Evaluation of Intervention Mapping - Essay Example

Describe the key principles of intervention mapping, and evaluate its potential to inform the development of health change interventions. Introduction Intervention mapping has been well acclaimed to be a protocol delineating a process for health promotion programme development based on theory and evidence from research literature. According to its original innovators, this is a process comprising of development of health promotion programme leading to change or health change behaviours in six predefined steps. This is initiated with a needs assessment which defines performance and change objectives, scientific analyses of prevalent health problems of a given population, and identification of factors that might have causes the problems. This will be followed by choice, implementation, and evaluation of intervention methods that may pose to change the health-related behaviour. (Bartholomew et al., 1998, 545-563). If a health intervention is effective leading to change in related health practices, there would be demonstrable change in the determinants and antecedents of health behaviour. Health promotion strategies are closely related to the psychological theories of behavioural changes. These can be achieved in an organised manner through intervention mapping, which had been the result of works of L. Kay Bartholomew, Guy S. Parcel, Gerjo Kok, and Nell H. Gottlieb (Bartholomew et al., 2001), which was published as “Intervention Mapping: Developing theory and evidence-based health education programs” in the year 2001. This was designed to provide a framework for effective decision making in intervention planning, implementation, and evaluation. It is known that health promotion is possible only through an effective health education. Drawing on this, health promotion is a synergy of educational and environmental supports for actions and conditions health-conducive living. Green & Kreuter (2005) have defined health promotion 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). If these change health behaviour, appropriate evaluation is necessary to ensure detection of these changes to assess whether these conform to evidence, so the health promoters can take a decision at every step of the process of planning and implementation of intervention (Kok et al., 2004, 85-98). Key Assumptions Theory is the pillar of evidence-informed health promotion. Interventions that address the determinants of intervention or change must be evidence based and guided by need (Green, 2000, 125-129). Many authors have concluded that needs assessment is the first step of intervention mapping. Therefore, intervention mapping is effective integration of theory and models in the “conceptualization, development, implementation, and evaluation of the designed interventions” (Heaney, 1998, 564-568). These theories may be necessary from the point of conceptualization through evaluations, results, and their dissemination (Green, 2001, 165-178). Intervention mapping is a 6-step protocol but that is grounded on the assumption of enablement of successful translation of information about behavioural determinants into goals for changes leading to strategies. These would also culminate into delineation of the programme components, anticipation of dissemination of the programme, its adoption, along with anticipation of the process and evaluation of the outcome (Glasgow et al., 2004, 3-12). Key Processes Intervention mapping is presented as a series of processes. These are essentially group processes with interactive discussion. The parameters of at-risk population, quality of life, and health problems need to be identified, and behavioural and environmental causes for this behaviour must be determined. Next, the planners specify the target of the intervention (Michie, 2008, 64-69). Following it, matrices are created for individual, group, organizational, and societal levels. Next, the evidence-based theories and methods are identified through review of programme ideas, ensuring conformity to change objectives (Campbell et al., 2007, 455-459). In the next step, the sequence and scope of the intervention are elucidated along with creation of a complete set of programme materials. Following that all programme materials are developed only to pretest them with the target groups. All materials and protocols must undergo pilot testing with the personnel who are responsible for implementing the programme as well as with the recipients of the programme (Flay, 1986, 451-474). In the final step, the team finalizes an evaluation plan that is designed to parallel the intervention map. Evaluation of Intervention Mapping If there is a paucity of evidence, it may be difficult for the planners to implement an intervention, even when the interventions are used as policies (Goodman et al., 1998, 258-278). Original studies have tested different possible interventions, but there is a perceived need for planning due to the fact that adoption of an intervention can be arrived at only with appropriate evidence-based planning. An ideal intervention programme should be designed for specific populations with active involvement of participants with integration of processes directed towards individuals, social and physical environment changes including those of communities and policies. If it is to be effective, it must link the