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HEP4213 - Intervention development SUMMARY

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Summary of the Lectures and important pages of the Book 'Planning Health Promotion Pograms' of Bartholomew et al.

Voorbeeld 4 van de 37  pagina's

  • Onbekend
  • 27 juli 2018
  • 37
  • 2017/2018
  • Samenvatting
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HEP4213 – Intervention Mapping: Lectures

Intervention Mapping (IM)  STEP 1 (03-11-2017) [CHAPTER 4]
Intervention Mapping
 Steps:
o 1: Logical Model of the Problem
o 2: Program Outcomes and Objectives  Logic Model of Change
o 3: Program Design
o 4: Program Production
o 5: Program Implementation Plan
o 6: Evaluation Plan
 Iterative process
 Increasing likelihood of effectiveness, but no guarantee

Perspective 1: theory and evidence
 Using theory from a problem-driven perspective
o Not theory generation or single-theory
testing
o Theoretical promiscuity is encouraged
 Causal theories and change theories
 Evidence goes beyond the scientific literature
o Opinions and experience of community members and planners
Perspective 2: ecological models and systems thinking
 Social ecological model is consonant with and
encompassed by systems thinking
o Health is a function of individuals and of
the environments in which individuals live
o Interventions are events in systems and
other factors within a system can reinforce
or dampen the influence of an intervention
o Focus on the interrelationships between
individuals and their environments  look
at agents at each ecological level
Perspective 3: participation in health promotion planning
 Broad participation of target group and other relevant stakeholders
o Intervention focus reflects actual concerns
o A greater breadth of skills, knowledge and expertise
o A greater acceptance of the intervention that is going to be developed
Core processes for using theory and evidence  you can apply these processes from step 1 to
step 6

1

,  Posing questions (starting with the worksheets)
 Brainstorming to figure out what the planning ream already knows about potential
answers to the question
 Reviewing findings from the empirical literature for answers to the question (breadth
and depth of search)
 Reviewing theories for additional constructs
 Assessing and addressing needs for new data
 Developing a working lists of answers, then moving on to the next question

Accessing and using theory
 1) Topic approach: theories used in previous work on the topic
 2) Construct approach: from brainstorm to theoretical constructs
 3) General theories approach: general explanations

Tasks within Step 1 [Examples whole step  page 256 - 261]

 Establish and work with planning group
 Describe the context form the intervention including the population, setting and
community
 State program goals
 Conduct a needs assessment (to create a logic model of the problem)
o Systematic study of discrepancy between “what is” and “what should be”
o A statement of need is a statement of a problem and does not suggest a solution
o Fully analysing the problem and its multiple causes to create a logic model of
the problem
o A full analysis is needed before selections can be made based on relevance and
changeability
o A full analysis requires an adequate planning group
 Planning group needs  planning group can change over time, being in a planning
group does not necessarily means being in the same room.
o Expertise in the health problem or its causes
o Diverse perspectives and community participation
o Responsibility and authority
o Influence
o Commitment to the issue




2

, Logic model of the problem
[Example Epilepsy page 234, Example Sex education page 259]




 Describing the priority population
o Epidemiologically and demographically defined population at risk
o At risk group is not necessarily the target group (e.g. intervention trough
parents)
 Describing health problems and quality of life (Phase 1 & 2)
o Basic questions e.g.
 What is the problem?
 What are the incidence, prevalence and distribution of the problem?
 What are the demographic characteristics of the population that faces
the problem or is at risk for the problem?
 What segments of the population have an excess burden from the health
problem?
o Dimensions
 Health problems: e.g. disability, fertility, morbidity, mortality
 Quality of life: e.g. absenteeism, stigma, employment
 Describing possible causes of health problems (Phase 3)
o Behaviour of at-risk group
o Environmental factors: indirectly or directly causes health problem
 Social environment: e.g. behaviour of parents, employers, health care
providers, access to services; legislation; availability or resources
 Physical environment: e.g. no access to clean water, air pollution,
inadequate housing
o Identify environmental factors at interpersonal, organizational, community and
societal levels
 Specify the agents responsible for each environmental factor
 Describing determinants of the causes (behaviour/environmental factors) (Phase 4)
o Reside at the individual level (predisposing, reinforcing and enabling factors
e.g. attitudes, self-efficacy)

3

, o Evidence for determinants is usually correlational
o As always: use core processes

Intervention Mapping (IM)  STEP 2A – program outcome and program objectives
(Logic model of Change) [CHAPTER 5]
Time for ‘the flip’: from problem causation (= step 1) to program effects (= step 2)  from
problem to solution  from focus more on unhealthy behaviour to healthy behaviour
[Example Sex education page 320]




[Examples whole step  page 322-330]

Four important tasks in step 2:
 State outcomes
o For the behaviour and for the environment
 State performance objectives
o For the behaviour of the target group and the environmental agents
 Make a list of determinants
o Select determinants based on importance and changeability
 Create a matrix with change objective

State outcomes = behaviours [Examples outcomes + POs: PA page 299, Stroke page 300]
 People in the target group and environmental agents have to engage in healthy
behaviours = outcomes
 A distinction can be made between:
o Risk reducing behaviours  actions that have been proven to directly decrease
the risk of disease
o Health promoting behaviours  actions that have been proven to protect or
enhance health
o Adherence and self-management behaviours  actions that have been proven
to aid self-management or adherence to treatment
Brainstorming outcomes
 The outcome behaviour is not always simply the opposite of the risk behaviour: e.g.
unsafe sex = no sex before marriage, condom use, STI testing etc.

4

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