Creating an Intervention Planning Table
The early stages of applying the Person-Based Approach involve seeking to gain an in-depth understanding of user perspectives and key context-specific behavioural issues around the target behaviour(s) and potential intervention elements.
This may involve:
- Discussions with PPI representatives who are members of the target user group, and with other stakeholders (e.g. practitioners, providers, policy-makers, community groups)
- Exploring, reviewing or synthesising the relevant empirical literature (especially mixed methods and qualitative studies)
- Identifying relevant theories and models
- Primary qualitative research into user needs, views and experiences
An Intervention Planning Table (see example below) allows the development team to collate these sources of evidence and ideas. Benefits are that it can be used to:
- Provide a structure to support co-creation with colleagues/PPI/stakeholders
- Record the rationale and evidence-base for selecting or designing intervention elements
- Capture any unresolved questions or issues to be followed up
The table is intended as a simple and flexible tool that can be adapted to the needs of a specific intervention. Some useful adaptations are:
- Adding behavioural analysis columns to describe the behaviour change techniques that are included in the intervention
- Adding ranking criteria for guiding decisions about whether and how to include intervention elements. A research team might agree to give highest priority to elements that are required for legal or clinical reasons, second priority to elements that are endorsed by stakeholders and central to the logic model, and lower priority to elements that do not meet these criteria.
Excerpts from Intervention Planning table for the Active Brains digital behaviour change intervention.
This intervention aims to reduce the risk of cognitive decline amongst 60-85 year olds through encouraging: greater engagement with physical activity behaviours, regular participation in ‘brain training’ activities, and healthier eating patterns.
Note: The final four columns of the table (highlighted in red) are an optional part of the intervention planning table. They demonstrate how intervention planning can include mapping of target behaviours, behavioural determinants and possible intervention components onto relevant theoretical frameworks – in this case, the Behaviour Change Wheel (BCW) and Theoretical Domains Framework (TDF).
| Target Behaviour | Barrier/ facilitator to target behaviour | Evidence for barrier/ facilitator/ intervention ingredient | Intervention ingredient | Target construct (BCW) | Key TDF domains relevant |
Intervention function (BCW) | BCT (using 93 BCTs on BCT taxonomy v1) |
|---|---|---|---|---|---|---|---|
| Key behaviour: Initial engagement with Active Brains starter session |
|||||||
| Registering on Active Brains study website | -Low health literacy -Low digital literacy -Busy -Too little time -Forgetting to do it -Privacy and credibility concerns -Access to home computer -Skills in using computer -Desire to maintain healthy cognitive function -Time to engage -Perceived utility of online technology -Interest in study |
Ware, Bartlett (1) – qual. study of older adults’ preferences, interests and concerns re. use of e-health technologies Adams, Stubbs (2) – psychological barriers to internet use Bozoki, Radovanovic (3) – lack of access a barrier O’Connor, Hanlon (4) – factors affecting patient/public engagement with digital health interventions PPI provided various suggestions about wording clarification on recruitment materials |
Targeting user group who may have more time to engage (retired older adults) Persuasive information leaflet highlighting benefits of study Information leaflet and website written in clear simple language to ensure readability (iterated with PPI and users) |
Psychological capability Physical opportunity Reflective motivation |
Knowledge Environmental context and resources Beliefs about capabilities, beliefs about consequences, intentions |
Education Persuasion Enablement |
1.2 Problem Solving 5.1 Information about health consequences 9.1 Credible source |
| Selecting physical activity, reducing sedentary time, strength and balance, brain training, or healthy eating session in Active Brains website |
-Lack of interest in/recognition of importance of behaviour -Negative attitudes towards/perceptions of behaviour -Behaviour not considered important/relevant -Positive outcome expectancy -Interest in/enjoyment of target behaviour -Novelty of activities -Perceived benefits |
van Uffelen, Heesch (5) -people don’t accurately recognise/report sedentary time Chong, Doyle (6), Cox, Flicker (7) – enjoyment of activities important Yardley, Morrison (8) – user preferences for information provision PPI feedback suggested some clarifications needed to navigation of ‘menu’ pages |
Introductory section presents rationale for study and different components Staggered release of modules to allow gradual engagement with content and periodic ‘new’ content Users presented with choice of sessions, with guided advice tailored to mobility Motivational emails highlighting benefits of target behaviours Behavioural facilitation (support arm) |
Psychological capability Physical opportunity Social opportunity |
Knowledge Environmental context and resources Social influences |
Education Enablement Environmental restructuring Modelling Persuasion |
