The document outlines the steps of plan-based evidence informed prevention which includes carefully assessing needs, selecting relevant and changeable determinants of behaviors or environments, choosing theory-based intervention methods to address those determinants, developing and testing a program, and planning for adoption, implementation and evaluation. The approach emphasizes thinking through problems systematically before taking action and allowing for adaptation through an iterative process.

1. Plan Based Evidence Informed Prevention Safe and Strong

4. A logic model adapted from PRECEDE Safe and Strong Behavioral Factors Environmental Factors Health Problems Quality of Life Personal and External Determinants ( Predisposing, enabling and reinforcing factors) Personal and External Determinants (Predisposing, enabling and reinforcing factors)

5. A logic model adapted from PRECEDE Safe and Strong Behavioral Factors: compliance, consumption, coping, preventive actions, risk behavior, utilization, self-care Environmental Factors: medical care, social support, access to service, rules or laws, availability of resources, attitudes and behavior of health care providers, peers, parents, employers Health Problems: disability, discomfort, fertility, fitness, morbidity, mortality, physiological risk factors Quality of Life Indicators: alienation, comfort, happiness, hostility, self esteem, unemployment, welfare Personal and External Determinants ( Predisposing, enabling and reinforcing factors) Personal and External Determinants (Predisposing, enabling and reinforcing factors)

7. Safe and Strong Fishbein Model EXTERNAL VARIABLES DEMOGRAPHICS PERSONAL CHARACTERISTICS INDIVIDUAL DIFFERENCES ATTITUDE NORM SELF- EFFICACY ENVIRONMENTAL CONSTRAINTS INTENTION BEHAVIOUR BELIEFS ABOUT EFFICACY NORMATIVE BELIEFS BEHAVIOURAL BELIEFS SKILLS

8. Safe and Strong EXTERNAL VARIABLES DEMOGRAPHICS PERSONAL CHARACTERISTICS INDIVIDUAL DIFFERENCES GENERAL KNOWLEDGE - general knowledge about hepatitis B - general knowledge about the consequences of hepatitis B - knowledge about the campaign BELIEFS ABOUT BEHAVIOUR - the shots are painful BEHA-VIOUR - doesn’t get vaccinated SELF-EFFICACY - cannot deal with the test results - openness about gay lifestyle (self-esteem) - no adherence to vaccination schedule NORM - you only get vaccinated if you have run a risk BELIEFS ABOUT EFFICACY - “I don’t want to know the results” NORMATIVE BELIEFS - only gays get vaccinated - you have obviously run a risk if you get vaccinated - negative characterisation by others (“slut”) ENVIRONMENTAL CONSTRAINTS - costs related to this - not familiar with campaign - negative social influence (getting vaccinated is not the norm) - inflexible scheduling at policlinic SKILLS - making an appointment is time-consuming and complicated. ATTITUDE -low risk assessment for hepatitis B and its infectiousness - low risk assessment, because “I always have safe sex” - negative attitude due to fear of shots - fear of vaccine / side effects - fear of test results - health motivation (“I’m going to get it anyway”) INTENTION - low level of intention to get vaccinated Schorer example: Hepatitis B