Planning Health Promotion Programs E-Book

L. Kay Bartholomew Eldredge

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1328

Veröffentlichungsjahr: 2011

Beschreibung

This guide to the planning of health promotion programs uses the increasingly popular Intervention Mapping approach, a theory- and evidence-based interactive process that links needs assessment with program planning in a way that adds efficiency and improves outcomes. Students, researchers, faculty, and professionals will appreciate the authors' approach to applying theories of behavior and social change to the design of coherent, practical health education interventions. Written by internationally recognized authorities in Intervention Mapping, the book explains foundations in Intervention Mapping, provides an overview of the role of behavioral science theory in program planning¾including a review of theories and how to assess theories and evidence¾and a step-by-step guide to Intervention Mapping, along with detailed case examples of its application to public health programs. Planning Health Promotion Programs is the second and substantially revised edition of the bestselling resource Intervention Mapping.

Leseprobe

Table of Contents

Title Page

Copyright Page

Table of Figures

List of Tables

PREFACE

Acknowledgments

THE AUTHORS

PART ONE - FOUNDATIONS

CHAPTER ONE - OVERVIEW OF INTERVENTION MAPPING

Reader Objectives

Perspectives

The Need for a Framework for Intervention Development

Intervention Mapping Steps

Navigating the Book

Summary

CHAPTER TWO - CORE PROCESSES: USING EVIDENCE, THEORY, AND NEW RESEARCH

Reader Objectives

Perspectives

Core Processes for Intervention Mapping

Skills for Core Processes: Literature Review

Skills for Core Processes: Qualitative and Quantitative Methods

Core Processes Applied to Determinants: The Case of Child Restraint Devices

Core Processes Applied to Methods: HIV Infection in Drug Users

Formulating Working Answers for Risk and Shifting Norms

CHAPTER THREE - BEHAVIOR-ORIENTED THEORIES USED IN HEALTH PROMOTION

Reader Objectives

Perspectives

Overview of Theories

Learning Theories

Health Belief Model (HBM)

Protection-Motivation Theory (PMT)

Theory of Planned Behavior (TPB)

Current Developments in TPB

Theories of Goal Setting

Theories of Goal Directed Behavior

Theories of Automatic Behavior and Habits

Transtheoretical Model (TTM) of Behavior Change

Precaution-Adoption Process Model (PAPM)

Attribution Theory and Relapse Prevention

Attributional Retraining and Relapse Prevention

Persuasion-Communication Matrix (PCM)

Elaboration Likelihood Model (ELM)

Theories of Self-Regulation

Social Cognitive Theory (SCT)

SCT and Behavior Change

CHAPTER FOUR - ENVIRONMENT-ORIENTED THEORIES

Reader Objectives

Perspectives

Interpersonal-Level Theories

Organizational Change Models and Theories

Community-Level Theories

Societal and Governmental Theories

PART TWO - INTERVENTION MAPPING STEPS

CHAPTER FIVE - INTERVENTION MAPPING STEP 1: NEEDS ASSESSMENT

Reader Objectives

Perspectives

Collaborative Planning and the Preassessment Phase

Conducting the Needs Assessment

Sources of Needs-Assessment Data

The Needs Assessment as a Risk Model

Community Capacity

Setting Priorities

Implications for Evaluation

CHAPTER SIX - INTERVENTION MAPPING STEP 2: PREPARING MATRICES OF CHANGE OBJECTIVES

Reader Objectives

Perspectives

Behavioral and Environmental Outcomes

Peformance Objectives

Personal and External Determinants

Matrix of Change Objectives

Creating a Matrix for Program Revision

Implications for Program Evaluation

CHAPTER SEVEN - INTERVENTION MAPPING STEP 3: SELECTING THEORY-INFORMED ...

Reader Objectives

Perspectives

Ideas About the Program

Identifying Theoretical Methods

Methods Selection

From Methods to Strategies

Where Have All the Objectives Gone?

Implications for Evaluation

CHAPTER EIGHT - INTERVENTION MAPPING STEP 4: PRODUCING PROGRAM COMPONENTS AND MATERIALS

Reader Objectives

Perspectives

Designing Culturally Relevant Program Materials

Creating the Initial Program Plan and Structure

Preparing Design Documents

Reviewing Existing Materials

Developing Program Materials

Pretesting, Revising, and Producing Program Components

Implications for Evaluation

CHAPTER NINE - INTERVENTION MAPPING STEP 5: PLANNING PROGRAM ADOPTION, ...

Reader Objectives

Perspectives

Program Users and Linkage System

Performance Objectives for Adoption, Implementation, and Sustainability

Determinants of Program Use

Matrices and Plans for Promoting Program Use

Methods and Strategies for Dissemination

Adoption, Implementation, and Sustainability Plan

Implications for Program Evaluation

CHAPTER TEN - INTERVENTION MAPPING STEP 6: PLANNING FOR EVALUATION

Reader Objectives

Perspectives

Reviewing the Program Logic Model

Impact on Health, Quality of Life, Behavior, and Environment

Impact on Change Objectives

Program Process

Selecting and Developing Measures

Design Issues

PART THREE - CASE STUDIES

CHAPTER ELEVEN - A SCHOOL HIV-PREVENTION PROGRAM IN THE NETHERLANDS

Reader Objectives

Perspectives

Intervention Mapping Step 1: Needs Assessment

Step 2: Matrices

Step 3: Intervention Theory-Informed Methods and Practical Strategies

Step 4: Creating a Coherent Program

Step 5: Specifying Adoption and Implementation Plans

Step 6: Generating an Evaluation Plan

Summary

CHAPTER TWELVE - ASTHMA MANAGEMENT FOR INNER-CITY CHILDREN

Reader Objectives

Perspectives

Intervention Mapping Step 1: Needs Assessment

Step 2: Matrices of Change Objectives

Step 3: Theory-Informed Methods and Practical Strategies

Step 4: Program Design

Step 5: Adoption and Implementation

Step 6: Monitoring and Evaluation

CHAPTER THIRTEEN - THEORY AND CONTEXT IN PROJECT PANDA: A PROGRAM TO HELP ...

