Intervention Mapping Research Articles

Developing a typology of interventions to support doctors’ mental health and wellbeing

BackgroundThe problem of mental ill-health in doctors is complex, accentuated by the COVID-19 pandemic, and impacts on healthcare provision and broader organisational performance. There are many interventions to address the problem but currently no systematic way to categorise them, which makes it hard to describe and compare interventions. As a result, implementation tends to be unfocussed and fall short of the standards developed for implementing complex healthcare interventions. This study aims to develop: 1) a conceptual typology of workplace mental health and wellbeing interventions and 2) a mapping tool to apply the typology within research and practice.MethodsTypology development was based on iterative cycles of analysis of published and in-practice interventions, incorporation of relevant theories and frameworks, and team and stakeholder group discussions.ResultsThe newly developed typology and mapping tool enable interventions to be conceptualised and/or mapped into different categories, for example whether they are designed to be largely preventative (by either improving the workplace or increasing personal resources) or to resolve problems after they have arisen. Interventions may be mapped across more than one category to reflect the nuance and complexity in many mental health and wellbeing interventions. Mapping of interventions indicated that most publications have not clarified their underlying assumptions about what causes outcomes or the theoretical basis for the intervention.ConclusionThe conceptual typology and mapping tool aims to raise the quality of future research and promote clear thinking about the nature and purpose of interventions, In doing so it aims to support future research and practice in planning interventions to improve the mental health and wellbeing of doctors.

Understanding the need and opportunity for a trauma-informed early childhood organisations (TIO) program using intervention mapping

Early Childhood Education and Care (ECEC) services are critical points of intervention for children impacted by trauma. Intervention Mapping was utilised to develop an initiative for trauma-informed organisational change in ECEC. This paper describes how the research team understood the need and opportunity for the program using Intervention Mapping Step 1. This included: (i) convening a planning group, (ii) conducting needs assessment, (iii) describing the context for intervention, and (iv) establishing program goals. Benefits, challenges, and recommendations on using Intervention Mapping for program development in ECEC settings are discussed.

Evidence Map of Non-Pharmacological Dementia Care Partner Interventions Implemented in the US: Gaps and Impact Opportunities.

There are 200+ tested interventions for care partners (family, friends, and fictive kin) of people living with dementia (PLWD). But these interventions do not systematically cover relevant settings. Nor do these interventions affect all relevant outcomes that matter to people and healthcare systems. We present an evidence map of settings and outcomes from translated interventions to identify gaps. Of 190 studies identified, 31 unique interventions were retained in the evidence map. Identified setting gaps included studies set solely in hospitals/medical centers or set in multiple settings. Identified outcome gaps included interventions that improved care partner beliefs about providing care, care partner negative coping strategies, PLWD resources (e.g., social support), and PLWD coping strategies. Armed with an understanding of present gaps, we call on researchers to fill the identified gaps to ensure systematic coverage of settings and evaluation of outcomes that matter to people and healthcare systems.

Integrating ‘undetectable equals untransmittable’ into HIV counselling in South Africa: the development of locally acceptable communication tools using intervention mapping

BackgroundThe global campaign for “Undetectable equals Untransmittable” (U = U) seeks to spread awareness of HIV treatment as prevention, aiming to enhance psychological well-being and diminish stigma. Despite its potential benefits, U = U faces challenges in Sub-Saharan Africa, with low awareness and hesitancy to endorse it. We sought to develop a U = U communications intervention to support HIV counselling in primary healthcare settings in South Africa.MethodsWe used Intervention Mapping (IM), a theory-based framework to develop the “Undetectable and You” intervention for the South African context. The six steps of the IM protocol were systematically applied to develop the intervention including a needs assessment consisting of a systematic review and qualitative research including focus group discussions (FGD) and key informant (KI) interviews. Program objectives and target population were determined before designing the intervention components and implementation plan.ResultsThe needs assessment indicated low global U = U awareness, especially in Africa, and scepticism about its effectiveness. Lay counsellors and clinic managers stressed the need for a simple and standardized presentation of U = U addressing both patients’ needs for encouragement and modelling of U = U success but also clear guidance toward ART adherence behaviour. Findings from each step of the process informed successive steps. Our final intervention consisted of personal testimonials of PLHIV role models and their partners, organized as an App to deliver U = U information to patients in primary healthcare settings.ConclusionsWe outline an intervention development strategy, currently in evaluation stage, utilizing IM with formative research and input from key U = U stakeholders and people living with HIV (PLHIV).

