Applied Psychology Intervention Design PDF

Chapter 1: Applied psychology: Intervention design for psychological problem. Psychology = the science of behaviour and mind. According to the scientific approach, the concept of behaviour refers to observable actions, whereas the concept of mind refers to subjective experiences. History of Psych...

Chapter 1: Applied psychology: Intervention design for psychological problem. Psychology = the science of behaviour and mind. According to the scientific approach, the concept of behaviour refers to observable actions, whereas the concept of mind refers to subjective experiences. History of Psychology: Approach of Behaviourism This approach focuses on observable behaviour 🡪 Behaviourism Basic idea: Only the systematically study of the behaviour of individuals or groups of individuals would make it possible to infer expectation about future behaviour and to enable the formulation of psychological theories. Law of Thorndike (Thorndike, 20th century) are based on studies, which used objective measurement of behaviour. 1. Law of Exercise = the relationship between a stimulus and a response becomes stronger when a stimulus is more often followed by the same response of an individual (law of use). The relationship between a stimulus and a response becomes weaker when a stimulus is only seldom followed by the same response of an individual (law of disuse) 2. Law of Effect (influences within the behavioural approach) = the relationship between a stimulus and a response becomes stronger when the response is followed by a reward. The relationship between a stimulus and a response becomes weaker when the response is followed by a punishment -> does lead to the disappearance of certain, unwanted behaviour but once it is removed the undesired behaviour reappears again -> rewarding a desired behaviour is much more powerful. Cognitive psychology = gains more insight into the mental process in the mind because it focuses on the motives, the emotions, and the thoughts that trigger an individual to perform certain behaviour 🡪 processes in our mind are crucial for explaining actual behaviour 🡪 more complicated because it formulates assumptions about processes that cannot be perceived. In 1967, Ulric Neisser published “Cognitive Psychology” in which information processing in humans was for the first time systematically and empirically described in a coherent manner. (Milestone) 🡺 Both behaviourism (limit in the observable behaviour) and cognitive psychology have the aim to describe, understand, and predict human behaviour. Cognitive psychology is more complex because it focuses its research in the motives, emotions and thoughts, which lead to the formulation of assumption about unperceived process. 🡺 Psychology involves the study of mental processes and human behaviour in order to explain, predict and to change that behaviour 🡺 Psychological knowledge allows us to make statements about human motives, emotions, desires and their influence on behaviour  🡺 Applied psychologist are practice oriented and aim to change specific behaviours through actions that directly change behaviour or through actions that influence mental processes, which indirectly changes behaviour. History of applied psychology First psychological research laboratory was built in Germany and was founded by Wilhelm Wundt. ▪ Structuralism = Approach to reduce complex psychological processes to set of basic components ▪ The Empirical Method = focuses on operationalization (reducing complex psychological concepts). It emphasizes precise measurement, repetition of events and verifiability. Theories need to be investigated and proven (TOO REDUCTIONISTIC) ▪ Functionalism = how awareness can be useful in analyzing and overcoming everyday problems (John Dewey) o The results from psychological research could lead to useful applications (a strict separation between basic research and the solution of psychological problems) o Evidence from basic research could not be easily translated into applications o Linking science (a connecting science) to translate evidence from research (collected under strictly controlled conditions in laboratories) into solutions for various practical problems. Dewey compared psychologists with physicists. Both psychologists and physicists try to understand and try to arrive at practical problems. Physicists try to understand the functioning of machines and buildings, while psychologists deal with problems related to the functioning of humans. Applied psychologists = develop a linking science to enable practitioners to benefit from it, by applying scientific knowledge into practical purpose. Like all technical sciences, applied psychology tells us what we ought to do if we want to reach certain ends. This all system has two aspects: 1. Start from various mental processes and ask for what end each mental factor can be useful and important (structuralism, research is mostly carried out under isolated laboratory conditions – starts from a known solution) 🡪 The result of a basic research as a starting point and examine whether these results can be used to solve practical problems. 2. Begin with studying what significant ends are acknowledged and seek psychological facts which are needed for the realization of these ends (linking science – starts from a known problem) 🡪 First the objectives should be defined, before we can determine which solutions fits best. 🡺 The first approach started with a known solution and formulates an appropriate problem. The second approach first analyses a known problem and subsequently develops a solution based on the problem. In Dutch social science, the empirical cycle and the regulative cycle are different. ▪ The empirical cycle investigates phenomena and it describes, explains and tests them. There are different crucial activities for knowledge generation: 1. Observation: occurrence of a phenomenon and circumstances (hypotheses)  2. Induction: number of hypothesis and assumptions 3. Deduction: making prediction about the occurrence of the phenomenon 4. Testing: experiment and analysis of the collected data 5. Evaluation: evaluation of the hypotheses 🡺 The empirical cycle is often used as a basic research to test a previously formulated hypotheses. ▪ The regulative cycle is general method with the intention to solve an identified problem. 1. Problem analysis = a preliminary problem is analyzed to determine whether we are dealing with consequences or with an actual problem. 2. Solution generator = the problem is described and an overview of the behavioural determinants is made. Develops an intervention which targets specific behavioural determinants. 3. Implementation of the solution = development of an intervention and it is applied on a small scale. 4. Evaluation of the impact = the intervention is carried out on a larger scale and a summative evaluation is performed This approach is also called engineering approach. Types of psychological research 1. Basic research = conducted in laboratory, descriptive or explanatory research. a. Performed in artificial situations (laboratory conditions) b. Data is collected with the aim of learning more about the origins of a phenomenon or to test predictions 2. Applied research = study of a phenomenon in real life. a. Try to explain a phenomenon without the goal of using the outcomes to explain other situations b. In some cases the goal is to generalize the results to other practical situations with the aim of explaining or testing a hypotheses (bring it to a more general situation) 3. Design-orientated research = aim to design and test interventions. The scientific activities are directed to a solution derived from a problem analysis (experiences with applying solutions are the basic of knowledge development) a. The systematic study of designing, developing and evaluating psychological interventions b. Focusses on designing and developing interventions c. It is also about developing knowledge about effective interventions, and about the actual process leading to the design of interventions: 1. Problem analysis answers the questions: what is happening? What is the actual problem? Are there obstacles that will hamper a possible solution? 2. Formative evaluation is about a pilot study that can be performed to examine whether all details are considered and whether the designed solution works. 3.Summative evaluation verifies the effects of the solutions (has the problem been solved by the solution?) Problem solving in psychology Problem solving in psychology was considered a general way of working, also referred to as a generic way that can be applied to all kind of problems (strategy or skill). “How to Solve it” by Polya shows a four steps method; which can be used in problem solving. The steps are the following: 1. Understanding the problem 2. Devise a plan 3. Carry out the plan 4. Look back This is a deductive way of working which uses heuristics strategies (logical way of thinking and working). In the design approach an inductive method (attempt to derive a general rule which is applicable to all problems encountered) is used with the goal of reaching a solution or intervention. 🡺 When faced with a problem, first the problem is described and analysed in order to understand the actual problem. Once, a definition of the problem has been formulated (understanding the problem), a plan can be designed according to the characteristics of the problem (devise a plan). After that, the solution or intervention can be carried out (carry out the plan) and the solution can be evaluated to determine whether the problem is solved and to find out how the application went (look back). Newell and Simon develop three major elements problem solving steps: 1. A general scheme of problem 2. Synthesis 3. Evaluation 🡺 Similar to Poyla, both approaches are deductive Inductive method of reasoning or problem solving 🡪 the problem solver attempts to derive a general rule which is applicable to all problems encountered. There are major differences in problem solving strategies between experts, depending on the type of problem and prior knowledge: ▪ Access to large amount of knowledge (important role) ▪ Analyze the problem (structure and meaning) ▪ Quickly see the solution ▪ Much knowledge held for a short period of time The basic scheme for design-orientated problem solving has its theoretical base in problem solving including the work of Polya, Newell and Simon. Design approaches in other disciplines Instructional design = instructional solutions for educational problems; ▪ Knowledge and skills are used to systematically design and create instructional solutions for educational problems ▪ Main activities: analysis, synthesis and evaluation. ▪ Implementation is continuously monitored (outcome acceptable and feasible?). Technical implementation is different from psychological implementation ▪ The target group should always be involved. They can provide valuable knowledge about their needs and results from the analysis can be shared ▪ Evaluation is always monitored (right track?). The lack of time and money always plays a crucial role. Technical design = a method in which designers are working in a systematic way towards a solution (solution as a product). In the generical model: 1. Problem definition and analysis 2. Development 3. Construction 4. Evaluation and revision 5. Implementation Similar model is used in mechanical engineering and in technical design. Van der Kroonenberg’s design: 1. Problem definition = what should be the to be design product? 