101024

Mendoza, J. A., Levinger, D. D., & Johnston, B. D. (2009). Pilot evaluation of a walking school bus program in a low-income, urban community. BMC Public Health, 9, Article 122. https://doi.org/10.1186/1471-2458-9-122

Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018). The Physical Activity Guidelines for Americans. JAMA, 320(19), 2020-2028. https://doi.org/10.1001/jama.2018.14854

Smith, L., Norgate, S. H., Cherrett, T., Davies, N., Winstanley, C., & Harding, M. (2015). Walking school buses as a form of active transportation for children: A review of the evidence. Journal of School Health, 85(3), 197-210. https://doi.org/10.1111/josh.12239