[Bedside-teaching on dementia and delirium: Development, implementation, and evaluation in an acute care hospital].

Bedside-teaching on dementia and delirium: Development, implementation, and evaluation in an acute care hospital Abstract: Background: Demographic change and the accompanying increase in people with dementia and delirium in acute care hospitals pose growing challenges for nurses in acute care wards. Objective: Pilot implementation and evaluation of knowledge gain and implementation of previously defined critical behaviors. Method: Implementation of the training by APNs. Parallel evaluation of the training along the New World Kirkpatrick model using questionnaires and non-participant observation. Analysis of the data using descriptive statistics. Results: The training itself was well evaluated by the participants. It showed an increase in knowledge of the participants in the main topic categories. The targeted critical behaviors were implemented for the most part. There are deficiencies in the mapping of interventions in the nursing care process. Conclusion: The training concept is suitable to give nurses confidence in dealing with people with dementia and delirium. Continuous support in practice is needed to maintain the interventions in the long term and sustainably in everyday life.

What works to support carers of older people and older carers? an international evidence map of interventions and outcomes

BackgroundUnpaid carers of older people, and older unpaid carers, experience a range of adverse outcomes. Supporting carers should therefore be a public health priority. Our understanding of what works to support carers could be enhanced if future evaluations prioritise under-researched interventions and outcomes. To support this, we aimed to: map evidence about interventions to support carers, and the outcomes evaluated; and identify key gaps in current evidence.MethodsEvidence gap map review methods were used. Searches were carried out in three bibliographic databases for quantitative evaluations of carer interventions published in OECD high-income countries between 2013 and 2023. Interventions were eligible if they supported older carers (50 + years) of any aged recipient, or any aged carers of older people (50 + years).Findings205 studies reported across 208 publications were included in the evidence map. The majority evaluated the impact of therapeutic and educational interventions on carer burden and carers’ mental health. Some studies reported evidence about physical exercise interventions and befriending and peer support for carers, but these considered a limited range of outcomes. Few studies evaluated interventions that focused on delivering financial information and advice, pain management, and physical skills training for carers. Evaluations rarely considered the impact of interventions on carers’ physical health, quality of life, and social and financial wellbeing. Very few studies considered whether interventions delivered equitable outcomes.ConclusionEvidence on what works best to support carers is extensive but limited in scope. A disproportionate focus on mental health and burden outcomes neglects other important areas where carers may need support. Given the impact of caring on carers’ physical health, financial and social wellbeing, future research could evaluate interventions that aim to support these outcomes. Appraisal of whether interventions deliver equitable outcomes across diverse carer populations is critical.

Move&Connect-Youth: A Virtual Group Intervention for Youth Experiencing Persisting Symptoms After Concussion

ABSTRACT Move&Connect-Youth (M&C-Y) is an interdisciplinary virtual group intervention for youth experiencing persisting symptoms after concussion (PSAC) that includes psychoeducation, active rehabilitation, and goal-setting. Using an intervention mapping framework, this paper describes the iterative development of M&C-Y and findings from initial feasibility testing. Ten youth participated in M&C-Y completing pre-intervention demographic questionnaires and semi-structured exit interviews to understand participants’ experience and gather feedback. M&C-Y was feasible based on apriori criteria and findings from interviews provided insights related to: (1) intervention structure, (2) intervention engagement, and (3) intervention takeaways. M&C-Y is a meaningful, feasible, and engaging intervention for youth with PSAC.

Hearing and vision support in people with dementia living at home: Outcomes  from the intervention development programme for the European SENSE-Cog Trial