Reader Objectives

Perspectives

Intervention Mapping Step 1: Needs Assessment

Step 2: Matrices of Change Objectives

Step 3: Methods and Strategies

Step 4: Program Design

Step 5: Implementation

Step 6: Evaluation

Summary

CHAPTER FOURTEEN - CULTIVANDO LA SALUD

Reader Objectives

Perspectives

Intervention Mapping Step 1: Needs Assessment

Step 2: Matrices of Change Objectives

Step 3: Methods and Strategies

Step 4: Program

Step 5: Adoption and Implementation

Step 6: Evaluation Planning

REFERENCES

NAME INDEX

SUBJECT INDEX

Table of Figures

FIGURE 1.1 . SCHEMATIC OF THE ECOLOGICALAPPROACH IN HEALTH PROMOTION PROGRAMS.

FIGURE 1.2 . INTERVENTION MAPPING.

FIGURE 1.3 . LOGIC MODEL OF RISK.

FIGURE 1.4 . INTERVENTION LOGIC MODEL

FIGURE 2.1 . CORE PROCESSES:HOW TO USE THEORY, LITERATURE, AND NEW DATA.

FIGURE 2.2 . CONSIDERATIONS IN EVALUATING REVIEWS: A CHECKLIST.

FIGURE 2.3 . INTEGRATING QUALITATIVEAND QUANTITATIVE METHODS.

FIGURE 2.4 . INTEGRATING METHODS: CF FEP.

FIGURE 2.5 . CAUSAL MODEL FOR CRD USE.

FIGURE 3.1 . LOGIC MODEL FOR METHODS, DETERMINANTS, BEHAVIORS, ENVIRONMENTAL CONDITIONS, AND HEALTH.

FIGURE 4.1 . LOGIC MODEL FOR RELATIONSHIPSBETWEEN METHODS, DETERMINANTS, BEHAVIORS,ENVIRONMENTAL CONDITIONS, AND HEALTH.

FIGURE 4.2 . OVERVIEW OF INTERVENTION PROCESS AT HIGHER ECOLOGICAL LEVELS.

FIGURE 4.3 . MODEL OF ENVIRONMENTAL HEALTH ETIOLOGY AND EMPOWERMENT.

FIGURE 4.4 . NATURAL-HELPER INTERVENTION MODEL.

FIGURE 4.5 . COMMUNITY COALITION ACTION THEORY.

FIGURE 4.6 . STAGES OF RESPONSIBILITY TO ACT.

FIGURE 4.7 . COMMUNITY-ORGANIZING AND COMMUNITY-BUILDING TYPOLOGY.

FIGURE 4.8 . PUBLIC SOCIOENVIRONMENTAL POLICY THAT SHAPES AMERICAN ENVIRONMENTS.

FIGURE 4.9 . A MODEL OF THE PUBLIC POLICYMAKING PROCESS IN THE UNITED STATES.

FIGURE 5.1 . LOGIC MODEL FOR NEEDS ASSESSMENT.

FIGURE 5.2 . ASTHMA PRECEDE MODEL.

FIGURE 5.3 . ENVIRONMENTAL LEVELS AND THEIR IMPACT ON HEALTH.

FIGURE 5.4 . PRECEDE LOGIC MODEL.

FIGURE 6.1 . LOGIC MODEL OF CHANGE.

FIGURE 7.1 . LOGIC MODEL OF CHANGE WITH METHODS AND STRATEGIES.

FIGURE 7.2 . SCHEMATIC REPRESENTATION OF THE SHIFT FROM EXTERNAL DETERMINANTS TO ENVIRONMENTAL FACTORS.

FIGURE 8.1 WATCH, DISCOVER, THINK, AND ACT SCREEN WITH SELF-REGULATORY ICONS.

FIGURE 8.2 . CATCH THEME.

FIGURE 8.3 . CYSTIC FIBROSIS FAMILY EDUCATION PROGRAM THEME.

FIGURE 8.4 . COMPUTERIZED TELEPHONE SYSTEM FOR SMOKING COUNSELING.

FIGURE 8.5 . DEVELOPING TAILORED FEEDBACK.

FIGURE 8.6 . PCCaSO FLOWCHART DESIGN DOCUMENT.

FIGURE 8.7 . DETAIL FROM PCCaSO FLOW DIAGRAM.

FIGURE 8.8 . WALK TEXAS! DESIGN DOCUMENT.

FIGURE 8.9 . ADVOCACY DESIGN DOCUMENT: ORGANIZING THE INTERVIEW TEAM.

FIGURE 8.10 . TASKS FOR PRODUCING A PRINT PIECE.

FIGURE 8.11 . TASKS FOR PRODUCING A VIDEOTAPE.

FIGURE 8.12 . STORYBOARD: PROJECT PCCaSO.

FIGURE 8.13 . STROKE PROJECT BILLBOARD.

FIGURE 8.14 . NEWSLETTER.

FIGURE 8.15 . NEWSPAPER ARTICLE (THE DAILY SENTINEL).

FIGURE 10.1 . INTERVENTION LOGIC MODEL.

FIGURE 10.2 . OVERVIEW OF PROGRAM PATHWAYS.

FIGURE 10.3 . INTERVENTION LOGIC MODEL FOR EVALUATION.

FIGURE 11.1 . THEORY OF PLANNED BEHAVIOR.

