MSW Capstone    Naomi T Robinson

In the social development field BCC is used predominately for changing behaviours around hygiene, health and reproductive health. It has been used extensively in Sub-Saharan Africa for addressing behaviours related to malaria, HIV&AIDS, family planning, maternal-child health & nutrition, and domestic abuse. The types of communication mediums used are numerous, from posters and billboards to television commercials, television dramas, radio dramas, graphic novels, to community discussion forums and one-on-one conversations.

 

In many settings the participatory models of practice fit in only into the design portion of Behaviour Change Communication. While the BCC model is not geared toward empowerment, the design of the communication materials should reflect people’s own ideas, needs and nuances of their understandings of health issues. 

 

 

Common Theories that Underpin BCC Interventions

 

The Health Belief Model (HBM), remains the most common and widely used theory in health-related behaviour change communication. The theory proposes that the behaviour of individuals is guided by their expectations of the consequences of adopting new practices. Therefore a person’s likelihood to take preventative action can be determined by his or her perceptions and understanding of the risks at hand (Maiman & Becker, 1974).

 

 

The Stages of Change Theory, which is also referred to as the Transtheoretical Model, identifies a common set of distinct stages through which all individuals progress in the process of making behavioural changes. These stages are defined as: pre-contemplation, contemplation, preparation, action, and maintenance. A BCC intervention based on the stages of change theory would strive to connect with individuals according to their respective stages in the change process. Interventions would be matched to the individual’s needs at each stage and would provide the most relevant and useful information to encourage them to progress to the next stage (McKee, Manoncourt, Yoon, & Carnegie, 2008).

 

 

The Theory of Reasoned Action (TRA) model is similar to the HBM in that it presupposes that individual’s thoughts and perceptions determine his or her behaviours. However the TRA focuses on the idea of behavioural ‘intent’. The theory supposes that influence of subjective norms plays a large part in determining the intent behind any behaviour (Fishbein and Ajzen, 1975). When working with this theory health communicators endeavour to influence individuals’ perception of social normative pressures. For example, the idea that their loved-ones would expect them to prescribe to the recommended, ‘safe’ actions would be utilized to motivate an individual to commit to changing their behaviours (Phippard, 2012).

 

 

Social Cognitive Theory (SCT) is unique in that it considers the social context alongside the individual cognitive factors. SCT focuses on the interactions between the internal and external determinates effecting behaviour. The theory postulates that an individual’s behaviour is determined by the relationship between environmental factors and internal cognitive factors (Mimiaga, Reisner, Reilly, Soroudi, Safren, 2009). Two aspects of this theory that are of particular importance in HIV-related behaviour change are ‘self-efficacy’, which refers to a belief in one’s personal capacity for behaviour change and maintenance; and ‘social modelling’ which is based on the idea that people learn vicariously through imitating the behaviours of the people they observe around them.

 

 

Rogers’ Diffusion of Innovations Theory is cited as having been particularly influential in the dissemination of health information in development contexts. It outlines the process by which members of a community adopt ‘innovations’ such as technology, new ideas, attitudes and practices. Rogers outlines five stages through which all individuals or communities pass when accepting new innovations as: awareness, knowledge and interest, decision, trial, and adoption/rejection (Rogers 1962; 1996).