Intervention Mapping Step 3 Program Design Intervention Mapping

Intervention Mapping Step 3: Program Design

Intervention Mapping Steps 1. Logic model of the problem 2. Program outcomes and objectives (logic model of change) 3. Program design 4. Program production 5. Program implementation plan 6. Evaluation plan 2

Step 3: Tasks 1. Generate program themes, components, scope, and sequence 2. Choose theory- and evidence-based change methods 3. Select or design practical applications to deliver change methods 3

Intervention Logic Model INSERT Figure 6. 2 HERE Figure 6. 1 4

Task 1: Generate Program Themes, Components, Scope, and Sequence • The product of the first part of Step 3 is an initial plan that describes the program • Dismiss all preconceived notions and program constraints “What would we do if we could do anything that comes to mind? ” 5

Program Themes • A theme is a general organizing construct for a program • Some programs have several subthemes • Either can be related to the • Behavioral or environmental change objectives • Priority population • Program content

Theme Based on Health Behavior and Priority Population Reprinted with permission from the National Center for Farmworker Health

Designing Program Components • Scope and sequence • Breadth and amount of program • Order in which components are delivered • Setting & duration • Delivery vehicles • Messages • Creativity 8

Scope and Sequence for TLL Temple Foundation Stroke Project INSERT Table 6. 1 HERE Table 6. 1 9

Communication Channels and Delivery Vehicles Interpersonal Communication Channels • Volunteers, peer leaders, teachers, health care providers, community health workers (promotoras) Mediated Communication Channels • Circulating print: Local and online newspapers, magazines, newsletters, e-mail blasts • Display print: Billboards, posters, brochures, flip charts • Radio: News items, interviews, PSAs • Television: News stories, talk shows, interviews, edutainment, PSAs, infomercials, novellas • Videotape: training, documentary, role model stories • Computer & internet-based: decision-support, curricula, serious games, simulations, websites • Phones & smart phones: text messages, apps • Social media: Facebook, twitter, emerging social networks

Task 2: Choose Theory- and Evidence-based Change Methods • A method is a general process for influencing changes in the determinants of behavior and environmental conditions • An application is a practical technique for the operationalizing methods in ways that fit with the intervention group and the context in which the intervention will be conducted 11

Selecting Methods • Different methods are effective for influencing different determinants • Select appropriate methods for all change objectives in your behavioral and environmental matrices • Pay attention to the parameters for use for each selected methods • Method – Modeling • Parameters for use – Attention, remembrance, reinforcement of model, identification with model, coping model instead of mastery model 12

Core Processes for Selecting Methods • Organize complete list of change objectives by determinants (the matrix columns) • Formulate questions about methods • Brainstorm provisional list of methods that may influence each determinant • Topic approach: Go to the literature related to the specific problem to identify evidence to support, refute, or add to list of methods • Construct approach: Review the list of methods, determinants, and objectives, and follow these constructs to theories • General theories approach: Review the list of methods for general theoretical patterns • Consider the need to collect additional data on methods through qualitative/quantitative research

Task 3: Select or Design Practical Applications to Deliver Change Methods • Select or design practical applications to operationalize change methods • One change method may be accomplished by many applications - decide which applications best fit the situation’s context 14

Example Methods and Applications from the TLL Temple Foundation Stroke Project INSERT Table 6. 19 HERE Table 6. 19 15

Test Your Methods & Applications IQ üModeling üPersuasion üGuided practice üReattribution üRole model stories üSupport groups üReinforcement üCertificate of achievement üSocial comparison üFear arousal üPatient counseling üStimulus control üNo-smoking signs üVideo presentation of learner attempts at skill üCoping response planning

Example It’s Your Game…Keep It Real (IYG) A sexual health education program for middle school students 17

Task 1: Generate Program Themes, Components, Scope, and Sequence • Setting • Urban middle schools • Duration • 12 lessons in 7 th & 8 th grade • Delivery Vehicles • Classroom lessons (interpersonal) • Role plays, group discussion • Journaling • Parent-child homework • Computer activities (technology) • Selected activities tailored by gender, sexual experience • Parent newsletters (print materials) 18

Scope & Sequence 7 th Grade Lesson Topic 8 th Grade Delivery Lesson Topic Delivery 1 Pre-Game Show Classroom 2&3 Healthy Friendships Classroom Computer 2 Consequences of Pregnancy Classroom 4&5 Setting Personal Limits & Detecting Risky Situations (general) Classroom Computer 3&4 Consequences of STI/HIV Pregnancy Computer Classroom 5 Condoms & contraception Computer 6&7 Refusal Skills (general) Classroom 6&7 Classroom Computer 8 Know your Body Computer Setting Personal Limits & Detecting Risky Situations (about sex) 8&9 Healthy Relationships Computer 10 Refusal Skills (about sex) Classroom 9 10 & 11 12 Setting Personal Limits (about sex) Classroom Refusal Skills (about sex) Classroom Computer 11 Computer Free Time Computer Post Game Show Classroom 12 Post Game Show Classroom

Theme: It’s Your Game, Keep It Real • “Game” = Life • “Real” = Telling it like it is, being respectful, being responsible, doing the right thing, being yourself, being healthy and happy • How do you keep your game real? • Respecting yourself and respecting others • Playing by your rules

Additional Subtheme • Select your personal rules ahead of time • Detect signs or situations that could challenge your rules (risky situations) • Protect your rules • Avoid risky situations ahead of time • Refusal skills and alternative actions

Tasks 2 & 3: Choose Theory- and Evidencebased Methods and Practical Applications Determinants Example Methods Example Applications Knowledge • Information Transfer Quizzes & games about puberty, sex, reproduction, condoms Attitudes • Anticipated Regret Journal Activity (My #1 reason not to have sex is…. because if I have sex…) Skills & Selfefficacy • Modeling Role Plays • Guided Practice • Identifying & avoiding risky situations with Feedback • Using refusal skills Demonstrations • Correct condom use Normative Beliefs • Modeling Peer Video • Other students saying they’ve chosen not to have sex • Older teens saying they use condoms 22 Parent role model stories

Summary IM Step 3 comprises 3 key tasks: 1. Generate program themes, components, scope, and sequence 2. Choose theory- and evidence-based change methods 3. Select or design practical applications to deliver change methods

Questions?