Media development action with informed and engaged societies
After nearly 28 years, The Communication Initiative (The CI) Global is entering a new chapter. Following a period of transition, the global website has been transferred to the University of the Witwatersrand (Wits) in South Africa, where it will be administered by the Social and Behaviour Change Communication Division. Wits' commitment to social change and justice makes it a trusted steward for The CI's legacy and future.
 
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Behaviour Change Communication in Public Health

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as presentated at the VIII International Communication for Development Roundtable, Managua, Nicaragua

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Summary

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A Generation Ago...


Monologue: The "Medical Era"





Expert (sender) sending messages to non-expert (receiver)


The 70s: "Field Era"




Moving from monologue to dialogue

  • Need to reach people beyond the clinics
  • Derived from extension agent approach in agriculture
  • Field work supported by IEC materials, films and audio visuals
  • Mass media impact on behavior considered modest due to limited reach
  • Large volume IEC
  • SMCR(E) as dominant communication model

The 80s: "Social Marketing Era"


Moving from non-paying clients to customers who ask and pay


The 90s to Present: "Strategic Era"




Moving from dialogue to mutual adjustment and convergence


On the process side

  • Participants in the communication process create and share together
  • Distinction between "senders" and "receivers" begin to disappear
  • Communication not as a spare wheel
  • Greater multi-channel integration
  • Multiplicity of stakeholders
  • Increased attention to evaluation and evidence-based programming
  • Increased sophistication in audience segmentation
  • Large scale impact at national and sub-national level
  • Role of electronic media more pervasive

Developing World Radio and TV Receivers





Strategic Communication Today


Strategic communication is a process carried out with the active participation of stakeholders and beneficiaries that addresses a long-term vision and affects the causes of as well as the barriers to behavior change.


Strategic communication includes many approaches such as: community mobilization, client-centered counseling, social network interventions, social marketing, entertainment-education, TV/radio spots, dramas and music, provider promotion, behavior change communication, public policy advocacy, media advocacy, personal and community empowerment, public relations, mass media dissemination...


12 Key Elements of Strategic Communication: Making Evaluation More Complex


Results-orientedMulti-channeled
Science-basedTechnically high quality
Client-centeredAdvocacy-related
ParticipatoryExpanding to scale
Benefit-orientedProgrammatically sustainable
Service-linkedCost-effective



Strategic Directions in HIV/AIDS Behavior Change Communication


More applications of theory-driven communication and behavior change at multiple levels


Theory Driven Behavior Change Communication


Ideation is defined as new ways of thinking and the spread of those whays of thinking by means of communication and social interaction in local, culturally homogeneous communities.

Cleland & Wilson, 1987


A predictive model of communication & change:

Influence of ideational element on behavior





Ideational Factors Related to Condom Use (Zambia)

  • Perceives self to be at a moderate-to-high risk of contracting HIV/AIDS
  • Knows at least three ways to protect self from HIV/AIDS
  • Has talked with at least three people about safe sex
  • Has a positive attitude towards people who use condoms
  • Knows where to purchase condoms
  • Has an above-average sense of efficacy regarding ability to use condoms even when facing opposition from partner

Cumulative Effect of Ideational Factors on Condom Use among Male Adolescents, Zambia 2000





Cumulative Effect of Ideational Factors on Condom Use among Female Adolescents, Zambia 2000





Odds of Condom Use by Ideation and Exposure, Zambia Youth Survey, 2000




Controlling for TV use, sex, age, educational attainment, residence


Theory Driven Behavior Change Communication


Ideation

Need to Identify/influence ideational factors related to desired behaviors

  • Abstinance
  • Being faithful to one partner
  • Consistent condom use
  • Delaying sexual debut
  • Seeking treatment for STIs
  • Seeking VCT
  • Preventing MTCT

Social legitimization: improving social environment

  • Breaking the silence
  • Improving policy environment/strengthening political will
  • Overcoming stigma
  • Agenda priority setting
  • Increasing public understanding of HIV impact

Social network

  • Stimulating couple & community discussions
  • Influencing community norms
  • Developing community capacities

Social learning/modeling

  • Modeling individual and collective self-efficacy
  • Modeling health provider behaviors
  • Scaling up entertainment education programming

The Individual - Social Continuum





Indicators for Community Empowerment and Change

  • Leadership
  • Degree & Equity of Participation
  • Information Equity
  • Collective Self-Efficacy
  • Sense of Ownership
  • Social Cohesion
  • Social Norms













Comments

User Image
Submitted by Anonymous (not verified) on Sat, 10/16/2004 - 04:29 Permalink

it underscore health seeking beahviour

User Image
Submitted by Anonymous (not verified) on Sat, 10/16/2004 - 04:29 Permalink

it underscores health seeking beahviour