Health Communication Exam Prep
Week 1: Intervention Mapping
Monday
1. Bartholomew Eldredge, L. K., Markham, C. M., Ruiter, R. A. C., Fernández, M. E.,
Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: An
intervention mapping approach (4th ed.).
Summary:
The purpose of intervention mapping is to provide health promotion program planners with a
framework for effective decision making at each step in the intervention planning,
implementation, and evaluation. It is based on theory and empirical findings from the
literature and data collected from a population. This ensures that we can describe and address
the factors that cause health problems and the methods to achieve change. In intervention
mapping we use theory from a problem-driven perspective. To understand a problem the
planning team begins with a question about a specific (One) health problem. In the social
ecoglogical model – health is a function of individuals and of the environment in which
individuals live, including family, social networks, organisations, communities and societies.
Intervention mapping consists of 6 steps, upon completion planners have a blueprint for
designing, implementing and evaluating an intervention based on theorethical, empirical and
practical information. The process looks linear but is rather iterative and cumulative.
1. Iterative: move back and forthe between tasks and steps as new information and
perspectives are gathered
2. Cumulative: base each step on the previous steps – inattention can lead to
jeopardising the potential effectiveness by compromising the validity of the
foundation on which later steps are conducted.
The steps include: 1– develop a logic model of the problem based on a needs assessment, 2 –
state program outcomes and outcomes and objectives, logic model for change, 3 – develop
the program plan, 4 – produce the intervention, 5 – plan the program use and implementation,
6 – develop an evaluation plan.
2. Kok, G., Harterink, P., Vriens, P., de Zwart, O., & Hospers, H. J. (2006). The gay
cruise: Developing a theory- and evidence-based internet HIV-prevention
intervention. Sexuality Research & Social Policy, 3, 52-67
Summary:
This paper uses the Intervention Mapping (IM) and applies it to the health problem HIV
among men having sex with men.
1
,Wednesday
3. Bartholomew Eldredge, L. K., Markham, C. M., Ruiter, R. A. C., Fernández, M. E.,
Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: An
intervention mapping approach (4th ed.). – Pages 232-241
Summary:
Planners already have an idea of a problem and possible target group that might suffer the
most, they use concepts of epidemiology (=the study of the occurrence and distribution of
diseases and their risk factors in populations).
- Dimensions of health problems – include disability, discomfort, fertility, fitness,
morbidity, mortality, and physiological risk factors.
- Dimensions of quality of life – include effects of illness on both individual and
societal indica- tors, such as cost of health care, absenteeism, work or school
performance, activities of daily living, stigma, isolation and alienation, discrimination,
happiness and adjustment, self-esteem, and employment.
Risk and rate concepts and statistics are helpful in the process of describing the health
problem, and we refer the reader to texts in epidemiology. The extent of the health problem is
usually described as a rate, making possible comparisons among groups and geographic areas
as well as judgments of the importance or seriousness of the problem. A rate is the number of
events (people with a problem) over a period of time per population of 1,000 or 100,000.
Think of environmental factors that influence health directly through disease-causing
exposures or indirectly by influencing health-related behavior. Each level of the environment
(interpersonal, organizational, community, and societal) can influence both individual
behavior and any (lower) level of environment.Why do members of the at-risk group behave
in ways to increase their risk of a health problem? Why do agents in the environment create
or maintain unhealthy environmental conditions? We refer to these factors as personal
“determinants” because, from an intervention-development perspective, causation is implied.
These determinants can be changed or modified by interventions that involve influencing
how people think about or have the capacity to change a behavior or an environment.
4. Ruiter, R. A. C., Crutzen, R., De Leeuw, E., & Kok, G. (2020). Changing behavior
using theories at the interpersonal, organizational, community, and societal levels. In
The Handbook of Behavior Change (pp. 251–266).
Summary:
Societal problems, such as the burden of chronic health behavior–related diseases or
inefficient resource usage, can be alleviated by changing people’s behaviors. Addressing
behavior change usually requires the coordinated pooling of expertise of individuals from
multiple backgrounds and disciplines and at multiple ecological levels.
- Theory-driven applied psychology involves testing a theory in an applied setting, for
example in schools or organizations, primarily in order to gain insight into the
external validity of the theory.