Background Hearing and vision loss are among the most common and disabling comorbidities in dementia and may worsen the trajectory of decline. Improving sensory function may be an accessible and cost-effective means of improving quality of life (QoL) and other outcomes for people with dementia (PwD). Here we describe the outcome of a multi-step intervention development programme for the components and implementation of a cross-national intervention to support hearing and vision in PwD in community settings. Methods We used the process of ‘intervention mapping’ and a set of mixed method sub-studies to develop the intervention for PwD with hearing and/or vision loss. This involved scoping the gaps in understanding, awareness, and service provision, modelling a prototype intervention, refining the prototype into a draft intervention, and finally field trialling the draft intervention for feasibility, acceptability, and tolerability. Input from the ‘patient and public voice’ (PPV) was interlinked with each step of the development programme (Miah et al., 2017). This paper synthesises the results of sub-studies leading to a description and logic model of the intervention which was then evaluated in a fully powered definitive trial. The sub-studies of the programme took place in participants’ own homes and in university or clinic settings in four EU countries: Cyprus, France, Greece, and the UK. The Expert Reference Group took place in Athens, Greece. We used quantitative and qualitative approaches to analyse the data from the different sub-studies. Results A multi-component psychosocial home-based ‘sensory intervention’ designed to optimise hearing and vision in PwD to improve QoL and other dementia-related and care partner-related outcomes. Conclusion This intervention represents the output of the iterative development of a complex intervention to fulfil an unmet need for PwD and sensory loss.

Planning Individual and Population-Based Interventions in Global Health: Applying the DEA-A Framework to Promote Behavioral, Emotional, and/or Cognitive Change among Stakeholders.

Addressing health challenges that impact human well-being requires a comprehensive, interdisciplinary approach that would be at the crossroad of population-based prevention and individual-level clinical care, which is in line with a Global Health perspective. In the absence of a unifying theoretical framework to guide such interventions, a Dynamic Ecosystem Adaptation through the Allostasis (DEA-A) framework has been proposed, emphasizing the functional adaptation of individuals and organizations in symbiosis with their living ecosystem. While a conceptual model has been presented, this methodological contribution aims at illustrating the practical application of the DEA-A framework for planning Global Health interventions. The methodology combines Intervention Mapping and Cognitive and Behavioral Theory, extended to the ecosystem. Practical guidelines and supporting tools are provided to help public health providers and clinicians in establishing a functional ecosystem diagnosis of the issue; defining not only behavioral, but also emotional and cognitive change objectives (allostasis targets) expected for each stakeholder; and designing intervention plans targeting determinants of these allostasis. The discussion addresses implementation and evaluation perspectives of interventions based on the DEA-A framework, emphasizing the importance of considering change in its processual and ecosystem complexity. Lastly, encouragements for a deeper understanding of individual and ecosystem homeostasis/allostasis processes are made in order to promote more functional interventions.

Promoting meaningful activities by occupational therapy in elderly care in Belgium: the ProMOTE intervention

BackgroundOlder people want to age in place. Despite advancing functional limitations and their desire of aging in place, they are not always faithful to therapy that maintains independence and promotes safety. Occupational therapists can facilitate aging in place. Occupational therapy is defined as the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation.AimTo describe the content a high-adherence-to-therapy and evidence-based occupational therapy intervention to optimize functional performance and social participation of home-based physically frail older adults and wellbeing of their informal caregiver, and the research activities undertaken to design this intervention.MethodsA roadmap was created to develop the occupational therapy intervention. This roadmap is based on the Medical Research Council (MRC) framework and is supplemented with elements of the Intervention Mapping approach. The TIDieR checklist is applied to describe the intervention in detail. A systematic review and two qualitative studies substantiated the content of the intervention scientifically.ResultsThe application of the first two phases of the MRC framework resulted in the ProMOTE intervention (Promoting Meaningful activities by Occupational Therapy in Elderly). The ProMOTE intervention is a high-adherence-to-therapy occupational therapy intervention that consists of six steps and describes in detail the evidence-based components that are required to obtain an operational intervention for occupational therapy practice.ConclusionThis study transparently reflects on the process of a high-quality occupational therapy intervention to optimize the functional performance and social participation of the home-based physically frail older adult and describes the ProMOTE intervention in detail. The ProMOTE intervention contributes to safely aging in place and to maintaining social participation. The designed intervention goes beyond a description of the ‘what’. The added value lies in the interweaving of the ‘why’ and ‘how’. By describing the ‘how’, our study makes the concept of ‘therapeutic use-of-self’ operational throughout the six steps of the occupational therapy intervention. A further rigorous study of the effect of the ProMOTE intervention on adherence, functional performance and social participation is recommended based to facilitate the implementation of this intervention on a national level in Belgium.

Design of a Multiple-Behavior Change Intervention for Supporting Self-management in Patients With Chronic Heart Failure: An Intervention Mapping Approach.

