The planning of community health education interventions aimed at multiple levels is complex and challenging. This challenge is increased when a primary audience is difficult to reach. Individuals who were exposed to diethylstilbestrol (DES) decades ago represent a difficult-to-reach audience because they are not always aware of their exposure or the health risks of their exposure. However, DES-exposed individuals need specific screening and health care. An intervention was developed to increase awareness about DES in Nassau County, New York to address this concern. The Precede-Proceed Model was used to develop distinct intervention strategies to reach the general public, which includes individuals who may not be aware that they were exposed; those who are aware of their exposure but may not be following recommended health care practices; and community physicians. Behavioral targets, determining factors, and intervention goals were identified for each group. Specific intervention strategies were planned and implemented for each target audience. Addressing three target audiences simultaneously may produce a synergistic effect, enhancing program impact.
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