Motivating Motivating Behavior and Behavior and Social ChangeSocial Change

Maseru, LesothoMaseru, Lesotho

February 2, 2009February 2, 2009

Exercise

Motivating behavior Motivating behavior changechange

Sleep in a quiet room

Talking to Wife

HusbandGirlfriendBoyfriend

Working

Stayed up too late in the lounge

Breakfast

Our lives are filled with a series of conscience and unconscious behaviorswe have adopted or avoided……

Behaviors ChangeBehaviors Change

Choose a partner Choose a partner Tell your partner about Tell your partner about a behaviora behavior

that you have changed?that you have changed? How did you do it?How did you do it? What motivated you?What motivated you? What was easy/ difficult about the What was easy/ difficult about the

change?change? How do you feel about the change?How do you feel about the change? Is the change temporary or permanent?Is the change temporary or permanent?

Learning Objectives of Learning Objectives of Session TodaySession Today

Understand the science of behavior Understand the science of behavior changechange

Review the process for developing Review the process for developing BCC programsBCC programs

Identify ways that Peace Corps staff, Identify ways that Peace Corps staff, counterparts and volunteers can be counterparts and volunteers can be involved in behavior change involved in behavior change programsprograms

List current BCC List current BCC activitiesactivities

BehaviorBehavior AudienceAudience ActivityActivity

What is Behavior ChangeWhat is Behavior Change

Behavior change communication has Behavior change communication has many aliasesmany aliases IECIEC Health promotionHealth promotion Health educationHealth education Behavior change communicationBehavior change communication Social and behavior change Social and behavior change

communicationcommunication Disciple that has grown and developed Disciple that has grown and developed

over time and with experienceover time and with experience

Individual

Early Behavior ChangeEarly Behavior Change

Focus on information and creating Focus on information and creating awarenessawareness

Posters, pamphlets, eventsPosters, pamphlets, events Disease Days for awarenessDisease Days for awareness Little input from the target Little input from the target

audiencesaudiences Little attention to multiple Little attention to multiple

influences influences

Don’t SmokeDon’t Drink and Drive

AIDS KILLS

Family

Social Status

Community

Media Income

Services

Genderroles

Culturereligion

Policy

Individual

No Smoking inPublic Places

Drink and DriveYou’ll do 5

Protect your newborn, get tested and know your status

Social and Behavior Change Social and Behavior Change CommunicationCommunication

Theory and evidence drivenTheory and evidence driven Behavior is complex and Behavior is complex and

multidimensional multidimensional Internal and external factors Internal and external factors

influence behaviorinfluence behavior Requires a combination of activities Requires a combination of activities

over timeover time

What can BCC doWhat can BCC do Individual LevelIndividual Level

Increase knowledge of Increase knowledge of health health risk/solution/servicesrisk/solution/services

Promote attitude changePromote attitude change Reduce stigma and Reduce stigma and

discriminationdiscrimination Create a demand for Create a demand for

information and servicesinformation and services Promote services for Promote services for

prevention, care and prevention, care and support support

Improve skills and sense Improve skills and sense of self-efficacyof self-efficacy

Community/Community/Environmental LevelEnvironmental Level Stimulate community Stimulate community

dialoguedialogue Gain support of Gain support of

Community Community leaders/influencialsleaders/influencials

Address and change Address and change community normscommunity norms

Reduce stigma and Reduce stigma and discriminationdiscrimination

Advocate for policy Advocate for policy development or changedevelopment or change

Useful Frameworks by Useful Frameworks by Level Level

IndividualIndividual:: Stages of Change Model Stages of Change Model Health Belief ModelHealth Belief Model

InterpersonalInterpersonal:: Social Learning Theory Social Learning Theory

InstitutionalInstitutional:: Organizational Change Organizational Change ModelsModels

Community & nationCommunity & nation:: Community Community organization models; Diffusion of organization models; Diffusion of InnovationsInnovations

PolicyPolicy:: Policy communication approaches Policy communication approaches

Stages of ChangeStages of Change

Pre-contemplativePre-contemplative ContemplativeContemplative

Preparation for Preparation for ActionAction

ActionAction Assume the Assume the

behavior over timebehavior over time

No problem…..No problem….. Hmmm…maybe I Hmmm…maybe I

should do should do something…something…

Ok let’s give it a Ok let’s give it a go…go…

That wasn’t so That wasn’t so bad…bad…

This is a part of my This is a part of my life now….life now….

Stages of Change Stages of Change ExerciseExercise

•Pre-contemplativePre-contemplative•ContemplativeContemplative•Preparation for ActionPreparation for Action•ActionAction•Assume the behavior Assume the behavior over timeover time

AssignmentAssignment

Create a message for:Create a message for:

Target: a 25 year old rural Target: a 25 year old rural male who is sexually active male who is sexually active

The Topic: testing for HIV The Topic: testing for HIV infectioninfection

Process of Developing Process of Developing BCCBCC

Establishing the behavior to addressEstablishing the behavior to address Define the target audienceDefine the target audience Determining the determinants (internal Determining the determinants (internal

and external) that influence behaviorand external) that influence behavior Craft the message appeal or approachCraft the message appeal or approach Selecting effective interventionsSelecting effective interventions Monitoring how things are goingMonitoring how things are going Measuring successMeasuring success