Nonadherence to medication and low physical activity contribute to morbidity, mortality, and decreased quality of life among patients with chronic heart failure (CHF). Effective interventions that can be delivered during routine clinical care are lacking. We aimed to adapt the feasible and cost-effective Adherence Improving self-Management Strategy (AIMS) for patients with human immunodeficiency virus (HIV) to CHF treatment. Subsequently, we determined its acceptability and feasibility. Adherence Improving self-Management Strategy is a systematic, nurse-delivered counseling intervention blended with eHealth to facilitate patient self-management. We used the intervention mapping framework to systematically adapt AIMS-HIV to AIMS-CHF, while preserving essential intervention elements. Therefore, we systematically consulted the scientific literature, patients with CHF and nurses, and pretested intervention materials. Adherence Improving self-Management Strategy-HIV was modified to AIMS-CHF: a multiple-behavior change intervention, focused on medication adherence and physical activity. Key self-management determinants (such as attitudes, self-efficacy, and self-regulatory skills) and organization of care (such as specialized nurses delivering AIMS) were similar for HIV and heart failure care. The AIMS protocol, as well as material content and design, was systematically adapted to CHF. Preliminary testing suggests that AIMS-CHF is likely feasible and acceptable to patients with CHF and care providers. Using the intervention mapping protocol, AIMS-HIV could be systematically adapted to AIMS-CHF and seems acceptable and feasible. Evidence from the literature, behavioral theory, and input from nurses and patients were essential in this process. Adherence Improving self-Management Strategy-CHF should now be tested for feasibility and effectiveness in routine care.

AN EDUCATIONAL ASSESSMENT OF PREVENTIVE BEHAVIORS OF CARDIOVASCULAR DISEASE AMONG ADULT WORKERS WITH HYPERTENSION

Introduction: In Thailand, approximately 13 million adult workers have hypertension, with approximately 4.7% of those living in acculturated societies at a higher risk of developing cardiovascular disease (CVD). Aims: This study aims to examine the factors that predicted CVD prevention behaviors in individuals with hypertension. Methods: A cross-sectional analytical study was conducted on 1,151 adult workers with hypertension from Sukhothai Province, Thailand, using a multistage sampling technique. The measurement tools included a standardized questionnaire approved by three experts and tested for reliability using the Cronbach’s alpha. A multiple regression analysis was used to identify factors that predicted CVD prevention behaviors. Results: This study involved a total of 1,151 participants, 61.90% of whom were females, with an average age of 52 years. In addition, 71.80% of the participants had a family history of CVD. The majority of the participants (73.4%) exhibited moderate levels of CVD preventive behaviors. Factors that predicted CVD preventive behaviors included self-efficacy (β = 0.423), family and social support (β = 0.162), perceived information (β = 0.119), attitude (β = 0.117), knowledge (β = 0.089), living with nuisance (β = -0.049), and family history of hypertension (β = 0.049). These predictors accounted for 39.2% of the variance (R2 = 0.392, p = 0.05). Conclusion: The intervention mapping to promote CVD preventive behaviors in adult workers with hypertension should focus on increasing self-efficacy by providing information to improve individual knowledge and attitude, as well as addressing environmental factors that may affect people's well-being, such as nuisances.

Optimizing the Maastricht Work-Related Support intervention in clinical patient care: the value of integrating action research into intervention mapping

BackgroundHealthcare professionals (HCPs) are increasingly recommended to play an important role in supporting people with chronic disease in work participation. An intervention for HCPs to provide work-related support to their patients in clinical care was developed with intervention mapping (Maastricht Work-Related Support; Maastricht WRS). Action research proposes ‘combining research and practice’, which allows us to incorporate experiences of HCPs while implementing and to realize intervention’s full potential. Therefore, the aim of this study is to explore, by integrating action research into an intervention mapping approach, how experiences of HCPs with early implementation can be used to optimize the Maastricht WRS in clinical care.MethodsSemi-structured interviews were held with nine HCPs (response rate 82%), involved in care for people with inflammatory arthritis, knee problems or inflammatory bowel disease. Some of them were not yet trained in the Maastricht WRS while others had received the training and were providing the Maastricht WRS.ResultsAll participants regarded WRS an important part of clinical care. Untrained HCPs indicated a lack of knowledge and skills in providing the Maastricht WRS, and a need for tools. Trained HCPs were satisfied with the training and tools, but stressed that practical limitations hindered providing the Maastricht WRS. Action research showed that the intervention meets the needs of HCPs, but need some optimizations: (1) organizing ‘intervision’ for HCPs, (2) inform and activate patients to discuss work with their HCP, (3) update initial tools and (4) including patients’ work status in the electronic patient system.ConclusionsAction research integrated into intervention mapping proved to improve the Maastricht WRS intervention. By involving HCPs, the intervention could be optimized to provide to support people with chronic diseases in clinical care in healthy and sustainable work participation.

