Descriptive theories are meant to describe behavior and are very good at telling us what the factual truths, moral norms, or group identities of a community are. Descriptive theories are great for telling us what is happening in a community, but they do not necessarily emphasize how to promote change.
Prescriptive theories are designed to tell us what the theorists think the best possible world would look like. They are great to help analyze a situation. The trouble with prescriptive theories is that they can be difficult to apply to practical problems and the "real world" because they look at what should be done rather than what actually can be done.
Below we list 10 common groups of theories that are used to guide SBCC interventions. Each theory, or group of theories, attempts to explain human behavior at one or more of three levels of change – Individual level, Interpersonal level, and Community level.
Back to top Social Movements and Media Advocacy (Community)
Social movements refer to collective publics mobilized to raise demands and promote changes at multiple levels. Social movements resort to policy and media advocacy to promote changes in policy debates and media coverage. Policy advocacy is conducted through several tactics such as meetings, lobbying, media campaigns, and street displays and mobilization (e.g. protest, rallies) to get attention from political elites, raise awareness about specific issues, and discuss demands and solutions. Media advocacy is done through meetings with media decision-makers, the provision of information to newsrooms (e.g. via press releases, news services, production of specific news stories), and training of reporters and editors. The latter is aimed at influencing media agenda – what is covered and how it is covered. The significance of agenda setting lies in the fact that media agenda has influence on public opinion (what people think) and policy agenda (regulatory or legislative actions on issues).
In Module 1, the Treatment Action Campaign in South Africa is a prime example of a social movement that intelligently used policy and media advocacy to promote change. Based on situation analysis, the TAC developed strategies to bring attention about the problems for HIV/AIDS treatment. It aimed at changing the lack of political will of the government and high prices for treatment through multiple tactics such as public mobilization and meeting with government officials and pharmaceutical companies to promote policy changes and reduce drug prices.
Back to top Cultural-Centered and Positive Deviance Approaches (Interpersonal and Community)
A key premise of the Culture-Centered Approach is the idea that “traditional cultural beliefs” should not be approached as barriers to positive social change. It opposes traditional visions of culture “as obstacle” and instead, views cultures in terms of assets and resources to be harnessed in change efforts. Culture, then, is seen as a reservoir of ideas and experiences that can be tapped to promote change. For example, a cultured-centered analysis culture may yield information about local cooking practices and foodstuff that can be recommended to improve nutrition rates. By the same token, the analysis may provide information about local trusted sources of information about nutrition and cooking among key publics.
Along similar lines, the idea of Positive Deviance suggests that the solution to existing challenges most likely already exists within the community. In any given community, there are often individuals and/or families that “deviate” from the norm in a positive way. For example, if a village has a 95% malnutrition rate for children under the age of five, a Positive Deviance approach would begin with the 5% that are NOT malnourished and attempt to identify promising practices that can be used by the entire community. Understanding why certain people do not follow negative norms or practices offers critical insights to assess motivations and causes. These insights can be used to identify and select possible courses of actions for the population at large. However, if an individual or family has access to additional resources (like extra farm land) then that “solution” is not applicable to the community – only practices that can be replicated by ALL in the community are sought and made visible. In the Positive Deviance approach, the “deviating” community members are the experts and it is they (not an external expert) who are called upon to share their successful practices with other community members. As discussed in Module One, Positive Deviance is a valuable analytical instrument to understand the situation - for example, why some people practice safe sex when most don’t, or why a group of expecting mothers regularly seeks services from health clinics when most don’t. Back to top Gender and Power (Community)
In any society, members face constraints and barriers, many of which are gender specific (Connel 1987). For example, in most societies there is a “sexual division of labor,” which means that certain types of work are designated for certain types of people. Men often seek paid employment outside the home while women work, without payment, inside the home. In these households men have more economic power and freedom of movement than the women. In addition, domestic violence and rape can also be viewed as a result of gender-related inequalities of power. Understanding the relationship between power and gender is crucial for planning interventions to address issues of gender-related inequality and to identify barriers. Gender and power relations are constructed socially – in other words, men and women are notborn with more or less power – it is social norms and practice, and raising and educating people within these norms that reinforce existing gender norms.
