INTERVENTIONS
3.3 APPROACHES FOR GENERATING THEORY OF THE HEALTH PROBLEM
3.3.4 Combined Approach for Understanding the Problem .1 Overview
illustrated in Sidani et al. (2018b) who found that Chinese Canadians experience insomnia as difficulty initiating sleep, which they attribute to high levels of stress.
Strengths
The first step of the integrative strategy for cultural adaptation of interventions has the same advantages as concept mapping. However, its application is less cognitively burdensome.
Limitations
Integration of the quantitative and qualitative data may be challenging.
3.3.3.4 Strengths and Limitations
The experiential approach is a useful means for accessing the implicit theory or con- ceptualization of the health problem held by client populations, in contexts not rep- resented or investigated in previous studies, as is often the case with marginalized groups or ethno-cultural communities (Buffel, 2018). However, this approach has some limitations related to the selection of the target population members and the size of the participating group. These limitations may lead to unrepresentative sample, yielding potentially biased results that may not be applicable to all subgroups of the target population.
3.3.4 Combined Approach for Understanding the Problem
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reviews (e.g. Baker et al., 2018), systematic reviews (e.g. Brendryen et al., 2013), scoping reviews (e.g. Dalager et al., 2019), and narrative reviews (e.g. Athilin- gam et al., 2018; Beck et al., 2018; Besharati et al., 2017).
•
Integration of theoretical and empirical evidence into a comprehensive list of factors contributing to the problem or behavior.•
Engagement of stakeholder groups (e.g. clients, community leaders, health professionals) in events or activities aimed to explore the relevance of the determinants, identified from the literature, to the target client population and context. A range of activities have been used including: individual interviews with stakeholders (e.g. Baker et al., 2018; Beck et al., 2018), focus group discus- sions (e.g. Ammendolia et al., 2016; Besharati et al., 2017), roundtable meet- ings, workshops or nominal group techniques (e.g. Johnson et al., 2017; Meng et al., 2019), to review the determinants for their relevance and/or to prioritize the determinants that should be addressed when designing the intervention.•
Refinement of the theory or logic model of the problem so that it reflects the problem and its determinants, as experienced by the target client population.3.3.4.3 Strengths
Combining the theoretical, empirical, and experiential approaches, as recommended in intervention mapping, provides complementary and supplementary information for developing the theory of the problem and for refining it to enhance its relevance and applicability to the target client population and context.
3.3.4.4 Limitations
The drawback of this combined approach is that it is time consuming and labor intensive.
Regardless of the approach used, the theory of the health problem forms the foundation for designing interventions, as explained in the next chapter.
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Nursing and Health Interventions: Design, Evaluation, and Implementation, Second Edition.
Souraya Sidani and Carrie Jo Braden.
© 2021 John Wiley & Sons Ltd. Published 2021 by John Wiley & Sons Ltd.
C H A P T E R 4
Designing Interventions
Health interventions should be carefully designed or developed to enhance their potentials to successfully address health problems (Moore et al., 2019). This can be achieved by following a systematic process, in which the interventions are grounded in an understanding of the problem and designed to match the manner in which the problem is experienced by the target client population, in the context of interest (Beck et al., 2019; van Meijel et al., 2004). Results of systematic reviews indicate that interventions developed through a systematic and structured process such as intervention mapping are effective in addressing the respective health problem (e.g. Fassier et al., 2019; Garba & Gadanya, 2017; Lamort-Bouché et al., 2018).
In this chapter, the process for designing interventions is described and illus- trated with an example. Approaches for delineating the intervention’s active ingredi- ents are discussed. The intervention design process results in the generation of the theory of implementation and the theory of change that clarifies the intervention components and mechanism of action, respectively.