This document provides an introduction to behavior change communication (BCC) and discusses key concepts. It begins by defining behavior and the five key facts about human behavior. It then discusses information, education, and communication (IEC) and how it relates to health promotion. BCC is introduced as going beyond just information provision to motivate behavior change. The document outlines three elements of the BCC process - the rational, emotional, and practical elements. It also discusses five guiding principles for effective BCC.

1. NUTRITION BEHAVIOUR CHANGE COMMUNICATION
CN 407 -2 Credits
Victoria Awuni (BSc, MPhil)
Department of Nutritional Sciences
Email: victoria.awuni@uds.edu.gh
Mobile: 0204063445

2. Introduction to behavior change
communication
 Learning Objectives:
At the end of the session students will:
• Be able to describe five key facts about human
behavior
• Understand the concepts of IEC and Health
Promotion and how they relate to BCC
• Be able to define BCC
• Be able to identify the three approaches to
Behavior Change
• Understand and be able to explain the elements
of each BCC approach
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3. Behaviour
 Within the discipline of psychology, sociology,
anthropology and economics;
• “Anything a person does in response to
internal or external events
• Actions may be
overt (motor or verbal) and directly measurable,
or
covert (activities not viewable but involving
voluntary muscles) and indirectly measurable;
• behaviours are controlled by the brain”

