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Preparation for Outome Monitoring Pre-Conference Workshop
                                Key Terms-revised 5.18.2010


             Evidence-Based Interventions

                             Key Terms

Evidence-based interventions (EBI): A theory-based set of activities designed
to motivate people to change behavior. They have evidence that they been
proven to work with a specific audience (or target population) through evaluation.
They focus on changing the reasons that a person is engaging in an HIV risk
behavior.

EBIs can be individual, group, or community level.

*Individual level interventions (ILI): EBIs in which one staff member works with
one person at a time to promote individual behavior change.
    *Protocol-Based Counseling (PBC)-No Outcome Monitoring
    Comprehensive Risk Counseling Services (CRCS)-OM is done
    One-on-one, intensive
    Goal is individual behavior change
    Change occurs in those who receive the intervention

*Group-level intervention (GLI): EBIs in which one or two staff members work
with a group of persons (either in one session or multiple sessions) to promote
change in HIV risk behavior for the individuals of the group.
    Message carried by facilitator
    Change occurs in those participating and who receive the intervention
    Groups of up to 15 persons meet for 1-32 sessions
    OM is done

*Community-level interventions: EBIs in which staff train peer members of a
community or population to promote positive HIV behavior change norms and
ideas within a population. This shifts the community norm.
    Has a group-level component
    Focus on changing group norms
    Facilitator trains population members, who then carry message to the
      community
    Change occurs in members who may not have directly received the
      intervention
    Tends to be micro-site or venue based
    OM is done


Target population: A group of people that have similar characteristics. It can be
defined by geographic status (a community), an ethnic or racial group, gender,


17th Texas HIV/STD Prevention conference
Austin, TX 5.24.2010                       1
Preparation for Outome Monitoring Pre-Conference Workshop
                                Key Terms-revised 5.18.2010

age, sexual orientation or by an HIV risk behavior (such as intravenous drug
use). They can be very general (all women) or very specific (African-American
HIV+ MSM youth 12-20 years of age).

Duration: The length of time of an intervention.

Session: One meeting of an intervention.

Cycle: The number of sessions it takes to complete an intervention.

Setting: Where the intervention is held.

*Internal logic: The logic of the components of an evidence-based intervention
based on the behavior change theories and logic model of the intervention.
Adherence to the internal logic of the intervention is important for the intervention
to retain its effectiveness. Changes cannot be made to an intervention that
change its internal logic.

*Core Elements: Components of the intervention that are believed to be
essential to achieve the desired behavior change outcomes. They refer to the
features in the intent and design of an intervention that are responsible for its
effectiveness. They cannot be changed.

Key Characteristics: Those features of an intervention that are considered less
essential, and can therefore be modified or changed without diminishing the
effectiveness of the intervention.

*Fidelity: Staying true to the internal logic and the core elements of an
intervention; not altering activities that are considered essential for the
intervention to work.

Behavioral Change Theories: Social science theories or ideas about the
process of how people make consistent, healthier behavior changes

Facilitator’s Guide: Curriculum, guide, or manual that is needed to implement
an intervention.

Implementation: Taking a curriculum or guidance for an intervention and putting
it into practice with participants.

Technical assistance: The process by which assistance is given to a agency to
better implement an intervention. Any challenges or barriers to implementation
can often be solved through technical assistance.

Logic Model: A model that describes the main elements of an intervention and
how the elements work together to achieve the expected behavioral outcomes.


17th Texas HIV/STD Prevention conference
Austin, TX 5.24.2010                       2
Preparation for Outome Monitoring Pre-Conference Workshop
                                Key Terms-revised 5.18.2010



HIV Risk Behaviors: The behaviors that can directly pass HIV from one person
to another. All EBIs have a specific HIV Risk Behaviors that they are designed to
change.

*Factors that Influence Behavior –FIBs (also known as Influencing Factors,
Risk Factors, or Behavioral Determinants); The reasons that a person or
target population is engaging in an HIV risk behavior. Two people or populations
could be engaging in the same risk behavior, but for two completely different
reasons.

Outcomes: The change in the skills, knowledge, attitudes, beliefs, perceptions,
or behaviors of the participants or population in an intervention. Each intervention
has specific outcomes that are being addressed.

Immediate outcomes: immediate changes that can be measured as the direct
result of the intervention, such as change in knowledge, skills, attitudes,
perceptions or beliefs of the participants or population.

