Overview of Intervention Mapping

Purpose Intervention Mapping provides health promotion program planners with a systematic framework for effective decision-making in terms of: Development Implementation Evaluation

Intervention Mapping Steps Conduct a needs assessment. Formulate objectives. Select theory-based methods and practical applications. Organize methods and applications into an intervention program. Plan for program adoption, implementation, and sustainability. Generate an evaluation plan.

Overview The development of Intervention Mapping was stimulated by questions that could not be answered from available health education and health promotion resources.

Questions About Which Interventions Work to Create Change How to decide which intervention methods to use? How to get from program goals and objectives to intervention strategies for the program participants? How to link program design with program implementation?

STEP 1 Needs Assessment

PRECEDE-PROCEED:

Predisposing factors: “learning-related factors within the persons of the target population that facilitate or hinder motivation for change” e.g., awareness, knowledge, attitudes, beliefs, values, perceptions Learning, thus the factor can be changed Motivation, thus talk about factors that influence people’s motivation Anticipated social effects: perceived peer pressure and social support

Helmet use; example of health behavior Attitudes (own, of peers) may determine helmet use => example of predisposing factor

“factors that encourage or discourage continuation of the behaviour” Reinforcing factors: “factors that encourage or discourage continuation of the behaviour” e.g., social support, peer pressure, incentives, punishment Continuation, thus factors that follow behaviour.

Reinforcing

Educational and ecological assessment Enabling factors: “factors that can help or hinder the desired behaviours” e.g., skills, (material or financial) resources, barriers Help or hinder, thus factors that precede behaviour by making it possible.

Enabling

FORMULATING OBJECTIVES STEP 2 FORMULATING OBJECTIVES

Formulating objectives

SAFETY OUTCOMES (‘health’ level) What impact do we want to have on the actual road safety statistics? Road fatalities Severe road injuries Light road injuries Material damage only accidents

PRECEDE-model (Green & Kreuter, 2005) SAFETY OUTCOMES INTERVENTION PROGRAM Quality of Life Health PRECEDE-model (Green & Kreuter, 2005)

SAFETY PROMOTING GOALS (‘behavioral + environmental’ level) What do we like to change in individual behavior? What do we like to change in the environment?

PRECEDE-model (Green & Kreuter, 2005) SAFETY PROMOTING GOALS SAFETY OUTCOMES INTERVENTION PROGRAM Risk population Behavior Quality of Life Health Environment (social + physical) PRECEDE-model (Green & Kreuter, 2005)

SAFETY PROMOTING GOALS (‘behavior + environment’ level) 9 (instrinsically safe) road user behaviors 1. Use of seatbelt. 2. Use of child restraint. 3. Use of (motor)cycle helmet. 4. Use of protective (motorcycle) wear. 5. Respecting speed limits. 6. Refraining from alcohol-impaired driving. 7. Refraining from drug-impaired driving. 8. Refraining from medicine-impaired driving. 9. Refraining from fatigue-impaired driving.

SAFETY PROMOTING GOALS (‘behavior + environment’ level) In line with the S.M.A.R.T. principle, we need to further “break down” the behaviors into more specific “to do’s”: Put differently, as a next step we have to ask ourselves the following question: “What do the parents need to do to use a child seat?”

SAFETY PROMOTING GOALS (‘behavior + environment’ level) The use of child restraints implies several types of behavior! Risk-reduction (behavior) Parents don’t leave their children unrestrained. Health–promoting (behavior) Parents use a child restraint appropriately. Adherence (behavior) Parents use a child seat consistently. Screening (behavior) Parents check the status of the child restraint. Self-management (behavior) Parents negotiate restraint use with their partner.

PERFORMANCE OBJECTIVES (‘to do’ level) What do people (i.e. parents) specifically have to do to use child seats appropriately & consistently?

PRECEDE-model (Green & Kreuter, 2005) PERFORMANCE OBJECTIVES SAFETY PROMOTING GOALS SAFETY OUTCOMES INTERVENTION PROGRAM To do 1 PARENTS Behavior To do 2 Quality of Life Health To do 1 UNIVERSITY To do 2 PRECEDE-model (Green & Kreuter, 2005)

PERFORMANCE OBJECTIVES (‘to do’ level) To use child-seats correctly and consistently: PO1: Parents buy child seat (2nd if 2 cars) PO2: Parents keep child seat in the car PO3: Parents adjust seat to child’s length PO4: Parents replace seat in time

CHANGE OBJECTIVES (‘determinant’ level) Determinants: Factors that explain why would or wouldn’t keep the child seat in the car. PREDISPOSING FACTORS REINFORCING FACTORS ENABLING FACTORS Change objectives: What do parents have to learn to do what we like them to do?

PRECEDE-model (Green & Kreuter, 2005) PERFORMANCE OBJECTIVES SAFETY PROMOTING GOALS SAFETY OUTCOMES Predisposing Factors INTERVENTION PROGRAM To do 1 Reinforcing Factors PARENTS Behavior To do 2 Quality of Life Health Enabling Factors To do 1 UNIVERSITY To do 2 CHANGE OBJECTIVES PRECEDE-model (Green & Kreuter, 2005)

SELECTING METHODS & PRACTICAL APPLICATIONS STEP 3 SELECTING METHODS & PRACTICAL APPLICATIONS

As an illustration: fear appeals

Protection Motivation Theory FEAR APPEALS Perceived severity Perceived threat Perceived susceptibility Protection motivation Response efficacy Motivational model Perceived coping Self-efficacy

Extended Parallel Process Model

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