Plan Based Evidence Informed  Prevention Safe and Strong
Prevention <ul><ul><li>A set of activities aimed at keeping unhealthy situations / behaviour from taking place </li></ul><...
Prevention <ul><li>Primary prevention: Keeping problems from taking place </li></ul><ul><li>Secondary prevention: Identify...
A logic model adapted from PRECEDE Safe and Strong Behavioral Factors Environmental Factors Health Problems Quality of Lif...
A logic model adapted from PRECEDE Safe and Strong Behavioral Factors: compliance, consumption, coping, preventive actions...
Some more on Precede Model … <ul><li>Important to describe: what is the problem exactly? Who has it? Where can the group’s...
Safe and Strong Fishbein Model EXTERNAL VARIABLES     DEMOGRAPHICS         PERSONAL CHARACTERISTICS     INDIVIDUAL DIFFERE...
Safe and Strong EXTERNAL VARIABLES DEMOGRAPHICS PERSONAL CHARACTERISTICS INDIVIDUAL DIFFERENCES GENERAL KNOWLEDGE - genera...
Fishbein terms… <ul><li>Behaviour: You do something or you refrain from doing it  </li></ul><ul><li>Skills: Do you know ho...
Need for Action! <ul><li>Often the situation screems for action, although the  </li></ul><ul><li>health problem is not com...
Intervention Mapping <ul><li>Intervention Mapping is a collection of theories and  </li></ul><ul><li>methods from which yo...
Some important IM Principles <ul><li>Think first, then act </li></ul><ul><li>Step by step, so there is room for looking ba...
Plan-Based Prevention Steps <ul><li>Step 1: Needs Assessment </li></ul><ul><li>Carefully define the intervention populatio...
Plan-based intervention Steps <ul><li>Step 3: Select (theory based) intervention (change)  methods and strategies to addre...
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24 Maart Versie Bijlage Xx Bij De Modellen En Theorie Module 1

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24 Maart Versie Bijlage Xx Bij De Modellen En Theorie Module 1

