Mental model-based repeated multifaceted (MRM) intervention design: a conceptual framework for improving preventive health behaviors and outcomes.

OBJECTIVE: Field interventions employed to improve preventive health behaviors and outcomes generally use well-established approaches; however, recent studies have reported that health education and promotional interventions have little to no impact on health behaviors, especially in low- and middle-income countries. We aimed to develop a conceptual framework to improve intervention designs that would internalize these concerns and limitations.
RESULTS: We identified three major experimental design- and implementation-related concerns associated with mental models, including the balance between the treatment and control groups, the treatment group's willingness to adopt suggested behaviors, and the type, length, frequency, intensity, and sequence of treatments. To minimize the influence of these aspects of an experimental design, we proposed a mental model-based repeated multifaceted (MRM) intervention design framework, which represents a supportive intervention design for the improvement of health education and promotional programs. The framework offers a step-by-step method that can be used for experimental and treatment design and outcome analysis, and that addresses potential implementation challenges.