2. Functional design = what are the possibilities, conditions, sustainability, energy consumption, impact and costs (environment in which the design will be used should be explored) 3. Construction = making and implementation of a concrete product The function is the applied power to realize a transformation in the environment of the product. The central idea of a product (a program of requirements) is either technical, ergonomic, aesthetic, semantic or business economics. A psychological mental function is the active ingredient that helps accomplish a behavioural change. Behavioural determinants = starts as a mental process, determinants that influence someone’s behaviour ▪ Behavioural objectives are observable manifestations of behaviour ▪ Behavioural change program is about actions in a psychological environment in which behavioural determinants can be influenced Designing psychological interventions with knowledge of applied psychology. Psychological design = the discipline that encompasses knowledge and skills to develop interventions and to use these interventions. 1. The design approach has four core activities: ▪ Analysis: analysis and definition of the problem ▪ Synthesis: determine behavioural determinants and interventions ▪ Construction: concrete program or product and also how the product is used in actual practice ▪ Evaluation: assessment of the impact of the developed program 2. The four core activities are followed in the same way and sequence. They will come in various combinations. The evaluation is always performed. 3. The core activities can be used in a deductive, inductive and creative manner. ▪ Deductive: analysis and synthesis play an important role and they occur in the same order, the problem is tackled from a general prospective ▪ Inductive: implementation and evaluation are relevant, begins from specific case or program ▪ Creative: requires psychological expertise (important condition), there is no general procedure 4. The success of a behavioural intervention depends on the effectiveness of the functions 🡪 Translation of the concept of function engineering design into behavioural determinants  ▪ Theory of Planned Behaviour of Ajez = a number of behavioural determinants are discerned (attitude, subjective norm, and perceived behavioural control) 🡪 these determinants are powerful factors in changing behaviour 5. The outcome and effect of each element should be reviewed. Important if the designer wants to be accountable. Each step in the model of instructional design is evaluated. 6. Careful consideration to the feelings and views of those who are involved. Success only if the condition of involving the environment is met. Commitment = confidence of the environment and willingness to inform the environment. The ASCE model for psychological design 1. ANALYSIS = health psychology uses the PRECEDE model (blue print). PRECEDE is the acronym for the steps used in the model. a. Predisposing b. Reinforcing c. Enabling Constructs in Educational Diagnosis and Evaluation Psychological factors that are determinant for (un)desirable behaviour: ▪ Predisposing factors (possessing certain personality traits, genetic predisposition) ▪ Enabling factors (conditions for the (un)desirable behaviour to be maintained, for eg. Food for those who suffer from an eating disorder, a tolerance policy about smoking) ▪ Reinforcing factors (related to the people that causes the problem; internal and external factors 🡪 reinforce the existing (un)desired behaviour) The Logic Models = possible causes of behaviour are emphasized, by looking at background factors The Intervention Mapping method= PRECEDE is a basis for analyzing + the Needs Assessment for elaboration (systematic study of the difference between what the actual behaviour of an at risk or target group is and what it should be), provides steps about data usage  2. SYNTHESIS = outcome of analysis are used (can be used to determine a blueprint of an intervention) 3. CONSTRUCTION a. Educational psychology can provide clues for the design of learning activities aimed at behavioural change b. Perceptual psychology provides regulations on how to design auditory and virtual featured of the intervention c. Psycholinguistic provides evidence for language use and information presentation 4. EVALUATION provides evidence from test psychology and research methodology to provide effective methods, validity and reliability. The success of the core activities depends on accountability and commitment (implementation) Three I’s: 1. Initiation = being aware that something is wrong and becoming convinces that the development of intervention will solve the problem 2. Implementation = deployment and use of the intervention 3. Institutionalization = Sustainability; ensure that the target group don’t show the old habits Accountability: relates primarily to the evaluation process Commitment: ensures the success of the intervention by involving the (social)environment in each step of the design process Chapter 2 (READER): analysis of the psychological problem Introduction The ASCE model is a generic model that can be used within applied psychology. The aim is to analyze psychological problems and to enable the design of behavioural interventions in order to solve psychological problems. The ASCE model consist of four core activities and each core activities consists of several steps. The ASCE model is not applicable to all kinds of behaviours. A psychological problem follows from the observation that there is a difference between an actual situation and a desired situation and that this difference can be decreased by means of an intervention that is aimed at changing the behaviour. A psychological problem can only be defined when the problem situation can be solved by changing the behaviour of an individual or a group of individuals. The term psychological intervention is used, because the aim of it is to influence the behaviour of individuals. When factors other than human behaviour play a decisive role in a problem, a different approach than a psychological intervention should be chosen 🡪 A psychological problem always is a behavioural problem in which behaviour plays an important role. Solution to a problem can be achieved by changing the behaviour. Financial aspects play a major role. Before the development of an intervention, it is necessary to assess whether such type of factors play an important role. The first step of the core activity analysis is problem analysis. 1. STEP 1: problem analysis The problem analysis is a clear, concise and comprehensive description of the problem : what is the problem, why it is a problem, to what extent it is a problem, the consequences of the problem, for whom it is a problem (at risk group) and which individuals do have to change their behaviour in order to solve the problem (target group). It is important to target the behavioural intervention on the problem itself and not on the symptoms of the problem. A proper problem analysis will weigh the pros and cons from the different perspectives and will result in a clear problem statement. A problem statement is a statement on the psychological problem that has to be solved, preferably in ONE sentence. A clear problem statement allows the intervention designer to search for relevant literature, enables to make comparisons with existing interventions, and facilitates the seeking of psychological knowledge that can be applied in the development of the intervention. The problem statement is the heart of the design process. The clear definitions of core concepts enables the intervention designer to effectively evaluate the outcomes of the intervention. The design process starts with a problem analysis and a problem statement. In many cases, a literature search is needed to collect all relevant information and assess all available psychological knowledge. Problem analysis: literature search and appropriate sources. Scientific and statistical information: it is important to collect as much information (reliable sources) as possible about the problem at the start of the core activity. Scientific information is characterized by being peer-reviewed, meaning that before publication of scientific research, a term of other scientists have critically reviewed the research before it is even allowed to be published. ▪ Data from patient associations are less reliable because they are less rigorously controlled than data provided by independent institutes and government agencies. Limitations of scientific and statistical information: For problems in work situations or in organizations, the required information is often not readily available. A survey may be carried out. Ingredients of the problem analysis Academic literature is required to conduct a in depth problem analysis. The following information is needed to complete the problem amalysis: ▪ What is the problem? ▪ Why is it a problem? ▪ Which statistics and demographic data can you find about the problem? ▪ What are the consequences of the problem? ▪ What is the at risk group? ▪ What is the target group? What is the problem? It is important to first clearly define the problem. This definition may lead to the identification of some more aspects that an intervention can be aimed at (eg. Diseases). Before the development of an intervention, it should therefore be exactly clarified how the concept overweight will be operationalized. A clear description of the problem is also necessary when a limit should be specified, above which a problem is judge to be a severe problem. 