FIGURE 11.2 . AN ITERATIVE APPROACH TO DETERMINANT STUDY METHODS.

FIGURE 11.3 . EFFECT SIZES.

FIGURE 12.1 . ASTHMA SELF-MANAGEMENT BEHAVIORAL FRAMEWORK.

FIGURE 12.2 . ENVIRONMENTAL REPORT CARD.

FIGURE 12.3 . EVALUATION MODEL.

FIGURE 13.1 . RELAPSE CURVES.

FIGURE 13.2 . RELAPSE PREVENTION MODEL: A COGNITIVE-BEHAVIORAL MODEL OF THE RELAPSE PROCESS.

FIGURE 13.3 . STAGES, PROCESSES OF CHANGE, AND EVIDENCE THAT WOMEN MIGHT NOT BE QUITTERS.

FIGURE 13.4 . STAGE OF CHANGE FOR POSTPARTUM SMOKING.

FIGURE 13.5 EXAMPLE OF METHOD DELIVERY—NEWSLETTER.

FIGURE 13.6 . FLOW DIAGRAM FOR NEWSLETTER PREPARATION.

FIGURE 13.7 . PERCENTAGE OF SMOKING FOCUS IN MEN’S VIDEO.

FIGURE 13.8 . PERCENTAGE OF SMOKING FOCUS IN WOMEN’S VIDEO.

FIGURE 13.9 . PRETESTING NEWSLETTER.

FIGURE 13.10 . PROJECT PANDA EVALUATION LOGIC MODEL.

FIGURE 14.1 . PROGRAM LOGO.

List of Tables

TABLE 2.1 . PROVISIONAL LIST: DETERMINANTS OFLACK OF CONDOM USE AMONG SEXUALLY ACTIVE ADOLESCENTS.

TABLE 2.2 . EXAMPLES OF THEORIES FOR INTERVENTION MAPPING STEPS.

TABLE 2.3 . PROFILE OF PRIMARY STUDIES AND OUTCOMES BY INTERVENTION TYPE AND SETTING

TABLE 2.4 . PREDICTORS OF POSTPARTUM SMOKING FROM MULTIVARIATE ANALYSES.

TABLE 2.5 . PROVISIONAL LIST: DETERMINANTS OF LACK OF CRD USE.

TABLE 2.6 . SELECTING DETERMINANTS: RELEVANCE AND CHANGEABILITY.

TABLE 2.7 . PROVISIONAL LIST: METHODS FOR CHANGING RISK PERCEPTION AMONG DRUG USERS.

TABLE 2.8 . PROVISIONAL LIST: METHODS FOR CHANGING SOCIAL NORMS AMONG DRUG USERS.

TABLE 2.9 . THEORETICAL CONDITIONS FOR METHODS.

TABLE 2.10 . SELECTING METHODS: RELEVANCE AND CHANGEABILITY.

TABLE 3.1 . WHEN TO USE THEORY IN INTERVENTION PLANNING.

TABLE 3.2 . THEORIES ARRAYED BY LEVEL.

TABLE 3.3 . CHANGE PROCESSESIN THE TRANSTHEORETICAL MODEL.

TABLE 3.4 . THE PRECAUTION-ADOPTION PROCESS MODEL.

TABLE 3.5 . PERSUASION COMMUNICATION MATRIX.

TABLE 3.6 . SELF-REGULATORY THEORY.

TABLE 4.1 . STRUCTURAL AND RELATIONAL PROPERTIES OF SOCIAL NETWORKS.

TABLE 4.2 . CULTURE-EMBEDDING MECHANISMS.

TABLE 4.3 .CATEGORIES OF COMMUNITY PARTICIPATION WITH EXAMPLES.

TABLE 4.4 . PRINCIPLES UNDERLYING EFFECTIVE TACTICS.

TABLE 4.5 . GUIDELINES FOR EFFECTIVE ADVOCACY.

TABLE 5.1 . GROUP MANAGEMENT.

TABLE 5.2 . EXAMPLES OF SECONDARY DATA SOURCES FOR NEEDS ASSESSMENT

TABLE 5.3 . PRIMARY SOURCES OF EVIDENCE FOR BEHAVIOR AND ENVIRONMENT.

TABLE 5.4 . CONTRASTING THE “NEEDS” VS. “ASSETS” APPROACH TO COMMUNITY ENHANCEMENT.

TABLE 5.5 . TYPES OF OBJECTIVES.

TABLE 5.6 . STROKE PROJECT COMMUNITY SURVEY VARIABLES.

TABLE 6.1 . PERFORMANCE OBJECTIVES FOR CONSISTENTLY AND CORRECTLY USING CONDOMS DURING SEXUAL INTERCOURSE.

TABLE 6.2 . ENVIRONMENTAL PERFORMANCE OBJECTIVES FOR THE SPF PROJECT.

TABLE 6.3 . COMPARISON OF PERFORMANCE OBJECTIVES.

TABLE 6.4 . PERFORMANCE OBJECTIVES USING COPING THEORY.

TABLE 6.5 . MATRIX FOR AT-RISK CHILDREN IN THE SPF PRIGRAM.

TABLE 6.6 . SAMPLE OF ROWS FROM MATRIX FOR ORGANIZATIONAL ENVIRONMENTAL CHANGE IN SPF PROGRAM.

TABLE 6.7 . SELECTED CHANGE OBJECTIVES: ASTHMA IN HISPANIC CHILDREN—PARENT MATRIX.

TABLE 6.8 . EXAMPLES OF CELLS FROM A SIMULATED MATRIX: CONSISTENTLY AND CORRECTLY USING CONDOMS DURING SEXUAL INTERCOURSE.

TABLE 6.9 . LIST OF ACTION WORDS FOR WRITING PERFORMANCE OBJECTIVES.

