Knowledge and Beliefs about the Intervention

Skill in using the intervention is a primarily cognitive function that relies on adequate how-to knowledge and knowledge of underlying principles or rationale for adopting the intervention [1]. Enthusiastic use of an intervention can be reflected by a positive affective response to the intervention. Often, subjective opinions obtained from peers based on personal experiences are more accessible and convincing, and these opinions help to generate enthusiasm [1]. Of course, the converse is true as well, often creating a negative source of active or passive resistance [2]. The degree to which new behaviors are positively or negatively valued heightens intention to change, which is a precursor to actual change [3].

Users’ skilled and enthusiastic use of the intervention are two key features of effective implementation [4]. These attributes are important to understand at individual and sub-group levels in order to assess quality of implementation and prospects for sustainability. Skill levels reflect the effectiveness of training. If this knowledge (see Access to Information and Knowledge) is not obtained prior to an individual having to use the intervention, rejection and discontinuance are likely [5]. The competence of individuals to judge the effectiveness of an intervention is facilitated by their understanding of underlying principles that justify using the intervention. When knowledge can be codified and transferred across contexts, implementation is more likely to be successful [6].