Step 2 - Selecting determinants
outcomes for behavior and environment
are not simply the opposite of the "bad" behavior (e.g. unsafe sex)
abstinence, no penetrative sex, condom use, testing STDs & monogamy
e.g. harm reduction strategies for safe MDMA use
everything that's true for behavioral outcomes of target population, also applies to behavioral outcomes of the agents!
example environmental outcome (with
: bar owners provide free condoms in gay bars
parents reduce the child's exposure to asthma triggers
: community members demand that housing associations protect children from falls
: local government creates supportive environments
What does the environmental agent need to do to accomplish the changes in environmental factors?
what do people have to do to perform the health-related behavior?
X does Y
to write performance objectives
review literature (adapt list)
look for underlying theories
validate POs with additional research if necessary
for behavioral & environmental outcomes
determinants should be
awareness & risk perception, knowledge, Impulsive behaviors, attitudes, social influence, skills, self-efficacy, stigma
link with step 3 (methods): systematic reviews, interviews & surveys
, e.g. with attitudes --> use
Target, Action, Context, Time
= Confidence Interval-Based Estimation of Relevance
matrices of change objectives
logic model of change
you should be able to measure whether you are meeting the objectives or not
objectives should specify what they want to achieve
are the objectives you set, achievable and attainable?
can you realistically achieve the obejctives with the resources you have?
When do you want to achieve the set objectives?
Take home messages
use core processes during determinant selection
make use of existing data and/or collect new data
start with systematic reviews, but also use individual studies
combine qualitative & quantitative findings
homogenity within target groups
same goes for agents
hospital AND school support child with asthma (2 different agents, but same behavior)
e.g. principal ensures that contaminants are prevented from entering school building
1 behavioral outcome per agent in the environment
e.g. principal, teacher, school nurses
Who is the target? Who are we going to change?
subpopulations can be distinguished by age, gender, or ethnicity
for practical reasons not advisable to distinguish too many different subgroups
Wrap-up Task 1 (step 2)
healthy behavioral outcomes
healthy behavioral outcomes for environmental agents (e.g. principal)
healthy environmental outcomes
Wrap-up Task 2 (step 2)
use core processes
performance objectives - substeps of behavioral outcomes
what do people have to do to perform behavior?
what does environmental agent need to do to accomplish changes?
What needs to change in the behavioral & environmental factors to have improved health outcomes?