Motivating Behavior and Social Change

1. Motivating Behavior and Social Change Maseru, Lesotho February 2, 2009

2. Exercise

3. Motivating behavior change Stayed up too late in the lounge Sleep in a quiet room Breakfast Talking to Wife Husband Girlfriend Boyfriend Working

4. Our lives are filled with a series of conscience and unconscious behaviors we have adopted or avoided……

5. Behaviors Change • Choose a partner • Tell your partner about a behavior that you have changed? • How did you do it? • What motivated you? • What was easy/ difficult about the change? • How do you feel about the change? • Is the change temporary or permanent?

6. Learning Objectives of Session Today • Understand the science of behavior change • Review the process for developing BCC programs • Identify ways that Peace Corps staff, counterparts and volunteers can be involved in behavior change programs

7. List current BCC activities • Behavior • Audience • Activity

8. What is Behavior Change • Behavior change communication has many aliases • IEC • Health promotion • Health education • Behavior change communication • Social and behavior change communication • Disciple that has grown and developed over time and with experience

9. Individual

10. Early Behavior Change • Focus on information and creating awareness • Posters, pamphlets, events • Disease Days for awareness • Little input from the target audiences • Little attention to multiple influences

11. Don’tSmoke Don’t Drink and Drive AIDS KILLS

13. NoSmoking in Public Places Drink and Drive You’ll do 5 Protect your newborn, get tested and know your status

14. Social and Behavior Change Communication • Theory and evidence driven • Behavior is complex and multidimensional • Internal and external factors influence behavior • Requires a combination of activities over time

15. Individual Level Increase knowledge of health risk/solution/services Promote attitude change Reduce stigma and discrimination Create a demand for information and services Promote services for prevention, care and support Improve skills and sense of self-efficacy Community/Environmental Level Stimulate community dialogue Gain support of Community leaders/influencials Address and change community norms Reduce stigma and discrimination Advocate for policy development or change What can BCC do

16. Useful Frameworks by Level Individual: • Stages of Change Model • Health Belief Model Interpersonal: Social Learning Theory Institutional: Organizational Change Models Community & nation: Community organization models; Diffusion of Innovations Policy: Policy communication approaches

17. Pre-contemplative Contemplative Preparation for Action Action Assume the behavior over time No problem….. Hmmm…maybe I should do something… Ok let’s give it a go… That wasn’t so bad… This is a part of my life now…. Stages of Change

18. Stages of Change Exercise • Pre-contemplative • Contemplative • Preparation for Action • Action • Assume the behavior over time

19. Assignment Create a message for: Target: a 25 year old rural male who is sexually active The Topic: testing for HIV infection

20. Process of Developing BCC • Establishing the behavior to address • Define the target audience • Determining the determinants (internal and external) that influence behavior • Craft the message appeal or approach • Selecting effective interventions • Monitoring how things are going • Measuring success

21. Behavior change can be one action or a series of actions

22. Behaviors Simple Behaviors Complex Behaviors

23. Establish the behavior to address • Increase Uptake of ARVs • Get tested • Get results • Go for a CD4 test • Get results • Enroll in treatment program • Take medicines as prescribed • Visits clinic regularly to monitor your progress • Stay healthy (eat nutritious foods, don’t drink or smoke) • Enlist the help of your partner and family • Attend support group

24. Establish the behavior to address • Increase Uptake of ARVs • Train and prepare testing staff • Advertise where to get test and hours of operation • Work with the community to address stigma and discrimination • Establish community based support groups

25. Define the target audience The individual orgroup who’s behavior you are trying to change

26. Define the target audience • Young People • Male/female • Age • Income level • Education • In school/ out of school • Rural/urban • Sexually active/not sexually active • Use internet regularly/no access to internet • Participate in sports or club activity/don’t participate

27. Internal Self efficacy Perceived social norms Perceived positive/negative consequences Efficacy of action Real benefits Real barriers External Family Religion Gender Culture Community Acceptance Policies Determinants and Factors (internal and external) that influence behavior

28. Craft the message appeal or approach • Develop messages that • address key determinants • and promote benefits of • adopting or modifying behavior

29. Examples • Reduce your risk of colds and infections, wash your hands with soap after visiting the market or other busy places. • For peace of mind and a trusting relationship go for an HIV test together, know your status.

30. Wait a minute!!! How do I know this information???

31. Understand your target audience • Talk to your target audience (formally and informally) • Listen to your audience • Find out what they read, where they hang out, what they like to do, who they trust • Observe them • Involve them

32. Type of Intervention Interpersonal Media Community Formats Groups discussion, peer education, support group, one –to-one Radio, community newspapers, signs and billboards Public meetings, events, community theater, church group Selecting effective interventions

33. Exercise Applying the Behave Framework

35. Behaviors • Using bed nets to prevent malaria • Gaining community support for a life skills programs for 12- 14 year old girls • Introducing the use of a new technology for collecting data • Discouraging the practice of having sex in exchange for gifts, money, cell phones (young girls with older men)

36. Purposes Assess quality, frequency and process Is the program happening? How often is the program activity being carried out? Are materials distributed? Are people accessing services? Are services that are promoted available? Methods Simple data collection forms Observations of activities with checklist Interviews with participants Data on usage at service sites Inventory checks Monitoring and EvaluationMONITORING

37. Purpose Community acceptance or participation Support of key leaders Use or adaptation of program by local groups Update of new technology Increase or improvement in individual behaviors Methods Interviews with stakeholders and leadership Number of community groups conducting interventions, using materials, addressing issue/behavior Service referral, products sold Observed behavior Mystery client, shopper Monitoring and EvaluationEVALUATION

38. How to involve PC in programs • Many international NGOs, FBO involved in community based activities AED, PSI, CARE, RED CROSS, World Vision • Opportunities to engage PC volunteers and staff in existing programs • Program development • Monitoring • Capacity support