🡺 The proper definition is essential, because is the leading definition for all the steps of the ASCE model. Why is it a problem? It is valuable to explore the impact of a psychological problem of individuals. When the intervention designer is aware of the consequences of a problem for an individual, it may indicate the focus of the behavioural intervention 🡪 Which behavioural change should be considered to achieve in the intervention? Exploring the reasons why it is problem contributes to sharpen the problem statement. What is the extent of the problem (statistical and demographic data and consequences?) The extent of a psychological problem is determined by all statistical and demographic data. ▪ Which statistics and demographic data can you find about the problem? ▪ What are the consequences of the problem? First an estimation is made of the magnitude of the problem by examining how common the problem is: mortality rate, prevalence and incidence. A mortality rate indicates how many people die in one year because of the problem behaviours they exhibit. A prevalence rate indicates the number of persons having a particular diseases or exhibiting a particular problem behaviour at a certain point in time, divided by the total number of individuals in the population. The incidence rate is defined by the number of new individuals that will exhibit an illness or problem behaviour in a given period of time, divided by the total number of persons in the population. Not all problems can be expressed in terms of disease, incidence, prevalence, and mortality. Not all psychological problems are health problems. Determining the impact of the problem on society. In case of a serious problem, a successful intervention will have a major impact on the quality of lives of those involved. To determine the impact of a problem, statistical and demographic data can be used: ▪ Morbidity (how many people are sick in the total population) ▪ Mortality (how many people die from a certain disease) ▪ The degree of disability remaining ▪ Disease (the number of people who lose their lives added with the number of years they suffer from the disease, weighted by the severity of the disease) What is the at-risk group? The at-risk group is composed of people who suffer from the psychological problem and or people that cause the psychological problem. The at-risk group may consist of an entire population or a certain group that is relatively more involved with the psychological problem than others are. The prevalence of specific problems can be linked to specific characteristics of a group. There may be a complete separation of groups. A certain group of individuals will relatively more likely be involved in a specific problem than another group of individuals. The difference between groups can be expressed in different degrees of association, such as relative risk. An at risk group can be described on the basis of various characteristics by using statistical data such as: ▪ Demographic data: gender, (socio) economic status, age ▪ Geographic data: residential (country, province, urban, rural,…) ▪ Culture: ethnicity ▪ Personality traits: the big five personality traits, sexual preference ▪ Genetic factors: predisposition for specific disorders 🡺 Based on these various characteristics, a description can be made of the group who is most at risk to becoming involved with a problem or a certain behaviour. What is the target group? The target group consists of those individuals that the intervention is focused on and who have to change their behaviour in order to solve the psychological problem. Influencing the behaviour of the target group will also impact the behaviour of the at risk group. Another major advantage of the active involvement of the target group and the at risk group is that the connection between the acceptance of an intervention and the willingness to change behaviour is strengthened. 🡺 A problem statement is a description of the psychological problem that has to be solved, preferable in one sentence. A properly written problem statement includes a description of the psychological problem, the target group and the consequences of the problem. STEP 2: Behavioural analysis Systematic psychological design aims to influence human behaviour by developing interventions. The aim of an intervention is to change an undesired behaviour. Human behaviour is observable and can always be described. The goal of the ASCE model is to solve a psychological problem. An analysis of the undesired behaviour and the desired behaviour is required to achieve this behavioural change. The behavioural analysis is based on academic literature to give body to the behavioural analysis and to substantiate your design choices. The behavioural analysis consists of three components: a. Problem behaviour of the at risk group b. Influence of the environment c. Behaviour of the target group Problem behaviour of the at risk group Some undesirable behaviour may contribute negatively to a psychological problem, while other, desirable, behaviours may mitigate the problem. The behaviours of the at risk group must be carefully examined to be able to determine what the behaviours should be that the intervention targets. At risk groups often show a range of undesired behaviour. Several undesirable behaviours may generally play a role in a problem. Even in case of the problem behaviour itself is a specific, observable behaviour, distinctive sub behaviours that contribute to the problem to a greater or lesser extent need to be mapped out in the analysis of the behaviour. In analyzing the behaviour of the at risk group it is important to describe the behaviour and various sub behaviours as accurately in order to explicitly focus the intervention on the change of the relevant undesirable behaviour. Influence of the environment The problem behaviour of the at risk group will be established in interaction with the social and physical environment of these individuals. We must pay attention to the social, physical, economic and political environment. Social environment Family and friends are nearest to the individuals in the at risk group. Physical environment The immediate physical environment can affect the behaviour of the at risk group. Factors in the physical environment of individuals at risk may both play a role in the occurrence of the problem behaviour and in the maintenance of that behaviour. Economic environment Economic factors can be seen as an influence of the environment. The income of the individuals from the at risk group, the availability of resources, and the financial costs of problem behaviour may be important. Political environment The political environment may also play a role in problem behaviour. Municipal or national laws can encourage a particular, undesirable, behaviour. Determining the target group of the intervention The target group of the intervention can be determined once the at risk group, their behaviour and environment has been established. The aim of the intervention is to change the behaviour of the target group. Therefore, the development of intervention will be focussed on the target group. Since the ultimate aim of the intervention is to change the undesirable behaviour of the at risk group, the intervention usually focuses on the at risk group. In most cases the at risk group is the same as the target group. Sometimes it is advisable to target a different group than the at risk group in the intervention. Since the at risk group cannot be directly addresses through an intervention. Exploration of the social environment may identify other individuals to which the intervention could be addressed because these individuals influence the behaviour of the at risk group. I case the at risk group and the target group are different, the aim of the intervention will be to change the behaviour of the target group in such a way that ultimately a change in the behaviour of the at risk group will occur. The current behaviour of the target group contributes to the undesirable behaviour of the at risk group and hence to the problem. The behaviour of the target group is therefore undesirable as well. Determining the desired behaviours of the target group The aim of an intervention is to change the undesirable behaviour of the target group into desirable behaviour. After the behavioural analysis, possible solutions to the problem can be formulated by determining the desired behaviours of the target group. To be able to correctly describe the behavioural objectives, the undesired behaviour of the target group has to be ‘rewritten’ into desired behaviour. Based on academic literature, the undesired behaviour can be formulated, whereas the desired behaviour is to contrary of the undesired behaviour. Determining the intervention objective. The intervention objective explicitly described how the situation should be, when the problem is resolved. To be able to determine whether all goals have been achieved by the intervention program, the intervention objectives should be described in specific and measurable terms. A time constraint and a percentage have been added to the proposed intervention objectives.  Chapter 3: Analysis of Behavioural Determinants Introduction The aim of an intervention is to influence the behaviour of the target group. A careful analysis will have to be made of the undesirable, risky, behaviour of the target group. The undesirable behaviour will need to be changed in order to achieve a solution of the problem  The intervention needs to focus on the causes of the behaviour and these causes are usually denoted as the determinants of behaviour. Determinants are cognitive factors that underline (problem) behaviour o Exists in peoples mind o What causes the behaviour? o What promotes the behaviour? Determinants of behaviour The undesirable, risky, behaviour may be caused by various psychological factors. Individuals may have conscious, well known reasons for their behaviour. Individuals may be less aware of the factors that play a role for their behaviour. An analysis of the determinants of the behaviour may provide an intervention designer with clued on how to develop interventions. Unconscious factors may also influence human behaviour. Not all factors are related to it can be changed by psychological interventions. Explaining behaviour Behaviourism focused on the study of animal behaviour, which is determined by stimuli in the immediate environment. This aspect lead to the development of the model of classical conditioning (the first scientific model to explain human behaviour). ▪ A certain event induces a specific reaction. The principle of classical conditioning was applicable to human behaviour too. People unconsciously learn certain automatic behaviours and habits and they are performed in response of certain stimuli. The Theory of Operant Conditioning: rewarding the behaviour increases the frequency of behaviour. A change in the environment of a person leads to a change in human behaviour. More complex behaviours are learned through a process, called ‘shaping’, which means that the behaviour is learned through a number of intermediate steps. ▪ How do individuals develop automatic behavioural responses in reaction to environmental factors? o Individuals can be influenced by environmental factors that they are not aware of (subliminal perception) Intervention designers usually focus on the role of conscious cognitive processes. The role of conscious processes in the shaping of human behaviour originates from cognitivism (which focuses on the conscious thought processes that play a role in behaviour). ▪ An event in the environment does not automatically evoke behaviour, but the relation between environment and behaviour is mediated by thoughts. ▪ Social learning theory: individuals can learn behaviour by observing the behaviour of other individuals. Cognitive determinants of behaviour Human behaviour is shaped by the beliefs that individuals have about events in their environment. Individuals make a responded decision to behave in a certain way. In fact, behaviour is primarily related to individual thoughts and beliefs, and not to external, environmental, cues. The ABC- model was developed within health psychology and was directly related to the development of a therapy that was able to induce behavioural change. ▪ Activating events activate beliefs in individuals, which lead the specific consequences. Individuals have specific thoughts about an activating event, before they react with specific emotions and specific behaviour. The relation-emotion therapy focuses on cognitions and behaviours. The aim of it is to replace irrational beliefs by rational beliefs. More recent models assume that people make more or less conscious decisions to perform certain behaviour. Behavioural change can also be achieved by influencing this process of decision making. Individuals make conscious, individual tradeoffs, between the advantages and disadvantages of certain behaviour. Individuals also male an estimation to what extent they think that they are able to perform the behaviour successfully. Health Belief Model According to this model, individuals will only change their behaviour when they realize that their behaviour may have serious negative consequences and when they realize that there is a substantial possibility that these consequences may affect them personally. Protection Motivation Theory It states that two cognitive processes play a role when people are confronted with a situation. 