title: Developing a theoretical framework for complex community-based interventions.
abstract: Applying existing theories to research, in the form of a theoretical framework, is necessary to advance knowledge from what is already known toward the next steps to be taken. This article proposes a guide on how to develop a theoretical framework for complex community-based interventions using the Cardiovascular Health Awareness Program as an example. Developing a theoretical framework starts with identifying the intervention's essential elements. Subsequent steps include the following: (a) identifying and defining the different variables (independent, dependent, mediating/intervening, moderating, and control); (b) postulating mechanisms how the independent variables will lead to the dependent variables; (c) identifying existing theoretical models supporting the theoretical framework under development; (d) scripting the theoretical framework into a figure or sets of statements as a series of hypotheses, if/then logic statements, or a visual model; (e) content and face validation of the theoretical framework; and (f) revising the theoretical framework. In our example, we combined the "diffusion of innovation theory" and the "health belief model" to develop our framework. Using the Cardiovascular Health Awareness Program as the model, we demonstrated a stepwise process of developing a theoretical framework. The challenges encountered are described, and an overview of the strategies employed to overcome these challenges is presented.
authors.affiliation: 1McMaster University, Hamilton, Ontario, Canada.
authors.forename: Ricardo N
authors.initials: RN
authors.lastname: Angeles
authors.forename: Lisa
authors.initials: L
authors.lastname: Dolovich
authors.forename: Janusz
authors.initials: J
authors.lastname: Kaczorowski
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008962:Models, Theoretical; D016730:Program Development; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors
keywords: community intervention; epidemiology; health research; program planning and evaluation; theory