Nursing and Health Interventions. Souraya Sidani

engagement, and adherence to all treatment recommendations in their daily life context.

TABLE 2.2 Examples of programs or multicomponent interventions.

Health problem	Chronic insomnia	Stroke and multi‐morbidity	Promotion of physical health
Program/intervention name	Multicomponent intervention	Hospital‐to‐home transitional care intervention	For health, I move in my neighborhood!
Description	Sleep education and hygieneDiscussion of factors that contribute to insomniaPresentation of behavioral and environmental recommendations to promote a good night's sleepStimulus control therapyDiscussion of instructions for sleep‐related behaviorsApplication of recommendations in daily lifeSleep restriction therapyIdentification of sleep needsWorking out a sleep–wake scheduleApplication of schedule in daily lifeBehavior change supportIdentification of barriers and strategies to overcome barriers to the application of recommendations in daily lifeSelf‐monitoring of sleep behaviors and sleep parameters	Person‐centered careComprehensive health assessmentMedication review and reconciliationSelf‐management education and supportProvision of caregiver supportCare coordination/system navigationIn‐person (inter‐professional case conferences) and electronic (web‐based application) communication among health professionalsTimely referral to appropriate health professionals and community resources	.Improved offering and accessibility to physical activityProvision of new activities (e.g. walking, yoga) in schoolsCommunication about physical activity (i.e. information about benefits of physical activity)Distribution of flyers or brochuresPhysical activity instructor's visits to different structures (e.g. schools, community centers) and availability for consultationSports festivalEnvironmental changesOrientation pathways (i.e. information on distance and duration of walk to different services)Provision of additional sports devices at community centersUrban redevelopmentRoad work (e.g. bike path, widening sidewalk)Redevelopment of green areas“Shape and Health Challenge” programPhysical and sports activities program
Reference	Adapted from Sidani et al. (2019)	Adapted from Markle‐Reid et al. (2019)	Adapted from Buscail et al. (2016)

      There are two categories of intervention components: specific and nonspecific. Specific components are unique and essential in distinguishing the intervention. They represent the “active ingredients,” which are theoretically hypothesized to bring about the intended changes in the health problem and to produce related beneficial outcomes (Carey et al., 2018; Kühne et al., 2015; Michie et al., 2009). The nonspecific components are techniques used to enable, support, reinforce, or facilitate the implementation of the intervention's specific components (Sidani et al., 2020). Nonspecific components are usually not unique to a particular intervention and, therefore, are not expected to contribute significantly to the intended beneficial outcomes (Araújo‐Soares et al., 2018). Recent evidence, however, suggests that nonspecific components, in combination with the way the intervention is delivered, may enhance or undermine its effectiveness (Dombrowski et al., 2016). For example, sleep education and hygiene, stimulus control therapy and sleep restriction therapy are specific components of the multicomponent intervention for insomnia. The behavior change support is a nonspecific component because it is generic and can be integrated in other health behavior change interventions.

2.3 CHARACTERISTICS OF INTERVENTIONS

      Interventions are characterized by their elements (i.e. goals and components), which define them conceptually, and the way in which the interventions and their components are delivered. This encompasses features through which interventions' content is conveyed (Dombrowski et al., 2016) and specific components and activities are implemented. The features include mode of delivery, structure, and dose.

      2.3.1 Mode of Delivery

      The mode of intervention delivery is described in terms of medium and format.

      Medium is the means through which the intervention and its components and respective activities are carried out. Medium is defined by the intersection of person‐dependency and method. For the former, medium can be classified as person‐dependent and person‐independent (Beall et al., 2014; Cutrona et al., 2010). In the person‐dependent medium, individuals, including health professionals and/or laypersons, offer the intervention to clients, whereas these individuals are not directly involved in the intervention delivery in person‐independent medium. There are two methods of delivery: verbal/oral and written.

Format refers to the specific technique used within the verbal and written method for providing the intervention. Examples of specific media illustrating the intersectionality of person‐dependency, method, and format are presented in Table 2.3.

Different modes can be used to deliver different components of an intervention and more than one mode can be used to deliver each component. For instance, the sleep education and hygiene component of the multicomponent intervention for insomnia can be provided via the combination of: (1) formal presentation of pertinent content by a health professional to a small group of persons with insomnia, complemented by a slide presentation; (2) involvement of persons in a group discussion to clarify the information; and (3) a booklet summarizing the key points that serves as a reference for persons carrying out the sleep hygiene recommendations.

TABLE 2.3 Examples of specific media for providing interventions.

Method	Person‐dependent	Person‐independent
Verbal	Face‐to‐face formatLarge group presentationSmall (6–10 persons) group meetings/sessionsIndividual meetings/contactsDistance formatTelephone callsVideoconferencingDigital media contacts	Recorded (audio/video) presentationsAutomated telephone callsMessage disseminated via media (radio, television, mobile telephones‐text messaging)
Written	Slide presentation	Posters located in public placesInformation distributed via diverse modes (e.g. regular mail, electronic mail, mobile telephones)Information available via digital media (World Wide Web, mobile applications, portable media players)

      2.3.2 Structure

      Structure has to do with the approach and sequence for providing the intervention components. Approach represents the manner in which the intervention is given. It can be standardized or tailored/adaptive.

      The standardized approach consists of giving the same intervention components, in the same mode, to all clients, regardless of the relevance of the intervention's components, activities, and mode of delivery to the characteristics and preferences of clients. The tailored approach involves customizing or individualizing the intervention to the characteristics and preferences of clients (Mannion & Exworthy, 2017). It is conceivable to provide some components and respective activities in a standardized approach and others in a tailored approach. In the example of the multicomponent intervention for chronic insomnia, the instructions of the stimulus control therapy are applicable to all clients and, thus, relayed in a standardized approach; however, setting a regular sleep–wake schedule, which is the specific component of sleep restriction therapy, is informed