2
, - Problem-driven applied psychology refers to scien- tific activities that focus on
changing or reducing a practical problem. In problem-driven applied psy- chology,
theories are used but problem-solving is the primary focus of this approach, and the
criteria for success are formulated in terms of problem reduction.
Various “social agents” in an individual’s envir- onment, such as family members and peers,
pro- fessionals in organizations, opinion leaders, and policy makers, can have a pervasive
influence when it comes to behavior change. The different social ecological levels, including
the interindividual, organizational, community, and societal levels. intervention programs can
therefore be applied to change the behavior of agents operating at these higher ecological
levels in much the same way as they are at the individual level.
- The socioecological approach to behavior change focuses on the interrelationships
between individuals and their interpersonal, organizational, community, and policy
environments. Two key assumptions from the socioecological approach can guide the
identification of interven- tion targets for promoting behavior change: (1) behavior
influences and is influenced by multi- level environmental factors and (2) individual
behavior both shapes and is shaped by the environment
interventions at the various ecological levels should focus on changing the behavior of agents
who are in a position to exercise influence over aspects of the environ- ment and, in doing so,
bring about behavior change at other environmental levels.
Changing behavior requires an understanding of the causes and effects of that behavior.
outcomes are determined by changes in the individual behavior of the “at- risk” group and by
changes in the behaviors of the “agents.” Environmental agents are the peo- ple within the
environment at various levels (organizational, community, and policy) that, together,
determine the environmental condi- tions that affect individual behavior. This follows the
logic that changes in the environmental conditions that precede behavior change necessitate
the application of theories at both the individual and the environmen- tal levels in order to be
able to understand and change behavior. Taking a socioecological approach to behavior
change means taking into account the contexts within which people live, work, and play. The
agents in this setting are the implementers of the intervention itself, for example teachers.
Slides:
“One Health is an integrated, unifying approach that aims to sustainably balance and
optimize the health of people, animals and ecosystems. – it recognizes that the health of
humans, domestic and wild animals, plants, and the wider environment (including
ecosystems) are closely linked and interdependent.”
Systematic Approach:
- Planning models give guidance on required activities (program transparency)
- IM is a planning protocol for the systematic development of theory-and
evidence-based behavior change interventions.
- Meta-analyses health education/health promotion: Theory-based interventions
superior
- Planned development allows for efficient evaluation
3
, Use of theory = necessary in evidence informed health promotion
- Describe and address factors that cause health problems
- Identify methods to achieve change
Week 2: Needs Assesment
Monday
5. Yzer, M. (2012). The Integrative Model of Behavioral Prediction as a tool for
designing health messages. In H. Cho (Ed.), Health communication message
design: Theory and practice (pp. 21-40).
Summary:
Why do we study health communication? – We have an interest in improving public health,
and specifically, that we believe that communication has the potential to improve health
behavior through health messages. A primary contributing factor in this regard is the
correspondence between the message and the recipient. Maximizing the message–recipient
match requires a good understanding of why people engage in healthy or risky behavior. A
conceptual framework that can account for different health behaviors in different populations
is the integrative model of behavioral prediction. The integrative model takes a reasoned
action approach to understanding behavior, which holds that although an infinite number of
variables may in some way influence behavior, only a small number of variables need to be
considered to predict, change, or reinforce a particular behavior in a particular population. The
integrative model thus accounts for any behavior, regardless of whether behavior is deemed rational or
irrational.
- The integrative model can identify in any given population which variables most
importantly determine a given behavior, and proposes that a health message should
address those critical determinants in order to improve the recommended behavior in
the particu- lar population.
- It therefore has the ability to maximize the correspondence between the target
population’s unique needs and the content of a message.
The Intention–Behavior Relationship. The integrative model predicts that people act on their
intentions when they have the necessary skills and when environmental factors do not impede
behavioral performance. The problem here is not one of motivation but one of competence
(i.e., skills) and means (i.e., environmental constraints or facilitators). A wide range of
contextual factors can also either facilitate or impede behav- ioral performance. These are
referred to as environmental constraints in the integrative model.
Determinants of Intention. The integrative model further postulates that intention is a
function of three types of perceptions: attitude, perceived norm, and self-efficacy. Attitude is a
person’s evaluation of how favorable or unfa- vorable his or her performing a particular
behavior would be. Perceived norm, which is the social pressure one expects regarding
4
Week 1: Intervention Mapping
Monday
1. Bartholomew Eldredge, L. K., Markham, C. M., Ruiter, R. A. C., Fernández, M. E.,
Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: An
intervention mapping approach (4th ed.).
