What do you do in the help phase?
- Selecting a target variable from the process model.
- Developing an evidence-based intervention.
- Implementing the intervention.
When do you use a balance table
Before you actually start with the intervention development, you take one step further from the process model to the balance table.
Balance table
Includes all variables from the process model in a table to create an overview of variables including their modifiability and effect size.
You will use this balance table as input for your decision on what your target variable will be for your intervention development.
Modifiability in the balance table
Assess how modifiable each variable is.
- For example, decide on whether a variable is a personality trait or part of religious beliefs or culture.
Indicate by ++, +, 0 or -.
Effect size in the balance table
How strong is the effect of the variable on the outcome variable?
Use empirical evidence from the Test phase to estimate.
Indicate by ++, +, 0 or -.
What are the steps of the intervention development?
Target variable
- Based on the balance table, select variable(s) that are the most promising to target for changes in the outcome variable.
- Once you have this variable, you start to build the intervention around this variable. So you want the intervention to influence this target variable to end up with a change in the outcome variable.
Channel
- What is the best way to reach your target group?
- E.g., talking to them, sending an email, hanging up posters/flyers, tv ad.
Method
- Select a behaviour change method that is likely to change the target variable, based on empirical evidence.
How do you choose a channel for the intervention development?
Effectiveness
- Is this channel an effective way of reaching your target group?
Intensity
- Is exposure to this channel intensive enough to change the variable?
- What is needed for your target group and for your behaviour change method to work?
Appropriateness
- Is this channel appropriate for the methods that you want to use?
- Some methods don’t fit all channels and vice versa.
Impact
- What is the impact on the population level of using this channel?
- This is based on participation rate * effectiveness.
o Participation rate = how many people are exposed
How do you search for a method for the intervention development?
The target variable is the basis when you look for behaviour change methodologies that have the potential to change this target variable and thus also change the outcome variable.
You do a deep dive into literature, focused on the target variable and how to change it. You use literature and expertise on core processes in behaviour and behaviour change. You zoom in on more topical processes in behaviour change focused on your target variable.
Brainstorm
- You are an expert in the field.
Target group
- The target group can tell you what they think would and would not work
o You need to always connect this to theoretical background
The theoretical background can be very focused on your target variable, but it can also be very broad on behavioural change
How do you select a method for the intervention development?
All behaviour change methods come with their own set of boundary conditions.
- It’s important to take these into account when selecting a method.
- These conditions need to fit the conditions that you have for your problem and intervention.
Parameters:
- Every theory has its own set of ‘parameters’: conditions under which it is effective.
Attending and understanding:
- Many theories require the target group to both attend the intervention, and understand its content for it to work.
Exceptions:
- Nudging and other heuristics-based methods do not require attending and understanding.
- They have other parameters that are required to make it effective.
It’s important to not only look at if a method can change the target variable, but to also look at when it works, when it doesn’t work and if that matches the conditions that are in front of you.
Modelling
A kind of method
Learning through the observation of others.
Behaviour change is most likely when role models are mixed
- Mixed: when they show positive and negative examples.
Goal setting
A kind of method
Having goals directs people’s effort and attention, regulating motivation.
Fear communication
A kind of method
- E.g., fear appeals
- Triggering fear is often used to change (risk) behaviour.
- Not recommended because the parameters are quite complex:
o Providing a feasible and effective alternative behaviour is extremely important.
o It can backfire if the parameters are not met.
Reward and punishment
A kind of method
People tend to avoid negative consequences, and approach positive consequences.
However, the resulting behaviour is extrinsically motivated.
- This is not always sustainable behaviour in the long run.
Practical application
This is the next step in the Help phase.
You will work on the practical applications of the method and the channel.
This is a problem because:
- Channels and methods are general and need to be translated to the target behaviour and target group.
What would the application be in the following example?
Outcome variable: reduce the number of adolescent smokers
Target variable: reduce smoking behaviour in schools
Method: social norms
Emphasize the proportion of non-smokers vs. smokers on posters inside the school.
What would the application be in the following example?
Outcome variable: sufficient SPF use in the adult population
Target variable: applying SPF before exposure to UV rays at the beach
Method: use a heuristic (a default)
Offer free and easily accessible SPF at beach entrances.
What would the application be in the following example?
Outcome variable: condom use intentions
Target variable: acknowledging that STD’s stem from risky sexual behaviour (attitude)
Method: personalizing risk and modelling
Scenario videos in which target group peers play the main part
Designing the intervention
Be specific.
Think about implementation.
Pre-test and/or pilot your intervention components before building the programme.
- If you have the resources and the time
Why do you need to be specific when designing the intervention?
Every part of the intervention needs to be designed.
What questions do you have to ask about the implementation when designing the intervention
- How do you get your intervention noticed?
- Who decides on using your intervention?
- How do you get organizations to join your intervention?
- Who do you need for implementation?
o E.g., do you need someone to hang posters? Do you need people to help you convey the intervention in classrooms?
o What kind of resources do you need?
Implementing the intervention
There are different theoretical frameworks that can help you with the implementation of the intervention. One of the more familiar ones is Rogers’ diffusion process.
Rogers’ (2010) diffusion process
It describes four phases of implementation:
- Dissemination phase
- The information/intervention reaches and is noticed by stakeholders (e.g., the target group)
- Adoption phase
- Stakeholders become motivated to use the intervention
- Implementation phase
- Stakeholders engage with the intervention
- The intervention is being implemented
- Continuation phase
- The intervention becomes part of the standard behaviour of stakeholders
What steps do you take in the help phase?
- A balance table is set up and a target variable is selected
- A channel and method are selected and translated into a practical application
- The intervention is designed and implemented/an implementation plan is build
