1. Correspondence: Linda.D.Highfield@uth.tmc.edu; Daniella.M.Chambers@uth.tmc.edu
Funding: Agency for Healthcare Research & Quality (1R18HS023255-01)
The content is solely the responsibility of the presenters and does not necessarily represent the official views of the funders.
Intervention Mapping for Implementation
Intervention Development:
A Systematic Approach
Linda Highfield, PhD, MS1
, L. Kay Bartholomew, EdD., MPH2
, Suja S. Rajan, PhD, MHA1
, Maria Fernandez, PhD2
, Melissa Valerio, PhD, MPH3
,
Gretchen Walton, JD, MPH4
, Daniella Chambers1
and Parisa Asgarisabet1
(1)MPACH, University of Texas School of Public Health, Houston, TX, (2) HBHP, School of Public Health, The University of Texas Health Science Center at Housto, Houston, TX,
(3)The University of Texas School of Public Health, Houston, TX, (4)Breast Health Collaborative of Texas, Houston, TX
Background
Underserved women are less likely to use
mammography screening, have higher rates of
appointment no-shows, and ultimately poorer
outcomes when diagnosed with breast cancer.
Aim: Develop an implementation intervention to
support the uptake and use of an evidenced-based
intervention to reduce mammography no-show rates
for underserved women seeking service in federally
qualified health centers and charity clinics in the
Greater Houston area.
Table 2: Products of the Intervention Mapping Process
Conclusions
•Intervention mapping is a useful tool for developing and
adapting evidenced-based interventions.
•It is also useful during the development of implementation
interventions, as it provides as systematic "how-to" for
translating evidence-based programs to the community.
Implementation
Intervention
Purpose
Dissemination and
Implementation
Objective
Site Assessment
Establish
understanding of
clinic structure
and services;
outline
participation
expectations.
Facilitate open
communication and
collaboration; arranges
information sharing.
Packaged
Implementation
Guide
Reference on
implementation,
use of the
intervention and
the stakeholder
group.
Provide packaged
materials to clinics for
review and use (chunking)
Creation of a
Stakeholder
Group
Linkage system
to support
implementation.
Facilitate open
communication; seek
clinic input; role model
and reinforce desired
behaviors.
Certified Training
Provision of
Continuing
Education
Credits (CEU).
Incentivize EBI training
compliance
Computer
Assisted Script
Intervention use;
tracking of data
outcomes.
Ease of use for EBI and
data tracking; Paper free
E-Newsletter
Program
reinforcement
and sharing of
success stories.
Reinforce desired
behaviors; disseminate
findings; support clinic
reporting and fundraising
efforts
Identification and
Troubleshooting
of Barriers
Support
implementers
over time
Open communication;
address concerns early;
support implementation
Results
From the intervention mapping process, seven unique
implementation interventions were developed (Table 2).
Methods
Utilized systematic intervention mapping to develop the
implementation intervention through a four step process.
Blended constructs from diffusions of innovations of
theory, social cognitive theory, and the consolidated
framework for implementation research to develop
performance objectives and implementation interventions
(CFIR).
Incorporated collection of CFIR constructs via
participating clinic survey prior to enrollment (baseline) and
two months post-implementation (following the
implementation interventions) to assess changes.
Step 1:
Identify Program Adopters,
Implementers, and Maintainers
Implementation
Evaluation
Table 1: Intervention Mapping Steps in the Development of the Implementation Intervention