Samenvatting
HEP4213 - Intervention development SUMMARY
- Instelling
- Maastricht University (UM)
Summary of the Lectures and important pages of the Book 'Planning Health Promotion Pograms' of Bartholomew et al.
[Meer zien]Voorbeeld 4 van de 37 pagina's
Voorbeeld 4 van de 37 pagina's
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Voorbeeld van de inhoud
HEP4213 – Intervention Mapping: LecturesIntervention 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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