Summary:
The purpose of intervention mapping is to provide health promotion program planners with a
framework for effective decision making at each step in the intervention planning,
implementation, and evaluation. It is based on theory and empirical findings from the
literature and data collected from a population. This ensures that we can describe and address
the factors that cause health problems and the methods to achieve change. In intervention
mapping we use theory from a problem-driven perspective. To understand a problem the
planning team begins with a question about a specific (One) health problem. In the social
ecoglogical model – health is a function of individuals and of the environment in which
individuals live, including family, social networks, organisations, communities and societies.
Intervention mapping consists of 6 steps, upon completion planners have a blueprint for
designing, implementing and evaluating an intervention based on theorethical, empirical and
practical information. The process looks linear but is rather iterative and cumulative.
1. Iterative: move back and forthe between tasks and steps as new information and
perspectives are gathered
2. Cumulative: base each step on the previous steps – inattention can lead to
jeopardising the potential effectiveness by compromising the validity of the
foundation on which later steps are conducted.
The steps include: 1– develop a logic model of the problem based on a needs assessment, 2 –
state program outcomes and outcomes and objectives, logic model for change, 3 – develop
the program plan, 4 – produce the intervention, 5 – plan the program use and implementation,
6 – develop an evaluation plan.
2. Kok, G., Harterink, P., Vriens, P., de Zwart, O., & Hospers, H. J. (2006). The gay
cruise: Developing a theory- and evidence-based internet HIV-prevention
intervention. Sexuality Research & Social Policy, 3, 52-67
Summary:
This paper uses the Intervention Mapping (IM) and applies it to the health problem HIV
among men having sex with men.
1
,Wednesday
3. Bartholomew Eldredge, L. K., Markham, C. M., Ruiter, R. A. C., Fernández, M. E.,
Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: An
intervention mapping approach (4th ed.). – Pages 232-241
Summary:
Planners already have an idea of a problem and possible target group that might suffer the
most, they use concepts of epidemiology (=the study of the occurrence and distribution of
diseases and their risk factors in populations).
- Dimensions of health problems – include disability, discomfort, fertility, fitness,
morbidity, mortality, and physiological risk factors.
- Dimensions of quality of life – include effects of illness on both individual and
societal indica- tors, such as cost of health care, absenteeism, work or school
performance, activities of daily living, stigma, isolation and alienation, discrimination,
happiness and adjustment, self-esteem, and employment.
Risk and rate concepts and statistics are helpful in the process of describing the health
problem, and we refer the reader to texts in epidemiology. The extent of the health problem is
usually described as a rate, making possible comparisons among groups and geographic areas
as well as judgments of the importance or seriousness of the problem. A rate is the number of
events (people with a problem) over a period of time per population of 1,000 or 100,000.
Think of environmental factors that influence health directly through disease-causing
exposures or indirectly by influencing health-related behavior. Each level of the environment
(interpersonal, organizational, community, and societal) can influence both individual
behavior and any (lower) level of environment.Why do members of the at-risk group behave
in ways to increase their risk of a health problem? Why do agents in the environment create
or maintain unhealthy environmental conditions? We refer to these factors as personal
“determinants” because, from an intervention-development perspective, causation is implied.
These determinants can be changed or modified by interventions that involve influencing
how people think about or have the capacity to change a behavior or an environment.
4. Ruiter, R. A. C., Crutzen, R., De Leeuw, E., & Kok, G. (2020). Changing behavior
using theories at the interpersonal, organizational, community, and societal levels. In
The Handbook of Behavior Change (pp. 251–266).
Summary:
Societal problems, such as the burden of chronic health behavior–related diseases or
inefficient resource usage, can be alleviated by changing people’s behaviors. Addressing
behavior change usually requires the coordinated pooling of expertise of individuals from
multiple backgrounds and disciplines and at multiple ecological levels.
- Theory-driven applied psychology involves testing a theory in an applied setting, for
example in schools or organizations, primarily in order to gain insight into the
external validity of the theory.
