11.3 Nutrition behaviour change communication
Nutrition behaviour change communication is a strategy that you will be able to use to change nutrition related behaviours in your community. Using the techniques and approaches described in this study session you will be able to bring about practices that promote better health through optimal feeding practices and improved dietary habits. You will be able to use behaviour change communication (BCC) to teach people about essential nutrition actions, most particularly optimal infant and young child feeding practices and the key messages in relation to these, and also to facilitate the adoption of healthy adult dietary styles.
The BCC activity in your community will involve you educating the community about a wide range of activities including horticultural activities, development of backyard fruit and vegetable gardens, and use of irrigation and water harvesting systems. For such activities you will need to gain collaboration from the frontline agricultural workers in your community, as together you will have a greater impact. Table 11.1 summarises some of the actions you will probably need to do to facilitate the progress of behaviour change at each stage.
Of course the methods you are able to use in your work will depend on your own situation. As you read through the table you should think about the ways that you can bring about these stages of change in your own practice as a Health Extension Practitioner.
| Stage of behaviour change | Action needed | Communication strategies |
|---|---|---|
| 1. Pre-aware (never having heard about the behaviour) | Build awareness and provide information | Drama, songs Community groups Radio Individual counselling Young child feeding support groups |
| 2. Aware (having heard about the new behaviour and knowing what it is) | Give more information, discuss benefits and persuade | Group discussions or talks Oral and printed word Counselling cards Feeding support groups |
| 3 and 4. Contemplation and intention (thinking about new behaviour) | Persuasion and encouragement | Group discussions or talks Individual counselling Counselling cards Feeding support groups |
| 5. Trial (trying new behaviour out) | Negotiate the best ways of overcoming obstacles | Home visits Use of visuals aids Groups of activities for family and the community Negotiate with the husband and mother-in-law (or influential family members) to support |
| 6. Adoption (demonstrating the new behaviour) | Further discussion on the benefits to ensure the behaviour continues | Encouraging and praising Emphasising the importance of the behaviour |
| 7. Maintenance (continuing to do new behaviour or maintaining it) | Discuss benefits, provide support at all levels | Congratulate mother and other family members as appropriate Suggest support groups to visit or join to provide encouragement Encourage community members to provide support |
| 8. Telling others | Praise and reinforce the benefits and give support | Reinforce the benefits Praise |
Nutrition BCC can be done with individuals or with groups or communities. To facilitate the progress of a person through each stage of behaviour change you can use the different actions and communication strategies that are summarised in Table 11.1. These are just possible examples however, and are by no means an exhaustive list of all the possible strategies. As a communicator, you will also be able to improvise (or adapt strategies) using locally available resources in your own community’s context. The following activity will help you think how to put these stages into practice in different scenarios.
Activity 11.1 Behaviour change
Read the following case studies and then answer the two questions that follow.
Case 1 A woman has heard the new breastfeeding information, and her husband and mother-in-law are also talking about it. She is thinking about trying exclusive breastfeeding because she thinks it will be best for her child.
Case 2 A woman has brought her eight-month-old child to the baby weighing session. The child has lost weight and the mother asks the health worker for advice.
Case 3 In the past month a health worker talked with a mother about gradually starting to feed her seven-month-old baby three times a day instead of just once a day. The mother started to give a meal and a snack and then added a third feed.
Questions
- a.What stage in the behaviour change model do you think each person has reached?
- b.What could the health worker do to help each of the women?
Answer
Case 1 The mother here is at the contemplation and intention stages. She is thinking about changing her behaviour. So the health worker can give her information and support (Stage 3). The mother has understood the benefits of exclusive breastfeeding but may not be sure how to do this. For example, she may be away for work and needs encouragement to overcome the obstacles to exclusive breastfeeding that this creates (Stage 4).
Case 2 In this case the mother does not know the cause of her child’s weight loss and the health worker will need to explain that there could be a feeding problem. The mother is at Stage 1 (pre-awareness) and the health worker can provide the mother with information about an appropriate diet for her child and persuade (Stage 2) the mother of the advantages of the proposed diet for her child.
Case 3 In the third case the mother has implemented what the health worker told her at earlier visits and she has started feeding her child differently. This indicates that she is in the trial stage and moving towards adoption (Stage 5). The health worker can support the mother by providing additional encouragement and praising her.
11.2 Stages of behaviour change