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Table 1 Intervention mapping step 1, needs assessment logic model

From: Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: an intervention mapping protocol

 

Phase 4: determinants

Phase 3: behavioural and environmental factors

Phase 2: body structures and functions

Phase 1: function, participation, and health

Modifiable

Knowledge about condition

Goal setting and action planning

Swallowing

Decreased functional status,

Fatigue

Knowledge about symptom management and resources

Health care professionals knowledge about rehab and HNC treatment

Muscle strength, joint mobility

Decreased health status, Decreased participation and engagement in personally-meaningful life areas

Cardiovascular capacity

Knowledge about metacognitive strategy use

Expectations

Dental issues

Energy budgeting

Mouth opening

Neck and arm range of motion

Decreased psychosocial function

Knowledge about association among needs/issues?

Coping habits

Speech

Exercise habits

Anxiety

Decreased role function

Dietary habits

Dry mouth

Substance use, particularly smoking

Neuropathies/sensory issues

Decreased employment

Local processes

Fibrosis

Physician referral processes

Action planning

Pain

Problem solving

Cardiovascular capacity

Developing strategies

Self efficacy

Communication style

Self regulation/self evaluation

Digestive system functioning

Coping style

Rehab resources

Weight loss

Pre-existing mood/behaviour

Community resources

Cognitive impairments

Access to resources

Personality changes

Emotional issues

Intimacy

Body image/body satisfaction

Lymphedema

Late effects

Non-modifiable

Disease site

Hospital type (eg cancer centre vs tertiary care centre)

Aesthetic outcomes

 

Treatment received

Age

Sex

Education level

Socioeconomic status/finances

Personality

  1. Items in italics are targeted for change.