A Conceptual Framework for Mental Model-based Repeated Multifaceted Intervention Design to Improve Preventive Health Behaviors and Outcomes
Abstract Background: Improving the effectiveness of health interventions is a major challenge in public health research and program development. A large body of literature found low or no impact of health education and promotional interventions, especially in low- and middle-income countries.Objectives: To develop a conceptual framework in support of intervention designs of preventive health behavior improvement programs and outcomes.Methods: An overview of systematic and scoping reviews along with empirical literature was conducted to assess the limitations of preventive health education and promotion interventions using water, sanitation, and hygiene (WASH) programs and outcomes as examples.Results: We analyzed the limitations of the less effective or ineffective field interventions cited in peer-reviewed articles. We found three major limitations regarding the mental model’s balance of treatment and comparison groups, treatment groups’ willingness to adopt suggested behaviors, and the type, length, frequency, intensity, and sequence of treatments. To minimize the influence of these concerns, we proposed a mental model-based repeated multifaceted (MRM) intervention design framework.Conclusions: Our proposed framework aims to provide an intervention design for improving health education and promotional programs. Further studies using this framework are essential to examine our hypotheses and advance the understanding of how MRM design can improve preventive health behaviors and outcomes.