P a g e 1 Study Guide Test 3 DIE 4310 Fall 2012 Professor Dr Jenice Rankins Designing Community Interventions 10 questions Be able to describe how to design a community intervention such as understanding the target group having tools choosing the right strategy 1 questions The first step in designing an intervention is to review the program s goals and objectives which specify the program outcomes Study the target populations eating patterns and beliefs values and attitudes about food and health o The purpose is to understand their values and why they believe what they believe and why they eat what they eat o Many factors affect the food intake and nutritional status of the target population Food supply and food availability Income and food prices Sociocultural factors food choices are strongly influenced by social groups Food preferences cognitions and attitudes Health beliefs and practices Describe and give examples of the different levels of intervention strategies 2 questions Intervention strategy is the approach for achieving the program s goals and objectives o It addresses the question of how the program will be implemented to meet the target population s nutritional need The intervention strategy can encompass one or more levels of intervention It can be designed to o Build awareness level I o Change lifestyles and or level II o Create a supportive environment level III o Provide incentives for behavioral change at individual community and system levels Level I interventions focus on increasing awareness of a health or nutritional topic or problem Awareness programs can be very successful in helping change attitudes and beliefs and increasing knowledge of risk factors but they seldom result in actual behavior changes Level II interventions are designed to help participants make lifestyle changes such as quitting smoking and being physically active These interventions can be successful when they call for small changes over time and when they use a combination of behavior modification and education Level III interventions include worksite health promotions and cafeteria programs Describe discuss five theories models of health behavior Diffusion of innovation Social Cognitive Theory Theory of Reasoned Action Health Belief Model Transtheoretical Model Stages of Change know their constructs definitions and examples of their application in designing community nutrition interventions 4 questions Diffusion of innovation o Focus a process by which an innovation idea or behavior spreads and involves an ever increasing number of individuals in a population o The model consists of four stages Knowledge the individual is aware of the innovation and has acquired come info Persuasion the individual form an attitude either in favor or against the innovation Decision the individual performs activities that lead to either adopting or rejecting the innovation Confirmation the individual looks for reinforcement for his or her decision and may change it if exposed to counter reinforcing messages o Application To boost interest and enthusiasm for heart healthy cooking and eating a nutritionist contacted a popular local chef who had recently been interviewed of local tv about the challenges he faced after surviving a heart attack The nutritionist then asked him P a g e 2 to join the group because she believed his enthusiasm would be catching and would influence other participants Social Cognitive Theory o Focus people and their environment interact continuously each influencing each other o Explains behavior in terms of a model in which behavior personal factors such as cognitions and the environment interact constantly such that a change in one area has implications for the others o Learning occurs through taking action observations of others taking action and evaluation of the results of those actions o Was developed to explain how people acquire and maintain certain behaviors o Application Use peer counseling to model healthful eating patterns and provide support Theory of Reasoned Action o Focus behaviors are determined by a person s intentions to behave in certain ways o The theory is a fundamental model for explaining social action and can be used to explain virtually any health behavior over which the individual has control o Intentions are the instructions people give to themselves to behave in certain ways Intentions are influenced by attitudes and subjective norms o Application In a diet program the community nutritionist paired some participants who had not been successful losing weight with others who had This was meant to improve the participant s intentions to master their eating habits and lose weight Health Belief Model o Focus perception of the health problem and appraisal of proposed behavioral changes are central to a decision of change o Three components The perception of a threat to health Physical or clinical such as death or pain Social such as infecting family members or missing work The expectation of certain outcomes related to a behavior Self efficacy the conviction that one can successfully execute the behavior required to produce the outcomes o Application Posters and a public service television announcement that reinforces the message this strategy was designed to influence the beliefs of people in high risk groups Be able to apply the Stages of Change Model What does each stage mean for guiding intervention focus and strategy 1 questions Stages of change model is founded on three assumptions o Behavior change involves a series of different steps or stages o There are common stages and processes of change across a variety of health behaviors o Tailoring an intervention to the stage of change people are in at the moment is more effective than not considering they stage people are in The five stages are 1 Precontemplation the individual is either unaware of or not interested in making a change 2 Contemplation the individual is thinking about making a change They may be weighing the risks and benefits of changing a behavior 3 Preparation The individual actively decides to change and plans a change usually within a month The individual may have already tried changing in the recent past 4 Action individual is trying to make the desired change and has been working at it for less than 6 months 5 Maintenance individual sustains change for six months or longer Define terms 2 questions P a g e 3 Subjective norm the perceived social pressure to perform or not perform a