Because gender inequality is the result of these institutions and processes, any communication intervention/activity design should consider how gender and power relations may affect participation (do women have time or need permission to attend?) and the ability to act on recommended actions (can a woman ask her husband to get tested for HIV without him accusing her of cheating on him and/or reacting with violence?).
As discussed in Module One, the issue of gender and power is crucial to examine barriers at multiple levels (household, community, society) that discourage positive practices and promote negative behaviors. When this is the case about specific issues, then, communication needs to find ways to encourage changes in power relations in ways that they can effectively influence specific practices and norms. By the same token, communication analysis needs to be sensitive to how power inequalities affect women’s participation in specific activities or would react to proposed messages. Back to top Messaging (Individual, Interpersonal, and Community)
Messaging is not a theory, but it is directly related to how theoretical arguments and operational research shape messages. Messages are a core part of any communication program. They are intended to influence people’s knowledge, attitudes, perception, behaviors, social norms, and participation. Theory-based message design links theory and practice by explaining what may motivate people to change opinions and practices. Messages are embedded in specific views about what drives change given existing conditions. For example, Social Learning Theory suggests that if audiences positively identify themselves with a character in a TV or radio soap opera, they are more likely to adopt behaviors which that character has modeled for them. The Culture-Centered Approach suggests that messages need to be embedded in local cultures and resonate with people’s expectations, norms, and desires. Messages need to be designed on the basis of nuanced knowledge about how diverse audiences’ cultures, beliefs, barriers, assets and needs can be addressed.
Module 3 offers several ideas about the creative process, in which message design is critical. Messages should not only reflect what has been learned in analysis, but also certain theoretical premises about change. If theory says that increased risk perception leads to positive change, then, the message should do that. If theory suggests that people are driven by emotions, not rationality, about a given issue, then, messages should reflect that premise. If theory says that local knowledge is particularly prized in a given community, then, messages should incorporate local ideas and solutions. Back to top Fear Appeals (Individual)
The use of fear appeals in messaging to change behaviors has been extensively discussed. According to the Extended Parallel Process Model (EPPM), people make decisions based on:
Analyzing a threat/fear (Is the threat serious? Can it happen to me?)
Deciding on their ability to deal with the threat (Does the response to the threat work?
Can I perform the response (self efficacy - What barriers keep me from responding?).
Once they have analyzed the situation, people either
Act defensively by controlling the fear, e.g., by being in denial about it and not acting on it, or
By controlling the danger and using preventive behaviors to reduce the fear.
For preventive action to take place, it is important that individuals considers the preventive action to be effective (e.g., condoms) and that they believe they are capable of performing the action (effectively use condoms).
In order to make sure that populations control the danger (rather than controlling their fear) by using preventive action, several choices exist: a) increase the perceived seriousness of e.g., malaria, b) increase audience’s risk perception of getting malaria (threat), c) increase knowledge of effective solutions such as malaria nets, d) model response behaviors (show how to use it), and/or e) show how others have overcome barriers to using nets (response) (Witte & Allen 2000). Which one is chosen depends on findings from formative research and audience consultation results. Back to top Gender and Social Norms (Community)
Social Norms are the rules that a group uses to discriminate between appropriate and inappropriate values, beliefs, attitudes and behaviors - the “dos and don’ts” of society (Appelbaum, 1970). Social norms may be explicit or implicit. Failure to conform to norms can result in social sanctions and/or social exclusion. Gender refers to widely shared expectations and norms within a society about male and female behavior, characteristics, and roles. It is a social and cultural construct that differentiates women from men and defines the ways in which women and men interact with each other. Gender is a culture-specific construct. There are significant differences in what women and men can or cannot do in one society when compared to another. However, in all cultures the roles of men and women are distinct, as are their access to productive resources and their authority to make decision. Typically, men are held responsible for the productive activities outside the home while the domain for women are the reproductive and productive activities within the home. In most societies women have limited access to income, land, credit and education, and limited control over these resources.