A spark of change: developing an innovative gerontological nursing intervention mapping initiative for training and education (IGNITE)

BackgroundWith an aging global population and advancements in medical technology, there is an urgent need for innovative gerontological nursing education programs. This study aimed to develop and evaluate the Innovative Gerontological Nursing Intervention Mapping Initiative for Training and Education (IGNITE) program. This program is a digital platform-based postgraduate nursing curriculum that employs the Intervention Mapping Approach (IMA) and Transformative Learning Theory to address the evolving needs of gerontological nursing.MethodsThe IGNITE program’s development process encompassed a comprehensive approach, including needs assessment, mapping of course objectives, integration of theory-based methods and strategies, course design, implementation, and rigorous evaluation. The pilot evaluation study involved pre- and post-tests focused on ageism, attitudes towards elder care, knowledge about older adults, transformative behavior change, and program satisfaction. The findings revealed significant improvements across all these dimensions, affirming the effectiveness of the program.ResultsThe program leveraged experiential learning, critical reflection, and rational discourse to facilitate transformative educational experiences. Notably, pre- and post-test comparisons showed marked improvements in attitudes towards older adult care and dementia care knowledge. Participants expressed high satisfaction with the program, with significant reported changes in transformative behaviors. The study also illuminated the initial negative attitudes of clinical nurses towards older adults and underscored the importance of transformative learning experiences in fostering empathy and understanding.ConclusionsThe IGNITE program lays a foundational framework for developing educational materials that promote transformative learning and self-reflection among healthcare professionals. This approach can lead to innovative nursing practices and personal growth. The application of the IMA and Transformative Learning Theory in gerontological nursing education shows significant promise. Future research should focus on exploring the long-term impacts of such programs and their applicability in diverse healthcare settings.

Implementation of Digital Faculty Portfolio in Medical College Using an Intervention Mapping Approach.

The Digital faculty portfolio (DFP) is a well-established Teaching Portfolio, a tool that combines student evaluations with teaching materials, narrative reflections, and evidence of pedagogical effectiveness. The research aimed to test the DFP concept and determine whether faculty find it useful for integrating faculty activities, including teaching and extracurricular activities. Thus, the main aim is to identify key technical details that must be addressed before creating a larger DFP platform. This research study adopted a six-step theory- and evidence-based approach of an Intervention Mapping (IM) protocol to assess the need for a DFP-like program at the College of Medicine, King Saud Abdulaziz University for Health Sciences and the efficacy of the pilot DFP program. The study was done in three steps: 1) Evaluation of educational needs; 2) Design of the "DFP" program; and 3) Validation and refinement of the designed program. The college conducted the needs assessment using a validated survey with full-time faculty members. Eighty-two survey participants comprised the sample. We described to them the DFP implementation procedure, design, and advantages. The DFP is valuable to most users (60%) and has inherent benefits that boost professional competency (80%). Nearly 73% were willing to keep using and/or updating their DFP periodically. The created program was validated by sharing the findings with designated specialists in health professions education. Based on their comments, the program was further refined and ready for piloting. To maximize the potential of the platform's success, its capabilities should be consistently enhanced in addition to resolving technical issues. This program has managed to effectively identify new avenues for working on enhancing methods for effective communication, coordination and enhance the scope of evaluation process.

Four-Step Co-Designing of the Reablement Strategies Targeting Sarcopenia (ReStart-S): An Exercise-Based Multicomponent Program for Older Adults Residing in Long-Term Care Settings.

