1. Developing new strategies for behavior change Susan Zimicki The CHANGE Project/AED Presented at the USAID SOTA course, June 2000

2. The CHANGE Project/AED Basic principles Build on successes Learn from previous failures

3. The CHANGE Project/AED Behavior is Contextual – People behave differently with different partners and in different settings Dynamic – People change over time Best understood from within – “think like the other”

4. The CHANGE Project/AED What do we know works?  Simple interventions (1 behavioral outcome)  Interventions that are “theory-based” – No single theory – Commonality = going after something besides knowledge (skills, outcome expectancy, …

5. The CHANGE Project/AED A checklist of important theoretical factors Expected outcomes Intention Skills Self-efficacy Emotion Self-standards Perceived social norms Barriers

6. The CHANGE Project/AED Some reasons programs appear to fail: Measurement failure – Measurement of wrong outcome (too far downstream) – Insufficient time for effect – Inappropriate evaluation design Expectation failure – Change occurred but did not meet the expectations of planners/funders

7. The CHANGE Project/AED Main reasons programs actually fail: Strategy failure – Focuses on wrong behavior or wrong determinant Insufficient regard for the context – e.g., attention to knowledge, attitudes instead of changing system Insufficient consideration of all needs Work at the wrong level Execution failure – Poor implementation Message too complex, poor quality – Insufficient intensity of exposure

8. The CHANGE Project/AED Preventing measurement and expectation failures Develop a process model: – Specify steps that need to be completed for an intervention (depict as a flowchart) – Assess the probability of success of each step – Multiply through the probabilities for each step – Then: Lower expectations Simplify Arrange to monitor success of critical steps

9. The CHANGE Project/AED Preventing strategic failures: Enlarge the focus Develop better frames for diagnostic research Ensure that interventions address: – The most relevant factors (Use a checklist of the common theoretical factors) – Multiple factors (e.g., both intention and efficacy) – Multiple levels of influence (individual, social network, public policy to effect enabling structural change)

10. The CHANGE Project/AED Another way to enlarge the focus: move beyond the individual Currently: – Problem definition - focuses on ‘risk’ – Behavioral models - focus on the individual Theoretical basis: individual psychology An alternative – move beyond the individual

11. The CHANGE Project/AED Beyond the individual: Ideas from other social sciences Network analysis Game theory Community efficacy Vulnerability

12. The CHANGE Project/AED Rogers & Kincaid, 1981) Example of a network

13. The CHANGE Project/AED Things to do with a network Identify opinion leaders, persuade them, so they diffuse new knowledge, attitudes, skills to others What if they are resistant? – Try ‘bridges’ – Build new links from those who can change

14. The CHANGE Project/AED Basic game theory diagram Group 1 WINLOSE Group 2 WINOptimal equilibrium LOSESuboptimal equilibrium

15. The CHANGE Project/AED Community efficacy Analogous to self-efficacy Factors: – Cohesion* – Trust* – Networks – Norms

16. The CHANGE Project/AED Another alternative- move from ‘risk’ to a “vulnerability” model Exposure – Risk Capacity – Social Capital Potential – Empowerment – Acquiring new skills, information