Intermediate outcomes: Changes in the goal HIV risk behavior of the
participants or target population an intervention.

*Tailoring: Small changes to an intervention that do not alter the core elements
or internal logic of the intervention, thus maintaining fidelity to the intervention.
Examples could be changes in the delivery method, key characteristics, or
activities.

*Adaptation: Making changes to the intervention, such as the target population,
setting, or location, but do not change or contradict the internal logic of the
intervention. Adaptation keeps fidelity to the internal logic.

*Reinvention: Making changes to an intervention that change the internal logic
or rationale of the intervention. This changes an intervention so drastically that
the original intent is no longer applicable.

DEBI (stands for Diffusion of Effective Behavioral Interventions): Effective
behavioral interventions that meet CDC’s standards for evidence of behavior
change and that have been chosen by CDC for national diffusion. DEBI’s are all
EBIs, but not all EBIs are DEBIs!

SMART Outcome Objectives: Specific, Measurable, Appropriate, Realistic,
Time-Based


Differences in Data Collection per intervention:



17th Texas HIV/STD Prevention conference
Austin, TX 5.24.2010                       3
Preparation for Outome Monitoring Pre-Conference Workshop
                                Key Terms-revised 5.18.2010

    Individual Level
         Intermediate and Immediate Outcomes
         Can use questions from behavioral assessment
         One initial assessment, up to two reassessments
         No standardized survey
         Driven by prevention plan and goals to be achieved
         Designated outcomes
         Pre/post done on same individual
         Percentages for outcomes 15-50%
         Not all outcomes will apply to all individuals

    Group Level
         Immediate Outcomes
         Pre/post tests
         Standardized survey
         3-4 outcomes individualized per intervention
         Pre/post done on same individual
         Percentages for outcomes 40-75%
         Can measure any SKABB

    Community Level: 2 components
        Group Component-measured first
             2-4 immediate outcomes
             Will measure M-Groups, training of peer volunteers
             Standardized survey
             Knowledge, skill-level, ability to communicate very
               important
             Will be collected first stage

    Community Level:
        Community Component-measured second
             2-4 Immediate Outcomes
             Happens during community assessment
             Pre/Post tests; Venue-based
             Mainly measures knowledge, attitudes, beliefs,
               community norms
             Percentages up to 15%
             Gathered yearly
             Will be collected in second stage




17th Texas HIV/STD Prevention conference
Austin, TX 5.24.2010                       4

