1. The Role of Negotiation in Counseling:
Borrowing from TIPS (Trials of Improved
Practices)
CORE Spring Meeting May 2014
Janine Schooley, MPH

2. TIPS
 A participatory, asset-
based approach
 Based on concept of “test
marketting”
 Negotiation and
experimentation leading to
practical, feasible
recommendations for
behavior change
 Motivators and barriers are
key to those
recommendations working

3.  Program participants try out a new practice
during a trial period to assess its feasibility
within the culture/situation
 Has been used in many countries, primarily
for improving feeding of young children
 Both research and implementation

4.  TIPS indicate both what behaviors should be
included and not included in the program and
how best to promote them
 Certain behaviors that are impossible to
predict precisely (such as childbirth) or which
take a long time (child immunization series)
are a challenge to test with TIPS

5. TIPS is:
 Formative research
 Empowering to the
client/patient
 Can provide field workers
with much needed
practice in counseling
and negotiation skills
 Really 2 kinds of TIPS:
negotiation TIPS and
learning TIPS

6. TIPS leads to a better understanding of:
 Current practices -- Helpful? Harmful?
Don’t know? Among what group?
 Problem (s)
 Beliefs, practices, and influences
– Potential motivators
– Constraints
 Recommendations
 This then becomes the foundation
of counseling guidelines,
behavior change strategies, etc.

7. TIPS helps us pinpoint and
articulate:
 Behaviors that are both
feasible and efficacious
 Behaviors that the project
should NOT promote
 Motivations and barriers
 Level of change expected
 Level of health and nutrition
impact expected

8. TIPS Steps: Field Work over 2-3 visits
(assessment, interviews,
observation)
Negotiation (feedback,
solutions, suggestions,
discussion, agreement,
evaluation)
Analysis (quantitative,
qualitative, influencers,
barriers, what was
easy/hard, how did they
overcome barriers,
perceived benefits,
intentions to continue? Etc.)

9. Negotiation Process
 Introduce problem
 Recommendations by
the mother
 Recommendations by
the field staff
 Motivators and
encouragement
 Mother’s response and
compromise
 Mother will try…
 Result?
 Reasons?
 Will continue practice?
 If not, why not?

10. So, what can we learn from TIPS
and how can we apply that learning
more broadly?