Arogya World’s work to change the course of non-communicable diseases embraces sound science and effective strategies to realize behavior change. We are pleased to present this post by by Ann Jimerson, Senior Specialist in Behavior Change at Alive & Thrive, FHI 360. You can follow Alive & Thrive on Twitter @aliveandthrive and on Facebook. This piece is the inaugural post from their LESS GUESS series – you can sign up for it here.
As the U.S. turned to President Obama’s inauguration, we at Alive & Thrive reflected on what re-electing a U.S. president and promoting a health behavior may have in common:
Being precise about which behavior you need to promote
Obama’s door-to-door canvassing effort was clear in its behavioral objective. Rather than knocking all doors to persuade undecided voters to support Obama, volunteer canvassers were directed, through a carefully constructed database, to the homes of people who had already indicated they were pro-Obama. The behavioral objective was to make sure those likely Democrat voters would “go to the polls and vote.”
That focus is not so different from our strategy for promoting exclusive breastfeeding. In Viet Nam, most mothers already said they know that breastfeeding is best. But it didn’t occur to mothers that when they give the baby water it means that they aren’t getting the benefit of exclusive breastfeeding for 6 months. To increase the percentage of mothers practicing exclusive breastfeeding, one of our TV spots focuses on the specific behavior “don’t give the baby water.”
In A&T’s Viet Nam breastfeeding campaign, a little baby names the precise behavior that results in exclusive breastfeeding.
Making it feel easy to do the behavior
Behavioral scientists advised Obama’s strategists that people are more likely to act when the action seems easy to do. After months of news about the many U.S. states that had passed new regulations requiring voters to show valid photo identification (ID) in order to vote, people were confused or fearful about what the act of voting would be like. Volunteers in the state of Virginia were shown a list of the types of IDs that would be acceptable but were advised to avoid complicated discussions of what is and isn’t a valid ID. The volunteers were told: “The message you want to give people is, ‘It’s EASY to vote in Virginia!'”
That focus is like our strategy for promoting washing hands with soap and water before preparing food or feeding a baby. Studies in Bangladesh showed us that one of the big reasons busy mothers found it hard to wash their hands before handling baby’s food is because soap and water were nowhere near the part of the home where they prepared food and fed baby. A&T’s campaign, then, encouraged families to maintain a handwashing station with soap and water near the child’s feeding place. Through behavioral trials, we had found that with soap and water nearby, mothers were much more likely to wash the right way at the right time.
Remember, keep soap and water near the child’s feeding place.
Asking people to make a plan for how they will adopt the behavior
Obama’s strategists called upon behavioral economists and others to identify small steps that could make a difference. By analyzing data from previous elections, researchers had shown that people who have made a specific plan for when and how they will get to the polls on Election Day are more likely to vote than are those who don’t have a plan. Every face-to-face or phone interaction with an Obama supporter, then, included the question: “What time of day do you plan to vote?” Apparently, helping people pin down a personal plan could increase voting by 4 percentage points, and in a close race, that can make the difference.
That focus on making a plan can strengthen a text message to motivate mothers to put the child to the breast in the first hour of life. Asking a mother to make a personal plan is like inserting a bit of motivational counseling into any interaction. As the U.S. presidential campaign was underway, Alive & Thrive staff helped MAMA (Mobile Alliance for Maternal Action) refine the feeding messages in its set of adaptable text messages for pregnant women and new mothers. One of MAMA’s messages, timed so the pregnant woman receives it on her mobile phone in her 19th week of pregnancy, advised early initiation of breastfeeding. But the first version of the message read like just another piece of guidance. A&T advisors suggested asking mothers to make a plan. The new message reads, “Make a plan with your family to put your new baby to the breast in the first hour. The creamy first milk will help protect him from illness.”
Maybe reflecting on the ways a political campaign applied practical findings from behavioral science can inspire you, too, as you aim for helping people adopt better health behaviors – whether through face-to-face counseling, mass media, or even mHealth with text messages.