Behaviour change


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Behaviour change

  1. 1.
  2. 2. Behavior change- a need for prevention Behavior determines whether a person is atrisk or not. Those with risky behavior need to changetheir risky behavior to safe behaviors. Those with safe behaviors need to maintainexisting behaviors. Targeted interventions aim behavior changeof people with risky
  3. 3. Change in behavior is the ultimate goal oftargeted interventionsBehavior change can take place at theindividual, community and
  4. 4. Steps of behavior change Knowledge Approval Intention Practice Advocacy(motivating others to change)
  5. 5. Steps of behavior changeKnowledgeUnawareaware/informedApprovalConcernedKnowledgableand skilledMotivated tochangeIntentionPracticeReady tochangeTrial change ofbehaviourMaintenenanceadoption of
  6. 6. Behavior changeUnsafe SafeSTD ,BCC,Condoms,Enabling
  7. 7. Behavior change communication A key element of behavior change interventions BCC involves negotiation with the individual orcommunity for behavior change It uses dialogue, messages, persuasion,interpersonal and group communication as ameans of exchanging information, ideas, skillsand values aimed at bringing about behaviorchange or adoption of safe behavior Negotiation happens at all levels and involvesseveral people. Ultimately it involves negotiationwith ‘Self’ to practice desired
  8. 8. Behavior change Communication BCC is referred to by many names.◦ IEC◦ Health education◦ Health promotion◦ AIDS education◦ Social Marketing They share some common elements but havediffer in scope. Most of them include attempts to changebehavior through communication in differentstages and
  9. 9. BCC- Salient featuresBehaviour change communication uses a sciencebased approach to communication that involvesbehavioural sciences, social learning, persuasiontheory to achieve realistic targets.Emphasises on audience involvement andparticipation throughout the BCC process.Recognises that behaviour change is much asocietal process as it is an individual decisionmaking
  10. 10. BCC- Salient featuresAppreciation of the crucial role of environment to captureattention, interest and most importantly emotions tomake learning and change a pleasurable experience.Focus on sustainability of communication messages andstrategiesBehaviour change is a goal, but people move throughseveral stages and steps before they change
  11. 11. Behavior change is a continuous process Not all individuals go through the same steps of theprocess in the same order, speed or time People at different steps require different messages andsometimes different approaches. It is important to know what stage the person is beforebeginning a communication process As knowledge and approval reaches high levels, BCCemphasis must shift to later steps◦ identifying cues for action◦ maximizing access and quality of services◦ identifying and removing barriers to change◦ creating opportunities for increased peer
  12. 12. Percentage CSWs having knowledge, intent,trial and maintainence for use of condom-Bangladesh37.827.814.66.30510152025303540Knowledge Intent Trial MaintenanceKnowledge= knows about use of condoms prevent STD; Intent=desire to use condom; Trial= tried condom ataleast once in last 24 hrs; Maintanence= used condom>50% of all last sexual encounter in last 24
  13. 13. BCC alone is not enough Social norms and public policies influencebehavior change. A strategic shift must be alsobe attempted simultaneously. Behavior change communication is not a standalone strategy. It has to be used in conjunction with otherstrategies such as STD treatment, condoms andcreation of enabling environment BCC often complements and supports otherprevention strategies and
  14. 14. Main methods of BCC Interpersonal◦ Interpersonal communication is the preferredchoice for Targeted interventions as it involves asustained contact and communication with thesub-population Mass Media◦ Can be used to support Interpersonalcommunication efforts and the creation of anenabling
  15. 15. Behavior change communication must adopt aenabling approach in targeted interventions•It involves strong communityparticipation•Having gender sensitive
  16. 16. Common lessons learnt in developmentof communication materials andmessages◦ Professional quality and creativityApproaches that work in developing messagesand materials for professional marketing andadvertising can work for health communicationCommunication professionals know best how todevelop communication products, but finding theright person takes time and effortCommunication professionals need closesupervision and support in developingappropriate
  17. 17. Common lessons learnt in developmentof communication materials andmessages◦ Health expertise Health professionals need to provide inputand to review materials for technical quality◦ Value High quality materials hold up over time andencourage
  18. 18. Common lessons learnt in developmentof communication materials andmessages◦ Community participation Message development is a collaborative andparticipatory process The participation of representatives of intendedaudiences in pretesting helps ensure that thematerials will speak effectively to actual audiences. Pretesting and revision takes time and money buthelps to avoid greater costs of ineffective materialsand messages. Pretesting can inform gatekeepers and policy makersabout communication
  19. 19. Seven ‘C’s of communication Command Attention Only messages that are noticed andremembered can be effective. Messagesneed to attract attention and elicitcomments. Peer educators talking aboutHIV/AIDS should be received by theirpeers as an important
  20. 20. Seven ‘C’s of communication Cater to the Heart and head Most people are moved at least as much byemotion as much as reason. A message that arouses emotion are effectivebecause people learn better when their emotionsare aroused. Emotions can be aroused by story telling,reflecting however briefly on the individual orgroup. Appeal to reason at the same time adds stayingpower to the message and consolidates the
  21. 21. Seven ‘C’s of communication Clarify the message Focus and freedom from clutter are important. Amessage should convey a single important point.Ancillary information and multiple themesdistract and some may simply miss the
  22. 22. Seven ‘C’s of communication Communicate a benefit People need a strong motive to change theirbehaviour. The best motivator is the expectationof a personal benefit. People rarely use a cleanneedle or a condom, unless they see practicalbenefit in it. “The factories make the condoms…the peers sell hope for life”
  23. 23. Seven ‘C’s of communication Create trust A message that people will act on their ownaccord must come from sources they trust. If thepromise of trust does not come from a crediblesource, they will not believe it. It is importantfor the source to be available to support anyneed arising as a result of the trial of themessages given by
