Model and Behaviour theory, Implemetation mapping.pdf
- 1. Models and Theories to Support Health Behavior Intervention and Program Planning dr. Amelya Augusthina Ayusari MGizi SpGK dr. Amel IG : amelya_augusthina_ayusari FB: Amelya Augusthina A
- 2. SubTopics 1. Introducing 2. About model 3. Models : socioecological, transtheoretical, and health belief 4. Intervention Mapping
- 3. Introducing Developing health promotion programs that support healthy lifestyle behaviors requires comprehensive planning. Program planners can use models and theories to guide this process as they work with individuals, groups, and communities. Individuals and communities have multiple risky lifestyle behaviors including physical inactivity, unhealthy diets, smoking, and stress.
- 4. Introducing Other factors that can affect an individual’s or community’s ability to effectively change behaviors, including low income, lack of access to safe places to exercise, inaccessibility of healthy food, and cultural and ethnic differences. These factors can make determining how to best design a program seem like an overwhelming task. To be effective, programs must not only address the behavior, but also the factors that surround it. Models and theories can provide a framework for program planners to build upon as they develop health promotion programming
- 5. About models Models refer to a more descriptive process. In other words, a model may describe how a process occurs but not necessarily why it occurs in that way. Theories and models both include concepts and constructs. Concepts are the primary components of a model or theory. Constructs are components that have been created for use in a specific model or theory. Health behavior models and theories help to explain why individuals and communities behave the way they do. Planners can use these models and theories to increase the effectiveness of their program design, implementation, and evaluation. It’s useful to remember that different models may be appropriate in different situations
- 6. Models : socioecological addresses behavior change at multiple levels and considers the inter-relationship between behavior and the environment. identifies five levels of influence on health behavior and discusses the reciprocal relationship between them: 1 . Intrapersonal factors — these include individual characteristics such as knowledge, beliefs, and self-concept. Most health promotion programming is aimed at this level. 2. Interpersonal processes and primary groups — these include the individual’s social environment such as family, friends, peers, and co-workers that surround the individual and influence behavior. In turn, an individual’s behavior also influences family, friends, and peers.
- 7. Models : socioecological 3. Institutional or organizational factors ---these refer to workplaces, churches, and other organized social institutions. These institutions have formal or informal policies and structures. 4. Community factors — these describe the relationships among organizations and institutions. This includes community norms. 5. Public policies — these refer to policies or regulations concerning healthy practices.
- 8. Figure 1. A socioecological approach to obesity. This figure shows interventions that program planners can take at each level of the socioecological model to implement a health program that targets obesity.
- 9. Models : Transtheoretical Model (Stages of Change) describes the process of behavior change and accounts for an individual’s readiness to make and sustain behavior changes. This model is useful because it helps planners design programs based on an individual’s readiness, motivation, and ability. The model includes five stages 1. Precontemplation — in this stage, the individual has no intention to change behavior within the next six months. The individual may lack knowledge or may have been unsuccessful with previous attempts at a change. 2. Contemplation — in this stage, an individual is considering a behavior change within the next six months. Ambivalence, however, may keep the individual from progressing to the next stage.
- 10. Models : Transtheoretical Model (Stages of Change) 3. Preparation — in this stage, the individual takes some steps toward making a change and doing so within the next 30 days. 4. Action — an individual reaches this stage once he or she has made an apparent behavior change for six months or less. 5. Maintenance — if the individual’s behavior change lasts for more than six months, he or she moves into the final stage, maintenance.
- 11. A transtheoretical model approach to physical inactivity. This figure shows interventions that program planners can implement at each stage to support an individual’s behavior change related to physical activity.
- 12. Models : Health Belief Model The health belief model is one of the oldest models of health behavior, but is still very relevant when discussing health behavior change. This model addresses the readiness to act upon a health behavior based upon several individual beliefs. If individuals perceive they are susceptible to a condition (1) and that the condition could be severe (2), they will most likely take action to avoid the condition. The likelihood of action is enhanced if the perceived benefits (3) outweigh the perceived barriers (4).
- 13. Models : Health Belief Model The model also includes two other constructs: cues to action and self- efficacy. Cues to action are events that spur individuals toward action. For example an individual may see a television ad featuring a well- known actor discussing weight-loss strategies. Self-efficacy refers to an individual’s confidence that he or she can successfully carry out the indicated actions. If individuals do not believe they can successfully make a behavior change, they are unlikely to do so
- 14. A health belief model approach to addressing obesity as a factor in diabetes. This figure shows interventions that program planners can use to help individuals change their behaviors to avoid the risk of diabetes.
- 15. Summary Each model reflects different, yet related, dimensions of the behavior change process. Determining which model to use will depend upon the situation. In many cases, planners may find thatusing more than one model is appropriate or that only certain aspects of a model are useful. Consider a program planner who is working with an obese individual whose family members seem to be able to eat whatever they want without developing diabetes. In such instances, the health belief model may be useful. In this example, the planner may need to enhance the interventions for perceived susceptibility. If an educator is working with a group of low-income individuals who are dealing with obesity and work for the same employer, the socioecological model may be more useful. The planner may need to aim more effort to create and support healthy work environments and find resources that provide low-income individuals opportunities for exercise and healthy food options.
- 16. Summary In both of these examples, the transtheoretical model may help an educator determine what interventions are appropriate to move both groups along the continuum toward behavior change. Models and theories can help us understand behavior and plan health promotion programming, to consider and address the many variables and factors that affect the behavior change process at the individual, group, and community levels. However, there are many more models and theories that explain. The availability of multiple models and theories allows the program planner to support design of effective health promotion programs.
- 17. Intervention Mapping (IM): Theory- and Evidence- Based Health Promotion Program Planning IG : amelya_augusthina_ayusari FB: Amelya Augusthina A
- 18. Definition Intervention Mapping (IM), a framework for theory- and evidence-based health promotion program planning that addresses this challenge by providing a systematic and stepwise approach to planning interventions. IM has been used to develop health promotion interventions and implementation strategies in community and clinical settings globally IM is a planning framework that provides a systematic process and detailed protocol for effective, step-by-step decision-making for intervention development, implementation, and evaluation.
- 19. Intervention Mapping Steps Step 1. Logic Model of the Problem : is a careful description of the problem that will enable intervention planning. Step 2. Logic Model of Change : the planning group articulates the desired health promoting behaviors and environmental conditions. Step 3. Program Design : the planning group discusses initial ideas for the program and selects theory- and evidence-based behavior change methods based on the determinants that they need to change Step 4. Program Production : the various applications selected in Step 3 are organized and produced → The program planning group decides the overall structure, themes, channels, and vehicles of the program Step 5. Program Implementation Plan : guides the development of implementation approaches, also known as strategies or interventions. Program implementers are the people who are responsible for the delivery of the program and can include organizational leaders responsible for program adoption and maintenance as well as those responsible for actual delivery of program materials and activities to participants. Step 6. Evaluation Plan : Effect and process evaluation
- 20. Steps for IM
- 21. Multilevel factors influencing health.
- 22. Daftar Pustaka Fernandez, M.E., Ruiter, R.A.C., Markham, C.M., Kok, G., 2019. Intervention Mapping: Theory- and Evidence-Based Health Promotion Program Planning: Perspective and Examples. Front. Public Health 7. Vicki Simpson PhD, RN, CHES .Models and Theories to Support Health Behavior Intervention and Program Planning. 2015. Purdue Extension, Purdue University