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Ebi key terms rev5.18.2010

  • 1. Preparation for Outome Monitoring Pre-Conference Workshop Key Terms-revised 5.18.2010 Evidence-Based Interventions Key Terms Evidence-based interventions (EBI): A theory-based set of activities designed to motivate people to change behavior. They have evidence that they been proven to work with a specific audience (or target population) through evaluation. They focus on changing the reasons that a person is engaging in an HIV risk behavior. EBIs can be individual, group, or community level. *Individual level interventions (ILI): EBIs in which one staff member works with one person at a time to promote individual behavior change.  *Protocol-Based Counseling (PBC)-No Outcome Monitoring  Comprehensive Risk Counseling Services (CRCS)-OM is done  One-on-one, intensive  Goal is individual behavior change  Change occurs in those who receive the intervention *Group-level intervention (GLI): EBIs in which one or two staff members work with a group of persons (either in one session or multiple sessions) to promote change in HIV risk behavior for the individuals of the group.  Message carried by facilitator  Change occurs in those participating and who receive the intervention  Groups of up to 15 persons meet for 1-32 sessions  OM is done *Community-level interventions: EBIs in which staff train peer members of a community or population to promote positive HIV behavior change norms and ideas within a population. This shifts the community norm.  Has a group-level component  Focus on changing group norms  Facilitator trains population members, who then carry message to the community  Change occurs in members who may not have directly received the intervention  Tends to be micro-site or venue based  OM is done Target population: A group of people that have similar characteristics. It can be defined by geographic status (a community), an ethnic or racial group, gender, 17th Texas HIV/STD Prevention conference Austin, TX 5.24.2010 1
  • 2. Preparation for Outome Monitoring Pre-Conference Workshop Key Terms-revised 5.18.2010 age, sexual orientation or by an HIV risk behavior (such as intravenous drug use). They can be very general (all women) or very specific (African-American HIV+ MSM youth 12-20 years of age). Duration: The length of time of an intervention. Session: One meeting of an intervention. Cycle: The number of sessions it takes to complete an intervention. Setting: Where the intervention is held. *Internal logic: The logic of the components of an evidence-based intervention based on the behavior change theories and logic model of the intervention. Adherence to the internal logic of the intervention is important for the intervention to retain its effectiveness. Changes cannot be made to an intervention that change its internal logic. *Core Elements: Components of the intervention that are believed to be essential to achieve the desired behavior change outcomes. They refer to the features in the intent and design of an intervention that are responsible for its effectiveness. They cannot be changed. Key Characteristics: Those features of an intervention that are considered less essential, and can therefore be modified or changed without diminishing the effectiveness of the intervention. *Fidelity: Staying true to the internal logic and the core elements of an intervention; not altering activities that are considered essential for the intervention to work. Behavioral Change Theories: Social science theories or ideas about the process of how people make consistent, healthier behavior changes Facilitator’s Guide: Curriculum, guide, or manual that is needed to implement an intervention. Implementation: Taking a curriculum or guidance for an intervention and putting it into practice with participants. Technical assistance: The process by which assistance is given to a agency to better implement an intervention. Any challenges or barriers to implementation can often be solved through technical assistance. Logic Model: A model that describes the main elements of an intervention and how the elements work together to achieve the expected behavioral outcomes. 17th Texas HIV/STD Prevention conference Austin, TX 5.24.2010 2
  • 3. Preparation for Outome Monitoring Pre-Conference Workshop Key Terms-revised 5.18.2010 HIV Risk Behaviors: The behaviors that can directly pass HIV from one person to another. All EBIs have a specific HIV Risk Behaviors that they are designed to change. *Factors that Influence Behavior –FIBs (also known as Influencing Factors, Risk Factors, or Behavioral Determinants); The reasons that a person or target population is engaging in an HIV risk behavior. Two people or populations could be engaging in the same risk behavior, but for two completely different reasons. Outcomes: The change in the skills, knowledge, attitudes, beliefs, perceptions, or behaviors of the participants or population in an intervention. Each intervention has specific outcomes that are being addressed. Immediate outcomes: immediate changes that can be measured as the direct result of the intervention, such as change in knowledge, skills, attitudes, perceptions or beliefs of the participants or population. Intermediate outcomes: Changes in the goal HIV risk behavior of the participants or target population an intervention. *Tailoring: Small changes to an intervention that do not alter the core elements or internal logic of the intervention, thus maintaining fidelity to the intervention. Examples could be changes in the delivery method, key characteristics, or activities. *Adaptation: Making changes to the intervention, such as the target population, setting, or location, but do not change or contradict the internal logic of the intervention. Adaptation keeps fidelity to the internal logic. *Reinvention: Making changes to an intervention that change the internal logic or rationale of the intervention. This changes an intervention so drastically that the original intent is no longer applicable. DEBI (stands for Diffusion of Effective Behavioral Interventions): Effective behavioral interventions that meet CDC’s standards for evidence of behavior change and that have been chosen by CDC for national diffusion. DEBI’s are all EBIs, but not all EBIs are DEBIs! SMART Outcome Objectives: Specific, Measurable, Appropriate, Realistic, Time-Based Differences in Data Collection per intervention: 17th Texas HIV/STD Prevention conference Austin, TX 5.24.2010 3
  • 4. Preparation for Outome Monitoring Pre-Conference Workshop Key Terms-revised 5.18.2010  Individual Level  Intermediate and Immediate Outcomes  Can use questions from behavioral assessment  One initial assessment, up to two reassessments  No standardized survey  Driven by prevention plan and goals to be achieved  Designated outcomes  Pre/post done on same individual  Percentages for outcomes 15-50%  Not all outcomes will apply to all individuals  Group Level  Immediate Outcomes  Pre/post tests  Standardized survey  3-4 outcomes individualized per intervention  Pre/post done on same individual  Percentages for outcomes 40-75%  Can measure any SKABB  Community Level: 2 components  Group Component-measured first  2-4 immediate outcomes  Will measure M-Groups, training of peer volunteers  Standardized survey  Knowledge, skill-level, ability to communicate very important  Will be collected first stage  Community Level:  Community Component-measured second  2-4 Immediate Outcomes  Happens during community assessment  Pre/Post tests; Venue-based  Mainly measures knowledge, attitudes, beliefs, community norms  Percentages up to 15%  Gathered yearly  Will be collected in second stage 17th Texas HIV/STD Prevention conference Austin, TX 5.24.2010 4