Unit 4: Lesson 2
Define Behaviour Change Communication:
Concept and Functions
Dr. Rajesh Agrawal
Associate Professor, MBICEM
Introduction
Behaviour is an observable action of an individual or community
often in reaction to specific circumstances or stimuli.
It is acquired and liable to change.
It is affected by a number of factors like genetics, social norms,
culture, attitudes, emotion, perceived risks and benefits,
personal interest and so on.
Behaviour is different from beliefs and attitude.
Belief is the psychological state in which an individual holds a
proposition or premise to be true.
Attitude is an expression of favour or disfavour towards a
person, place, thing or event.
Attitude can be defined as a positive or negative evaluation of
people, objects, event, activities, ideas, or just about anything in
the environment.
Health Behaviour: Concept
Health behaviour as any activity undertaken for the purpose
of preventing or detecting disease or for improving health
and well-being.
It relates to health maintenance, restoration and
improvement.
It includes medical service utilisation such as visit to a
physician, a vaccination, screening, compliance with medical
regimens (A plan or a regulated course that is designed to
give a good result).
For example nutritious diet, exercise, giving up smoking and
alcohol consumption, compliance of health treatment and
so on.
Factors Affecting Health Behaviour
Social deprivation: Socially deprived population have a smaller range of
healthy options, for instance, the areas are unsafe and have less pleasant
environment, which reduces the motivation to increase physical activity,
like walking etc.
Psychological difficulties: It refers to mental behavioural disorder. If the
stress is high, the person does not take any action for his or her health.
Poor health literacy: People are not even aware of their normal range of
biochemical and physiological changes.
Poor understanding of the behaviour: A poor understanding of normal
and abnormal behaviour also affects their preventive, illness and sickness
behaviour.
Lack of social support: Persons who live alone, or in a broken family, or
are unmarried or divorced, have more chances of ignoring their health.
Health Behaviour Models
Health Belief Model (HBM): It considers that people will act to
protect their health if they perceive that they are at risk and that a
particular action will enable them to deal with such a risk, without
triggering excessive personal sacrifice.
Protection Motivation Theory (PMT): It is a mediating variable
whose function is to arouse, sustain and direct protective health
behaviour. It is the result of the threat and coping appraisals.
Theory of Reasoned Action (TRA): This principle states that each
attitude and behaviour has four elements i.e. (i) Action, (ii) Target,
(iii) Context and (iv) Time.
Theory of Planned Behaviour (TPB): A person who considers the
decision to adopt a balanced diet, will analyse the potential
consequences of this behaviour and also analyses what other people
will think about his/her willingness to comply with these opinions.
These perceptions reflect in an attitude towards the behaviour.
Trans-theoretical Model: is based on the analysis of
behavioural change in clinical psychology. People change their
behaviour through following six phases:
Pre-contemplation: people still resist change, deny the
problem and have no intention of changing
Contemplation: people assume they have a problem, but do
not take any action to resolve it.
Preparation: people plan to take action and prepare
themselves to do so through specific plans.
Action: people modify their behaviour
Maintenance: people reinforce the preventive behaviour
over time
Terminance: the problem will not return and is not a threat
anymore
Illness Behaviour Model: Undertaken by an individual who feels ill, to get
relief from that experience or to feel better. Many social and
psychological factors intervene and determine the type of illness
behaviour expressed by the individual.
Stage 1: Symptom experience: Person recognises a physical sensation
or a limitation in functioning but does not suspect a specific diagnosis.
Stage 2: Assumption of sick people: Person seek confirmation from
their families and social groups .
Stage 3: Medical care contact: Person motivate to seek professional
health services or expert acknowledgement of the illness as well as
treatment.
Stage 4: Dependent client role: Person adopt the dependent role in a
health care institution, at home, or in a community setting. The client
must also adjust to the disruption of a daily schedule.
Stage 5: Recovery and rehabilitation: In case of chronic illness, the
final stage may involve an adjustment to a prolong reduction in health
and functioning.
Behaviour Change Communication (BCC): Concept
BCC is an interactive process of any intervention with
individuals, communities or societies to develop
communication strategies to promote positive behaviours
which are appropriate to their settings.
This provides a supportive environment which will enable
people to initiate, sustain and maintain positive and
desirable behaviour outcomes.
BCC is the strategic use of communication to promote
positive health outcomes, based on proven theories and
models of behaviour change.
Steps involved in BCC
1. Unaware
2. Aware
3. Concerned
4. Knowledgeable
5. Motivated to change
6. Practicing trial behaviour change
7. Sustained behaviour change
Unaware to Aware:
Initially a person is unaware that a particular behaviour
may be dangerous. Therefore, make people aware.
Person can be aware through various sources like face-to-
face guidance, NGOs, various mass media tools.
Concerned:
Information must be given is such a way that the audience
feels it applies to them.
The audience becomes concerned and people are
motivated to evaluate their own behaviour.
At times Mass media approaches are less likely to be
effective in creating concern and overcoming denial.
Therefore, targeted communication and interpersonal
approaches are more useful.
Knowledgeable:
Once concerned, individuals acquire more knowledge by talking
to friends, social workers or health care providers about the
dangers and methods of protection.
More interpersonal communication approaches are needed at
this stage.
Motivated and ready to change:
Individuals might now seriously begin to think about the need
to protect themselves.
This is a time when a person become motivated and ready to
change.
At this stage Mass media and target media can help provide a
supportive environment by showing role models and promoting
a positive view. Positive messages from peers are also effective.
Trial Change of Behaviour:
Individuals are in a situation where they could decide to try
to adopt new behaviour and evaluate the experience.
If the experience has been too difficult or embarrassing,
due to lack of skills then they may not try again for a long
time.
Therefore, the skills suggested should be well tried before
and easy to adopt.
Sustained Behaviour Change:
Finally the individual decides to make habit about the new
behaviour.
The new behaviour continues to be evaluated as largely
positive, sustained behavioural change take place at this
stage.
BCC involves the following stages
Situational analysis and State program goals
Involve stakeholders
Identify target populations
Conduct formative BCC assessments
Segment target populations
Define behaviour change objectives
Define BCC strategy, monitoring and evaluation plan
Develop communication products
Pre-test
Implement and monitor
Evaluate
Analyze feedback and revise
Strategies for BCC
The strategies for BCC vary from group to group. Following points
are important while considering the BCC strategy:
The vulnerability factor of the group which is to be addressed
The conflict and obstacles in the way to desired change in
Behaviour
Type of message and communication media which can best be
used to reach the target group.
Type of resources available and
Assessment of existing knowledge of the target group about
the issue which is going to be dealt with.
There can be several more points in this list.
A successful BCC requires lots of research and meticulous
planning about the knowledge content of the subject and
behaviour/attitude pattern of the target group.
Implications and Functions of BCC
BCC plays a role to:
Increase knowledge
Stimulate community dialogue
Promote essential attitude change
Advocate for policy changes
Create a demand for information and services
Reduce stigma and discrimination
Promote services for prevention and care
