Behavior Change
Communication for Health
Interpersonal Communication
Counseling
Advantages and disadvantages of
interpersonal communication channels
Advantages
Reach people face to face
Allows for immed...
Some forms of interpersonal media
Forms
Demonstrations

Advantages

Disadvantages

Suggestions

Shows in practical way how...
Forms
Home visits

Advantages
Establishes good relationships
between families and staff.
Useful in providing timely
releva...
Forms
Story telling

Advantages

Disadvantages

Suggestions

Abundant availability in some
communities. Culturally
relevan...
In the area of health, interpersonal
communication takes place:


using various methods and approaches



at several dif...
Levels of interpersonal interaction and approaches in
health
Levels of Interaction
1. Client-provider Interaction
 To en...
Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
1.client-provider
interaction

Approach...
Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
2. Husband-wife
(Spousal communication)...
Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
3. Couples and Family

Approaches
Couns...
Levels of interpersonal interaction and approaches in
health
Levels of
Interaction
4. Peer groups and social
networks

App...
Environment and social context
A supportive environment and social context is
essential for promoting effective interperso...
Clinic and Community
 Budget: adequate staff, sufficient training, materials for
client and providers.
 Environment: cli...
Mass Media
 Role modeling: modeling how to talk to spouse,
good questions to ask the service provider, establish
the soci...
Policy
 Budget Support: mandates to provide financial support
for IPC/C
 Systems support: monitoring and supervising sys...
Five General Principles of Motivational
Counseling
Motivational counseling focuses on five general
principles to identify ...
Express empathy
When a client presents a potential problem with following a treatment
regimen, the service provider should...
Develop discrepancy


Client are ambivalent or unsure about change. Therefore,
it is the job of the service provider to m...
Avoid argumentation




During motivational counseling, the health service
provider increases the client’s awareness of ...
Roll with resistance


When dealing with patients who do not want to change,
are overwhelmed, or won't take their illness...
Support self-efficacy
Clients have to believe that they have the knowledge and
skills or abilities to carry out the needed...
Express empathy
When a client presents a potential problem with following a treatment
regimen, the service provider should...
See File: RH BCC WHCF
Example
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Behavior Change Communication for Health

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Behavior Change Communication for Health