The prevalence of sarcopenia is concerningly high in long-term care settings (LTCS); yet, no exercise programs specifically targeting older adults living in residential care are available. The goal of the present study was to co-design and validate a program named Reablement Strategies targeting Sarcopenia (ReStart-S) for older long-term care residents. Cross-sectional study with an exploratory phase. LTCS in Udupi, Karnataka, India. Sarcopenic older adults diagnosed using Asian Working Group for Sarcopenia 2019 criteria. The program was designed using a four-step intervention mapping technique involving systematic progression after completing each step. The steps included 1) identifying the appropriate exercise-based intervention for sarcopenia, 2) determining objectives and expected outcomes, 3) seeking expert views through a Delphi consensus approach, and 4) assessing the feasibility of ReStart-S program among older adults living in LTCS. A comprehensive literature review appraised existing exercise programs for managing sarcopenia. A workshop held with six older adults and one caretaker, decided on morning exercise sessions, recommended 2-7 days/week. The results of the review and workshop were compiled for the Delphi process that had seven experts from 5 countries, achieving a 71% response rate after four rounds. In the last step, a pilot study on eight LTCS residents, two males and six females with a mean age of 78.3 ± 8.3 years, was conducted and the program was found to be feasible. The ReStart-S program for managing sarcopenia among older adults residing in LTCS incorporates evidence from the literature and the engagement of older adults, caregivers, and experts, making it a contextually appropriate intervention. Our study also provides researchers and healthcare professionals insight into co-designing an intervention program for vulnerable older adults. Finally, the program evaluation indicates that a full-scale trial testing the efficacy of the ReStart-S program is feasible.

Designing a Contextualized Food-Based Strategy to Improve the Dietary Diversity of Children in Rural Farming Households in Central Uganda.

Food-based strategies have a high potential of improving the diet quality and reducing the prevalence of nutrient deficiencies in agriculture-dependent communities. Their design is however complex with trade-offs that are rarely systematically presented to allow replication and efficient contextualization. The systematic design of a food-based strategy to improve the dietary diversity of children in rural farming communities in Uganda. The intervention mapping protocol was used to provide a systematic approach to developing theory-based and evidence-based intervention methods and strategy. The priority behavioral and environmental determinants identified were related to food production, consumption, and efficacy while the personal determinants focused on knowledge, skills, self-efficacy, attitude, and outcome expectations. The aim of the resulting strategy was set to improve the availability, accessibility, and consumption of diverse foods, with a particular focus on production diversity, production practices, market access, and market diversity. Behaviour change methods were selected to enhance ability and self-efficacy, strategic goal setting, and provision of feedback. The strategy focused on household groups for learning, demonstration, practice, and social support. The validation showed that the determinants and actors incorporated in the strategy were important and relevant for improving the productivity, food availability, dietary diversity, livelihoods, and health of rural farming households and communities. Application of the protocol yielded a contextualized food-based strategy that can be adjusted for use in other smallholder contexts in developing countries by piloting implementation plans based on the strategy; reassessing the key determinants and implementing the revised strategy; or replicating the whole design process.

Development of a psychological health promotion intervention for ultra-orthodox Jewish mothers of children with ADHD using the intervention mapping protocol

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a common neuro-developmental health condition in children and adolescents, in which its associated behavior manifestations are known to negatively affect members of the family unit, especially mothers. Ultra-orthodox Jewish (UOJ) community is growing globally and mothers of children with ADHD in this community are potentially at risk for negative health outcomes. As the UOJ community is culturally conservative, maintaining a distinct separation from outside influences, they often avoid utilizing public mental health services due to stigma and a lack of culturally sensitive treatments. Thus, this study aimed to develop a theory-driven and culturally appropriate psychological health promotion intervention for these mothers using the Intervention Mapping protocol.MethodsA mixed-method design was used. Qualitative content analysis was performed on four focus groups (n=25). Additionally, descriptive statistics including the content validity index was used to measure feedback regarding the developed intervention protocol’s relevance, effectiveness, and appropriateness Theoretical models for behavior change, including the Behavior Change Wheel’s COM-B system and the Theoretical Domains Framework, and literature on ADHD in the general population and the ultra-orthodox community were integrated in the process. Intervention components were systematically derived from findings.ResultsKey determinants of health behavior change were identified, resulting in formulating intervention objectives addressing stigma reduction surrounding ADHD, increasing knowledge about the ADHD condition and treatment, awareness of the school systems’ capabilities in meeting the ADHD child’s needs, enhancing mothers’ advocacy skills, and maternal self-care. Intervention? strategies included a group setting, providing information on health consequences, social support, re-attribution, active learning, goal setting, and promoting an identity associated with the desired behavior change. Mothers’ quantitative feedback confirmed the overall relevance, effectiveness, and appropriateness of the interventions’ content (CVIavg= .86, .85, .87).ConclusionsIntervention Mapping facilitated the development of a culturally sensitive psychological health promotion intervention for ultra-orthodox Jewish mothers of children with ADHD. Further research is warranted to assess intervention feasibility and effectiveness.