TABLE 6.10 . USING THE INTERVENTION MAPPING STEPS TO ADAPT A PROGRAM FOR A NEW POPULATION.

TABLE 6.11 . COMMUNITY (BYSTANDER) PERFORMANCE OBJECTIVES.

TABLE 6.12 . EMERGENCY DEPARTMENT PERFORMANCE OBJECTIVES.

TABLE 6.13 . EMS PERFORMANCE OBJECTIVES.

TABLE 6.14 . PRIMARY CARE PROVIDER PERFORMANCE OBJECTIVES.

TABLE 6.15 . WORK ON HYPOTHESIZED DETERMINANTS OF COMMUNITY MEMBERS’ RESPONSE TO STROKE.

TABLE 6.16 . WORK ON HYPOTHESIZED DETERMINANTS OF HEALTH CARE PROVIDERS’ RESPONSE TO STROKE.

TABLE 6.17 . COMMUNITY (BYSTANDER) MATRIX FOR RESPONSE TO STROKE.

TABLE 6.18 . EMERGENCY DEPARTMENT MATRIX FOR RESPONSE TO STROKE.

TABLE 6.19 . EMERGENCY MEDICAL SERVICE MATRIX FOR RESPONSE TO STROKE.

TABLE 6.20 . PRIMARY CARE PROVIDE MATRIX FOR RESPONSE TO STROKE.

TABLE 7.1 . OBJECTIVES AND METHODS FOR CHANGING AWARENESS AND RISK PERCEPTION.

TABLE 7.2 . OBJECTIVES AND METHODS AT VARIOUS LEVELS.

TABLE 7.3 . BASIC METHODS AT THE INDIVIDUAL LEVEL.

TABLE 7.4 . METHODS TO INCREASE KNOWLEDGE.

TABLE 7.5 . METHODS TO CHANGE AWARENESS AND RISK PERCEPTION.

TABLE 7.6 . METHODS TO CHANGE HABITS, AUTOMATIC BEHAVIOR, AND ACTION CONTROL.

TABLE 7.7 . METHODS TO CHANGE ATTITUDES.

TABLE 7.8 . METHODS TO CHANGE SOCIAL INFLUENCE.

TABLE 7.9 . METHODS FOR SKILLS, CAPABILITY, AND SELF-EFFICACY.

TABLE 7.10 . BASIC METHODS AT HIGHER ENVIRONMENTAL LEVELS.

TABLE 7.11 . METHODS TO CHANGE SOCIAL NORMS.

TABLE 7.12 . METHODS TO IMPROVE SOCIAL SUPPORT AND SOCIAL NETWORKS.

TABLE 7.13 . METHODS TO CREATE HEALTH-PROMOTING ORGANIZATIONS.

TABLE 7.14 . METHODS TO CREATE HEALTH-PROMOTING COMMUNITIES.

TABLE 7.15 . METHODS TO CREATE HEALTHFUL PUBLIC POLICY.

TABLE 7.16 . SCENE FROM HIV-PREVENTION ACTIVE LEARNING VIDEO.

TABLE 7.17 . COMBINATION OF ANTICIPATED REGRET, RISK SCENARIO, AND FEAR AROUSAL.

TABLE 7.18 . COMBINATION OF METHODS IN BEHAVIORAL JOURNALISM.

TABLE 7.19 . HIV-PREVENTION PROGRAM FOR WOMEN IN JAIL: METHODS AND STRATEGIES.

TABLE 7.20 . METHODS AND STRATEGIES FOR COMMUNITY MATRICES.

TABLE 7.21 . METHODS AND STRATEGIES FOR EMERGENCY DEPARTMENT MATRICES.

TABLE 8.1 . SAFER CHOICES 2 PROGRAM SCOPE AND SEQUENCE.

TABLE 8.2 . COMMUNICATION CHANNELS AND VEHICLES.

TABLE 8.3 . TAILORED ON WHAT?

TABLE 8.4 . PROJECT PANDA PRELIMINARY DESIGN DOCUMENT—NEWSLETTER.

TABLE 8.5 . PANDA NEWSLETTER DESIGN DOCUMENT.

TABLE 8.6 . DESIGN DOCUMENT FOR HEALTH HERO VIDEO GAMES.

TABLE 8.7 . SUITABILITY ASSESSMENT OF MATERIALS (SAM) RATIONALE.

TABLE 8.8 . COMMUNICATION PREFERENCES IN COLLECTIVIST AND INDIVIDUALISTIC CULTURES.

TABLE 8.9 . PRETESTING AND PILOT-TESTING METHODS.

TABLE 8.10 . MAKING SENSE OF PRESTEST DATA.

TABLE 8.11 . SCOPE AND SEQUENCE OF THE T.L.L. TEMPLE FOUNDATION STROKE PROJECT.

TABLE 8.12 . MATERIALS AND DESIGN DOCUMENT HIGHLIGHTS.

TABLE 8.13 . MESSAGE DEVELOPMENT GUIDE FOR THE STROKE PROJECT.

TABLE 9.1 . CYSTIC FIBROSIS FAMILY EDUCATION PROGRAM (CF FEP) MATRIX.

TABLE 9.2 . CYCTIC FIBROSIS FAMILY EDUCATION PROGRAM (CF FEP) DIFFUSION INTERVENTIONAL PLAN.

TABLE 9.3 . SMART CHOICES DIFFUSION.

TABLE 9.4 . SCOPE AND SEQUENCE OF THE CYSTIC FIBROSIS FAMILY EDUCATION PROGRAM DIFFUSION INTERVENTION.

TABLE 10.1 . EVALUATION STAKEHOLDERS.

TABLE 10.2 . EVALUATION OF A SCHOOL HIV-PREVENTION PROGRAM.

