Designing Individual-Level Implementation Strategies

This course focuses on changing health-related behaviors (or practices) of individuals—including providers, patients, and community members—in order to facilitate uptake of evidence-based health interventions. Scholars will be introduced to health behavior change theories across a range of socio-ecological contexts and intervention design frameworks. The emphasis will be on the application of theory and frameworks to 1) selecting behavior change targets; 2) characterizing barriers and enablers of behavior change; and 3) identifying techniques likely to be effective in addressing key barriers and enablers of behavior change. Scholars will apply concepts taught by either 1) developing a conceptual framework and instrument to guide data collection on barriers and enablers of a selected target behavior; or 2) designing an implementation strategy to facilitate uptake of their chosen evidence-based health intervention or program by target individuals. Scholars will also learn to incorporate the conceptual basis for their work into grant applications/funding proposals.


  • Cognitive and socio-ecological health behavior change theories
  • Frameworks for the design of effective health behavior change interventions (e.g., Behaviour Change Wheel)
  • Common behavior change tools (e.g., behavioral economics, social marketing)
  • Writing implementation science grants

At the end of the course, scholars will be able to:

  • Describe common behavior change theories used to facilitate uptake of health interventions
  • Identify behavioral and contextual determinants that can influence health intervention uptake by individuals using behavior change theories
  • Design, adapt, and/or tailor an implementation strategy that targets key behavioral and contextual determinants using an intervention design framework
  • Create visual representations (e.g., figures and tables) of the logic, functions, and techniques of an implementation strategy to foster individual behavior change.


Clinicians, public health practitioners, and researchers wishing to gain knowledge and skills in translating evidence into practice.

Offered: Winter Term


Introduction to Implementation Science Theory and Design. Exceptions to this prerequisite may be made with the consent of the Course Director, space permitting.


Course Directors

Emilia De Marchis, MD is an Assistant Professor in the Department of Family & Community Medicine. Her primary interest is in addressing health disparities by assessing and improving screening for and delivery of social services within the health care setting, and adjusting patients' medical care informed by patients' social risk factors. Emilia's research utilizes mixed methods, including secondary analyses of large data sets and analyses of primary collected survey and semi-structured interview data. Through her work, she hopes to better understand how efforts to address health-related social needs within health care impact the health care workforce, patient behavior and health outcomes, and health care utilization and costs. Emilia's clinical experiences as a family medicine physician at UCSF provide the impetus for her work.

Matthew Spinelli, MD, MAS is an HIV/ID physician with training in implementation science methods who uses these approaches to support pre-exposure prophylaxis (PrEP) implementation, PrEP/HIV ART adherence, and PrEP persistence/HIV retention in care. A key tool we are using in this work is a point-of-care urine tenofovir test that can provide real-time adherence information to clinicians to drive adherence interventions. More recently, he leads projects on the intersection of the HIV and COVID-19 epidemics using epidemiological, translational, and sociobehavioral methods. Finally, he is a member of Partnerships for Research in Implementation Science for Equity, a collaboration between the SF Department of Public Health and UCSF that seeks to use implementation science methods to advance equity.


Course Requirements

Required Readings: The Behaviour Change Wheel. A Guide To Designing Interventions. Written by Susan Michie, Lou Atkins & Robert West. 2015. Available at Behaviour Change Wheel website.

Recommended: Health Behavior and Health Education: Theory, Research, and Practice by Karen Glanz. Jossey-Bass. 4th edition. 2008.

Evaluation of student performance will be based on successful completion of assignments for the first 7 weeks and a final 3-5 page protocol or grant proposal section. Completing this course will take an estimated 60 hours of work.