  1. 1. Behavior Change Communication for Health Interpersonal Communication Counseling
  2. 2. Advantages and disadvantages of interpersonal communication channels Advantages Reach people face to face Allows for immediate audience feedback Very useful in influencing a group; messages may be tailored fit to the group Ideal for sharing knowledge and skills, problem-solving, reaching agreements and planning actions. Delivers message in non-threatening way; cultural acceptable. Disadvantages May reach a relatively smaller number of people, may be costly Communication effectiveness may be influenced by the skill of the facilitator and the organizer or information officer
  3. 3. Some forms of interpersonal media Forms Demonstrations Advantages Disadvantages Suggestions Shows in practical way how to do things. Makes abilities of the worker evident, thus promoting community trust. Allows for brad participation through technique of “learn by doing”. Requires careful preparation. May be misleading since situation in real life is generally different. External factors may affect results. In poor communities, it is difficult to obtain resources for demonstration. Have audience participate in demonstration. Establish situation as close as possible to real life. Test demonstration, anticipating possible snags. Combine with discussion and written materials.
  4. 4. Forms Home visits Advantages Establishes good relationships between families and staff. Useful in providing timely relevant information to family. Lend themselves to keeping a record of what has been learned. Disadvantages Very time-consuming. Tendency to visit only most accessible homes. Requires careful programming, in order to select appropriate time which does not interfere with work or other family activities. Suggestions Keep record of visits and accomplishments. Leave pamphlet or other instructional materials for family. Visit those most in need.
  5. 5. Forms Story telling Advantages Disadvantages Suggestions Abundant availability in some communities. Culturally relevant and acceptable. Stimulates participation, generates and maintain interest. Problems, outmoded customs, etc… of a community may be indicated in a simulated fashion without offending anyone. Only useful where there is tradition of story telling and listening. Audience may feel offended by childlike treatment. Message may be lost in plot. Difficult to find pleasant narrator. If interrupted to provide clarification, train of thought may be lost. Collect stories about and with community. Use local narrators whenever possible. Illustrate story with audio visual aids. Combine with group discussion. Use stories which are short, with simple plots and few characters.
  6. 6. In the area of health, interpersonal communication takes place:  using various methods and approaches  at several different levels of interaction  within a variety of environmental or social contexts.
  7. 7. Levels of interpersonal interaction and approaches in health Levels of Interaction 1. Client-provider Interaction  To enable clients to make free and informed choice among health options  To promote the safe, effective and correct use of contraceptive methods or new health behavior Approaches G A T H E R Counseling Provider Perspective Greet Establish rapport Ask Gather information Tell Provide information Help Facilitate decision Explain Demonstrate and practice Reinforce Revisits for use and return satisfaction
  8. 8. Levels of interpersonal interaction and approaches in health Levels of Interaction 1.client-provider interaction Approaches V A L U E S H A R E Counseling Client Perspective Value your needs Ask provider to clarify Lead the conversation Understand the benefits for you and your family Establish an action plan and encourage others Interaction Share conversation Heighten client participation Agree on mutual goals Respect each other Equal input
  9. 9. Levels of interpersonal interaction and approaches in health Levels of Interaction 2. Husband-wife (Spousal communication) Approaches Counseling Interpersonal Communication Persuade Negotiate Seek agreement and/or approval Share decision making Participate and learn together Appreciate each other Discuss together
  10. 10. Levels of interpersonal interaction and approaches in health Levels of Interaction 3. Couples and Family Approaches Counseling Interpersonal Communication (small group) Persuade Negotiate Seek agreement and/or approval Share decision making Participate and learn together Appreciate each other Discuss together Educate other family members
  11. 11. Levels of interpersonal interaction and approaches in health Levels of Interaction 4. Peer groups and social networks Approaches Counseling Group communication Advocacy Community mobilization Organizational mobilization  peer pressure  social support  strengthen in numbers  credibility  high priority  establish new norm
  12. 12. Environment and social context A supportive environment and social context is essential for promoting effective interpersonal communication. Program managers and decision-makers need to enhance effective IPC by introducing and improving the following:
  13. 13. Clinic and Community  Budget: adequate staff, sufficient training, materials for client and providers.  Environment: clinic hours, client flow, reception, space arrangements, waiting areas, counseling areas, group meeting areas, examination areas.  Staff: job description, specific procedures, communication among staff, monitoring counseling, performance, recognition of good performance.
  14. 14. Mass Media  Role modeling: modeling how to talk to spouse, good questions to ask the service provider, establish the social norms.  Reinforce/Support: reminders in mass media to see service provider, testimonials to discuss new health behaviors with spouse and family, call to action to join a community mobilization effort.
  15. 15. Policy  Budget Support: mandates to provide financial support for IPC/C  Systems support: monitoring and supervising systems, reward systems, specific procedures  Staff support: mandate enough managers and personnel to support effective IPC/C.
  16. 16. Five General Principles of Motivational Counseling Motivational counseling focuses on five general principles to identify the stage of change the client is in and to assist with change.  Express empathy Develop discrepancy Avoid argumentation Roll with resistance  Support self-efficacy   
  17. 17. Express empathy When a client presents a potential problem with following a treatment regimen, the service provider should start by soliciting information like:      What concerns does the patient have? What barriers does he/she see? What will be the hardest thing(s) about this change? Does the patient have anyone at home to assist with the change? What does the patient understand about his/her condition and its treatment?
  18. 18. Develop discrepancy  Client are ambivalent or unsure about change. Therefore, it is the job of the service provider to move the client in the direction of the desired behavior.   Persuasive strategies do not work when the client is in the precontemplation or contemplation stage. The useful strategy is to develop discrepancies between a client's present behavior and the behaviors desired.  People are much more highly motivated to change when discrepancies exist between current behavior and desired personal goals.
  19. 19. Avoid argumentation   During motivational counseling, the health service provider increases the client’s awareness of problems and the need to do something about them. However, the provider must be careful not to argue with the client.  Arguing tends to increase resistance rather than increasing motivation to change
  20. 20. Roll with resistance  When dealing with patients who do not want to change, are overwhelmed, or won't take their illnesses seriously, there is a tendency for the health service provider to become frustrated or angry.  But the health service provider should avoid trying to persuade patients even more that they have a problem. Do not force the issue.
  21. 21. Support self-efficacy Clients have to believe that they have the knowledge and skills or abilities to carry out the needed health behavior change. The health service provider can do this by: 1. 2. 3. 4. 5. providing and clarifying information; offering realistic hope and expressing confidence in the patient's ability to succeed noticing successful attempts at adherence, even if they are shortlived; praising ideas that the patient comes up with to solve problems; and continuing to emphasize and support the responsibilities that both the patient and provider have in improving treatment adherence and treatment outcomes.
  22. 22. Express empathy When a client presents a potential problem with following a treatment regimen, the service provider should start by soliciting information like:      What concerns does the patient have? What barriers does he/she see? What will be the hardest thing(s) about this change? Does the patient have anyone at home to assist with the change? What does the patient understand about his/her condition and its treatment?
  23. 23. See File: RH BCC WHCF Example

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