Modules 2 and 3 discuss the importance of analyzing and addressing barriers to change. Gender norms are critical to understand the persistence of specific practices. They dictate decisions about family planning, sexual interaction, HIV testing, use of healthcare services and other health practices. Women’s actions are subordinated to the desires of male partners as well as social perceptions about the proper role of women. Identifying the role of gender norms (what purpose they serve) and finding alternative norms to replace the dominant “negative” norm helps to understand how change may be possible. Back to top Community Organization Models (Community)
These models emphasize the active involvement of community members from a wide range of sectors. Community organization activities are implemented with communities rather than for them. A key guiding question for implementation is: Who else can we invite to join us for this activity? Whose collaboration and/or assistance can we seek? A central premise is that community organization is fundamental to promote and maintain changes. This is why, as discussed in Modules 2 and 4, it is critical to identify partners interested in common issues. Local partnerships offer tremendous resources to design and implement activities, as well as commitment to continuing programs. Here it is fundamental to bring them together in each stage of the process and assess strengths and contributions in ways that avoid duplication and maximize reach and sustainability. Back to top Social Capital and Social Network Theories (Interpersonal and Community)
Social capital refers to the social resources of a community - networks, institutions, and attitudes that can be mobilized to promote positive change. The first step is the identification of existing social networks in a community that are well-respected, trusted, and reach significant segments of the population. Many communities have women’s groups that meet on a regular basis and are highly involved in community organizing and mobilizing for issues of priority even outside of their community. Programmers should also consider their implementation partners as part of an existing social network that is a social resource to be cultivated and nurtured. Consistent communication and collaboration among partners helps strengthen social networks. Social networks require reciprocal, “give and take,” relationships. These social resources allow for reaching people through credible and effective networks. Module 4 offers examples of how social capital and social networks are fundamental to the success of a program by expanding platforms and encouraging participation from various actors. Communities particularly with dense associational life (organizations/networks) and high levels of trust and social connection offer plenty of opportunities. The development and cultivation of partnerships coupled with the tapping into local social networks need to be constant processes throughout the life of a communication program. Back to top Theories of Change (Individual, Interpersonal, and Community)
A Theory of Change is a “concrete statement of plausible, testable pathways of change that can both guide actions and explain their impact" (Kubisch et al., 2002). A Theory of Change is laid out with a logic model, a visual representation that charts (or maps) a path from the problem to be addressed, to the inputs (available resources), then outputs (activities and participation) to finally arrive at outcomes (short, medium and long-term results), which ideally will lead to impact (long-lasting change). A Theory of Change brings underlying assumptions to the surface so that the reasoning behind an intervention can be assessed and adjusted, if necessary. Theories of Change inform all stages of the process. From Module 1 – the situation analysis – to Module 5 – evaluation and replanning, theories are always present. Just as they inform our thinking at the beginning of the process by directing our attention to causes and possible solutions to specific problems, they are useful to understand if, at the end, theoretical models were correct in terms of understanding and predicting change. Programs offer evidence to test and refine theoretical arguments, and thus, plan future actions. Back to top Socio-Ecological Theory (Community)
Socio Ecological models integrate multiple levels of influence on health behaviors and norms and are noted for emphasizing the interdependence of environmental settings and life areas. It assumes that barriers and opportunities to change exist at the individual, group/community, social, and structural/system levels. Understanding how various factors at these levels affect the problem at stake as well as offer ideas for possible solutions is critical to determine courses of actions. However, trying to develop more complex programs to affect social and behavioral change also increases the complexity of assessing the different influences on the assumed change. If challenges are grounded in multiple levels, typically, interventions at all levels may be necessary. Yet given time constraints and limited resources, it is necessary to select plausible actions at specific levels, and link to and collaborate with other programs that are addressing the other issues already.