TABLE 10.3 . PROCESS EVALUATION INDICATORS AND PROPOSED MEASUREMENT.

TABLE 10.4 . HYPOTHETICAL PROCESS EVALUATION OF DIABETES COUNSELING PROGRAM.

TABLE 10.5 . IMPLEMENTATION CHECKLIST FOR COUNSELING SESSIONS.

TABLE 10.6 . COMPARISON OF DOMAINS OF ASTHMA KNOWLEDGE.

TABLE 10.7 . AVALUATION PLAN SUMMARY: SCHOOL HIV-PREVENTION PROGRAM.

TABLE 10.8 . EVALUATION PLAN.

TABLE 11.1 . EXAMPLES OF FOCUS GROUP AND INTERVIEW QUESTIONS.

TABLE 11.2 . OUTLINE OF DETERMINANTS SURVEY QUESTIONNAIRE.

TABLE 11.3 . FINAL DETERMINANT DELINEATION: PERFORMANCE OBJECTIVES—BEHAVIOR.

TABLE 11.4 . PERSONAL CHANGE OBJECTIVES.

TABLE 11.5 . METHODS AND STRATEGIES.

TABLE 11.6 . SELECTING METHODS: RELEVANCE AND CHANGEABILITY.

TABLE 11.7 . PROGRAM SCOPE AND SEQUENCE.

TABLE 12.1 . PERFORMANCE OBJECTIVES CHILD AND PARENT.

TABLE 12.2 . MATRIX FOR CHILDREN WITH ASTHMA (SAMPLE CELLS).

TABLE 12.3 . PERFORMANCE OBJECTIVES FOR MEDICAL CARE CHANGE.

TABLE 12.4 . PLANT OPERATOR, PRINCIPAL, AND TEACHER ENVIRONMENTAL CHANGE PERFORMANCE OBJECTIVES (PARTIAL).

TABLE 12.5 . MATRIX AT THE INTERPERSONAL LEVEL: PHYSICIANS (PARTIAL).

TABLE 12.6 . MATRIX AT THE ORGANIZATIONAL LEVEL: PLANT OPERATOR (PARTIAL).

TABLE 12.7 . BRAINSTORMING METHODS AND STRATEGIES FOR CHILD AND PARENT MATRIX.

TABLE 12.8 . BRAINSTORMING METHODS AND STRATEGIES FOR THE INTERPERSONAL LEVEL MATRICES.

TABLE 12.9 . BRAINSTORMING METHODS AND STRATEGIES FOR THE ORGANIZATIONAL LEVEL.

TABLE 12.10 . PROGRAM SCOPE AND SEQUENCE.

TABLE 13.1 . CONCERNS OF WOMEN AND THEIR PARTNERS DURING PREGNANCY.

TABLE 13.2 . CONCERNS OF WOMEN AND THEIR PARTNERS AFTER THE BIRTH.

TABLE 13.3 . TARGET POPULATION DIFFERENTIATION.

TABLE 13.4 . SAMPLE MATRIX FOR SMOKING AND ETS, WOMEN PRECONTEMPLATORS, 29 TO 30 WEEKS.

TABLE 13.5 . SAMPLE MATRIX FOR SMOKING AND ETS, WOMEN CONTEMPLATORS, 32 TO 34 WEEKS.

TABLE 13.6 . SAMPLE MATRIX FOR MEN CONTEMPLATORS FOR QUITTING SMOKING AND ACTION FOR ETS AND SOCIAL SUPPORT, 32 TO 34 WEEKS.

TABLE 13.7 . METHODS AND STRATEGIES FOR PROJECT PANDA.

TABLE 14.1 . DEMOGRAPHIC CHARACTERISTICS OF SURVEY PARTICIPANTS.

TABLE 14.2 . IDENTIFYING DETERMINANTS OF UNDERUTILIZATION BREAST AND CERVICAL CANCER SCREENING.

TABLE 14.3 . MAMMOGRAPHY MATRICULES FOR FARMWORKER WOMEN.

TABLE 14.4 . PAP TEST MATRICES FOR FARMWORKER WOMEN.

TABLE 14.5 . MATRICES FOR CLINICS FOR PAP TESTS AND MAMMOGRAPHY.

TABLE 14.6 . METHODS, STRATEGY, AND PROGRAM.

TABLE 14.7 . DEVELOPING PROGRAM COMPONENTS AND MESSAGES.

TABLE 14.8 . VIDEO SCENES.

TABLE 14.9 . VIDEO TREATMENT.

TABLE 14.10 . SAMPLE CHANGE OBJECTIVES ADOPTION AND IMPLEMENTATION CLINICS.

TABLE 14.11 . IMPLEMENTATION MATRIX FOR PROMOTORAS.

Copyright © 2006 by John Wiley & Sons, Inc. All rights reserved.

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Library of Congress Cataloging-in-Publication Data

Planning health promotion programs: an intervention mapping approach/L. Kay

p.; cm.

Includes bibliographical references and index.

ISBN-13 978-07879-7899-0 ISBN-10 0-7879-7899-X (cloth)

1. Health promotion. 2. Health promotion—Planning—Methodology. 3. Health education.

[DNLM: 1. Health Education. 2. Health Promotion. 3. Evidence-Based Medicine. 4. Planning techniques. 5. Program Development—methods. WA 590 P712 2006] I. Bartholomew, L. Kay.

