Planning Health Promotion
Chaper 1: Overview of Intervention Mapping
The purpose of Intervention Mapping is to provide health promotion program planners
with a framework for e ective decision making at each step in intervention planning,
implementation, and evaluation
1.1 Perspectives
Theory and Evidence
Theory plays a crucial role in health promotion planning by guiding the design of
interventions and helping to prevent failures caused by poor design or implementation.
The use of theory ensures that interventions address key determinants of behavior
change, making them more robust and generalizable. However, more guidance is
needed for applying theory e ectively in practice, as some practitioners find it irrelevant
or di icult to use. Planners often integrate multiple theories and perspectives when
addressing health issues, drawing from both research evidence and community input.
Intervention Mapping provides a structured framework for using theory and evidence to
develop health interventions.
An Ecological Approach to Health Promotion Program Planning:
The ecological approach: health as shaped by both individual behaviors and
environmental factors, including social networks, organizations, and policies.
(individual, community, societal)
By identifying leverage points within this web of influences, planners can develop
e ective multi-level interventions. Changes at higher levels (e.g., policy or norms) can
impact behavior at lower levels, as seen in examples of social advocacy and health
legislation. While this complexity can be challenging, Intervention Mapping helps
manage it systematically.
,Agency in the Environment
Change at various ecological levels requires understanding the roles of key actors, or
“gatekeepers,” who control resources and influence behaviors within their
environments. Drawing on theories from Kurt Lewin, social exchange theory, and the
MATCH model, this approach emphasizes the role of agents at di erent levels
(interpersonal, organizational, community, societal) in shaping conditions. By identifying
the decision-makers at each level and understanding their motivations and constraints,
health educators can plan targeted interventions to influence behaviors and drive
change across systems.
,1.2 The Need for a Framework for Intervention
Development
Health educators must have the skills to design and adapt e ective interventions. While
some recommendations are clear-cut (e.g., client reminders for vaccinations), others,
like multi-component interventions, may be harder to apply due to their complexity.
Best practices in health promotion should be:
tailored to specific populations
involve participants in planning, implementation and evaluation
Integrate e orts aimed at changing individuals, social and physical
environments, communities, and policies
Link participants’ concerns about health to broader life concerns and to a vision
of a better society
Use resources within the environment
Build on the strengths of participants and communities
Advocate for resources and policy changes needed to achieve the desired health
objectives
Prepare participants to become leaders
Support the di usion of innovation
Seek to institutionalize successful intervention components and replicate them
in other settings
,1.3 Intervention Mapping Steps
The completion of all of the steps serves as a blueprint for designing, implementing, and
evaluating an intervention based on a foundation of theoretical, empirical, and practical
information.
Six fundamental steps:
1. Conduct a needs assessment or problem analysis
2. Create matrices of change objectives based on the determinants of behavior and
environmental conditions
3. Select theory-based intervention methods and practical strategies
4. Translate methods and strategies into an organized program
5. Plan for adoption, implementation, and sustainability of the program
6. Generate an evaluation plan
, Step 1: Needs Assessment
description of a health problem, its impact on quality of life, behavioral and
environmental causes, and determinants of behavior and environmental causes.
Two components:
1. Scientific, epidemiologic, behavioral, and social analysis of an at-risk group or
community and its problems
2. Understand the character of the community, its members, and its strengths.
Tasks:
1. Planning group
that includes potential program participants and plan the needs assessment
2. Needs assessment using the PRECEDE model
to analyze health and quality of life problems and their causes and to decide on priorities
3. Balance the needs assessment
with an assessment of community capacity.
4. Link the needs assessment to evaluation planning by establishing desired
5. program outcomes
Step 2: Matrices of Change Objectives
specifying who and what will change as a result of the intervention to provide
the foundation for the intervention
In order to develop performance objectives beyond the individual, the planners identify
roles of environmental agents at each selected ecological level.
For example:
Increase vegetable consumption in elementary school, matrices would be created for
the child and the food service, that might contain more than one role: the manager’s
purchasing practices, the dietitian’s menu development, and the cooks’ recipe choices.
Tasks:
1. State the expected change or program outcomes for health-related behavior and
environmental conditions
2. Subdivide behavior and environmental conditions into performance objectives
3. Select important and changeable personal and external determinants of at- risk
group behavior and environmental conditions
4. Create a matrix of change objectives for each level of intervention planning
(individual, interpersonal, organizational, community, and societal) by crossing
performance objectives with determinants and writing change objectives
