Innovation in health care includes important challenges: to find or create technologies and practices that are better able than the prevailing ones to reduce morbidity and mortality and to make those improvements ubiquitous quickly.

—McCannon, Berwick, and Massoud (2007, p. 1937)

How does one develop a behavioral intervention? Where does one begin? This is a common query and one for which there is no straightforward or simple response. Despite increased recognition of the importance of this form of inquiry, there is no consensus, agreed upon strategy, or recipe, as we discussed in Chapter 2, for getting started in developing an intervention.

However, all interventions have a common origin or etiology, the starting point of which is referred to as a period of “discovery” or a prephase to the pipelines discussed in Chapter 2. This prephase discovery period is one in which the fundamental idea for, or anatomy of, an intervention is conceptualized and fleshed out. It is the linchpin from which all subsequent decisions are made concerning the next steps to be taken to evaluate and advance an intervention. Although all succeeding steps, phases, pilot testing, and related research activities to advance an intervention are important, establishing the foundation of an intervention in this prephase of discovery is perhaps one of the most critical as it directs all subsequent thinking and action processes.

Therefore, the purpose of this chapter is to examine in depth this crucial period of “discovery” in which the basic concept for an intervention is initially conceptualized and defined. We provide a roadmap as to the essential decision making that needs to occur in the process of creating an intervention and some working tools to help map out this process.

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