RA427.8.P553 2006

362.1—dc22

2005036844

HB Printing

PREFACE

The practice of health promotion (used synonymously here with health education) involves four major program-planning activities: conducting a needs assessment, developing the program, implementing the program, and evaluating the program’s effectiveness. Since the 1980s, significant enhancements have been made to the conceptual base and practice of health education and promotion, especially in needs assessment (Green & Kreuter, 2005), program evaluation (Windsor, Clark, Boyd, & Goodman, 2003), adoption and implementation (Rogers, 2003), and the use of theory (Glanz, Lewis, & Rimer, 2002; DiClemente, Crosby, & Kegler, 2002). However, the health education community has been slow to specify the processes involved in program design and development. Applications of behavioral and social science theories to intervention design are given important consideration, but even in this regard, the processes involved are not typically made explicit in the research or practice literature. Researchers often discuss intervention development and design in only a few sentences.

This book and the Intervention Mapping process are the products of our frustration in teaching health education students the processes involved in planning an intervention. Although the literature provides helpful models for conducting a needs assessment and program evaluation, as well as ecological models for conceptualizing the multiple levels of health education intervention (Simons-Morton, Green, & Gottlieb, 1995; McLeroy, Bibeau, Steckler, & Glanz, 1988), it lacks comprehensive frameworks for program development. In our experience, students have been able to understand theories of behavior and social change but have not been able to use them to design a coherent, practical health education intervention. Students frequently ask the following questions:

• When in the planning process do I use theory to guide my decisions?

• How do I know which theory to use?

• How do I make use of the experience of others and the results of other program evaluations?

• How do I decide which 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 planning for program implementation?

• How do I address changing the behavior of other people in the environment when they are not at risk for the health problem but are important to changing conditions that affect those at risk?

Motivated by these questions, we began to examine programs we had developed through our work as researchers and practitioners and to identify general principles and procedures in intervention design that were common to most of our work. One of our early case examples was the Cystic Fibrosis Family Education Program, an intervention designed to improve self-management skills, the interaction between patient and health care provider, and the health and quality of life of children with cystic fibrosis and their families (Bartholomew et al., 1997; Bartholomew et al., 2000; Bartholomew et al., 1991; Bartholomew, Parcel, Swank, & Czyzewski, 1993; Bartholomew, Seilheimer, Parcel, Spinelli, & Pumariega, 1989; Bartholomew et al., 1993).

To substantiate the steps of Intervention Mapping and to further delineate the tasks required for each, we then conducted a retrospective review of several large demonstration projects in the United States (Mullen & Bartholomew, 1991; Mullen & Diclemente, 1992; Parcel, Eriksen, et al., 1989; Parcel, Taylor, et al., 1989; Perry et a1., 1992; Perry et al., 1990) and the Netherlands (De Vries & Dijkstra 1989; Mesters, Meertens, Crebolder, & Parcels, 1993; Schaalma, Kok, Poelman, & Reinders, 1994; Siero, S., Boon, Kok, & Siero, F., 1989). This review led to a working framework for health education program development, the process of Intervention Mapping. Analogous to geographic mapping, Intervention Mapping enables the planner to discover relations, locate desired destinations, plan a route for getting from one place to another, and execute a plan for covering distance. Intervention Mapping also has a visual component, including numerous diagrams and matrices that are used as landmarks to logical program development.

To further develop the steps of the process, we applied Intervention Mapping prospectively to ongoing projects that involved health education and promotion program development. The following projects are among those that we used to test, revise, and refine our proposed Intervention Mapping steps and tasks:

• Long Live Love, an HIV prevention program for Dutch adolescents that is described in Chapter Eleven (Schaalma & Kok, 1995; Schaalma, Kok, Bosker, et al., 1996; Schaalma, Kok, & Paulussen, 1996)

• The Partners in Asthma Management Program, a self-management program for children with asthma that is described in Chapter Twelve (Bartholomew, Gold, et al., 2000; Bartholomew, Shegog, et al., 2000; Shegog et al., 2001)

• Five a Day, a nutrition education program for nine- to twelve-year-old girls (Cullen, Bartholomew, & Parcel, 1997; Cullen, Bartholomew, Parcel, & Kok, 1998)

Additional experience with and refinement of the Intervention Mapping process has occurred throughout the course of ten years of graduate instruction in health promotion planning and implementation at the School of Public Health, University of Texas Health Science Center at Houston; at the Schools of Health Sciences and Psychology, University of Maastricht, the Netherlands; and elsewhere.

After the first edition of Intervention Mapping appeared in 2001, a number of new projects have applied the Intervention Mapping process to patient adherence (Heinen, Bartholomew, Wensing, Van de Kerkhof, & Van Achterberg, in press), diet (Hoelscher, Evans, Parcel, & Kelder, 2002), screening (Hou, Fernandez, & Parcel, 2004), stroke treatment (Morgenstern et al., 2002; Morgenstern et al., 2003), HIV prevention (Van Empelen, Kok, Schaalma, & Bartholomew, 2003), and the new application in Chapter Fourteen of this 2006 edition. Other recent publications have described the usefulness of applying Intervention Mapping to various topics (Brug, Oenema, & Ferreira, 2005; Kok, Schaalma, Ruiter, Brug, & Van Empelen, 2004; Van Bokhoven, Kok, & Van der Weijden, 2003).

We present Intervention Mapping as an additional tool for the planning and development of health education and promotion programs. It serves as a way to map the path of intervention development from recognizing a need or problem to identifying and testing potential solutions. The steps and tasks included in Intervention Mapping provide a framework for making and documenting decisions about how to influence change in behavior and conditions to promote health and to prevent or improve a health problem. This documentation provides a means to communicate to everyone involved in the process a logical and conceptual basis for how the intervention is intended to work to make change possible. The level of specificity included in each of the products of Intervention Mapping enhances the possibility that a planned program will be effective in accomplishing its goals and objectives. In addition, by making explicit the pathways and means by which change is expected to occur and by examining the assumptions and decisions made in each step and task of the Intervention Mapping process, program planners, users, and participants can better explain why a program succeeds or fails. It is our hope that this new tool will contribute to more effective health promotion programs and better explication of these programs and will result in an enhanced knowledge base for research and practice.