1. People make an appraisal of the threatening situation. 2. The perceived capabilities to cope with the problem, which are determined by the expectation that a desired behaviour will effectively reduce the problem). Not in all cases, people will be able to effectively cope with a problem. Social Cognitive Theory It is based on the theory of observational learning. The expectation of individuals about the consequences of a specific behaviour play an important role in the performance of that behaviour. The consequences refer to the consequences for the individual; also refer to the consequences in the social environment. Important factor: the perceived capability of the individual to execute the behaviour successfully (self-efficacy). Behaviour is shaped in a process of social interaction with the environment. Individuals learn specific behaviour by merely imitating the behaviour of other individuals. Theory of Planned Behaviour It assumes that individuals use personal subjective deliberation what in the decision to perform specific behaviours (this theory cannot be applied to health behaviours). During the problem analysis, the intervention designer makes a list of the most important cognitive determinants. Based on this list, the designer use a specific cognitive theory that is most suitable for the development of a specific intervention. ▪ Specific determinants of behaviour in a specific model are more or less equal to the cognitive determinants of another cognitive model. ▪ The feeling that a specific behaviour cannot be performed successfully can be conceptualized as the determinant self-efficacy. ▪ This theory assumes that individuals make more or less conscious decisions, that determine their behaviour. Based on external cues (previous experiences and direct cues from the environment) individuals develop an intention to perform certain behaviours. These external cues shape behaviour by contributing to the development of various cognitive determinants. ▪ The intention to perform a behaviour is the most important and direct determinant of that behaviour. Three cognitive determinants influence the development of the behavioural intention: attitude, subjective norm and perceived behavioural control. This theory is used to understand which cognitive determinants play a crucial role in the development and persistence of the undesired problem behaviour. Solution: extend the theory of planned behaviour Add extra determinants Select determinants that can be changed Select important determinants Proximal and distal determinants of behaviour Three types of determinants: Proximal Determinants o Determinants with a direct influence on behaviour are called proximal determinants (attitude, perception of risk, perceived severity, perceived vulnerability, self-efficacy, perceived behavioural control, perceived benefits or advantages of behaviour, perceived disadvantages of behaviour and the perceived opinion of the social environment on a specific behaviour) Distal Determinants o The indirect determinants are called distal determinants. o These determinants have a direct influence on proximal determinants and indirectly influence behaviour. An intervention primarily needs to focus on enhancing perceived vulnerability by making individuals realize that they themselves can also be affected by the risks of the harmful behaviour.  Ultimate Determinants o Ultimate determinants are determinants that in general are assumed to be unchangeable (broader social and cultural surroundings). The influence of these determinants is often small. Attitude, subjective norm and perceived behavioural control. (The Theory of Planned Behaviour) Important proximal determinants are attitude, subjective norm and perceived behavioural control. ▪ Attitude is the state of mind of individuals to objects and behaviours. Attitudes are primarily shaped by personal experiences of individuals in the past. They can vary on two dimensions: 1. Attitudes can differ in strength. 2. Attitudes can vary in valence (very positive – very negative) Attitudes are more strongly related to behaviour when they are more extreme in valence and have a higher strength. They can be related to various type of objects (abstract objects, real objects, the object can be the self, other individuals, or social groups). ▪ Subjective norm represents the perceived social pressure from other important individuals in the social environment (referents or referent groups). Subjective norm is related to normative beliefs (the perceived opinion of other individuals on specific objects and behaviours) and to motivation to comply these normative beliefs 1. It represents a subjective perception of the opinion of other important individuals in the social environment 2. The motivation to comply to these social norms is also important. 3. Individuals may be inclined not to comply with the opinion of important others. ▪ Perceived behavioural control is the subjective estimation of individuals of the difficulty to perform a behaviour and varies on a continuum with the extremes “very easy to perform” to “very difficult to perform”. Individuals take into account the personal capacities to successfully perform the behaviour and the perceived level of control over the behaviour. A high level of perceived control is especially important in the case of behavioural change. Accountability: investigating determinants of behaviour The core activity analysis focuses on the determination of the determinants of the desired behaviour. By investigating why individuals do not perform the desired behaviour, an intervention designer can discover on which beliefs an intervention needs to focus in order to be able to change the behaviour of these individuals in the desired direction. ▪ An intervention designer may be confronted with a new type of problem behaviour and the scientific literate may not provide any information on the cognitive determinants of this specific problem behaviour. For the design of an effective intervention, it is important to investigate all  possible cognitive determinants of the behaviour and to make sure that important determinants are not missed. After the analysis of the behavioural determinants, the core activity Analysis of the ASCE model has been completed.  Chapter 4: Synthesis, defining the goals of an intervention Introduction The core activity Synthesis is about: formulating the goals of an intervention Within the ASCE Model three types of goals or objectives are discerned: ▪ The intervention objective (formulated during the core activity Analysis) ▪ The behavioural objective (describes desired behaviour in terms of concrete observable behaviour 🡪 what should the target group do?) ▪ The change objective (based on cognitive determinants; what an individual has to learn or change in order to achieve the behavioural objective) Preparation before formulation of behavioural objectives ▪ It is recommended to adjust the target group and to select the most important and influential desired behaviours and determinants. ▪ In case of substantial differences between subgroups within the target group, it is may necessary to select one of these subgroups as a target group. ▪ Or, it can be decided to address different subgroups separately and to develop a full intervention program for each subgroup. ▪ The underlying determinants of a certain problem behaviour may also differ between subgroups. ▪ The consultation of academic literature may lead to a revision of design choices made during the core activity Analysis ▪ Groups may also be divided on the grounds of other background characteristics such as age, cultural background or existing readiness for personal or organizational change The Transtheoretical Model: o individuals may vary in stages of change preparation o When individuals are already willing to change, they will have a different attitude towards the behavioural change than when they have never even considered that their behaviour might be the cause of the problem. Individuals in active positions will be more ready to change their behaviour than people in more passive jobs. o Sometimes it is recommendable to expand the target group or to include groups from multiple ecological levels around the at-risk group in the program. The selected target group may also have to be expanded. The choice of the target groups needs to be reconsidered at this moment, and a definite target group has to be defined, to increase the chances that the intervention will have the intended results. For the final selection of the target group, a trade-off will have to be made between the costs and efficiency of creating multiple sub-groups and the expected effects of a program when the target group has been too broadly defined. The most important and changeable behaviours have to be selected 🡪 these desirable behaviours are rephrased into behavioural objectives ▪ The circle of accountability plays a central role in this process ▪ In order to know which behaviours are important, it is necessary to gather as much information as possible from reliable sources in order to determine the appropriate target behaviours. ▪ Sometimes it is possible to find interventions designed for problems that are similar in some aspects to the problem at hand ▪ Otherwise, a new intervention has to be designed → in short: 1. Select target group 2. Select most important and changeable behaviours → behavioural objectives 3. Consider determinants of these behaviours Phrasing of the behavioural objective: SMART ▪ Intervention design will be based on the behavioural objectives 🡪 phrase the behavioural objectives as clear as possible ▪ In the behavioural objectives, the desired behaviour is describes in a statement of what the behaviour would look like in an ideal situation. (🡪 what does the target group need to do?) ▪ Desired behaviour has to be described in terms of active verbs and concrete observable desired behaviour. ▪ The ability to evaluate whether the objectives have been achieved within a reasonable period of time after the implementation of the intervention, the definition should meet with SMART requirements: 1. Specific: a description of the ideal behavioural outcome of the intervention in terms of observable behaviours. This is a clear instruction based on active verbs and concrete observable behaviour.  