L. Kay Bartholomew, Guy S. Parcel, Gerjo Kok, and Nell H.

Gottlieb

Intervention Mapping: Designing Theory and Evidence Based Health Promotion Programs

Introduction

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Developing and Analyzing Health Promotion Programs

What is Intervention Mapping?

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Intervention Mapping Development

Questions that we couldnt easily answer from available resources:

THEORY

When in the planning process do I use theory to guide my decisions? How do I know what theories and constructs to use?

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Intervention Mapping Development

Questions that we couldnt easily answer from available resources:

EVIDENCE

How do I make use of the experience of others and the results of program evaluations. How do I judge the the validity and strength of evidence?

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Intervention Mapping Development

Questions that we couldnt easily answer from available resources:

EFFECTIVE METHODS

How do I decide what intervention methods to use? How can I get from program goals and objectives to the specific intervention strategies for the program participants? How do I link program design with program implementation?

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Intervention Mapping Development

Questions that we couldnt easily answer from available resources:

ECOLOGICAL APPROACH

How do I address changing the behavior of people in the environment (i.e. make sure intervention addresses those people who are not at risk for the health problem , but are important to changing conditions that affect those at risk)?

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Possible innovation in the way we do planning :

Explication of Multilevel Environmental Factors Related to Health and Behavior

Explicit attempts to facilitate an ecological planning approach that takes into consideration both the social and physical environmental factors that influence a health problem

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Possible innovation in the way we do planning :

Focus on Behavior of Both the At-Risk Population and the Agents of Environmental Change

Explicit definition of behavior including performance objectives

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Possible innovation in the way we do planning Proposed Determinants

The explicit delineation of the factors that can be supported as [causally] related to behavioral or environmental causes of a health problem The explicit intersection of these determinants with the performance necessary to carry out the health behavior or change the environmental factor MATRICES
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Possible innovation in the way we do planning :

Matrices of Proximal Program Objectives The use of the Matrix device to plan methods and strategies for both The intervention itself

Adoption, implementation, maintenance and wide diffusion of the intervention

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Possible innovation in the way we do planning: The Difference between Methods and Strategies

The attempt to force a division between theoretical methods and practical strategies

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The goal of developing Intervention Mapping was to describe and clarify the processes that have been used to create effective interventions.

Not to create a new process!

For Classroom Use Only 2003 University of Texas Houston Health Science Center

Designing Theory- and Evidence-Based Health Promotion

What is Intervention Mapping?

For Classroom Use Only 2003 University of Texas Houston Health Science Center

Intervention Mapping

For Classroom Use Only 2003 University of Texas Houston Health Science Center

Intervention Mapping Step I Matrices of Proximal Program Objectives

State expected changes in behavior and environment Specify performance objectives Specify hypothetical determinants Create matrices (if necessary, differentiate the population)

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Creating a Matrix of Proximal Program Objectives

Determinant 1 Determinant 2 Performance objective 1 Performance objective 2
Learning/change objective Learning/change objective Learning/change objective Learning/change objective

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Matrix on Determinants of Buying or Obtaining a Condom

Performance Personal Determinants Objective Knowledge Self-efficacy
Buys or obtains a condom Learning objectives Learning objectives Identify where Express confidence condoms can be in ability to go into a obtained store and buy a Identify location of condom Feel confident in condoms in stores ability to deal with Describe types of embarrassment when condoms and features buying a condom for effectiveness Explain how to buy or obtain a condom
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Intervention Mapping Step 2 Methods and Strategies

Brainstorm methods Translate methods into practical strategies Organize methods and strategies by groups of leaning objectives at each level and check that methods are properly operationalized

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Methods and Strategies

A strategy is a practical technique for the application of methods in ways that fit with the intervention group and the context in which the intervention will be conducted

A Method is a general process for influencing changes in the determinants of behavior and environmental conditions

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Intervention Mapping Step 3 Producing Program Components

Operationalize the strategies into plans that consider implementers and sites Develop design documents and produce materials Pretest programs and materials with intervention groups and implementers

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Intervention Mapping Step 4 Planning for Adoption, Implementation and Sustainability

Develop a linkage system Create matrices of proximal program objectives Select methods and strategies and create a diffusion intervention table Write an adoption and implementation plan

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Intervention Mapping Step 5

Planning for Evaluation

Develop an evaluation map State process and effect questions Develop or select indicators and measures using the matrices Specify evaluation designs and write the plan

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Analyzing Programs

Behaviors Environmental Conditions? What determinants are targeted? Justifiable determinants? Methods matched to determinants Methods operationalized into strategies?

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