This is basics of SBCC- Theories of behavior change and health communication. This has been developed using presentations and study materials I received as a student. This also include definitions and charts/models used in other presentations already available in the web and not my original work.

1. SOCIAL AND BEHAVIOR
CHANGE COMMUNICATION
(SBCC)

2. INTRODUCTION
What is Health?
What are the levels of prevention in epidemiology?

3. HEALTH PROMOTION
Health promotion is the process of enabling people to increase
control on determinants of health and thus improve their health.
WHO, 1986
Education – building knowledge (But is knowledge enough to change
behavior)
Social marketing – audience focus (much needed but need to broaden
beyond individual level)
BCC – incorporates behavior change theory (identify determinants,
but still individual focus)
SBCC – Broadened focus to encompass the whole social & enabling
context and different levels of change.

4. SBCC
SBCC uses communication strategies that are based on behaviour
science to positively influence knowledge, attitudes and social norms
among individuals, institutions and communities.
or
SBCC is the systematic application of interactive, theory based, and
research driven communication processes and strategies for change
at the individual, community, and social levels. C-Change Project

5. WHAT IS BEHAVIOR & WHAT
DETERMINES IT?
Behavior is an action/habit that has a specific frequency, duration and
with/without purpose, whether conscious or unconscious. It is what
we do and how we act.
Predisposing factors-Those characteristics of a person/population
that motivate behavior before the occurrence of that behavior. E.g.
Knowledge, beliefs, values, attitude, self-efficacy
Enabling factors- They are those that make it possible (or easier) for
individuals/populations to behave in a way/change their behavior.
E.g. skills, resources, living conditions, environment, support systems
etc.
Re-enforcers- reward/punishment; hurdles/barriers; benefits/loss;
persuasion

6. THEORIES OF BEHAVIOR
CHANGE

7. WHY DO WE NEED TO STUDY
THEORIES?
Help understand why people act the way they do? Why behaviors
change?
Theories can guide SBCC program design and help you focus on what
or who to address in your program.
When we set out to improve life for others without a fundamental
understanding of their point of view and quality of experience, we do
more harm than good.

8. STAGES OF
CHANGE
MODEL
It tells us that individuals go through different
stages when changing a behavior.
Precontemplation: There is no intention to
change behavior in the future.
Contemplation: An individual is aware that the
problem exists and is seriously thinking about
overcoming it, but has not yet made a
commitment to take action.
Preparation: An individual intends to take action
immediately.
Action: An individual begins performing the
behavior.
Maintenance: An individual continues the
behavior and works to maintain it. If one fail to
maintain there will be relapse. Some SBCC
professionals have added a sixth stage to this
model – Advocacy.

9. STAGES OF
CHANGE
MODEL

10. EXAMPLE
Anjum is not thinking about using contraception to avoid
unintended pregnancy.
She has learned about contraception and is thinking about
starting to use it.
She is planning to go to the health facility this month to start
using contraception.
She starts using contraception to avoid unintended pregnancy.
She continues using the contraception of her choice
consistently and correctly.
Advocacy is the stage in which Anjum is maintaining her use of
contraception, as well as promoting the benefits of
contraception to her friends and encouraging them to try it,

11. HEALTH
BELIEF
MODEL
For people to change their behavior, it is
important that their perceived threats
(susceptibility, severity and cues to action)
and benefits of change must out-weight
their perceived barriers to change.
Perceived susceptibility/seriousness: One
believes he/she is at risk.
Perceived benefits: One believes that the
behavior change will reduce risk.
Perceived barriers: How one interprets the
cost/barriers of the desired behavior.
Cues to action: Strategies to activate
“readiness."
Self-efficacy: Confidence in one’s ability to take
action.

12. HEALTH BELIEF MODEL

13. EXAMPLE
Anjum believes she is at risk of becoming pregnant.
She believes that using contraception will reduce her risk of
unintended pregnancy.
She believes that her partner would not want her to use
contraception, but, for her, the benefits of using contraception
outweigh his reaction.
She receives education about contraception and the different options
available to her.
Anjum feels confident that she can access contraception and that she
can use it correctly to avoid unintended pregnancy.