2. Measurable: it should be possible to measure how much the problem situation has changed due to the intervention. The optimal percentage cannot be found in literature, but should be based on realistic estimations of the intervention designer. 3. Acceptable: all members of the linking group should be convinced that it makes sense to direct an intervention towards the achievement of these goals. The linkage group needs to be actively involved in the process of defining the goals of the intervention, and all members should have a valid contribution in making the right choices during the design process. 4. Realistic: we assume that the behavioural objectives contribute to the achievement of the intervention objective, and any positive changes in the undesirable behaviour need to be substantial to eventually achieve an improvement in quality of life. 🡪 is the objective feasible? 5. Timely: Timely means stating a time frame for the measurement of the possible achievement of the behavioural objective 🡪 when do we expect the change? Essential are the performance criteria of behavioural objectives, because they become apparent when evaluating the intervention. Formulating of objectives according to the SMART acronym are also very important for the core activity Evaluation of the ASCE model. Schematic representation of change objectives Change objectives describe what the target group has to learn or change based on the determinants in order to achieve the behavioural objective (learning objectives). Change objectives serve as a basis for the further development and design process. A schematic representation is a tool to formulate change objectives in the form of a table. Change objectives are a combination of behavioural objectives and determinants. A schematic representation contains four ingredients: o the target group o behavioural objectives o determinants o change objectives The schematic representation enables to systematically select the most important and influential determinants for specific behaviours. Target group Determinants Attitude Subjective Norm perceived behavioural control  Behavioural objectives Change objectives Phrasing the change objectives It is necessary to know as precisely as possible what the changes are that the intervention program aims for. It is desired to be able to measure the results. Explain how to consider the beliefs underlying the determinants in the selection of important change objectives for specific behaviours. Determine the necessary changes in attitude, subjective norm or perceived behavioural control in order to achieve the behavioural objectives. Attitude The individuals in the target group need to have a positive attitude towards the desired behaviour and behavioural objective. The underlying beliefs that determine the weighing of the perceived advantages and disadvantages of the desired behaviour will have to be investigated. The knowledge is a prerequisite for change objectives concerning attitude. The cognitive component is very important in the attitude determinant. Affective component: positive or negative feelings about a certain behaviour Behavioural component: habits, automatisms, stereotypes, previous experiences (demonstrates a willingness to…) Cognitive component: knowledge, opinion, schemata (can explain why it is important to…, can name advantages of…,) Emotional component (gives a positive rating to…, is positive about…, thinks it is fun to…,) Subjective norm All people are members of several different social groups. This may be groups with they strongly identify themselves (family or sport clubs), but even more or less randomly formed groups influence behaviour and the way decisions are made, as has often been demonstrated in experiments. ▪ What people think others expect them to do (perceived social pressure or support) ▪ Social norms can have a positive or a negative influence on a person’s intention to perform a certain behaviour. ▪ The subjective norm is determined by a person’s internal motivation to comply to the perceived expectations of others. Examples: Social Norm: ❖ Knows that others think that it is OK/normal to…. ❖ Have the idea that others expect them to ❖ Feel capable of asking for help when they Motivation to comply: ❖ Dare to go against prevailing beliefs and… ❖ Think that others expect them to perform the undesirable behaviour, but respond wisely and… Perceived behavioural control Individuals must have a feeling of control over the performance of that behaviour. Beliefs underlying the perceived behavioural control are estimates of the difficulty of performance and control over the expected behaviour, and estimated of the available skills for the performance of that behaviour. The perceived behavioural control is a subjective idea. Members of the target group can feel they are incapable of performing the desired behaviour. Examples: ❖ Feel capable of ❖ Have the idea that they can ❖ Trust their ability to ❖ Have the feeling they have the necessary skills to handle the situation and to Checking prerequisites for the intervention in the environment Sometimes it can be necessary to make some changes in the environment to enable or support a change in the behaviour of the target group. These environmental changes can be seen as prerequisite, or requirements, for the achievement of the behavioural objectives. Schematic representation and the systematic ASCE model Prescribed change in determinants → change of behaviour → achievement of the intervention objective → solving the problem The systematic character of the ASCE model can be found when defining goals: The intervention objective can be formulated on basis of the step problem analysis the behavioural objective on basis of the behavioural analysis the change objective on basis of the analysis of determinants Thus, the core activities Analysis and Synthesis are interconnected within the ASCE model.  Chapter 5: Synthesis: Methods and strategies Introduction Change objectives in the schematic representation are the most detailed goals, which can be used as a basis for further development of the intervention In order to achieve the realization of the formulated goals, it is important to develop the appropriate content of the intervention (knowledge from psychology on how to influence behaviour will be necessary). The formulated change objectives do make it clear in which direction the determinants have to be changed in order to achieve the desired behavioural change. Specific methods (methods of an intervention) are used in order to influence specific psychological processes that are related to behavioural change. Intervention designers need to formulate a specific strategy in order to make the chosen methods tangible. The development of interventions Mostly, interventions focus on directly changing human behaviour. (in many cases this is not effective) The analysis of behavioural determinants should not only identify individual motives but also genetic factors and the factors of the environment. A systematic approach is applied in the development of an intervention 🡪 Change objective are carefully formulated and the methods that will be used in the intervention are carefully chosen. Methods and strategies In order to be able to change their behaviour, individuals will have to learn something. The change objectives formulate in more details what individuals will have to learn. The required learning process is describes in the method of intervention The technical realization of the method is called the strategy of the intervention. After formulating the change objectives 🡪 Formulation of the intervention methods and practical strategies to realize the change objectives. ▪ Intervention method = a general technique or process for influencing changes in the determinants of behaviours and environmental conditions ▪ Practical strategy = a specific technique for the application of theoretical methods in ways that fit with the intervention population and the context in which the intervention will be conducted Methods A method is a theoretically based idea on how a change in behavioural determinants or environmental conditions can be achieved. A method describes which psychological mechanisms play an important role in changing human behaviour. Intervention methods refer to processes that are able to change the way that individuals feel, their way of thinking and the processes that underlie decision making The optimal choice of intervention methods should be based on the nature of the change objectives. Central in the optimal choice of the intervention method is the question: How can individuals optimally be learned to change their motivation and beliefs? Examples of methods are: to inform, to persuade, to confront,…) On an abstract level, a method describes which psychological mechanism needs to be used to achieve the desired change objective. Characteristics of the target group, the contexts of the intervention, economic and financial limiting condition play an important role in the optimal choice of intervention methods. A method: ▪ Consists of a psychological working mechanism to achieve a change of behaviour ▪ Is more abstract Strategies A strategy is the practical application of a method.  A strategy takes the characteristics of the target group and the context of the intervention into account 🡪 The choice of the appropriate strategy depends on the target group and the context A strategy is the operationalization of a method and the choice of a specific strategy determines the global characteristics of an intervention. The choice of the appropriate strategy depends on the target group and the context. Example for strategies are: television commercials, websites, workshops, etc.. A strategy: ▪ Is adjusted and tuned to the target group and the environment of the target group ▪ Is practical and tangible How to choose a method for an intervention A method contains a psychological working mechanism that is able to change behaviour. The use of psychological scientific literature on behavioural change is important to identify and select appropriate methods that can optimally contribute to achieving the change objective. We first need to consider whether it is necessary to educate the target group about the problem and the changes in behaviour that are required to solve the problem. ▪ A schematic representation of the change objective: The change objectives are closely related to required changes in cognitive determinants. Based on the type of change objectives, the intervention designer can select the most appropriate methods and strategies. The most appropriate methods can be identified in three ways: ▪ General methods ▪ Methods for achieving changes in determinants ▪ Methods according to learning theories and other theories about behavioural change Basic general methods A number of basic general methods educate individuals in the target group about the problem and about the required changes in behaviour: ▪ Informing (learning theories and information Processing theories): ⮚ Individuals have to learn the presented information ⮚ Individuals have a limited capacity for the processing of information ▪ Active learning (elaboration likelihood model of persuasion): ⮚ Individuals should think actively about the presented information.  ⮚ Presentation of information in a new and unusual way ⮚ Presentation of an unexpected messages ⮚ Explicit, personal requests to improve attention ▪ Persuasive communication (Elaboration Likelihood Model of Persuasion): ⮚ The message must be relevant ⮚ Surprising content and repeating message ▪ Feedback (Learning Theories, Goal-related Theories): ⮚ Feedback should be individualized ▪ Reinforcement (Operant Conditioning, Social Cognitive Theory): ⮚ The reinforcement of desired behaviour should be individualized ▪ Facilitating (Social Cognitive Theory): ⮚ The environment should be adapted to support the change of behaviour ▪ Individualisation (Transtheoretical Model, Precaution Adoption Process Model): ⮚ The provided information should be relevant for the factors or determinants ▪ Tailoring (Elaboration Likelihood Model of Persuasion, Transtheoretical Model): ⮚ The information is adapted to the characteristics of the participants ⮚ The information is adapted to the specific stage of change of the individual The Elaboration Likelihood Model of Persuasion = individuals can process information in two ways: 1. In the peripheral role of information processing, individuals pay little attention to the content of the message but individuals focus more on the superficial characteristics of the message (individuals form a global impression about the message) 2. In the central route of information processing, individuals pay much attention to the content of the message and process the message carefully (elaboration) Changing cognitive determinants The change objectives indicate the required change in cognitive determinants. in literature, much information is available about the cognitive determinants of specific desired behaviours.  For the final choice of one or more methods, the nature of the change objectives needs to be taken into account. Methods suitable for changing attitudes Two approaches can be followed to change the attitude of individuals to a specific behaviour: 1. The existing negative attitude to a specific behaviour can be undermined 2. The beliefs that contribute to a more positive attitude can be strengthened To change the cognitive aspect of attitudes, primarily basic general methods for behavioural change can be used. The goal of all methods is to achieve a stable positive attitude to the desired behaviour. Methods suitable for changing attitudes: ▪ Shift of focus (Health Belief Model, Protection Motivation Theory): ⮚ To shift focus in order to make individuals perceive their behaviour from the viewpoint of other individuals ▪ Providing arguments (Elaboration Likelihood Model of Persuasion): ⮚ The argument should be new for the target group ▪ Discussion (Information Processing Theories): ⮚ Individuals have to listen and discuss with other individuals to make sure that they use the correct way of thinking ▪ Repeating the message (Information Processing Theories): ⮚ Each repeat of the message contains new evidence or arguments ▪ Self-evaluation (Social Cognitive Theory, Self-regulated learning) ⮚ Enhance the cognitive and emotional components of the image of the self ▪ Formulating goals (Cognitive Behavioural Therapy): ⮚ Feel committed to the formulated goals (challenging and achievable) ▪ Anticipated regret (Theory of Planned Behaviour): ⮚ The idea that individuals will have feelings of regret when they fail to perform the desired behaviour ▪ Confronting with inconsistencies (Cognitive Dissonance Theory): ⮚ Reduce cognitive dissonance by adapting their attitudes or behaviours ▪ Providing Scenario Information (Precaution Adoption Process Model):  ⮚ Individuals should be confronted with a plausible scenario, that contains the causes and outcomes of the behaviour ▪ Fear appeal (Protection Motivation Theory): ⮚ The message should appeal to individuals and they should be convinced that the provided behavioural advises are effective and that they are able to perform them ▪ Reconsidering of advantages and disadvantages (Theory of Planned Behaviour): ⮚ The balance between advantages and disadvantages should shift to the positive side Methods suitable for changing subjective norms To change subjective norms, a number of basic methods are available. When individuals are not aware or have incorrect ideas, information can be provided on the correct opinion of the social environment on specific behaviours. Subjective norm consists of two components: 1. The perceived social norm about the appropriate behaviour 2. The motivation to comply to this social norm When individuals from the target group observe relevant others who do not get any negative comments or are praised for performing the behaviour, this may lead to a positive change in perceived social norm toward the desired behaviour. Methods suitable for changing subjective norms: ▪ Shift of focus (Health Belief Model, Protection Motivation Theory): ⮚ To shift focus in order to make individuals perceive their behaviour from the viewpoint of other individuals ▪ Social Comparison (Social Comparison Theory): ⮚ Individuals base their image of the self on social comparison with other individuals ▪ Encouraging communication (Transtheoretical Model, Social Theories): ⮚ Individuals and developers of an intervention should be able to communicate is an unbiased way and like equals ▪ Correcting errors (Theory of Planned behaviour): ⮚ Individuals have incorrect ideas about the social norms of other individuals ⮚ Some individuals think that all others perform the undesirable behaviour ⮚ Individuals think that they are the only ones to perform the desired behaviour ▪ Model learning (Social Cognitive Theory):  ⮚ The role model should match the individuals in the target group, the observing individuals must identify with the role model ▪ External reward (Social Cognitive Theory): ⮚ When individuals observe that the desired behaviour is rewarded, they will become motivated to imitate the behaviour ⮚ Individuals will be more inclined to imitate behaviour, when a role model praises himself or herself for the achievement ▪ Encouraging resistance to social pressure (Social Cognitive Theory): ⮚ Individuals learn to say no to social pressure ▪ Strengthening assertiveness and defensibility (Structured Learning Therapy): ⮚ The desired behaviour is shown and practiced in role plays ▪ Mobilising social support: ⮚ Appealing to existing social networks or building new social networks Methods suitable for changing perceived behavioural control Perceived behavioural control is the perception of individuals from the target group about the amount of control of a specific behaviour. It is based upon a number of beliefs about a specific behaviour. Information and education of individuals can be used to change these underlying beliefs about the control of behaviour and can eventually lead to a change in the perceived behavioural control of a specific behaviour. It is advisable to formulate sub goals, that can be achieved more easily and within a shorter time frame. By providing positive feedback on the achievement of sub goals, the motivation to raise the perceived behavioural control can be improved. The goal of these interventions is that individuals have the perception that they can control the desired behaviour and that this raise of perceived behavioural control is stable, so that the individuals will continue to perform the desired behaviour in the future. Methods suitable for changing perceived behavioural control: ▪ Reattribution training (Attribution Theory):  ⮚ Individuals have to learn to attribute success internally and to attribute failures externally ▪ Skills training (Social Cognitive Theory): ⮚ Individuals learn by observing others to perform the behaviours, but individuals learn from practicing the behaviour themselves ▪ Training with guidance (Social Cognitive Theory): ⮚ Individuals practice the desired behaviour with guidance from an experienced guide ▪ Model learning with guidance (Social Cognitive Theory): ⮚ Modelling with guided enactment (messa in atto) ▪ Formulating sub goals (Goal setting theory, Control Theory): ⮚ Complex desired behaviour with multiple goals is divided into a number of sub goals ▪ Learning with feedback (Goal setting theory, Control Theory): ⮚ The feedback should be provided immediately after the performance of the behaviour ▪ Changing habits by taking advantage of changes in the environment: ⮚ Many habits are triggered by cues in the environment. They can be broken when individuals are confronted with changes in their environment or their life style Theories about behavioural change Theories about behavioural change can be used to investigate the optimal approach to behavioural change. Social Cognitive Theory: individuals can learn new desired behaviours by merely observing other individuals that perform the behaviour. Model learning is an important method for behavioural change. ▪ Mode learning (role model) ▪ Facilitating behaviour ▪ Reinforcement Behaviouristic learning theories about classical and operant conditioning: ▪ Direct experiences ▪ Repeated exposure ▪ Sensitization  ▪ Conditioning Theory Problem Based Learning (Cognitive learning theory: focuses on conscious behaviour and on the process of learning new things. This theory is based on the zone of proximal development. The next higher level can be reached with a guidance of a teacher. Scaffolding = the initial use of support in the learning process, which is gradually diminished. ▪ Communication ▪ Skills training ▪ Active learning ▪ Feedback Theories about Meta-cognitive skills are also important in acquiring new behaviours (planning, monitoring and evaluating). In order to keep individuals motivated to learn new behaviours, it is important that the meta cognitive skills focus on sub goals, that can be more easily achieved. ▪ Self-evaluation ▪ Self observation ▪ Motive ▪ Informing, active learning ▪ Tailoring Transtheoretical Model of Behavioural Change: the importance of an optimal match between the content of the intervention and the stage of behavioural change. Individual move through a number of cognitive stages while changing their behaviour. Intervention should be optimally matched to the cognitive stage of individuals in the target group. ▪ Type of method depends on stage of change: ▪ (Raise awareness): confronting ▪ (Improve understanding): informing, persuasive communication ▪ (Behavioural change): shifting balance of advantages and disadvantages, model learning, skills training ▪ Accountability It is important to use available knowledge within psychology on how changes in determinants can be achieved.  