TABLE 2.

Operationalizing Social and Behavior Change Lessons Learned In Emergency Responses to Emerging Infectious Disease Epidemics

Lessons LearnedSuggested ActionsDesired Outcome(s)
Engage communities as a key pillar of emergency responsesOutbreak investigators should work with communities to:
  • Conduct participatory action research to identify contextually relevant barriers to uptake of preventive behaviors

  • Strengthen community-based networks for epidemiological and behavioral surveillance100

  • Support social mobilization for development and validation of risk-related communication strategies and messages

Communities are engaged in pandemic response, ensuring local ownership and leadership.
Strategies and communications are appropriate for community audiences.
Build trust through transparent risk communicationPolitical leaders and public health spokespeople should:
  • Communicate current state of affairs in a timely and consistent manner regarding known risks and spread of an emerging infectious disease

  • Acknowledge gaps in knowledge and limitations, and reiterate commitment to communicating new evidence and its implications in a timely manner

  • Strengthen existing community institutions in calm, nonemergency settings

Communities have trust in epidemic advisors and are more willing to follow advice and guidelines under changing circumstances.
Segment audiences for tailored interventions Response coordinators should:
  • Gather information and insights to understand the attitudes, perceptions, beliefs, concerns, and information needs of particular audiences, using the best social science evidence available

  • Use tools such as FHI 360’s rapid audience assessment to support analysis and development of audience profiles80

  • Tailor interventions by designing strategies, tools, and materials that reflect audience profiles

Audiences receive messages that are fit to their needs and priorities.
Messages are communicated in ways that respect community differences and do not promote stigma or biases.
Prioritize behaviorsEpidemic response teams should:
  • Define criteria for behavior prioritization such as behaviors based on segmented audiences, the state of the evidence for each preventive behavior, and feasibility of adopting the behavior85

  • Harmonize risk communication messages and channels to “speak as a single voice”

Messages clearly communicate the most important behaviors for more effective interventions.
Individuals understand the most important behaviors to undertake and are not overwhelmed with instructions or conflicting messages.
Cultivate political will and commitmentPublic health leaders should:
  • Proactively communicate with politicians and funders about the importance of social and behavior change expertise in preparedness and response

  • Use honest conversations about past failures to inform future agendas

  • Encourage multilateral coordination to promote efficiency and effectiveness

  • Help high-income country leaders recognize the implications of outbreaks in low- and middle-income countries

Policy makers are willing to make clear and evidence-based decisions.
Leaders prioritize effective pandemic response over short-term political motivations.
Decision makers in high-income countries respond earlier to disease outbreaks in low- and middle-income countries.