3.1 Social support (unspecified) 5.1 Information about health consequences 5.3 Information about social and environmental consequences 5.6 Information about emotional consequences 7.1 Prompts/cues 9.1 Credible source 15.1 Verbal persuasion about capability |
| Key behaviour: Increased physical activity | |||||||
| Modifying physical environment to encourage breaks from sitting |
-Lack of knowledge about how to implement -Considered too much effort to implement changes -Suggested changes not considered relevant/realistic -Perceived credibility/trustworthiness/ persuasiveness -Ease of making changes -Changes seem achievable/realistic -Perceived benefits |
Gardner, Smith (9) – environmental restructuring (physical and social) an important component of promising interventions to reduce sedentary time PPI feedback on early material question realistic nature of some of the action planning suggestions |
As part of goal setting, users are given information about the value of modifying the physical environment to encourage behaviour change and ideas as to how to do it Action planning offers suggestions of simple and quick ways to do this that users can choose from when setting goals |
Reflective motivation Physical opportunity |
Goals, intentions, beliefs about consequences Environmental context and resources |
Education Environmental restructuring Modelling Persuasion |
1.4 Action Planning 4.1 Instruction on how to perform a behaviour 5.1 Information about health consequences 5.3 Information about social and environmental consequences 5.6 Information about emotional consequences 7.1 Prompts/cues 8.2 Behaviour substitution 8.3 Habit formation 12.1 Restructuring the physical environment 12.2 Restructuring the social environment |
| Key behaviour: Maintained engagement with Active Brains intervention | |||||||
| Completing intervention measures | -Forgetting -Lack of time -Length of measures -Complexity of tasks -Altruism -Perception of benefit -Ease of participation |
Rolstad, Adler (10), Iglesias and Torgerson (11) – evidence about influences on completion of questionnaires PPI reported early draft of follow-up measures being too extensive and time-consuming – decision made to split into small ‘essential’ and larger ‘secondary’ measures |
Intervention measures limited to only essential measures, clearly explained and introduced to users, suitable for target user group Broken into sections to allow completion of ‘essential’ and secondary measures separately Motivational emails to remind users to log into website and give reasons for engagement |
Psychological capability Automatic motivation Physical opportunity |
Memory, attention and decision processes Reinforcement, emotion Environmental context and resources |
Education Enablement Environmental restructuring Persuasion |
3.1 Social support (unspecified) 4.1 Instruction on how to perform a behaviour 5.1 Information about health consequences 7.1 Prompts/cues 9.1 Credible source |
| N.B. The table provides key examples of evidence about behavioural determinants and intended intervention functions but is not an exhaustive record | |||||||
- Ware P, Bartlett SJ, Paré G, Symeonidis I, Tannenbaum C, Bartlett G, et al. Using eHealth Technologies: Interests, Preferences, and Concerns of Older Adults. Interact J Med Res. 2017;6(1):e3.
- Adams N, Stubbs D, Woods V. Psychological barriers to Internet usage among older adults in the UK. Medical informatics and the Internet in medicine. 2005;30(1):3-17.
- Bozoki A, Radovanovic M, Winn B, Heeter C, Anthony JC. Effects of a computer-based cognitive exercise program on age-related cognitive decline. Archives of Gerontology and Geriatrics. 2013;57(1):1-7.
- O’Connor S, Hanlon P, O’Donnell CA, Garcia S, Glanville J, Mair FS. Understanding factors affecting patient and public engagement and recruitment to digital health interventions: a systematic review of qualitative studies. BMC Medical Informatics and Decision Making. 2016;16(1):120.
- van Uffelen JGZ, Heesch KC, Hill RL, Brown WJ. A qualitative study of older adults' responses to sitting-time questions: do we get the information we want? BMC Public Health. 2011;11(1):458.
- Chong TW, Doyle CJ, Cyarto EV, Cox KL, Ellis KA, Ames D, et al. Physical activity program preferences and perspectives of older adults with and without cognitive impairment. Asia‐Pacific Psychiatry. 2014;6(2):179-90.
- Cox KL, Flicker L, Almeida OP, Xiao J, Greenop KR, Hendriks J, et al. The FABS trial: a randomised control trial of the effects of a 6-month physical activity intervention on adherence and long-term physical activity and self-efficacy in older adults with memory complaints. Preventive medicine. 2013;57(6):824-30.
- Yardley L, Morrison LG, Andreou P, Joseph J, Little P. Understanding reactions to an internet-delivered health-care intervention: accommodating user preferences for information provision. BMC Medical Informatics and Decision Making. 2010;10(1):52.
- Gardner B, Smith L, Lorencatto F, Hamer M, Biddle SJH. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults. Health Psychology Review. 2016;10(1):89-112.
- Rolstad S, Adler J, Rydén A. Response Burden and Questionnaire Length: Is Shorter Better? A Review and Meta-analysis. Value in Health. 2011;14(8):1101-8.
- Iglesias C, Torgerson D. Does length of questionnaire matter? A randomised trial of response rates to a mailed questionnaire. Journal of health services research & policy. 2000;5(4):219-21.