2
, - Problem-driven applied psychology refers to scien- tific activities that focus on
changing or reducing a practical problem. In problem-driven applied psy- chology,
theories are used but problem-solving is the primary focus of this approach, and the
criteria for success are formulated in terms of problem reduction.
Various “social agents” in an individual’s envir- onment, such as family members and peers,
pro- fessionals in organizations, opinion leaders, and policy makers, can have a pervasive
influence when it comes to behavior change. The different social ecological levels, including
the interindividual, organizational, community, and societal levels. intervention programs can
therefore be applied to change the behavior of agents operating at these higher ecological
levels in much the same way as they are at the individual level.
- The socioecological approach to behavior change focuses on the interrelationships
between individuals and their interpersonal, organizational, community, and policy
environments. Two key assumptions from the socioecological approach can guide the
identification of interven- tion targets for promoting behavior change: (1) behavior
influences and is influenced by multi- level environmental factors and (2) individual
behavior both shapes and is shaped by the environment
interventions at the various ecological levels should focus on changing the behavior of agents
who are in a position to exercise influence over aspects of the environ- ment and, in doing so,
bring about behavior change at other environmental levels.
Changing behavior requires an understanding of the causes and effects of that behavior.
outcomes are determined by changes in the individual behavior of the “at- risk” group and by
changes in the behaviors of the “agents.” Environmental agents are the peo- ple within the
environment at various levels (organizational, community, and policy) that, together,
determine the environmental condi- tions that affect individual behavior. This follows the
logic that changes in the environmental conditions that precede behavior change necessitate
the application of theories at both the individual and the environmen- tal levels in order to be
able to understand and change behavior. Taking a socioecological approach to behavior
change means taking into account the contexts within which people live, work, and play. The
agents in this setting are the implementers of the intervention itself, for example teachers.
Slides:
“One Health is an integrated, unifying approach that aims to sustainably balance and
optimize the health of people, animals and ecosystems. – it recognizes that the health of
humans, domestic and wild animals, plants, and the wider environment (including
ecosystems) are closely linked and interdependent.”
Systematic Approach:
- Planning models give guidance on required activities (program transparency)
- IM is a planning protocol for the systematic development of theory-and
evidence-based behavior change interventions.
- Meta-analyses health education/health promotion: Theory-based interventions
superior
- Planned development allows for efficient evaluation
3
, Use of theory = necessary in evidence informed health promotion
- Describe and address factors that cause health problems
- Identify methods to achieve change
Week 2: Needs Assesment
Monday
5. Yzer, M. (2012). The Integrative Model of Behavioral Prediction as a tool for
designing health messages. In H. Cho (Ed.), Health communication message
design: Theory and practice (pp. 21-40).
Summary:
Why do we study health communication? – We have an interest in improving public health,
and specifically, that we believe that communication has the potential to improve health
behavior through health messages. A primary contributing factor in this regard is the
correspondence between the message and the recipient. Maximizing the message–recipient
match requires a good understanding of why people engage in healthy or risky behavior. A
conceptual framework that can account for different health behaviors in different populations
is the integrative model of behavioral prediction. The integrative model takes a reasoned
action approach to understanding behavior, which holds that although an infinite number of
variables may in some way influence behavior, only a small number of variables need to be
considered to predict, change, or reinforce a particular behavior in a particular population. The
integrative model thus accounts for any behavior, regardless of whether behavior is deemed rational or
irrational.
- The integrative model can identify in any given population which variables most
importantly determine a given behavior, and proposes that a health message should
address those critical determinants in order to improve the recommended behavior in
the particu- lar population.
- It therefore has the ability to maximize the correspondence between the target
population’s unique needs and the content of a message.
The Intention–Behavior Relationship. The integrative model predicts that people act on their
intentions when they have the necessary skills and when environmental factors do not impede
behavioral performance. The problem here is not one of motivation but one of competence
(i.e., skills) and means (i.e., environmental constraints or facilitators). A wide range of
contextual factors can also either facilitate or impede behav- ioral performance. These are
referred to as environmental constraints in the integrative model.
Determinants of Intention. The integrative model further postulates that intention is a
function of three types of perceptions: attitude, perceived norm, and self-efficacy. Attitude is a
person’s evaluation of how favorable or unfa- vorable his or her performing a particular
behavior would be. Perceived norm, which is the social pressure one expects regarding
4
