L. Kay Bartholomew, Guy S. Parcel,
Gerjo Kok, and Nell H. Gottlieb
Intervention Mapping: Designing Theory and
Evidence Based Health Promotion Programs
Introduction
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Developing and Analyzing
Health Promotion Programs
What is Intervention Mapping?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Development
Questions that we couldn’t easily answer from available resources:
THEORY
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When in the planning process do I use theory to
guide my decisions?
How do I know what theories and constructs to use?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Development
Questions that we couldn’t easily answer from available resources:
EVIDENCE
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How do I make use of the experience of others and
the results of program evaluations.
How do I judge the the validity and strength of
evidence?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Development
Questions that we couldn’t easily answer from available resources:
EFFECTIVE METHODS
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How do I decide what intervention methods to use?
How can I get from program goals and objectives to
the specific intervention strategies for the program
participants?
How do I link program design with program
implementation?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Development
Questions that we couldn’t easily answer from available resources:
ECOLOGICAL APPROACH

How do I address changing the behavior of people in
the environment (i.e. make sure intervention
addresses those people who are not at risk for the
health problem , but are important to changing
conditions that affect those at risk)?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Possible innovation in the way we do
planning :
Explication of Multilevel Environmental Factors
Related to Health and Behavior

Explicit attempts to facilitate an ecological
planning approach that takes into
consideration both the social and physical
environmental factors that influence a health
problem
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Possible innovation in the way we do
planning :
Focus on Behavior of Both the At-Risk
Population and the Agents of Environmental
Change

Explicit definition of behavior including
performance objectives
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Possible innovation in the way we do
planning – Proposed Determinants
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The explicit delineation of the factors that can
be supported as [causally] related to
behavioral or environmental causes of a
health problem –
The explicit intersection of these
“determinants” with the performance
necessary to carry out the health behavior or
change the environmental factor MATRICES
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Possible innovation in the way we do
planning :
Matrices of Proximal Program Objectives
The use of the Matrix device to plan methods
and strategies for both
 The intervention itself

Adoption, implementation, maintenance and
wide diffusion of the intervention
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Possible innovation in the way we do
planning:
The Difference between Methods and
Strategies

The attempt to force a division between
theoretical methods and practical strategies
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
The goal of developing Intervention
Mapping was to describe and clarify
the processes that have been used to
create effective interventions.
Not to create a new
process!
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Designing Theory- and Evidence-Based
Health Promotion
What is Intervention Mapping?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Step I
Matrices of Proximal Program Objectives
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State expected changes in behavior and environment
Specify performance objectives
Specify hypothetical determinants
Create matrices (if necessary, differentiate the
population)
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Creating a Matrix of
Proximal Program Objectives
Determinant 1 Determinant 2
Performance
objective 1
Learning/change
objective
Learning/change
objective
Performance
objective 2
Learning/change
objective
Learning/change
objective
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Matrix on Determinants of Buying
or Obtaining a Condom
Performance
Personal Determinants
Objective
Knowledge
Self-efficacy
Buys or obtains a
condom
Learning objectives
Learning objectives
 Identify where
 Express confidence
condoms can be
in ability to go into a
obtained
store and buy a
 Identify location of
condom
condoms in stores
 Feel confident in
Describe types of
ability to deal with
condoms and features
embarrassment when
for effectiveness
buying a condom
 Explain how to buy
or obtain a condom
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Step 2
Methods and Strategies
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Brainstorm methods
Translate methods into practical strategies
Organize methods and strategies by groups
of leaning objectives at each level and check
that methods are properly operationalized
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Methods and Strategies
A Method is a general
process for influencing
changes in the
determinants of behavior
and environmental
conditions
A strategy is a practical
technique for the
application of methods
in ways that fit with the
intervention group and
the context in which the
intervention will be
conducted
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Step 3
Producing Program Components
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Operationalize the strategies into plans that
consider implementers and sites
Develop design documents and produce
materials
Pretest programs and materials with
intervention groups and implementers
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Step 4
Planning for Adoption, Implementation and
Sustainability
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Develop a linkage system
Create matrices of proximal program objectives
Select methods and strategies and create a diffusion
intervention table
Write an adoption and implementation plan
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Intervention Mapping Step 5
Planning for Evaluation
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Develop an evaluation map
State process and effect questions
Develop or select indicators and measures using the
matrices
Specify evaluation designs and write the plan
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center
Analyzing Programs
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Behaviors – Environmental Conditions?
What “determinants” are targeted?
Justifiable “determinants”?
Methods matched to “determinants”
Methods operationalized into strategies?
For Classroom Use Only
© 2003 University of Texas Houston Health Science Center