Introduction to Behavior Change Communication

Understanding main concepts

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Behavior Change

• Comprehensive process in which one passes through the stages of:

• Unaware >> Aware >> Concerned >> Knowledgeable >> Motivated to change >> Practicing trial behavior change >> Sustained behavior change

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Behavior Change Communication (1)

• BCC is an interactive process with communities (as integrated with an overall program) to develop tailored messages and approaches using a variety of communication channels to develop positive behaviors; promote and sustain individual, community and societal behavior change; and maintain appropriate behaviors.

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BCC – definition 2

• Behavior change communication (BCC) is the strategic use of communication to promote positive health outcomes, based on proven theories and models of behavior change.

• BCC employs a systematic process beginning with formative research and behavior analysis, followed by communication planning, implementation, and monitoring and evaluation. Audiences are carefully segmented, messages and materials are pre-tested, and both mass media and interpersonal channels are used to achieve defined behavioral objectives.

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BCC – definition 3

• Behavior change objectives refer to intended changes in the audience’s actual behavior.

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Role of BCC in HIV/AIDS

• Increase knowledge• Stimulate community dialogue• Promote essential attitude change• Advocate for policy changes• Create a demand for information and services• Reduce stigma and discrimination• Promote services for prevention and care

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Insights

• BCC has its roots in behavior change theories• BCC practitioners use a combination of

theories and practical steps that are based on field realities, rather than relying on any single theory or model.

• Rationale behind “staging” people is to tailor therapy to a person’s needs at his/her particular point in the change process.

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Insights

• When changing behavior, the individual, community, or institution goes through a series of steps, sometimes moving forward, sometimes moving backward, and sometimes skipping steps. Even when new behaviors have been adopted, the individual, community, or institution, under certain circumstances, may revert to old behaviors.

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Conceptual Examples of BCC activities

• State program goals • Involve stakeholders • Identify target populations • Conduct formative BCC assessments • Segment target populations • Define behavior change objectives • Design BCC strategy and monitoring and evaluation (M&E) plan • Develop communication products (main focus of the training)• Pre-testing • Implement and monitor • Evaluation • Feedback and redesign

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Steps in Developing Behavior Change Communication

1. State program goals2. Involve stakeholders3. Identify target populations4. Conduct formative BCC assessments5. Segment target populations6. Define behavior change objectives7. Define BCC strategy and M&E plan8. Develop communication products9. Pretest10. Implement and monitor11. Evaluate12. Analyze feedback and revise

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Communications products NOT counselling

• Communication products are the list of all possible interventions, most popular examples include:– Outreach– Secondary outreach– Group work– IEC distribution– Motivational counseling– Referral – VCT– Etc.

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Levels of BCC

• BCC has several levels it can be implemented at.

• Each level includes several theories.

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Levels of BCC and why so many levels?

• Individual Level– Health belief theory– Theory of Reasoned Action and planned behavior– Stages of change– Social Learning

• Community Level– Diffusion of innovations theory– Community mobilization

• Change in organizations – 4 stage change

• Public Policy Level– Distinct stages of initiation, action, implementation, evaluation and re-formulation

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Communication Channels

• Each level (and each theory) employs specific communication channels.

• Based on this, consider the training logic.

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Training logic - 1

• Understanding BCC

• Level: narrowing to individual to change risks affiliated with behavior

• Communication type: outreach conditions, counseling, referral, education.

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Training logic - 2

• Things to master (3 days): BCC techniques used during outreach and methods of their delivering; learning and satisfying need of IDUs on an individual level, development of counseling skills.

• Things to master during supervision (2 days): to develop skills in conducting training and delivering information to IDUs.

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Literature used

• http://www.hivpolicy.org/Library/HPP000533.pdf

• http://www.globalhealthcommunication.org/tools/strategy/behavior_change_communication

• http://www.fhi.org/NR/rdonlyres/ejp5m2gbtwupuf5h25y6b4oyz2lkxza334grizafsrlaux7qbbmlksdqy4bsoi2lw3ol27rukt7l6m/Mod06.pdf

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