Effective communication for behavior change – Conferences, Symposia, and Reports
Key insights resulting from this exchange of information are summarized as follows. First, effective and affordable nutrition communication projects can be designed and implemented in a variety of countries and circumstances to address a variety of needs. These effective programs are accomplished when professional communicators and nutritionists collaborate together throughout the design and implementation of interventions aimed at changing nutrition-related behavior. It was recognized, however, that nutrition-related behaviors are more complicated to change than many other health-related behaviors. Therefore, special attention must be given to the process of assesement, planning, development and pretesting of the messages, delivery, and continued monitoring of the program to make changes throughout as needed. Nutrition behavior change must be subtle and it often requires an entire series of messages that build to the desired change in a step-wise fashion. Such messages will work best if linked to a program (such as building wells) or value (such as healthy children) that the target audience already wants. Key guidelines include:
High level support, at the policy-making level, is essential.
Program success depends on a comprehensive and systematic approach to conceptualize, implement and evaluate a program.
The platform on which all effective communication programs are built is a deep understanding of the target audience including its behavior, attitudes, political and environmental constraints. Yltimately, the people are responsible for changing their behavior and only they know what is practical in their own villages and communities.
Therefore, community members must be involved in the formulation of concepts and messages. A “bottom-up/top-down” team approach to the planning process is recommended with a high level of community participation.
Pretesting of all materials and messages is vital, not only with members of the target audience, but also with members of the medical community, government workers, educators/practitioners and policy makers.
Successful communication programs can be largely attributed to the quality and extensiveness of the baseline research as well as message testing before the mass media campaign begins and process evaluation during the program.
A variety of social science research techniques should be used for formative and summative evaluation. A mix of qualitative and quantitative approaches is recommended.
Realistic objectives, based on a knowledge of the target audience, must be set. Nutrition communication cannot be expected to resolve all nutrition-related problems, e.g., accessibility to vitamin A capsules.
A multimedia mix that includes face-to-face as well as traditional communication and mass media technologies is most likely to succeed.
Flexibility is essential; mid-course adjustments should be expected and are necessary to maximize success.
Television messages have tremendous power to change behavior but, by themselves, cannot cause sustainable behavior change. Alternative media channels can also be as effective as television.
The medical or health-care community must be integrated and involved with the development and implementation of the nutrition communication intervention. In other words, consensus building may be critical for long-term success.
Educational programming must be blended with an entertaining, nondidactic approach.
Free materials and donated services can be incorporated into nutrition communication interventions, but there are trade-offs in their use. Alone, they are short-term and usually do not allow for evaluation, continuity, sustainability or integration into the existing health community.
In every case study presented at this meeting, social marketing provided the model for guiding the program’s development efforts. It should be emphasized that this model has changed substantially from the early social marketing models. The emphasis is not now on the 4 P’s (price, product, promotion and place), but on process. Helath communication models identify what should be done; social marketing models identify how to take action, but this action must be driven by a systematic, holistic approach. Therefore, funds for assessment, pretesting and evaluation as well as for mass media are essential for successful implementation and outcomes. Whereas the products of any particular social marketing program can be rarely transferred, the decision-making process can be. Thus, the key output to any program is the strategic plan about how to segment the audience and how to determine what actions to take, i.e., what themes to develop in the messages, what support can be drawn from workers in the community and what other supports can be/should be developed for the program. Discussion of this process and an understanding of various problem-solving approaches justifies the need for further conferences of this nature.
Dr. Achterberg is Associate Professor of Nutrition at Penn State University in University Park.
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