Socio-ecological theory helps to understand barriers/problems at the beginning of the process and determine points of entry into the social ecology of a given challenge. It also contributes to understanding the impact of a given multi-prong program at multiple levels, as discussed in Module 5. For example, an intervention aimed at changing gender norms around HIV testing may decide to educate people (individual/group level), promote safe spaces for women’s groups to discuss HIV-related issues (social), and ensure privacy in interactions with health staff through legal decisions (policy). During the evaluation stage, it would be necessary, then, to assess the impact at various levels and determine if there were changes, and how they affected HIV testing decisions. This is also helpful to assess possible positive synergy among actions at various levels. Back to top
Communication Theory and C-Change
Introduction | Social Movement and Media Advocacy | Culture-Centered and Positive Deviance Approaches | Gender and Power | Messaging | Fear Appeals | Gender and Social Norms | Community Organization Models | Social Capital and Social Network Theories | Theories of Change | Socio-Ecological Theory
Introduction
SBCC offers evidence-based, systematic interpretations of certain phenomena. Theories are set of concepts formed into propositions that explain causes of particular conditions and events. Theories give us explanations and predict relations among phenomena. Theories help us make sense of observations, findings and analysis. Theories highlight certain aspects of a given situation (“how to analyze it”) and offer insights to identify solutions for practical, concrete problems.
There are two main types of theories that serve different purposes:
Below we list 10 common groups of theories that are used to guide SBCC interventions. Each theory, or group of theories, attempts to explain human behavior at one or more of three levels of change – Individual level, Interpersonal level, and Community level.
Back to top
Social Movements and Media Advocacy (Community)
Social movements refer to collective publics mobilized to raise demands and promote changes at multiple levels. Social movements resort to policy and media advocacy to promote changes in policy debates and media coverage. Policy advocacy is conducted through several tactics such as meetings, lobbying, media campaigns, and street displays and mobilization (e.g. protest, rallies) to get attention from political elites, raise awareness about specific issues, and discuss demands and solutions. Media advocacy is done through meetings with media decision-makers, the provision of information to newsrooms (e.g. via press releases, news services, production of specific news stories), and training of reporters and editors. The latter is aimed at influencing media agenda – what is covered and how it is covered. The significance of agenda setting lies in the fact that media agenda has influence on public opinion (what people think) and policy agenda (regulatory or legislative actions on issues).
In Module 1, the Treatment Action Campaign in South Africa is a prime example of a social movement that intelligently used policy and media advocacy to promote change. Based on situation analysis, the TAC developed strategies to bring attention about the problems for HIV/AIDS treatment. It aimed at changing the lack of political will of the government and high prices for treatment through multiple tactics such as public mobilization and meeting with government officials and pharmaceutical companies to promote policy changes and reduce drug prices.
Back to top
Cultural-Centered and Positive Deviance Approaches (Interpersonal and Community)
A key premise of the Culture-Centered Approach is the idea that “traditional cultural beliefs” should not be approached as barriers to positive social change. It opposes traditional visions of culture “as obstacle” and instead, views cultures in terms of assets and resources to be harnessed in change efforts. Culture, then, is seen as a reservoir of ideas and experiences that can be tapped to promote change. For example, a cultured-centered analysis culture may yield information about local cooking practices and foodstuff that can be recommended to improve nutrition rates. By the same token, the analysis may provide information about local trusted sources of information about nutrition and cooking among key publics.
Along similar lines, the idea of Positive Deviance suggests that the solution to existing challenges most likely already exists within the community. In any given community, there are often individuals and/or families that “deviate” from the norm in a positive way. For example, if a village has a 95% malnutrition rate for children under the age of five, a Positive Deviance approach would begin with the 5% that are NOT malnourished and attempt to identify promising practices that can be used by the entire community. Understanding why certain people do not follow negative norms or practices offers critical insights to assess motivations and causes. These insights can be used to identify and select possible courses of actions for the population at large. However, if an individual or family has access to additional resources (like extra farm land) then that “solution” is not applicable to the community – only practices that can be replicated by ALL in the community are sought and made visible. In the Positive Deviance approach, the “deviating” community members are the experts and it is they (not an external expert) who are called upon to share their successful practices with other community members. As discussed in Module One, Positive Deviance is a valuable analytical instrument to understand the situation - for example, why some people practice safe sex when most don’t, or why a group of expecting mothers regularly seeks services from health clinics when most don’t.
Back to top
Gender and Power (Community)
In any society, members face constraints and barriers, many of which are gender specific (Connel 1987). For example, in most societies there is a “sexual division of labor,” which means that certain types of work are designated for certain types of people. Men often seek paid employment outside the home while women work, without payment, inside the home. In these households men have more economic power and freedom of movement than the women. In addition, domestic violence and rape can also be viewed as a result of gender-related inequalities of power. Understanding the relationship between power and gender is crucial for planning interventions to address issues of gender-related inequality and to identify barriers. Gender and power relations are constructed socially – in other words, men and women are not born with more or less power – it is social norms and practice, and raising and educating people within these norms that reinforce existing gender norms.