Chapter One presents the perspective from which Intervention Mapping was conceived, as well as its purpose. Before using Intervention Mapping, a planner should have at least an elementary grasp of the use of behavioral science theory in planning. Chapters Two through Four offer an overview of methods for accessing appropriate behavioral science theories and empirical evidence in the planning process and a review of applicable social and behavioral science theories. Chapters Five through Ten present a step-by-step guide to Intervention Mapping, and Chapters Eleven through Fourteen provide detailed case examples of the application of Intervention Mapping to public health programs.

January 2006

L. Kay Bartholomew Houston, Texas

Guy S. Parcel Houston, Texas

Gerjo Kok Maastricht, The Netherlands

Nell H. Gottlieb Austin, Texas

ACKNOWLEDGMENTS

Many people have been kind enough to offer suggestions and encouragement during the development of this text. Others have contributed through their contributions to health education and promotion, from which we have greatly benefited. Still others have allowed us to steer project teams down loosely defined pathways in order to test new ideas. We offer thanks to our friends and colleagues Charles Abraham, Stuart Abramson, Robin Atwood, Tom Baranowski, Karen Basen-Engquist, Judy Bettencourt, Cor Blom, Martine Bouman, Lex Bouter, Johannes Brug, Theresa Byrd, Noreen Clark, Matt Commers, Jennifer Conroy, Karin Coyle, Karen Cullen, Sharon Cummings, Danita Czyzewski, Marijn de Bruin, Evelyne de Leeuw, Hein de Vries, Nanne de Vries, Dirk-Jan den Boer, Elia Diez, Anton Dijker, Arie Dijkstra, Margot Dijkstra, Polly Edmundson, Cees Egmond, Michael Eriksen, Alexandra Evans, María Fernández-Esquer, Amy Fetterhoff, Brian Flay, Barbara Giloth, Phyllis Gingiss, Karen Glanz, Gaston Godin, Robert Gold, Bob Goodman, Patricia Goodson, Larry Green, Merwyn Greenlick, Jan Groff, Jong Long Guo, Arada Halder, Karol Kay Harris, Paul Harterink, Amy Jo Harzke, Maud Heinen, Helen Hill, Jeffrey Hill, Deanna Hoelscher, Carole Holahan, Harm Hospers, Dorothy Husky, Aimee James, Ruud Jonkers, Jolanda Keijsers, Steve Kelder, Gerda Kraag, Doug Kirby, Connie Kohler, Marieke Kools, Marshall Kreuter, Randi Bernstein Lachter, Cheryl Lackey, Sue Laver, Alexandra Loukas, Barbara Low, Alfred McAlister, Amy McQueen, Ree Meertens, Ilse Mesters, Barbara Meyer, Anna Meyer-Weitz, Jochen Mikolajczak, Aart Mudde, Nancy Murray, Marita Murrman, Brian Oldenburg, Theo Paulussen, Cheryl Perry, Bobbie Person, Gjalt-Jorn Peters, Fred Peterson, Gopika Ramamurthy, Priscilla Reddy, Lori Roalson, Barbara Rimer, Michael Ross, Rob Ruiter, Ann Saunders, Dale Schunk, Dan Seilheimer, Bruce Simons-Morton, Michele Murphy Smith, Gail Sneden, Marianna Sockrider, Teshia Solomon, Alan Steckler, Mary Steinhardt, Victor Strecher, Paul Swank, Peggy Tate, Wendell Taylor, Jasmine Tiro, Mary Tripp, Theo van Achterberg, Patricia van Assema, Bart van den Borne, Pepijn van Empelen, Katy van den Hoek, Angelique van der Kar, Nicole van Kesteren, Olga van Rijn, Sarah Veblen-Mortenson, Peter Veen, Sally Vernon, Rachel Vojvodic, Pjer Vriens, Marsha Weil, Henk Wilke, and Barry Zimmerman.

We are indebted to our students who allowed us to class-test the first edition of the text. We attempted to make it better each time we taught it. We also benefited from the review and class-testing by our colleagues Omowale Amuleru-Marshall, Morehouse School of Medicine; Julie Baldwin, Northern Arizona University; Michael Barnes, Brigham Young University; Dan Bibeau, University of North Carolina at Greensboro; Brian Colwell, Texas A&M University; Carolyn Crump, University of North Carolina at Chapel Hill; Debra Krummel, West Virginia University; Michael Pejsach, Central Michigan University; Rick Petosa, Ohio State University; Janet Reis, University of Illinois, Urbana-Champaign; and Ruth Saunders, University of South Carolina.

Our thanks to our colleagues who contributed case studies to the second edition: Carlo DiClemente, María Fernández, Alicia Gonzales, Chris Markham, Patricia Dolan Mullen, Sylvia Partida, Herman Schaalma, Ross Shegog, Guillermo Tortolero-Luna, and Shellie Tyrrell.

Some of our friends and colleagues provided extraordinary support. Comprehensive reviews of the first edition by John Allegrante and Kenneth McLeroy enabled us to fine-tune the manuscript. Patricia Dolan Mullen not only contributed her ideas to the book but unflaggingly believed in the usefulness of Intervention Mapping.

The following individuals have our deep gratitude for contributions to the second edition:

• Patricia Dolan Mullen, professor of Health Promotion and Behavioral Sciences at the School of Public Health, University of Texas Health Science Center at Houston, teaches classes on program evaluation and on systematic review and meta-analysis. She has served on many review groups, expert panels, and most recently on the U.S. Community Preventive Services Task Force to produce the new Guide to Community Preventive Services. She contributed to sections in Chapter Two on evidence reviews.

