Theory-informed Interventions: University Of Michigan School Of Public Health
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• Theory-informed interventions
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
•
Culture-based
•
Accessible
•
Values-based
•
Acceptable
•
Literacy-based
•
Consumer-centric
•
Adaptive
•
Data-centric
•
Engaging
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Culture-based • Heterogeneity • Regionalization • Country of origin • Generation of immigration • Language • Ethnic identity • Trust • Religiosity • Gender roles
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Accessibility • Television • Radio • Phone • IVR • IPOD • Web • Print • DVD and Video • e-Mail • Billboard • Parents • Teachers • Peers UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Values-based Responsibility, to family, co-workers, friends Purpose, to have meaning and direction in my life Helpfulness, to reach out to others Inner peace, to find a sense of quiet/calmness Justice, to promote fair and equal treatment for all Hope, to see what happens in life in a positive way Independence, to be able to meet my own needs God’s will, to follow God’s plan for me Loving, to give and receive love Family, to have a happy, loving family Spirituality, to grow and mature spiritually Strength, to be physically fit and capable Mental strength, to be mentally alert Humor, to see the funny side of life Friendship, to have close, supportive friends Growth, to keep changing and growing Health, to be physically well
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Acceptable • Politically? • Local branding (who takes credit?) • Turn-key from promotion to evaluation • ROI metrics & dashboard reports • Evidence-based
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Literacy-based • Keep reading level low but: •Teach new terms •Don’t talk down •Keep it interesting, relevant •Give options to investigate
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Consumer-centric
• Their garden versus your seed • Tone (choice) • “Might want to consider” vs. “You should” • How to be referred to • Transparency
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Adaptive • Learning style • User expertise • Longitudinal • Ipsitive
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Data-centric • Store baseline and all follow-up data • Use data • Links to other records • Valid behavioral and outcome measures
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Engaging •
Narrative stories
•
Interactive
•
Normative
•
Connect with community
•
Relevant!
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Average time of clinical opportunities (U.S.): Home
132 days
Mass media
Waiting room
20 min.
1957 Highlights magazines
Vital signs
5 min.
Vital sign feedback
Exam room (pre-encounter)
15 min.
Norman Rockwell picture
Exam room (encounter)
12 min.
Physician-patient interaction
Home
132 days
Mass media
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Mammography screening conceptual framework
attitudes Cultural norms
-Fear of pain -Fear of finding cancer -Radiation -Physical exposure -Negative experience
Perceived Susceptibility Severity -early detection -neg result
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
outcome
Intention to get screened
Social norms -partner -physician -children -friends -media -church -hair dresser
Mammography screening
-Availability -childcare -jobs -school -cultural divide -transportation -cost -DP rel -med anx
Mammography screening conceptual framework Intervention
Intervention
attitudes Cultural norms
-Fear of pain -Fear of finding cancer -Radiation -Physical exposure -Negative experience
Perceived Susceptibility * Severity -early detection -neg result
Intervention
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
outcome
Intention to get screened
Social norms -partner -physician -children -friends -media -church -hair dresser
Mammography screening -Availability -childcare -jobs -school -cultural divide -transportation -cost -DP rel -med anx
Intervention
The goal:
Cost High efficacy
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
High reach
Estimated status of typical interventions strategies for behavior change: Reach
Group counseling
Untailored print
Proactive telephonic
Reactive telephonic
Untailored video
Television
Radio
Tailored print
IVR
Web
Lay health advisors
Peer educators
Theater
Clinician counseling
Tailored web
Efficacy
x x x x x x x x x x x x x x x
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Cost
x x x x x x x x x x x x x x x
= = = = = = = = = = = = = = =
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
•
Culture-based
•
Accessible
•
Values-based
•
Acceptable
•
Literacy-based
•
Consumer-centric
•
Adaptive
•
Data-centric
•
Engaging
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Culture-based • Heterogeneity • Regionalization • Country of origin • Generation of immigration • Language • Ethnic identity • Trust • Religiosity • Gender roles
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Accessibility • Television • Radio • Phone • IVR • IPOD • Web • Print • DVD and Video • e-Mail • Billboard • Parents • Teachers • Peers UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Values-based Responsibility, to family, co-workers, friends Purpose, to have meaning and direction in my life Helpfulness, to reach out to others Inner peace, to find a sense of quiet/calmness Justice, to promote fair and equal treatment for all Hope, to see what happens in life in a positive way Independence, to be able to meet my own needs God’s will, to follow God’s plan for me Loving, to give and receive love Family, to have a happy, loving family Spirituality, to grow and mature spiritually Strength, to be physically fit and capable Mental strength, to be mentally alert Humor, to see the funny side of life Friendship, to have close, supportive friends Growth, to keep changing and growing Health, to be physically well
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Acceptable • Politically? • Local branding (who takes credit?) • Turn-key from promotion to evaluation • ROI metrics & dashboard reports • Evidence-based
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Literacy-based • Keep reading level low but: •Teach new terms •Don’t talk down •Keep it interesting, relevant •Give options to investigate
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Consumer-centric
• Their garden versus your seed • Tone (choice) • “Might want to consider” vs. “You should” • How to be referred to • Transparency
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Adaptive • Learning style • User expertise • Longitudinal • Ipsitive
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Data-centric • Store baseline and all follow-up data • Use data • Links to other records • Valid behavioral and outcome measures
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Engaging •
Narrative stories
•
Interactive
•
Normative
•
Connect with community
•
Relevant!
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Average time of clinical opportunities (U.S.): Home
132 days
Mass media
Waiting room
20 min.
1957 Highlights magazines
Vital signs
5 min.
Vital sign feedback
Exam room (pre-encounter)
15 min.
Norman Rockwell picture
Exam room (encounter)
12 min.
Physician-patient interaction
Home
132 days
Mass media
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Mammography screening conceptual framework
attitudes Cultural norms
-Fear of pain -Fear of finding cancer -Radiation -Physical exposure -Negative experience
Perceived Susceptibility Severity -early detection -neg result
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
outcome
Intention to get screened
Social norms -partner -physician -children -friends -media -church -hair dresser
Mammography screening
-Availability -childcare -jobs -school -cultural divide -transportation -cost -DP rel -med anx
Mammography screening conceptual framework Intervention
Intervention
attitudes Cultural norms
-Fear of pain -Fear of finding cancer -Radiation -Physical exposure -Negative experience
Perceived Susceptibility * Severity -early detection -neg result
Intervention
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
outcome
Intention to get screened
Social norms -partner -physician -children -friends -media -church -hair dresser
Mammography screening -Availability -childcare -jobs -school -cultural divide -transportation -cost -DP rel -med anx
Intervention
The goal:
Cost High efficacy
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
High reach
Estimated status of typical interventions strategies for behavior change: Reach
Group counseling
Untailored print
Proactive telephonic
Reactive telephonic
Untailored video
Television
Radio
Tailored print
IVR
Web
Lay health advisors
Peer educators
Theater
Clinician counseling
Tailored web
Efficacy
x x x x x x x x x x x x x x x
UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Cost
x x x x x x x x x x x x x x x
= = = = = = = = = = = = = = =
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