To make an optimal choice of a theory that can be used in a specific intervention, intervention designers should take into consideration the specific change objectives and the conditions that are important for the implementation of the intervention. The designer need to consider the specific circumstances, in which the intervention will be applied. It is important to communicate the message to individuals in the target group that changing the behaviour is possible and that they are able to do it themselves. To facilitate the correct estimation of the difficulty of changing the behaviour for the target group, it may be useful to divide the behavioural change in a number of steps, which are logical to the target group. Method confronting: intervention designers aim to confront the target group with the consequences of their behaviour with the aim of making them realize that these consequences (fear appeal) may also affect them, when they perform the undesirable behaviour. According to the Extended Parallel Process Model, two psychological processes are important when individuals are confronted with fear appealing information: 1. Threat appraisal, individuals try to estimate the seriousness of the threat and whether it is necessary to worry about the potential dangers of the threat. 2. Coping appraisal, individuals will evaluate whether the solution that is provided in the message will indeed be able to remove the threat When using the method confronting, it is important to evoke a sufficient amount of stress and fear by showing pictures that make clear the negative consequences of undesirable behaviour. It is also necessary to present in the message an effective way to escape the threat by depicting the desired behaviour as effective and rather easily achievable. The optional choice of strategies for an intervention A strategy describes how a method can be applied in practice. Based on a change objective, designers decide which method they will use, and based on the selected method intervention designers make an optimal choice of strategies that will be applied in the intervention. In selecting the optimal method, intervention designers should take into account the background characteristics of the individuals in the target group. In the optimal choice of the strategy, intervention designers will have to consider the specific nature of the change objectives. In many cases, intervention designers will use a mixture of strategies to bring a specific method to practice. According to the method reinforcement individuals will learn a desired behaviour faster, when they are rewarded Examples of suitable strategies after selecting a specific method: ▪ Informing: ⮚ Leaflet, poster  ⮚ Brochure ⮚ Manual, Handbook ⮚ E mail ⮚ Website ▪ Active learning ⮚ Discussion in groups ⮚ Brainstorming ⮚ Quiz ⮚ To fill out answer to questions ⮚ To fill out empty spaces in a text ▪ Persuasion and use of arguments: ⮚ Coaching and individual conversation ⮚ Talk show on television ⮚ Video of a presenter with authority in which new facts are presented ▪ Feedback: ⮚ Performance in front of a public ⮚ Trainer ⮚ Publishing on the company website of the achieved results of each department of a company ▪ Reinforcement: ⮚ Financial rewards ⮚ Mentioning of winners in a magazine ▪ Communicating and discussion: ⮚ Group discussion as part of a workshop ⮚ Interviews and assignments ⮚ Forum on a website ▪ Shifting focus: ⮚ Participating in the daily activities of a social worker  ⮚ DVD with a story on the experiences of a patient ▪ Scenario information: ⮚ Posing targeted questions to individuals on how they would feel after the performance of a specific behaviour. ▪ Self-observation and self-evaluation ⮚ Keeping a logbook of daily food intake ▪ Model learning ⮚ Various types of role models: ▪ Experiential story in a magazine ▪ Peer models television spots ▪ Expert models in magazine article ▪ Celebrities in an advertisement ▪ Interview with a leader with expertise ▪ Scene in a soap series ▪ Formulating goals: ⮚ Making an action plan ▪ Social comparison: ⮚ Interactive website ⮚ Games ⮚ Article ▪ Mobilising social support ⮚ Becoming member of an association ⮚ Forum for patients on a website ▪ Skills training ⮚ Training in simulator / visual environment ⮚ Communication training ⮚ One-to-one on the shop floor ⮚ Specific training for specific behaviours  ⮚ Group lessons ⮚ Role play Accountability and Commitment In the selection of the strategies, intervention designers should take into account the characteristics of the target group, the financial constraints need to be take into consideration, the scale of the intervention can influence the optimal choice of the strategy. It is also important that the members of the linkage group feel comfortable with the selected strategies. To investigate which characteristics of the target group could influence the optimal choice of a strategy, intervention designers can use data from the analysis of the target group, which already describe a number of factors. Before starting the production of the intervention, it is therefore important that the linkage group checks whether the chosen methods and strategies are appropriate for the selected target group. Chapter 6: Construction : Intervention Design Introduction Intervention design is a written detailed outline of the intervention programme.  The strategies that have been selected have to be assembled into one coherent intervention program. Before the program elements are determined, it has to be known what the requirements and possibilities are. In this step, the channels and media have to be chosen which enable the presentation of the final program to the target group. Subsequently, the concrete messages and program materials will have to be selected. The content of the different program elements needs to be specified and finally the different elements will have to be united into a coherent program plan. it is very important to have good knowledge of the target group (various characteristics have to be taken into account in order to improve the attractiveness of the intervention program). Closely aligned with the needs and wants of the target group It has to be considered whether or not additional people need to be involved in the design process. To be able to optimally design materials based on the previous steps, these professionals need to be informed about possible restrictions and the theoretical models underlying the intervention. 🡺 It is essential that individuals in the target group can identify themselves with the elements of the program and the program as a whole. 🡺 The intervention design is a creative process, which is structured by ingredients (blended in the blue print of the intervention) such as: ▪ Scope ~ The range of options in program elements, the total number of elements and the available choices in channels, media and materials determine the scope. The scope also depends on the size of the target group, finances, and the possible constraints and facilitators. o An element can be defined as a combination of similar or identical strategies selected during the core activity synthesis into one overall component o Multiple strategies need to be united in one coherent programme o The different elements need to be connected o This theme may be reflected in visual characteristics (background colours) or textual characteristics (language). ▪ Pretest and pilot test ~ The aim is to measure whether the design of the intervention programme meets the needs and wants of the target group o The feedback can be used to finalize the intervention design; fully adjusted to the target group and increases the chance of a successful implementation o A prestest is the testing of different elements of the intervention program on a small number of individuals o A pilot test is the testing of the entire program to a small number of individuals o Finally, a timeline needs to be developed that displays all the different program elements over time  ▪ Channels and media ~ It has to be decided which channels and media will be used to present the central message of the intervention program to the target group. The use of any specific channel has certain advantages and disadvantages. ▪ Channels: television, written press, internet, or interpersonal contact. ▪ Media can be distinguish within these channels. (siehe Tabelle 6.1 Channels and media that can be used in an intervention) ▪ Materials ~ The design process also includes selecting materials that will give the program its final shape (there is room for creativity). Also a decision needs to be made on the content of the different elements. Factors such as budget, human resources, available time, existing intervention formats, and characteristics of the organization that actually implements the intervention, will limit the options. The preferences of the target group need to be taken into consideration (mostly related to their cultural background). ▪ Cultural considerations ~ Different cultures may prefer the use of different channels for the transfer of information. Cultural characteristics can also play a role when choosing the program materials. Members of the target group have to identify themselves with the intervention. ~ The concept of culture comprises a large range of characteristics that individuals in a certain group may have in common (but also all characteristics that are learned, shared, and transmitted from one generation to the next). Cultural differences can also refer to differences in gender, religious beliefs, political beliefs, etc.. There are five different strategies to make programs and materials more cultural appropriate (cultural sensitivity): ▪ Peripheral strategies: the outward appearance of the program is adapted to the preferences of the target group (surface structure). ▪ Evidential strategies: the epidemiological evidence of the consequences of the undesired behaviour is specified for the target group. ▪ Linguistic strategies: the program and the materials are provided in the dominant or native language of the target group. ▪ Constituent-involving strategies: experience of members of the target group is used for the implementation of the program. ▪ Sociocultural strategies: the program appeals to the target group on the basis of cultural values and characteristics (deep structure) ▪ Message  ~ The aim of the intervention design is not only to develop an intervention that is liked by the target group, but also to design a message and program elements that will be understood and remembered by the individuals of the target group. ~ Modal model of the mind: ▪ A general framework, called the modal model of the mind portrays the mind as containing three types of memory stores: sensory memory, working memory, and long-term memory. ▪ Each type of memory store is characterized by its function, its capacity and its