For Classroom Use Only © 2003 University of Texas Houston Health Science Center L. Kay Bartholomew, Guy S. Parcel, Gerjo Kok, and Nell H. Gottlieb Intervention.

For Classroom Use Only

© 2003 University of Texas Houston Health Science Center

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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© 2003 University of Texas Houston Health Science Center

 Developing and Analyzing Health

Promotion Programs

What is Intervention Mapping?

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© 2003 University of Texas Houston Health Science Center

Intervention Mapping Development Questions that we couldn’t 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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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?

Intervention Mapping Development Questions that we couldn’t easily answer from available resources:

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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?

Intervention Mapping Development Questions that we couldn’t easily answer from available resources:

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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)?

Intervention Mapping Development Questions that we couldn’t easily answer from available resources:

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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!

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Designing Theory- and Evidence-Based Health Promotion

What is Intervention Mapping?

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© 2003 University of Texas Houston Health Science Center

Intervention Mapping

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Intervention Mapping Step IMatrices 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

Learning/change objective

Learning/change objective

Performance objective 2

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 Identify where

condoms can be obtained

Identify location of condoms in stores Describe types of condoms and features for effectiveness

Explain how to buy or obtain a condom

Learning objectives Express confidence

in ability to go into a store and buy a condom

Feel confident in ability to deal with embarrassment when buying a condom

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Intervention Mapping Step 2Methods 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 Method is a general process for influencing changes in the determinants of behavior and environmental conditions

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

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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?