Developing a behaviour change strategy

Case Study 9.1 The importance of linking information and strategy

Tedlar is a health worker who has been tasked with getting mothers in his community to wash their hands before cooking food. Tedlar thinks that the women don’t understand the health risks of not washing their hands and spends nearly all his budget on a big promotion campaign with leaflets and radio messaging. Three months into the campaign he conducts a survey and finds that there has been minimal progress in achieving the desired behaviour.

Tedlar realises he has relied on his own beliefs and needs a more objective understanding of the situation. He conducts a situation analysis and barrier analysis to inform a FOAM framework describing the existing situation. At this point he discovers that the women are aware of the health risks but not driven by this knowledge. The reasons for handwashing that are important to them are disgust at dirty hands, nurture of their children, and the critical opinions of other women. These are much stronger determinants in this context. He also finds that some of the women have no access to handwashing facilities, so no amount of desire to wash is going to help them with the practical activity. Those that do have access and good intentions still need frequent reminding to change their habits.

Tedlar now needs to develop a behaviour change strategy that focuses on providing the missing facilities and the facilitating determinants through appropriate communication and support. (Remember from Study Session 8 that determinants can be facilitating (helpful and encouraging) or deterrents (barriers) to desirable behaviour.)

What Tedlar was missing was a clear and well-designed behaviour change strategy that set out how resources are allocated and how he should plan his time in order to be most effective. Behaviour change strategies should focus on maximising the facilitating determinants of a behaviour and minimising the deterrents.

A behaviour change strategy should therefore be driven by the information you gathered in your framework analysis. It should include:

• the goal that you want to achieve
• the activities that you will need to complete in order to achieve that goal
• the resources you will need to support those activities (e.g. money, people, products, facilities, licenses, approvals, etc.)
• the schedule for the activities
• the means by which you will evaluate the effectiveness of the programme.

Arguably the most important thread in your behaviour change strategy is communication, the process by which information is exchanged between individuals or groups. Effective communication takes place when all parties in the exchange understand the information in the same way.