spring review 16

This presentation was made possible by the American people through the U.S. Agency for International Development (USAID) under Cooperative Agreement No. AID-OAA-A-11-00031,

the Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project.

Knowledge Sharing: A Practical Guide to Conducting Barrier Analysis

Oluwaseun OkediranSBCC/Nutrition Officer

SPRING Review Meeting2nd February 2016

Unlocking barriers to behavior change

What is Barrier Analysis?

Barrier Analysis (BA) is a rapid assessment tool used in community health and other community development projects to identify why recommended healthy behaviors are reluctantly adopted or not adopted at all. • survey that focuses on identifying what is

preventing the priority group from adopting the behaviour, as well as enablers of the behaviour.

• Used to develop more effective behavior change communication messages / activities.

• Compare Doers and Non-Doers- those that are doing the behavior and those that are not doing the behavior (doer/non-doer analysis)

What are behavioral determinants? • Reasons why someone does or does not

do a behavior • These behavioral determinants are

identified so that more effective behavior change communication messages, strategies and supporting activities (e.g., creating support groups) can be developed.

• There are eight determinants, as follows;

• Cues for Action/Reminders: Can I easily remember how/when to breastfeed(EBF) my child?

• Perceived Severity: Do I think the consequences of not EBF are very severe?

• Perceived Susceptibility: Am I putting my child at risk?

• Perceived Action Efficacy: Is EBF easy to do?

• Perception of Divine Will: Does God approve of EBF?

• Perceived Social Norms: Do my friends and family support me in EBF?

• Perceived Self-efficacy: Do I think know how to?

• Positive & Negative Consequences: What are the good/bad attributes associated with EBF?

And the benefits are…

• Gives you underlying reasons why some behaviors don’t or aren’t changing

• It provides a set of locally derived results of a single, specific behavior

• Results can be shared with other implementers addressing the same behavior in similar settings

• Results are valid for 5 years or so under most circumstances

Uses: BA can be used in a variety of different ways, including: • At the beginning of new programs, new

interventions are being developed to determine key messages and activities for intervention

• In ongoing programs to focus on behaviors that have not changed much despite repeated efforts, to understand what is keeping people from making a particular change.

Examples: • Are there any laws or policies that make

it more likely that you will use ORS? Policy

• Who would disapprove of you delivering at the health facility? Perceived social norms

• Do you think its God’s will that children get diarrhea ? Perceived divine will

Designing for behaviour Change framework

Behavior Priority Group or Influencing

GroupsDeterminants

Bridges to activities Activities

Behaviour Priority Group or Influencing Groups

Determinants

Bridges to Activities

Activities

To promote this behaviour…

…among this audience…(circle one)

Priority group:

Influencing groups:

…we will research these determinants…

*These can only be determined by conducting research studies.

…and promote these bridges to activities (priority benefits and priority barriers)…

…by implementing these activities.

Outcome Indicator:

Outcome indicators:

The Seven Steps of BA1. Decide what the behavior is that you want to

change 2. Decide what the definition is of a ‘doer’ and a

‘non-doer 3. Create a questionnaire based on samples

provided 4. Interview 45 doers and 45 non-doers 5. Analyze the data (excel spreadsheet) 6. Identify the statistically significant behavioral

determinants (major behaviors)7. Develop messages/interventions to overcome

barriers to change

Individual Interviews

For instance…• The problem: In

Kajuru, children under 2 are malnourished

• The solution: A program to promote EBF and teach mothers how to cook and feed their children nutritious 4 star meals

Behaviour change • Perceived action

efficacy?▫ eating good food

prevents malnutrition • Perceived self

efficacy? My child will not be malnourished! I can do it!

• Perceived social acceptability?

• My husband, family and others support my choice to feed our children 4 star meals!

What do you do with the results? • Emphasize them in your activities• Tweak your programming to ensure that

the determinants are emphasized? • ▫ E.g.: if action-efficacy, or belief that

you can do the behavior is a determinant, try skill- building exercises! Such as food demonstrations

• Use the messages on media and IEC materials

• Print them on T-shirts for CVs

Conclusions• By identifying barriers to behavior change through BA, and by targeting populations with BA activities, even very difficult behaviors can change!

Useful Resources • http://barrieranalysis.fh.org/annex/

Barrier_Analysis_Facilitator_Guide.pdf • http://www.eeotraining.eeoc.gov/imag

es/content/EXCELHandouts/1A%205B%20Barrier%20Analysis%20I%20final.pdf

• http://barrieranalysis.fhi.net