duration ▪ The model specifies a set of control processes: attention, rehearsal, encoding and retrieval. All information enters our memory system through our senses. The sensory memory store includes iconic (visual) and echoic (auditory) memory. When an individual pays attention to the information, the information enters the working memory. Individuals are able to filter information and can be controlled by bottom-up processes Information is only remembered when its stored in long term memory. Information needs to be encoded to enter long-term memory, by building associations with existing memory structures For behavioural change to occur, existing memories and thinking patterns will need to be reconsidered ~ Elaboration Likelihood Model: ▪ behavioural change is only possible when the message is processed along a consciously attended, central route. Individuals will not be motivated to process the message, when the message does not appeal to them. ▪ In that case, the message will only be processed along a peripheral route, using peripheral features as cues for urgency ~ Limited Capacity Model of Motivated Mediated Message Processing ▪ The LCMMMMP makes use of the modal model and the ELM and adds a dimension of motivational processing. People respond to relevant stimuli in the environment by means of an appetitive system or an aversive system (emotional associations). ▪ The looks and feel of the information play an important role in the way a message is processed ▪ Improving message processing: what can be done? ▪ Text coherence is the logical and consistent structure of a text. Topics on a macro-level are presented in a logical order. There is a logical coherence between sentences in every paragraph.  ▪ Texts and pictures integration also make it easier to understand and remember the message. ▪ Highlighting important features in a text means that headings or important pieces of text have different features than the overall text (pop out). ▪ Research has shown that messages become more convincing when they are frames in the right way, delivered by the right person, delivered in a personal story and tailored to the individual knowledge structures of the members of the target group. ~ Message framing: ▪ The LCMMMMP model describes that emotional messages can be processed in different ways depending on their emotional valence. In an intervention program, it would be possible to set as an aim to convey the negative consequences of the undesirable behaviour of the target group (loss-frame). The positive consequences of the desired behaviour could also be stressed to convince individuals (grain-frame) ~ Personal stories: narratives ▪ Make a story personally interesting ▪ Prototypical target group member ▪ Structure of the story (clear beginning, middle and end, and that actions and consequences are connected in a causal chain) ▪ Individuals can be transported into factual or fictional communications, and into written, spoken or visual narratives ~ Communicating the message: endorsers ▪ People who recommend products or services in advertisements are called endorsers. They depend on two factors: the type of endorser (regular consumers, experts, and celebrities) and the type of product (informative, affective, habitual, or pleasure giving). ▪ The Source Credibility Model claims that the degree to which individuals are persuaded by a message depends on the perceived expertise and perceived trustworthiness of the endorser (also depends on the attractiveness of the endorser). ▪ Source Attractiveness Model: the persuasive power is also dependent on the perceived attractiveness of the endorser ~ Increasing personal relevance: tailoring  ▪ Tailoring messages to individuals needs may increase personal relevance and the effectiveness of the message. Any kind of personalization is also called tailoring. Tailoring can also be used to ensure participation of the target group. Intervention design and the ASCE model: Circle of involvement and accountability ▪ Creativity is required when designing the intervention program. ▪ The intervention design is still part of the systematic model. ▪ All design choices have to contribute to the achievement of change objectives, behavioural objectives and the intervention objective. ▪ Strategies should be integrated in the intervention program and the conditions and limitations for using the selected method should be taken into account. ▪ The intervention is properly adjusted to the wants and needs of the target group. ▪ A critical review of the blue print of the coherent intervention plan is necessary to make sure that the plan is in alignment with previous design choices made during the core activities Analysis and Synthesis. Chapter 7 : Construction : Implementation Introduction For the effectiveness of the intervention and the ability to actually solve the problem, a thoughtful and rigorous implementation is required. Several factors can be identified that determine the success of an intervention. o If an intervention is not sufficiently brought to the attention of the individuals in the target group, the designed intervention will fail to be implemented. o It is important that the target group/at risk group participate in the intervention. 🡺 To achieve this, the intervention should be applied in the right way as intended, and as completely as feasible The evaluation of the implementation falls under the accountability ring of the ASCE model. It is also important that the behavioural change sustains. The Diffusion of Innovations Theory by Rogers: the development of an intervention has the aim to convince and persuade the at-risk group and the target group to be involved in the implementation of the main intervention which is intended to change the behaviour of the at-risk group.  The implementation is also part of the involvement ring; all activities that are meant to introduce, implement and sustain and innovation or intervention. The introduction (psychological implementation) needs to convince everyone involved, which means everyone has to be convinced of the usefulness of the intervention to correct the undesirable behaviour or to solve the problem. ▪ Sufficient attention needs to be given to the organizing of the commitment of all stake holders ▪ To ensure that an intervention can successfully change behaviour, it is recommended to gain the interest of the relevant stakeholders, their social environment, administrators and policymakers. This creates a sense of ownership of the problem, and commitment with the designed solution. The acceptance of the intervention as a possible solution to the problem will proceed along a natural path. The implementation (technical implementation) = actual application of the solution in practice must be conducted in such a way that the principles and goals of the solution are maintained. The intervention must be understandable to the target group and the at-risk group. The instructions of the designers should also be followed, or to be followed by the target group and the at-risk group. The sustained implementation It is necessary that the effect of the intervention lasts longer than its immediate implementation. Setting up an effective implementation requires a number of steps and activities. A successful implementation depends upon a carefully planned dissemination, adoption of the solution, implementation, and sustainability of its effects. Diffusion of Innovations Theory The theory seeks to explain how innovations are taken up, accepted, and sustained in a group of individuals. An innovation is an idea, a behaviour, or an object that is perceived as new by the individuals in a group. Diffusion of Innovations sees change as being primarily about the evolution or “reinvention” of products and behaviours. Interventions will be successful, if they provide better solutions for the needs of individual groups and individuals. Not individuals change, but the innovation themselves. Five qualities are recognized in the Diffusion of Innovations Theory that determine the success of an intervention: 1. Relative advantage: it is the degree to which an innovation is perceived as better than the idea it supersedes by a particular group of users, measured in terms that matter to those users, like quality of life economic advantage, social prestige, convenience, or satisfaction. It depends on the particular perceptions and needs of the target group. 2. Compatibility with existing values and practices: this is the degree to which an innovation is perceived as being consistent with the values, past experiences, and needs of potential adopters in the target group or at-risk group. The concept of ownership is related to this compatibility. To  increase the probability of adoption, the innovation must address an issue that adopters or others perceive to be a problem. 3. Simplicity and ease of use: this is the degree to which an innovation is perceived as difficult to understand, to use, and to comply. 4. Triability: this is the degree to which an innovation can be experimented with on a limited basis. 5. Observable results: the easier it is for individuals to see the results of an innovation, the more likely they are to adopt it. Visible results decrease uncertainty. 🡺 These five qualities make a valuable checklist to frame focus group discussions or project evaluations. They can help to identify weaknesses to be addressed when improving products or behaviours. Two additional principles are additionally important in the diffusion of an innovation. Reinvention = the success of an intervention depends on how well it evolves to meet the needs of more and more demanding and risk-averse individuals in a population. The concept of reinvention is important because it tells us that no product or process can rest on its laurels: continuous improvement is the key to spreading an innovation. The active involvement of adopters in the design of an intervention is intended to change behaviour is important for being successful. Through the active involvement they feel a kind of ownership. The importance of peer-peer conversation and peer networks. Peer Conversations spread adoption. It is usually only people we personally know and trust who can give us credible reassurances that our attempts to change will not result in embarrassment, humiliation, financial loss or wasted time. The process for acceptance of new products and behaviours has four distinct stages: 1. Dissemination: individuals can be informed about the innovation by various information channels 2. Adoption: individuals should know of the existence of the product/behaviour, know they need something new 3. Implementation: individuals need to try the behaviour or product and give it a chance 4. Continuation: individuals should sustain the behaviour The introduction of an innovation should take into account both the characteristics of the adopter, and the characteristics of the behaviour or product. There are five types of adopters: 1. Innovators = individuals who are entrepreneurial, curious, and like trying new things. The adoption process begins with a tiny numb