  1. 1. Plan Based Evidence Informed Prevention Safe and Strong
  2. 2. Prevention <ul><ul><li>A set of activities aimed at keeping unhealthy situations / behaviour from taking place </li></ul></ul><ul><ul><li>An intervention mix addressing different determinants of unhealthy behaviour / environment </li></ul></ul>Safe and Strong
  3. 3. Prevention <ul><li>Primary prevention: Keeping problems from taking place </li></ul><ul><li>Secondary prevention: Identifying problems at an early stage </li></ul><ul><li>Tertiary prevention: Limiting the consequences of a problem </li></ul>Safe and Strong
  4. 4. A logic model adapted from PRECEDE Safe and Strong Behavioral Factors Environmental Factors Health Problems Quality of Life Personal and External Determinants ( Predisposing, enabling and reinforcing factors) Personal and External Determinants (Predisposing, enabling and reinforcing factors)
  5. 5. A logic model adapted from PRECEDE Safe and Strong Behavioral Factors: compliance, consumption, coping, preventive actions, risk behavior, utilization, self-care Environmental Factors: medical care, social support, access to service, rules or laws, availability of resources, attitudes and behavior of health care providers, peers, parents, employers Health Problems: disability, discomfort, fertility, fitness, morbidity, mortality, physiological risk factors Quality of Life Indicators: alienation, comfort, happiness, hostility, self esteem, unemployment, welfare Personal and External Determinants ( Predisposing, enabling and reinforcing factors) Personal and External Determinants (Predisposing, enabling and reinforcing factors)
  6. 6. Some more on Precede Model … <ul><li>Important to describe: what is the problem exactly? Who has it? Where can the group’s at-risk individuals be reached with a program? What are the characteristics of the population at-risk? </li></ul><ul><li>Environmental determinants/factors can be identified at different levels: interpersonal, organizational, community, societal. Examples: solidarity, social norms, reputation, availability </li></ul><ul><li>Examples of personal determinants are: knowledge, attitude, beliefs, norms, values, perceptions, skills, self efficacy, outcome expectation, risk awareness, resources </li></ul>Safe and Strong
  7. 7. Safe and Strong Fishbein Model EXTERNAL VARIABLES     DEMOGRAPHICS         PERSONAL CHARACTERISTICS     INDIVIDUAL DIFFERENCES     ATTITUDE   NORM SELF- EFFICACY ENVIRONMENTAL CONSTRAINTS   INTENTION   BEHAVIOUR BELIEFS ABOUT EFFICACY NORMATIVE BELIEFS BEHAVIOURAL BELIEFS   SKILLS
  8. 8. Safe and Strong EXTERNAL VARIABLES DEMOGRAPHICS PERSONAL CHARACTERISTICS INDIVIDUAL DIFFERENCES GENERAL KNOWLEDGE - general knowledge about hepatitis B - general knowledge about the consequences of hepatitis B - knowledge about the campaign BELIEFS ABOUT BEHAVIOUR - the shots are painful BEHA-VIOUR - doesn’t get vaccinated SELF-EFFICACY - cannot deal with the test results - openness about gay lifestyle (self-esteem) - no adherence to vaccination schedule NORM - you only get vaccinated if you have run a risk BELIEFS ABOUT EFFICACY - “I don’t want to know the results” NORMATIVE BELIEFS - only gays get vaccinated - you have obviously run a risk if you get vaccinated - negative characterisation by others (“slut”) ENVIRONMENTAL CONSTRAINTS - costs related to this - not familiar with campaign - negative social influence (getting vaccinated is not the norm) - inflexible scheduling at policlinic SKILLS - making an appointment is time-consuming and complicated. ATTITUDE -low risk assessment for hepatitis B and its infectiousness - low risk assessment, because “I always have safe sex” - negative attitude due to fear of shots - fear of vaccine / side effects - fear of test results - health motivation (“I’m going to get it anyway”) INTENTION - low level of intention to get vaccinated Schorer example: Hepatitis B
  9. 9. Fishbein terms… <ul><li>Behaviour: You do something or you refrain from doing it </li></ul><ul><li>Skills: Do you know how to do it? </li></ul><ul><li>Intention: Do you want to behave in a certain way? </li></ul><ul><li>Environmental constraints: Does your environment make it harder or easier for you to behave in a certain way? </li></ul><ul><li>Attitude: Do you have a positive or negative feeling about the behaviour? </li></ul><ul><li>Norm: The social pressure you feel to behave or not behave in a certain way </li></ul><ul><li>Self-Efficacy: Do you think you are able to do it? </li></ul><ul><li>Beliefs: What are your views about (the results of) … ? </li></ul>Safe and Strong
  10. 10. Need for Action! <ul><li>Often the situation screems for action, although the </li></ul><ul><li>health problem is not completely clear (nor what is </li></ul><ul><li>causing it) people jump to action. </li></ul><ul><li>Often people skip the researching, thinking through </li></ul><ul><li>and careful planning and preparing for implementation </li></ul><ul><li>process. No time for this. </li></ul><ul><li>Plan-based evidence informed prevention supports you </li></ul><ul><li>in doing this right (making it relevant, effective and </li></ul><ul><li>efficient) </li></ul>Safe and Strong
  11. 11. Intervention Mapping <ul><li>Intervention Mapping is a collection of theories and </li></ul><ul><li>methods from which you can take whatever is useful </li></ul><ul><li>for you. </li></ul><ul><li>We are not doing 100% intervention mapping. </li></ul><ul><li>But are using the main principles and thoughts. </li></ul>Safe and Strong
  12. 12. Some important IM Principles <ul><li>Think first, then act </li></ul><ul><li>Step by step, so there is room for looking back and adapting: an iterative process </li></ul><ul><li>Analyse the target group AND the environment </li></ul><ul><li>Focus by looking at the relevance and changeability of determinants </li></ul><ul><li>Experts, target groups AND mainstream partners are involved </li></ul><ul><li>Evidence-informed: a combination of theory, (scientific) data and (personal) experiences (How do you know what you know) </li></ul><ul><li>Wait with the choice of activity/product </li></ul><ul><li>Determining your goals and implementation strategy from the very beginning </li></ul><ul><li>Implementation strategy and constant evaluation </li></ul>Safe and Strong
  13. 13. Plan-Based Prevention Steps <ul><li>Step 1: Needs Assessment </li></ul><ul><li>Carefully define the intervention population </li></ul><ul><li>Talk about the dimensions of the relevant problem and realted quality of life issues </li></ul><ul><li>Define the risk behaviours </li></ul><ul><li>Define the environmental factors that are related to the problem of that influence behavioural risk </li></ul><ul><li>Step 2: Determinant selection (weighing and thinking) </li></ul><ul><li>Relevance: the strength of the evidence relating a determinant and the behavior or environmental factor we want to change </li></ul><ul><li>Changeability: strength of the evidence that the proposed change can be realized by an intervention. </li></ul><ul><li>Behaviors and environmental conditions that are both more relevant and more changeable will be a high priority for program focus </li></ul><ul><ul><li>Not so relevant, not so changeable: X </li></ul></ul><ul><ul><li>Not so relevant, but easily changeable: easy gains </li></ul></ul><ul><ul><li>Quite relevant, but difficult to change: think well before investing </li></ul></ul>Safe and Strong
  14. 14. Plan-based intervention Steps <ul><li>Step 3: Select (theory based) intervention (change) methods and strategies to address those determinants </li></ul><ul><li>(also your ideas about how change works) </li></ul><ul><li>Step 4: Compile, pretest and produce a program </li></ul><ul><li>Step 5: Plan adoption and implementation </li></ul><ul><li>Step 6: Plan evaluation (link: evaluation studies) </li></ul><ul><li>Step by step, so there is room for looking back and </li></ul><ul><li>adapting: an iterative process </li></ul>Safe and Strong

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