Identify Interventions
1. Underlying theory
Identify what the underlying concepts/ theoretical approaches are to each of your three interventions. You should be able to write a thousand words situating each of your three interventions drawing on some of the conceptual frameworks discussed in the theory lecture e.g. Naidoo and Wills capture the basic conceptual elements of all HP theory in the descriptive schema:
• Medical,
• Educational,
• Behavioural Change,
• Empowerment and
• Social Change.
Which of these categories best describes the interventions you have chosen? Why? Can you elaborate further by linking this to more complex, broader explanations of the type of intervention.
• What are the epistemological elements of the intervention e.g how does it conceptualise knowledge of the health
phenomenon it is intervening on. Is it based on what the people who will be the recipients of the intervention think and feel about their situation (a subjectivist view of how knowledge is constructed), or is it based on objective measurements of a situation such as epidemiological and other measures (an objectivist view of how knowledge is constructed)?
• What concept does the intervention have of the society in which the intervention is taking place? (Core view of society) Is the intervention about social change, or is it about psychological/ behavioural change of individuals?
• An intervention therefore has implicit or perhaps explicit assumptions to do with what it considers to be the principle source of health problems. Where do health problems come from? Are they a consequence of the broader socio-economic environment or are they more localised at the level of poor individual choices?
Again the theory lecture contains a wide spectrum of information to draw on. The questions you need to address are:
• what are you trying to do?
• how is it supposed to work?
• what needs to be in place for it to work?
2. Evidence base
The lectures on Evidence and Evaluation should provide you with the necessary information to consider the various issues around the question of evidence. When you critically assess an intervention it is useful to bear in mind that it is the theory that selects the evidence rather than the other way round of common sense. In other words one usually has an explanation, or a set of assumptions, no matter how basic, about why people behave as they do. We then cite whatever evidence we are aware of to justify our assumptions/ explanation of the phenomenon. An example: Smoking behaviour is a problem of addiction as evidenced by the studies on nicotine addiction and the struggle individual smokers have in quitting. Consequently the medical and behavioural change approaches best describe the sort of intervention likely to work. On the other hand some of us believe that smoking behaviour is better understood in relation to social class inequalities and cite evidence of this in the social class gradient
distilled from various epidemiological studies. The sort of intervention prompted by this type of explanation is best described by the categories of social change and perhaps empowerment. Can you write another 1000 words discussing the following:
• For each of your three interventions what sort of evidence is there prompting the type of intervention?
• How robust is this evidence and do you consider it appropriate to justify the types of intervention?
• Do the different types of intervention draw on different kinds of evidence?
3. Aims of the intervention
Once you have clarified 1 and 2 above, you need to consider:
• what are the aims of the various interventions you have selected?
• more importantly, are the aims consistent with (a) the theory underlying the intervention and (b) the evidence.
TASK 2
Consider the methods for delivery of the interventions
If you have completed the first task and successfully addressed each of the questions/ issues raised there, then you need to reflect more carefully on the method/s used to deliver each of the interventions.
• (i) give a brief description of how the intervention is operationalized i.e. what are the methods it uses. Sessions 4 – 11 of the module assess a number of methods and approaches.
• (ii) are the methods used to deliver the intervention consistent with (a) the underlying theory and (b) the aims of the intervention.
Example:
The aim of the intervention is to address inequalities in
health.
This is based on an underlying theory of social change
and empowerment.
This is to be achieved through a traditional health
education approach focused on providing information to individuals.
There is clearly a mismatch here in the methods used to deliver the intervention. Of course I have used this example to highlight what is meant by a critical analysis. Many of the interventions you have selected may not be so easily inconsistent in matching theory, aims and methods. Nevertheless you need to reflect critically on the strengths and weaknesses of the methods used to deliver the intervention. It could be that while there is consistency between theory, aims and methods that the intervention could be better delivered via an alternative method.
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