Developing a Training in Motivational Counselling to Promote Return to Work: An Intervention Mapping Approach.

Due to the Belgian health insurance system's controlling nature, work-disabled claimants can feel forced to return to work (RTW), increasing their risk of relapse. RTW out of interest or importance is considered more sustainable. Such autonomous motivation for RTW can be promoted through 'motivational counselling', an integration of self-determination theory and motivational interviewing. To adopt this, health insurance practitioners need training, which can be designed through intervention mapping as an evidence-based planning tool. This paper reports on the development of a motivational counselling training for health insurance practitioners. Intervention mapping's six steps guided the formulation of programme goals and learning outcomes, matching the context. We then identified change methods which were translated into practical components. Together with the health insurances' input, this resulted in a concrete training programme with an implementation and evaluation plan. The training was designed to increase practitioners' knowledge, skills, and beliefs relevant for learning motivational counselling, which also requires solution-focused strategies. Methods like guided practice were translated into built-in exercises, feedback, and information, which were implemented through an online training format of five sessions including one follow-up. Reporting about training development increases understanding of its effectiveness and implementation, which will be evaluated via pre- and post-training data collection amongst practitioners. Future trainings can benefit from this by accounting for health insurances' organizational barriers or building on the training's evidence-based backbone whilst only requiring specific adaptations for other stakeholders and contexts. Further research should evaluate motivational counselling's impact on claimants' RTW trajectories.

IMPLEMENTATION OF STUNTING REDUCTION REGULATIONS AND POLICIES IN EAST LOMBOK REGENCY, INDONESIA

Objective: This research aims to develop a theoretical model for implementing stunting management policies applicable in East Lombok Regency, Indonesia, and other districts with high stunting prevalence across Indonesia through the enactment of statutory regulations. The study focuses on community engagement, cross-sector collaboration, and capacity building.   Theoretical framework: Drawing upon the Network Policy Model concept and supported by the Social-Ecological Model from USAID.   Methodology: Employing a qualitative approach, the research utilizes a phenomenological study of stunting incidents, complemented by focus group discussions and interviews. Field observations are integrated to validate the data. Research is conducted in 11 intervention and 10 non-intervention sub-districts.   Results: The 2023 intervention exhibited a significant decrease in stunting prevalence from 17.46% (2022) to 14.22% and wasting rate from 5.93% (2022) to 5.07%. Four aspects of success emerged: mapping of stunting areas, improved regulations, community involvement, and collaborative education programs.   Conclusion: Successful stunting and wasting management in 11 sub-districts in East Lombok Regency began with intervention mapping. Government collaboration with SEAMEO RECFON, UNICEF, and universities was pivotal. Regulatory improvements included strengthening marriage regulations and school regulations. Community involvement and collaborative education programs were vital, ensuring comprehensive program implementation.   Recommendation: The five recommendations from this research are strengthening community involvement by encouraging active participation, improving the governance structure, enhancing capacity building by continuing and expanding training initiatives for the organization's regional representatives, and fostering cross-sector collaboration by strengthening partnerships between regional organizations, NGOs, academic institutions, and international organizations; collaborative efforts can leverage diverse expertise, resources, and networks to accelerate efforts to reduce stunting and prevent wasting; promoting nutrition education and outreach: implement comprehensive nutrition education programs targeting schools, communities, and families. Emphasize the importance of a balanced diet, breastfeeding practices, and proper nutrition during critical periods of growth and development. Research Implications: The findings inform policymakers, program managers, and stakeholders involved in stunting reduction efforts in East Lombok Regency, facilitating evidence-based decision-making and program design for more effective and sustainable interventions.   Originality/Value: This research contributes to the existing literature on stunting reduction by providing empirical evidence and insights using the Network Policy Model concept and the Social-Ecological Model. The study's contextual specificity, methodological rigor, stakeholder engagement, and multiple perspectives enrich the understanding of stunting management initiatives.