PRECEDE PROCEED Model and Recycling Awareness

The Effect of a Recycling Program Based on the PRECEDE PROCEED Model on Recycling Awareness and Behaviors of Middle School Students: A Randomized Controlled Study

This research is a randomized controlled experimental study. The aim of the research is to determine the effect of a recycling program based on the Precede Proceed Model on the recycling awareness and behaviors of 6th-grade middle school students. The research population consists of 6th-grade students. The research sample will consist of a total of 90 students, with at least 45 students in each group (45 in the intervention group and 45 in the control group). The intervention group will participate in the activities planned within the scope of the recycling program. Students in the control group will not receive any special intervention and will follow their routine classroom curriculum.

Study Overview

• Status: Completed
• Conditions: Spectator Intervention
• Intervention / Treatment: Behavioral: Recycling Education Program

Detailed Description

The most fundamental reason for environmental pollution, the increase in environmental problems, and environmental damage is the rapid industrialization and the resulting increase in the use of fossil fuels. Acid rain, climate change, unplanned urbanization, desertification, and deforestation are among the leading environmental problems. It is humans who harm and pollute the environment, and it is humans who are most affected by this situation. These significant environmental problems pose serious threats to human health. Increased production and consumption are important factors in the increase of environmental problems. Furthermore, negative externalities are at the root of environmental problems. Those who profit from consumption and production activities cause harm to other people as a result of environmental pollution. Individuals who are not involved in the production and consumption processes also indirectly bear costs. Therefore, environmental problems are not local but global in nature. Consequently, implemented environmental policies and efforts to combat environmental problems should also be global in scope. In such a situation, costs are borne by all stakeholders, whether they contribute to pollution or not. Environmental health and protection, like other components of public health, should be the responsibility of a wide range of professionals and sectors, not just one profession or discipline. Multi-sectoral collaboration is the key to planning and implementing community-based interventions to foster environmental awareness. This process requires a joint effort among policymakers, community authorities, local leaders, and community members in general. Involving all elements of the community from the outset is critical to ensuring access to accurate information and community support. At the local level, health authorities often play a leading role in implementing environmental health programs. These institutions also undertake significant responsibilities related to planning, construction, and waste management concerning the protection and improvement of environmental health. Today, environmental goals and initiatives are implemented across seven distinct areas: fostering environmental awareness around sustainable development, promoting reduced energy consumption, increasing environmental sensitivity in transportation, reducing paper consumption, separating all waste at source, limiting the use of harmful chemicals, and considering environmental policies in all procurement processes. Sustainable development can be achieved through practices that embrace the goal of environmental protection with the understanding of "meeting the needs of the present without compromising the ability of future generations to meet their own needs." This concept includes not only the necessity of environmental protection but also the synergistic coexistence of ecological, economic, and social standards. Health professionals play a critical role in fostering positive attitudes and behaviors towards the community through environmental health programs. These professionals utilize individual and community-level theories in the design, implementation, and evaluation of programs aimed at improving health behavior. They aim to improve public health by implementing various strategies such as interpersonal communication, printed materials, interactive computer technologies, and media campaigns. Furthermore, health professionals need to possess the skills to effectively apply health behavior theories and the necessary competencies in designing contemporary programs that address the public. Success requires focusing on addressing behavioral risks underlying significant health problems. These problems, which significantly threaten public health, necessitate that all healthcare professionals, especially nurses, be more sensitive to environmental issues. Today, environmental health stands out as a significant part of healthcare and nursing practice. Nurses play a critical role in understanding the impacts of environmental factors on individual health and informing the public about these issues. In this context, environmental health and environmental sustainability topics are included in nursing education. The training nurses receive in the field of environmental health enhances their knowledge and skills, thereby improving the quality of healthcare services. Environmental health education enables nurses to respond more effectively to community health problems and encourages them to take leadership roles in environmental justice and health equity. Nurses undertake the task of informing the public about the prevention and management of environmental health problems, evaluating the impacts of environmental factors on health, and developing strategies to mitigate these impacts. Furthermore, nurses identify and address environmental health problems.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye), 06490
    • Gazi University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Students enrolled in 6th grade.
• Able to communicate and participate in group educational sessions.
• Have not previously participated in a structured recycling education program.
• Parent or legal guardian has provided written informed consent for participation.
• Participant provides assent to participate.

Exclusion Criteria:

• Students with special educational needs or cognitive/communication impairments that would preclude participation in group sessions.
• Any medical or behavioral condition that, in the opinion of investigators, would prevent safe participation in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Recycling education group; Participants receiving a 6- session recycling education program.	Behavioral: Recycling Education Program; A 6- session recycling education program developed based on the Precede-Proceed model. The program includes components targeting knowledge, attitudes, beliefs and recycling behaviors and aims to improve participants recycling practices.
No Intervention: Control Group; Participants on a waiting list receiving no intervention during the study period and will receive the after study completion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in recycling behavior score	The change in participants recycling behavior score measured using a structed recycling behavior questionnaire.	Baseline and immediately after the 6- session education program

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in stages of change for recycling	Change in participants stage of change classification for recycling behavior assessed using the recycling- adapted Stages of Change scale.	Baseline and immediately after the 6- session education program
Change in recycling self- efficacy score	The change in recyling self- efficacy levels measured using the recycling- adapted self- efficacy scale.	Baseline and immediately after the 6- session education program
Change in decisional balance for recyling	The change in perceived pros and cons of recycling measured using the recycling- adapted decisional balance scale.	Baseline and immediately after the 6- session education program
Change in processes af change for recycling	The change in cognitive and behavioral processed related to recycling measured using the recycling- adapted Processes of Change scale.	Baseline and immediately after the 6- session education program

Collaborators and Investigators

• Sponsor: Gazi University

Study record dates

Study Major Dates

• Study Start (Actual): November 11, 2025
• Primary Completion (Actual): January 2, 2026
• Study Completion (Actual): February 5, 2026

Study Registration Dates

• First Submitted: May 11, 2026
• First Submitted That Met QC Criteria: May 11, 2026
• First Posted (Actual): May 18, 2026

Study Record Updates

• Last Update Posted (Actual): May 18, 2026
• Last Update Submitted That Met QC Criteria: May 11, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: The Precede-Proceed Model, recycling, behavior, environmental awareness, middle school students, public health nursing, sustainability, environmental problems
• Additional Relevant MeSH Terms: Behavior
• Other Study ID Numbers: E-77082166-302.08.01-1251247

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: IPD sharing is restricted by data confidentiality, participant privacy, and applicable ethics rules and legislation. Sharing data with third parties may require relevant ethics committee approval, institutional permissions, and explicit consent from participants. If these conditions are not met, IPD sharing may not be possible.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No