14. THEORY OF
REASONED
ACTION/THEO
RY OF
PLANNED
BEHAVIOR
It assumes that humans are rational beings and
hence make use of the available information;
think about the implication of their actions; and
their action’s social acceptance before deciding
to act/not act in a particular way. Hence most of
their actions of social relevance are under
control.

15. THEORY OF
REASONED ACTION
-Attitude: This is dependent on a
person’s evaluation of the benefits and
barriers/threats of desired behavioral
change
-Subjective Norms: It relates to a person's
beliefs about whether peers and people
of importance to the person think he or
she should engage in the behavior.
-Control (later added in theory of
planned behavior): This control could be
internal or external.
-Intention- Willingness to change

16. EXAMPLE
Quitting smoking is good for my health. It is possible to quit it (Beliefs
& Attitude)
If I quit smoking, my friends may not like it but my family and friends
will appreciate my decision (Subjective norms)
I will discard my ashtray and will not buy cigarettes anymore. Thanks
to the laws that also ban smoking at public places and have increased
price of such products (Control)

17. DIFFUSION
OF
INNOVATION
S THEORY
(EVERETT
M. ROGERS)
Refers to the spread of new ideas and behaviors
within a community or from one community to
another.
Innovators: the quickest to adopt an innovation.
However, they may be seen as fickle by other
community members and are less likely to be
trusted and copied.
Early adopters: more mainstream within the
community and are characterized by acceptance
of innovation and some personal/financial
resources to be able to adopt the innovation.
Early majority: amenable to change and
persuaded of the benefits of the innovation by
observing.
Late majority: skeptical and reluctant to adopt
new ideas until the benefits are clearly
established.
Laggards: these are most conservative and
resistant to change; sometimes, they may never
change.

18. DIFFUSION OF INNOVATIONS
THEORY
Types of adopters classified by innovativeness and
their location on the adoption curve

19. OTHER THEORIES AND MODELS
Social Learning Theory /Social cognitive Theory
Theory of Gender and Power
Fear Management Theory
And many others

20. HEALTH COMMUNICATION

21. WHAT IS HEALTH
COMMUNICATION?
Health communication can modify factors
at these levels to change behaviors hence
improve health
Communication is to:
Impart, Transmit, Transfer,
Exchange/Share, Influence the….What?
Information, Knowledge, Idea, Thought,
Perception, Feeling etc.
Can be One way or Two way

22. KEY COMPONENTS OF
COMMUNICATION
Purpose/Objective
Receiver- Audience Research is most important (Educational, Socio-
cultural, Economic, Political factors and patterns of communication)
Sender (source)- If trusted/High on credibility, acceptance will be
better
Message (content)
Method/Channels (medium)
Feedback (effect)- pretesting, monitoring, evaluation

24. CHANNELS OF
COMMUNICATION
It is the physical means or the media by
which the message travels from a
sender to a receiver.
Inter-personal- Counseling, home
visits, training, group
meetings/discussions, health talks etc.
(varies with group size)
Broadcast/mass method- TV, Radio,
Newspapers, Magazines, Internet,
Mass SMS services through phones,
billboards

25. SBCC (NOW AFTER LEARNING
BASICS)
SBCC is a process of interactively communicating with individuals,
institutions, communities and societies as part of an overall programme of
information dissemination, motivation, problem solving and planning.
Communication
Understand the target audience’s needs, drives and preferences to
conceptualise tailored messages and approaches across communication
channels.
Behaviour Change
Interventions and efforts to bring about desired behaviour changes in an
easy and feasible way while protecting and improving outcomes.
Social Change
Achieve shifts in the definition and perception of issues, in people’s
participation, in policies, and social attitudes and behaviour.

26. Don’t be Him!
Involve the people.
SBCC employs a
systematic process that
includes formative
research and behaviour
analysis; communication
planning,
implementation and
monitoring; creating an
environment that
supports desired
outcomes; and
evaluation.

27. THANK YOU