  24. 24. Seven ‘C’s of communication Call for action After seeing or receiving a message, peopleshould know exactly what they should do. Onceconvinced that the promised benefit is worthpursuing, people need to know how to how toact on this belief ; where to go, what to do, whatto buy and how to use. Directives should beclearly stated. Without a specific cue for action,people may hear, understand and even approveof a message but still take no
  25. 25. Seven ‘C’s of communication Consistency counts Repetition is essential. The same messagerepeated with variations, but with basicconsistency, becomes familiar
  26. 26. Seven ‘C’s and Behavior changeprocessClarify the messagecommand attentionknow ledgeCater to the heart andheadCreate trustApprovalConvey a benefitIntentionPracticeAdvocacyCall to actionConsistency countsCreate confidence to speak
  27. 27. Interpersonal communication- main characteristics Uses principle of outreach Establishes personal relationships Builds group consciousness Encourages dialogue and feedback Elicits community initiatives andparticipation Links to community eventsInterpersonal communication could takeplace with the help of peer or outreachworkers who are closely identified with
  28. 28. Peer education Peer education is the involvement of communitymembers of the sub-population as facilitators ofbehavior change. Peer educators are part of the sub-populationand hence more acceptable Peer educators share similar life experiences asthose of the sub-population Peer education can take place on a street corner,a bar, a bus station, restraint, factory or anyplace where people feel
  29. 29. Benefits of peer education Culturally appropriate: "Peer education provides ameans of delivering culturally sensitive messages fromwithin." Community-based:"Peer education is a community-levelintervention which supports and supplements otherprograms. It is a link to other community-basedstrategies." Accepted by their target audiences:"Many peers reportthat they are more comfortable relating to a peer abouttheir personal concerns such as sexuality.” Economical: "Peer educators provide a large service at asmall cost and they provide that service very effectively."
  30. 30. Peer education Peer education is unlikely to be an empoweringexperience when educators are used as a free orcheap source of labour. Effective peer education is neither easy nornecessarily cheap Peer education requires considerable planningand management They use trained people to assist others in theirpeer group to make decisions aboutSTDs/HIV/AIDS through activities undertakenin one-to-one or small group
  31. 31. Role of peer educators Identify new sex workers Provide information to sex workers Reinforcing BCC message to known contacted sexworkers Distribute IEC material/BCC Distribute condoms Referral of STD/sick patients Care of sick patients Advocacy Training of new peer educators from within project
  32. 32. Criteria for selection of peer educators They should have the ability to communicateclearly and persuasively with their peers. They should have good interpersonal skills,including listening skills. They should have a socio-cultural backgroundsimilar to that of the target audience (this mayinclude age, sex and social class). They should be accepted and respected by thetarget group (their peers)
  33. 33. Criteria for selection of peer educators They should have a nonjudgmental attitude. They should be strongly motivated to work towardHIV risk reduction. They should demonstrate care, compassion andrespect for people affected by HIV/AIDS. They should be self-confident and show potentialfor
  34. 34. Criteria for selection of peer educators They should be able to pass a practical,knowledge-based exam at the end of the training. They should have the time and energy to devote tothis work. They should have the potential to be a "safer-sex"role model for their peers. They should be able to get to the location of thetarget audience. They should be able to work irregular
  35. 35. Training of peer educators it is less expensive to implement peer educationprograms if the initial training is very thorough. Where training is comprehensive, fewer peereducators drop out and less supervision andretraining are needed later. Training can be given in a number of ways,including half-day sessions spread out over anextended period or full-day sessions for an entireweek or more. Regardless of what schedule you choose, formaltraining should be supplemented by on-the-jobtraining and
  36. 36. Assumptions for deciding the number ofpeer educators For sub-populations such as sex workers,MSM or IDUs, one peer educator will reach25-35 peers There will be at least one, one to onemeeting with each community member in aweek lasting 20-30 minutes Each community member will atleastparticipate in one fortnightly group meetingof 4-5
  37. 37. Peer education: need for constantsupport and supervision The amount of supervision and support peereducators need will depend on:◦ the types of activities they do. (Peer educators whoconduct large group educational sessions may need moresupervision and support than those who meet peerscasually; also, those who deal with emotionally difficultsituations may need more support.)◦ the amount of training they have had. (Peer educators whohave had only a day or two of training may have moresupport and information needs than those who have hadmore thorough training.)
  38. 38. Types of support to peer educators Regular, in-service meetings for all peer educators Additional educational materials for peer educatorsown use (e.g., a peer educators handbook) IEC materials and condoms for distribution to peers Certificates, badges, t-shirts, bags or hats toidentify them as trained peer educators andacknowledge their contribution to the project Supervisor availability to help peer educators dealwith discouraging or difficult
  39. 39. Types of support to peer educators AIDS information booklets that giveanswers to commonly asked questions Referral book that allows educators to sendpeers to other available resources Opportunities for established peereducators to teach and mentor new
  40. 40. What to supervise in peer education? Supervision helps ensure that the peer educators aredoing a good job. There are various ways that peereducators can be supervised. Check the supervisiontechniques you will use.◦ One-to-one visits or meetings with peer educators to answertheir questions and observe them at work◦ Group meetings to resolve common problems◦ Observation of peer educators during their activities◦ Evaluation of peer educators performance and feedback tothem about the evaluation◦ Monthly written or oral reports and your responses to
  41. 41. Types of materials: some examples Leaflets Posters Pamphlets Fliers Flip charts Flip books Cinema slides Exhibitions Audio tapes Films Video Games Comics Puppets Theatre Local
  42. 42. Thank