Behavior change can be one action

or a series of actions

BehaviorsBehaviors

Simple Behaviors

Complex Behaviors

Establish the behavior to Establish the behavior to addressaddress

Increase Uptake of ARVsIncrease Uptake of ARVs Get testedGet tested Get resultsGet results Go for a CD4 testGo for a CD4 test Get resultsGet results Enroll in treatment programEnroll in treatment program Take medicines as prescribedTake medicines as prescribed Visits clinic regularly to monitor your progressVisits clinic regularly to monitor your progress Stay healthy (eat nutritious foods, don’t drink or Stay healthy (eat nutritious foods, don’t drink or

smoke)smoke) Enlist the help of your partner and familyEnlist the help of your partner and family Attend support groupAttend support group

Establish the behavior to Establish the behavior to addressaddress

Increase Uptake of ARVsIncrease Uptake of ARVs Train and prepare testing staffTrain and prepare testing staff Advertise where to get test and Advertise where to get test and

hours of operationhours of operation Work with the community to Work with the community to

address stigma and discriminationaddress stigma and discrimination Establish community based support Establish community based support

groupsgroups

Define the target Define the target audienceaudience

The individual or group who’s behavior you are trying to change

Define the target audienceDefine the target audience

Young PeopleYoung People Male/femaleMale/female AgeAge Income levelIncome level EducationEducation In school/ out of schoolIn school/ out of school Rural/urbanRural/urban Sexually active/not sexually activeSexually active/not sexually active Use internet regularly/no access to internetUse internet regularly/no access to internet Participate in sports or club activity/don’t Participate in sports or club activity/don’t

participateparticipate

Determinants and Factors Determinants and Factors (internal and external) that (internal and external) that

influence behaviorinfluence behavior InternalInternal

Self efficacySelf efficacy Perceived social Perceived social

normsnorms Perceived Perceived

positive/negative positive/negative consequencesconsequences

Efficacy of actionEfficacy of action Real benefitsReal benefits Real barriersReal barriers

ExternalExternal FamilyFamily ReligionReligion Gender Gender CultureCulture Community Community

AcceptanceAcceptance PoliciesPolicies

Craft the message appeal or Craft the message appeal or approachapproach

Develop messages that address key determinantsand promote benefits of

adopting or modifying behavior

ExamplesExamples

Reduce your risk of colds and Reduce your risk of colds and infections, wash your hands with infections, wash your hands with soap after visiting the market or soap after visiting the market or other busy places.other busy places.

For peace of mind and a trusting For peace of mind and a trusting relationship go for an HIV test relationship go for an HIV test together, know your status.together, know your status.

Wait a minute!!!Wait a minute!!!

How do I know this How do I know this information???information???

Understand your target Understand your target audienceaudience

Talk to your target audience Talk to your target audience (formally and informally)(formally and informally)

Listen to your audienceListen to your audience Find out what they read, where they Find out what they read, where they

hang out, what they like to do, who hang out, what they like to do, who they trustthey trust

Observe themObserve them Involve themInvolve them

Selecting effective Selecting effective interventionsinterventions

Type of Type of InterventionIntervention Interpersonal Interpersonal

MediaMedia

Community Community

FormatsFormats Groups discussion, Groups discussion,

peer education, peer education, support group, one –support group, one –to-one to-one

Radio, community Radio, community newspapers, signs newspapers, signs and billboardsand billboards

Public meetings, Public meetings, events, community events, community theater, church grouptheater, church group

ExerciseExercise

Applying the Behave Framework

Behavior Target Audience and Influencing Groups

Determinants

Key Factors(barriers and benefits)

Interventions Activities

BehaviorsBehaviors

Using bed nets to prevent malariaUsing bed nets to prevent malaria Gaining community support for a life Gaining community support for a life

skills programs for 12- 14 year old skills programs for 12- 14 year old girls girls

Introducing the use of a new Introducing the use of a new technology for collecting datatechnology for collecting data

Discouraging the practice of having Discouraging the practice of having sex in exchange for gifts, money, cell sex in exchange for gifts, money, cell phones (young girls with older men)phones (young girls with older men)

Monitoring and EvaluationMonitoring and EvaluationMONITORINGMONITORING

PurposesPurposes Assess quality, Assess quality,

frequency and process frequency and process Is the program Is the program

happening?happening? How often is the How often is the

program activity being program activity being carried out?carried out?

Are materials Are materials distributed?distributed?

Are people accessing Are people accessing services?services?

Are services that are Are services that are promoted available?promoted available?

MethodsMethods Simple data collection Simple data collection

formsforms Observations of Observations of

activities with checklistactivities with checklist Interviews with Interviews with

participants participants Data on usage at Data on usage at

service sitesservice sites Inventory checksInventory checks

Monitoring and EvaluationMonitoring and EvaluationEVALUATIONEVALUATION

PurposePurpose Community Community

acceptance or acceptance or participation participation

Support of key leadersSupport of key leaders Use or adaptation of Use or adaptation of

program by local program by local groupsgroups

Update of new Update of new technologytechnology

Increase or Increase or improvement in improvement in individual behaviorsindividual behaviors

MethodsMethods Interviews with Interviews with

stakeholders and stakeholders and leadershipleadership

Number of community Number of community groups conducting groups conducting interventions, using interventions, using materials, addressing materials, addressing issue/behaviorissue/behavior

Service referral, Service referral, products soldproducts sold

Observed behaviorObserved behavior Mystery client, shopperMystery client, shopper

How to involve PC in How to involve PC in programs programs

Many international NGOs, FBO Many international NGOs, FBO involved in community based activities involved in community based activities AED, PSI, CARE, RED CROSS, World AED, PSI, CARE, RED CROSS, World VisionVision

Opportunities to engage PC volunteers Opportunities to engage PC volunteers and staff in existing programsand staff in existing programs

Program developmentProgram development MonitoringMonitoring Capacity supportCapacity support