Page 16 - Preventing pertussis in early infancy - Visser

Chapter 1
Chapter 1
Second, the use of theory is emphasised in the development of successful behavioural change interventions. Theories are useful for the understanding of behaviour and can indicate how determinants might interact among each other or on different context levels (e.g. healthcare worker, team of HCWs, hospital management board, etc.) (Grol et al. 2007, Grol 2013, Davidoff et al. 2015, Bartholomew-Eldredge et al. 2016). They can thereby assist in the identification of a comprehensive set of determinants. Additionally, behavioural change theories can support the switch from determinant to intervention. They do so by indicating which intervention could be successful given a specific determinant, and by providing knowledge on the conditions under which the intervention will be effective (Bartholomew-Eldredge et al. 2016).
This means that for the planning of a pertussis cocooning and selective HCW vaccination programme, it is important to assess the determinants of vaccination acceptance and use this information to systematically build a theory and evidence based intervention.
Intervention Mapping
Intervention Mapping (IM) is a protocol for the design of interventions which systematically guides developers through a series of six steps. The IM protocol facilitates the theory- and evidence-based translation from problem to intervention, while considering different context levels and stimulating participation. Although the step-wise layout suggests otherwise, Bartholomew and colleagues emphasise that the IM process should be iterative and that the findings in the different steps continue to influence each other. The IM steps start off with an assessment of the health problem, including the related behavioural and environmental conditions and a specification of their associated determinants (Step 1, logic model of the problem). Thereafter, programme objectives, performance objectives and change objectives are formulated, specifying who and what will change as a result of the intervention (Step 2, logic model of change). Then, theory-based methods and practical applications matching the determinants and objectives are selected (Step 3, program design) and operationalised into a programme (Step 4, programme production). Finally, a plan is formed for adoption and implementation (Step 5, programme implementation plan) and evaluation of the programme (Step 6, programme evaluation plan). The systematic design of an intervention with IM results in detailed program descriptions, as well as a plan for implementation and evaluation that can easily be used or replicated by others to fine-tune interventions in similar but different contexts. IM has previously proven to be effective in the design of vaccination interventions for Human Papilloma Virus (HPV) and influenza among HCWs in the Netherlands (Looijmans-van den Akker et al. 2011, Pot et al. 2017). Therefore, we chose to use the IM protocol for systematically designing a theory- and evidence based vaccination programme.
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