4. The five key facts about human behaviour
1. People give meaning to information based on
the context in which they live
• Example: A married woman with three children may
be more receptive to family planning information than
a newly married woman who does not yet have
children
2. Culture and networks influence people’s
behaviour
• Example: Contraceptive use in India varies greatly by
religion and caste, though knowledge of
contraception is nearly universal
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5. The five key facts about human behaviour
3. People cannot always control the issues that
determine behavior
• Example: A woman may not be able to plan and space
her pregnancies if her husband does not support her
use of contraception.
4. People’s decisions about health and well-being
compete with other priorities
• Example: Men who consume frequently meat and meat
products as a sign of masculinity regardless of the
health effects to their prostate health. The pressure to
be seen as a ‘real man’ may override health
considerations
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6. The five key facts about human behaviour
5. People often make decisions based on emotional
factors, not logic
• Example: Woman with repeated, closely spaced
pregnancies may know that they are risking their lives.
But, if their desire is a male child, they may keep
trying until they achieve their goal
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7. Information, Education and Communication
(IEC)
 IEC is a strategy used to inform the public about
health concerns and to maintain important
health issues on a public agenda
 It is a process of working with individuals,
communities and societies to develop
communication strategies
 These strategies support positive behaviours that
• Promote health
• Are appropriate to their settings
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8. IEC
 It “combines strategies, approaches, and
methods that enable individuals, families,
groups, organizations, and communities to play
active roles in achieving, protecting, and
sustaining their own health
 Embodied in IEC is the process of learning that
empowers people to make decisions, modify
behaviours, and change social conditions”
[UNFPA, 1999]
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9. IEC
 The use of health education and the mass and
multimedia to disseminate useful health
information to the public, increases awareness of
specific health issues as well as the importance
of health in development
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10. IEC
 Disseminating information through multimedia
channels and health education provides
important information to individuals and the
general public
 However provision of information on its own
cannot motivate or support individuals and the
general public to take action on the information
they are given
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11. Health promotion
 Health promotion is the process of enabling
people to increase control over, and to improve
their health
 Participation by individuals and community is
essential as part of the health promotion process
to sustain healthy behavior and health promotion
action
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12. Health promotion
 According to the Ottawa Charter, Health
Promotion:
• Represents a comprehensive social and political
process
• It embraces actions directed at strengthening the skills
and capabilities of individuals to make healthy
behavior choices and change health behaviors
• It is also action directed towards improving social,
environmental and economic conditions to support
public and individual health (WHO, 1986).
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13. The Evolution of IEC to BCC to SBCC
A. Earlier models of communication used the
“expert–learner” or “sender–receiver”
paradigm to transfer information
B. The focus then shifted to BCC, which
emphasizes analysis of behaviors and
determinants to bring about changes in
knowledge, attitudes and practices
C. Now, the focus is SBCC, which employs a more
comprehensive approach.
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14. Behaviour change
 Comprehensive process in which one passes
through the stages of:
• Unaware >> Aware >> Concerned >> Knowledgeable >>
Motivated to change >> Practicing trial behaviour
change >> Sustained behaviour change
 Behaviour change is a very important aspect in
health communication and is used as an
intervention measure across a wide range of
health and nutrition problems
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15. Behaviour change communication
 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 behaviours; promote and
sustain individual, community and societal
behaviour change; and maintain appropriate
behaviours.
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16. BCC
 BCC is a process of working with individuals, families
and communities through different communication
channels to promote positive health behaviors and
support an environment that helps to maintain
positive behaviors taken on
 BCC is a multilevel tool for promoting and sustaining
risk‐reducing behavior change in individuals and
communities by distributing tailored health messages
using a variety of communication channels.
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17. BCC
 Behavior change communication (BCC) can
therefore be regarded as any communication (e.g.,
interpersonal, group talks, mass media, support
groups, visuals and print materials, videos) that
helps foster a change in behavior in individuals,
families, or communities
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18. BCC
 BCC employs a systematic process beginning with
formative research and behaviour 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
behavioural objectives.
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19. Role of nutrition behaviour change
communication
 It seeks to influence society and human
behaviours in order to impact positively on
nutrition practices
 BCC activities should therefore be essential
component of programmes that aim at improving
maternal, infant, and young child nutrition
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20. BCC moves people from awareness to action
 Though IEC programs result in improved health
knowledge they have often failed to produce
behavior change
 IEC campaigns are often better at imparting
knowledge and information than they are at
moving people from awareness to action
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21. BCC moves people from awareness to
action
 To move people from awareness to action, we
need behavior change which is a complex process
motivated by many factors including:
A.A person’s awareness of the need to change
B.A person’s understanding of the benefits of such
a change
C.A person’s belief in his/her ability to change
D. A person having the confidence in his/her ability
to maintain a behavior change
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22. BCC moves people from awareness to
action
 BCC must move people from awareness to action
by motivating people to believe that health
benefits will be obtained by changing behavior
and by increasing individuals’ sense of control
over their own health behavior choices.
 BCC must go beyond just providing information
to an approach that provides both information
and appeals to individuals emotions
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23. BCC moves people from awareness to
action
 Key Questions
 How can we convince a mother to change her
feeding practices?
 Does telling a mother what to do lead her to
change her behavior?
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24. BCC moves people from awareness to
action
 Giving someone information is not usually
enough to change behavior
 Behavior change communication is a way to
communicate with people by listening,
understanding, and negotiating so they will
change their behavior
 Promoting positive behavior change is a complex
process requiring a thorough understanding of
what motivates people to adopt or resist new
behaviors
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25. BCC moves people from awareness
to action
 BCC approaches recognize that behaviour
change is more about identifying the causes and
barriers to behaviour change and overcoming the
barriers.
 BCC is also about using persuasive techniques
to demand health rights and to make public
sector health services available and accessible to
the neediest
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26. Elements of BCC Process
 The following elements are crucial to the
success of BCC health messages and
programs:
1. The rational element, based on knowledge:
People need to know the basic facts about
a health issue. For example, people need to
know how HIV virus is and how likely they
are to become infected, and what they can
do to avoid infection.
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27. Elements of BCC Process
2. The emotional element, based on the intensity
of attitudes or feelings: Individuals need to feel
an intense and personal vulnerability to the
virus in order to develop an emotional
commitment to the behaviors needed to avoid
it.
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28. Elements of BCC Process
3. The practical element, based on personal skills
in a new behavior: People need to be
competent in practicing the new behavior and
be confident in their ability to do so. They need
a sense of self-efficacy to adopt new, health-
protective behaviors
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29. Elements of BCC Process
4. The interpersonal element, or social networks:
People need to associate with and be supported
by their significant others (such as family
members and peer groups) whose knowledge,
emotions and skills can reinforce healthy
behavior changes
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30. Elements of BCC Process
5. The structural element, or the social,
economic and legal context in which
behavior takes place:
 People need to have access to necessary
supplies and services (such as hand washing
facilities and voluntary counseling and
testing facilities), and to live in an
environment where safer behaviors are
accepted and promoted while risky
behaviors are discouraged
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31. Guiding principles for BCC
1. Follow a systematic approach (e.g., C-
Planning)
2. Use research, not assumptions to drive your
program
3. Consider the social context
4. Keep the focus on your audience(s)
5. Use theories and models to guide decisions
(e.g., the socio-ecological model)
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32. Guiding principles for BCC
6. Involve partners and communities
throughout
7. Set realistic objectives and consider cost-
effectiveness
8. Use mutually reinforcing materials and
activities at many levels
9. Choose strategies that are motivational and
action-oriented
10.Ensure quality at every step
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33. THANK YOU
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