Development of a gender-relevant tobacco cessation intervention for women in Brazil—an intervention mapping approach to planning

Abstract

The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. One of major advantages of utilizing IM was that decisions were made in a transparent and supportive manner with involvement of all stakeholders throughout the process. Despite the fact that this process is very taxing on researchers and the health care system as it takes time, resources and negotiation skills, it builds trust and promotes ownership which can assure sustainability.

Using Intervention Mapping to Develop a Media Literacy-Based Smoking Prevention Program for Female Adolescents

“…After setting program goals according to the process of intervention mapping [ 22 ], the program was organized according to a systematic process. In a previous study developed according to the intervention mapping process for gender-specific smoking cessation interventions for women in Brazil [ 39 ], women, community health workers, healthcare workers, and administrators took part in the needs assessment process. Although there were difficulties in the process, sustainable interventions were developed by investigating specific needs for various stakeholders.…”

Intervenção para cessação do tabagismo em pacientes internados por AVC

“…Baseada nos construtos da TSC e da TCC, foi desenvolvida uma intervenção utilizando objetivos e estratégias personalizados; foram elaboradas cinco cartilhas ativas para os pacientes, uma para os familiares e uma para os profissionais de saúde; e foi feito um relato de todos os passos seguidos para desenvolver uma intervenção baseada em teoria e culturalmente relevante. Estudo recente utilizou os mesmos construtos teóricos, demonstrando ser promissor para o desenvolvimento de intervenções em saúde (Kienen et al, 2019).…”

“…Ou seja, a TSC fornece uma estrutura para adaptações no nível macro e o TCC aborda diretamente os componentes no nível micro (Borrelli, 2010). Estes modelos embasaram o desenvolvimento de uma intervenção para cessação do uso de derivados do tabaco em mulheres de baixa renda no Brasil (Kienen, Wiltenburg, Bittencourt, & Scarinci, 2019). Devido à carência de descrição de intervenções específicas para pacientes com AVC, o objetivo deste estudo foi desenvolver e testar uma intervenção baseada em evidência para promover a cessação do uso de derivados do tabaco em pacientes internados com AVC.…”

Study of Adolescents’ Puberty, Adolescence Training Program: The Application of Intervention Mapping Approach

“…Different models have been developed for designing, implementing, and evaluating training programs by experts, one of which is IM. 11,12 This approach is a planning approach based on the significance of developing evidence-based programs that assess and intervene in health-related issues adopting an ecological approach. 10 IMA has a problem solving-based approach and enables the implementation of the program through six steps: need assessment, objectives matrix design, selection of theory and practical application-based intervention methods, production of components and materials of the intervention program, adoption planning, implementation and sustainability and evaluation planning of health training and promotion programming.…”

“…11 This approach focuses on behavioral change and the individuals who are influential on the behavior of those at risk known as environmental agents and individuals' health issues at different ecological levels to make changes. 12 This is done to change individual behaviors besides focusing on changing environmental agents' behavior to improve the life quality and health of the target group. Thus, it was decided to develop a health promotion program based on IMA for a puberty training program in adolescent girls.…”