• Herman Schaalma is associate professor and holds the Dutch AIDS Fund Chair in AIDS Prevention and Health Promotion at the School of Psychology, Maastricht University, The Netherlands. In 1995 he completed his doctoral thesis on the theoryand evidence-based development of school-based AIDS education. He is principal investigator of projects using Intervention Mapping for the development of HIV-PREVENTION programs targeting youth in Sub-Saharan Africa and migrant women in the Netherlands. Dr. Schaalma contributed greatly to the plan for the second edition.

• María Fernández is assistant professor of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston, School of Public Health Center for Health Promotion and Prevention Research. Her research focus is the development and evaluation of interactive multimedia health promotion programs, particularly in the area of cancer control for Hispanic populations. Since the mid-1990s Dr. Fernández has contributed to the refinement of Intervention Mapping through her teaching and use of the framework in program development. She also contributed to conceptualizing how to incorporate issues related to cultural competence and relevance within the Intervention Mapping planning process for the current edition of the text.

• Christine Markham is assistant professor in Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston. Her research area is child and adolescent health with emphasis on sexual and reproductive health and substance use prevention. She has been instrumental in demonstrating the use of Intervention Mapping as an effective approach for adapting existing programs to meet the needs of a new target population and has taught Intervention Mapping in the United States and the Netherlands.

• Helen Clark is a doctoral student at the School of Public Health, University of Texas Health Science Center at Houston. She managed the references for the second edition and provided unflagging support and goodwill to the authors.

• Karyn Popham is a biomedical editor and reference manager at the Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston.

Finally, the four coauthors thank each other. It seems that we discussed, wrote, argued over, and rewrote every part of Intervention Mapping again in the second edition, testing and deepening our friendships.

L.K.B. G.S.P. G.K. N.H.G.

THE AUTHORS

L. Kay Bartholomew is associate professor of Health Promotion and Behavioral Sciences and associate director of the Center for Health Promotion and Prevention Research at the School of Public Health, University of Texas Health Science Center at Houston. Dr. Bartholomew has worked in the field of health education and health promotion since her graduation from Austin College in the mid-1970s, first at a city-county health department and later at Texas Children’s Hospital. Currently, in her research center and faculty roles, she teaches courses in health promotion intervention development and conducts research in chronic disease self-management. Dr. Bartholomew received her M.P.H. degree from the School of Public Health, University of Texas Health Science Center at Houston and her Ed.D. degree in educational psychology from the University of Houston College of Education. Dr. Bartholomew has won the Society for Public Health Education Program Excellence Award for the Cystic Fibrosis Family Education Program as well as numerous other professional association and media awards.

Guy S. Parcel is dean of the School of Public Health, the John P. McGovern Professor in Health Promotion, and the M. David Low Chair in Public Health at the University of Texas Health Science Center at Houston. He also serves as a professor in the Division of Health Promotion and Behavioral Sciences at the School of Public Health. Dr. Parcel has directed research projects to develop and evaluate programs to address sexual risk behavior for adolescents, diet and physical activity in children, self-management of childhood chronic diseases, smoking prevention, sun protection for preschool children, and the diffusion of health promotion programs. Dr. Parcel received his B.S. and M.S. degrees in health education at Indiana University and his Ph.D. degree at Pennsylvania State University with a major in health education and a minor in child development and family relations. Dr. Parcel has authored or coauthored more than two hundred scientific papers and received the American School Health Association 1990 William A. Howe Award for outstanding contributions and distinguished service in school health.

Gerjo Kok is dean of the Faculty of Psychology at Maastricht University, the Netherlands. He also holds the Dutch AIDS Fund-endowed chair for AIDS prevention and health promotion. Currently a professor of applied psychology, from 1984 to 1998 he was professor in health education at Maastricht University. A social psychologist, he received his doctorate in social sciences from the University of Groningen, the Netherlands. His main interest is in the social psychology of health education.

Nell H. Gottlieb is professor and coordinator of health education programs in the Department of Kinesiology and Health Education at the University of Texas at Austin and professor of behavioral science at the University of Texas Health Science Center at Houston School of Public Health. Dr. Gottlieb is the author of numerous articles and two textbooks. She received her Ph.D. degree in sociology from Boston University. Her interests are in multilevel health promotion intervention development and evaluation, particularly in the area of chronic disease prevention and control. Dr. Gottlieb has served as chair of the executive board of the Health Education and Promotion Section of the American Public Health Association and as president of the Society for Public Health Education.

PART ONE

FOUNDATIONS

CHAPTER ONE

OVERVIEW OF INTERVENTION MAPPING

Reader Objectives

• Explain the rationale for a systematic approach to intervention development

• Describe an ecological approach to intervention development

• Explain the types of logic models that can be used to conceptualize various phases of program development

• List the steps, processes, and products of Intervention Mapping

In this chapter we present the perspective from which Intervention Mapping was conceived as well as its purpose. We also present a preview of the program-planning framework, which is detailed in the remaining chapters.

The purpose of Intervention Mapping is to provide health promotion program planners with a framework for effective decision making at each step in intervention planning, implementation, and evaluation. Health promotion has been defined as “Any combination of education, political, regulatory and organizational supports for actions and conditions of living conducive to the health of individuals, groups or communities” (Green & Kreuter, 2005, p. G-4), and health education is a subset of health promotion strategies that are primarily based on education. We recognize this distinction but also the fact that many people in the health field practice health promotion; some of them specialize in health education. Often the boundaries are quite blurred. This book uses the terms and interchangeably when a subject is needed to mean someone who is planning an intervention meant to produce health outcomes. An intervention can be designed to change environmental or behavioral factors related to health, but the most immediate impact of an intervention is usually on a set of well-defined determinants of behavior and environmental conditions.