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© 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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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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© 2003 University of Texas Houston Health Science Center
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?