concerns of the population about health (Goodson et al., 1999, 73-78). An intervention mapping provides all these in a single conceptual framework (Freudenberg et al., 1995, 290-306). The options for a useful programme evaluation depend on essentially the quality of programme planning. If there are no pre-justified measurable goals, the estimation of the impact of the programmes can be a wasteful exercise. Such a programme, well planned and adequately protocolized, would benefit communities, populations, and participants when theories from behavioural and social sciences can be applied to alter health behaviour towards a positive change (Hamilton & Hunter, 1998, 1-28). This also provides a pathway of examination of the ways the interventions are developed that turned out to be effective and reexamination of planning, development, evaluation, modification, and reimplementation of interventions to promote health. It maps the roadway for identification of a population need and working out of the solution to the health need (Jones & Donovan, 2004, 1-14). Although it may appear easy, intervention mapping is not an easy protocol. The frameworks should be used in tandem with sound research designs, psychometrically solid study measures, and carefully operationalized protocols for programme implementation, data collection, data management, and data analysis. This needs practical experience which may be lacking, and this may lead to problems in implementation. The real world programme planning and evaluation may be challenging which may be entirely different from knowledge drawn from academics, and this may pose problems (Julian, 1997, 251-257). Conclusion It is difficult to implement programmes pertaining to health education. Perhaps it is more difficult to sustain them since the organizational systems must also adapt to these changes. Intervention mapping should have in-built strategies to arouse interest in people who are the intended end users, so they are able to adopt it. In addition, programme effectiveness may differ widely from the efficacy of a programme, when really an intervention is designed and how it is practiced. With time, the amount, intensity, and quality of a programme may decline. Therefore, it is the responsibility of the practitioners to plan strategies according to acceptable level of implementation so a maintenance plan is developed. Reference List Bartholomew, LK., Parcel, GS., and Kok, G., (1998). Intervention Mapping: A Process for Developing Theory and Evidence-Based Health Education Programs. Health Educ Behav; 25: 545 - 563. Bartholomew, K., Parcel, G., Kok, G., & Gottlieb, N. (2001). Intervention Mapping: Developing theory and evidence-based health education programs. Mountain View, CA: Mayfield. Campbell, NC., Murray, E., Darbyshire, J., Emery, J., Farmer, A., Griffiths, F., Guthrie, B., Lester, H., Wilson, P., and Kinmonth, AL., (2007). Designing and evaluating complex interventions to improve health care. BMJ; 334: 455 - 459. Flay, B. R. (1986). Efficacy and effectiveness trials and other phases of research in the development of health promotion programs. Preventive Medicine, 15, 451–474. Freudenberg, N., Eng, E., Flay, B., Parcel, G., Rogers, T., & Wallerstein, N. (1995). Strengthening individual and community capacity to prevent disease and promote health: In search of relevant theories and principles. Health Education Quarterly, 22, 290–306. Glasgow, R. E., Klesges, L. M., Dzewaltowski, D. A., Bull, S. S., & Estabrooks, P. (2004). The future of health behavior change research: What is needed to improve translation of research into health promotion practice? Annals of Behavioral Medicine, 27, 3–12. Goodman, R. M., Speers, M. A., McLeroy, K., Fawcett, S., Kegler, M., Parker, E., et al. (1998). Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Education and Behavior, 25, 258–278. Goodson, P., Gottlieb, N. H., & Smith, M. M. (1999). Put prevention into practice. Evaluation of program initiation in nine Texas clinical sites. American Journal of Preventive Medicine, 17, 73–78. Green, J. (2000). The role of theory in evidence-based health promotion practice. Health Education Research, 15, 125–129. Green, L. W. (2001). From research to best practices in other settings and populations. American Journal of Health Behavior, 25, 165–178. Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4 ed.). New York: McGraw-Hill. G-4. Hamilton, M. A., & Hunter, J. E. (1998). A framework for understanding meta-analyses of the persuasion literature. In M. Allen & R. W. Preiss (Eds.), Persuasion: Advances through metaanalysis (pp. 1–28). Cresskill, NJ: Hampton Press. Heaney, CA., (1998). Intervention Mapping and the New Health Promotion. Health Educ Behav; 25: 564 - 568. Jones, S. C., & Donovan, R. J. (2004). Does theory inform practice in health promotion in Australia? Health Education Research, 19, 1–14. Julian, D. A. (1997). The utilization of the logic model as a system level planning and evaluation device. Evaluation and Program Planning, 20, 251–257. Kok, G., Schaalma, H., Ruiter, RAC., Empelen, PV., and Brug, J., (2004). Intervention Mapping: Protocol for Applying Health Psychology Theory to Prevention Programmes. J Health Psychol; 9: 85 - 98. Michie, S., (2008). Designing and implementing behaviour change interventions to improve population health. J Health Serv Res Policy; 13: 64 - 69. Read More