Behavior Change Communication
- Behavior Change Fast and Slow: Changing Multiple Key Behaviors a Long-Term Proposition?
An intensive radio campaign in rural areas of Burkina Faso addressed multiple key behaviors to reduce child mortality, using a randomized cluster design. After 20 months, despite innovative approaches and high reported listenership, only modest reported change in behavior was found, mainly related to care seeking rather than habitual behavior such as hand washing. Various methodologic difficulties may have obscured a true greater impact. Analysis of the intervention after its full 35-month duration may reveal more impact, including on actual child mortality. Improving a number of key behaviors is essential to child survival efforts, and much of it may require strong and sustained efforts.
- The Saturation+ Approach to Behavior Change: Case Study of a Child Survival Radio Campaign in Burkina Faso
This randomized radio campaign focused on the 3 principles of the Saturation+ approach to behavior change: (1) saturation (high exposure to messages), (2) science (basing design on data and modeling), and (3) creative storytelling. Locally developed short spots and longer dramas targeted multiple child survival-related behaviors and were delivered entirely by local radio stations. Innovative partnerships with radio stations provided free airtime in return for training, equipment, and investment in solar power.
- Behavior Change After 20 Months of a Radio Campaign Addressing Key Lifesaving Family Behaviors for Child Survival: Midline Results From a Cluster Randomized Trial in Rural Burkina Faso
The radio campaign reached a high proportion of mothers, but the impact on self-reported behaviors at midline was mixed. Some reported episodic behaviors such as care seeking for diarrhea and obtaining treatment for fast/difficult breathing improved more in intervention than control areas, but there was little or no difference between areas in reported habitual behaviors, such as exclusive breastfeeding, complementary feeding, hand washing with soap, and use of bed nets.
- Toward a Systematic Approach to Generating Demand for Voluntary Medical Male Circumcision: Insights and Results From Field Studies
Using an analytical framework to design and implement voluntary medical male circumcision (VMMC) programs can lead to more effective interventions, especially when insights are incorporated from disciplines such as behavioral science and commercial market research. Promising VMMC behavior change practices: (1) address individual, interpersonal, and environmental barriers and facilitators; (2) tailor messages to men’s behavior change stage and focus on other benefits besides HIV prevention, such as hygiene and sexual pleasure; (3) include women as a key target audience; (4) engage traditional and religious leaders; (5) use media to promote positive social norms; and (6) deploy community mobilizers to address individual concerns.
- Breaking new ground in family planning communication
The Urban Reproductive Health Initiative has shown impact on contraceptive use from its communication components even within a few years, as described in 2 GHSP articles. One specifically addressed “ideation” about family planning in detail and was able to show both changes in ideation due to program exposure and correlated changes in contraceptive use. The other used a sophisticated analytical technique that indicated the observed changes in contraceptive use resulted from exposure to the communication efforts, and not just because people more prone to adopt family planning were also more likely to recall exposure to the communication messages.
- Demand generation activities and modern contraceptive use in urban areas of four countries: a longitudinal evaluation
Demand generation activities that were significantly associated with increased use of modern contraception in India (Uttar Pradesh), Kenya, Nigeria, and Senegal included: (1) community outreach activities, such as home visits and group discussions about family planning; (2) local radio programs; and (3) branded slogans and print materials circulated widely across the city. Television programming was also significant in India and Nigeria. Exposure to more activities may increase women's likelihood of using contraception.
- Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative
Greater exposure to a comprehensive family planning program in urban Nigeria that emphasized demand generation and communication theory was associated with improved ideation among women (their beliefs, ideas, and feelings about family planning), and more positive ideation was associated with greater contraceptive use, especially among the poor. Improving providers' knowledge, attitudes, and skills was also key. By the end of the observation period, outreach through mobile service delivery contributed nearly one-half of the project clinics' family planning services.
- SMS versus voice messaging to deliver MNCH communication in rural Malawi: assessment of delivery success and user experience
Mobile SMS health messages had higher successful delivery and led to higher intended or actual behavior change among subscribers than voice messages. Providing multiple delivery modalities led to greater overall access.