Defining intervention objectives in stage 2 depends on a precise definition of the
behaviour changes required. These vary across interventions but, for example, in a
sexual health intervention, the design group might consider a series of behaviours that
facilitate successful condom use. For example, discussing condom use with a potential
partner, acquiring condoms (which may depend on price and accessibility), storing
and carrying condoms, negotiating condom use in intimate interactions and correct
use of condoms. This could generate a series of interventions targeting, for example,
accessibility and price, knowledge of correct use, attitudes towards carrying condoms,
normative beliefs about carrying and using condoms correctly and skills in sexual
negotiation and condom handling.
We will illustrate stage 3 of the IM process in more detail later below when we
discuss regulatory processes and the selection of corresponding change techniques. This
stage must be informed by anticipation of practical constraints that are the focus of
stage 4 when selected change techniques are embedded in practical components and
materials that constitute the intervention.
In the fifth stage of IM, implementation planning takes place. This involves
anticipating how the intervention will be used or delivered in everyday contexts. For
example, what are the motivations, skills and resources of those who will deliver the
intervention? Will the recipients like the intervention and be able to engage with it?
Will those meant to deliver the intervention be able to do so? Once developed,
interventions should be piloted to ensure that the intervention is acceptable to the
target population. Co-creation with recipients and those who will deliver the inter -
vention not only facilitates ownership of the intervention, but can highlight practical
challenges that need to be overcome during the design phases. For example, in creating
the Healthy Lifestyles Programme (HeLP), designed to prevent weight gain among
school children (Wyatt et al., 2013), the designers held regular discussions with key
stakeholders, including children, teachers and parents. This ensured that the choice of
change techniques and delivery modes were engaging and sustainable. The final
intervention involved a combination of different approaches including drama
workshops in which children interact with and advise characters such as ‘Snacky Sam’
and ‘Active Amy’. This important design feature might not have been included had
the designers not been closely involved with schools during stage 5.
The final stage is evaluation, which we will also consider in further detail below.
Although listed last, it is critical to anticipate evaluation from the outset. For example,
when the desired behaviour changes are defined in stage 2, designers can address the
challenge of measuring those changes to determine whether or not the intervention
has been effective. For example, how should we measure normative beliefs about
condom carrying and use (see Chapter 7). Similarly, in stage 3, when modifiable regu -
latory processes and change techniques capable of altering them are identified, measures
of process/mechanism change need to be considered.
REGULATORY PROCESSES OPERATING AT DIFFERENT LEVELS
Specifying the target behaviour(s) in stage 2 of intervention mapping is important.
For example, if we wish to increase physical activity to prevent obesity, we would
need to consider which activities, how many times a week, for what duration and
192 MOTIVATION AND BEHAVIOUR