Because gender inequality is the result of these institutions and processes, any communication intervention/activity design should consider how gender and power relations may affect participation (do women have time or need permission to attend?) and the ability to act on recommended actions (can a woman ask her husband to get tested for HIV without him accusing her of cheating on him and/or reacting with violence?).
As discussed in Module One, the issue of gender and power is crucial to examine barriers at multiple levels (household, community, society) that discourage positive practices and promote negative behaviors. When this is the case about specific issues, then, communication needs to find ways to encourage changes in power relations in ways that they can effectively influence specific practices and norms. By the same token, communication analysis needs to be sensitive to how power inequalities affect women’s participation in specific activities or would react to proposed messages.
Back to top
Messaging (Individual, Interpersonal, and Community)
Messaging is not a theory, but it is directly related to how theoretical arguments and operational research shape messages. Messages are a core part of any communication program. They are intended to influence people’s knowledge, attitudes, perception, behaviors, social norms, and participation. Theory-based message design links theory and practice by explaining what may motivate people to change opinions and practices. Messages are embedded in specific views about what drives change given existing conditions. For example, Social Learning Theory suggests that if audiences positively identify themselves with a character in a TV or radio soap opera, they are more likely to adopt behaviors which that character has modeled for them. The Culture-Centered Approach suggests that messages need to be embedded in local cultures and resonate with people’s expectations, norms, and desires. Messages need to be designed on the basis of nuanced knowledge about how diverse audiences’ cultures, beliefs, barriers, assets and needs can be addressed.
Module 3 offers several ideas about the creative process, in which message design is critical. Messages should not only reflect what has been learned in analysis, but also certain theoretical premises about change. If theory says that increased risk perception leads to positive change, then, the message should do that. If theory suggests that people are driven by emotions, not rationality, about a given issue, then, messages should reflect that premise. If theory says that local knowledge is particularly prized in a given community, then, messages should incorporate local ideas and solutions.
Back to top
Fear Appeals (Individual)
The use of fear appeals in messaging to change behaviors has been extensively discussed. According to the Extended Parallel Process Model (EPPM), people make decisions based on:
Once they have analyzed the situation, people either
For preventive action to take place, it is important that individuals considers the preventive action to be effective (e.g., condoms) and that they believe they are capable of performing the action (effectively use condoms).
In order to make sure that populations control the danger (rather than controlling their fear) by using preventive action, several choices exist: a) increase the perceived seriousness of e.g., malaria, b) increase audience’s risk perception of getting malaria (threat), c) increase knowledge of effective solutions such as malaria nets, d) model response behaviors (show how to use it), and/or e) show how others have overcome barriers to using nets (response) (Witte & Allen 2000). Which one is chosen depends on findings from formative research and audience consultation results.
Back to top
Gender and Social Norms (Community)
Social Norms are the rules that a group uses to discriminate between appropriate and inappropriate values, beliefs, attitudes and behaviors - the “dos and don’ts” of society (Appelbaum, 1970). Social norms may be explicit or implicit. Failure to conform to norms can result in social sanctions and/or social exclusion. Gender refers to widely shared expectations and norms within a society about male and female behavior, characteristics, and roles. It is a social and cultural construct that differentiates women from men and defines the ways in which women and men interact with each other. Gender is a culture-specific construct. There are significant differences in what women and men can or cannot do in one society when compared to another. However, in all cultures the roles of men and women are distinct, as are their access to productive resources and their authority to make decision. Typically, men are held responsible for the productive activities outside the home while the domain for women are the reproductive and productive activities within the home. In most societies women have limited access to income, land, credit and education, and limited control over these resources.
Modules 2 and 3 discuss the importance of analyzing and addressing barriers to change. Gender norms are critical to understand the persistence of specific practices. They dictate decisions about family planning, sexual interaction, HIV testing, use of healthcare services and other health practices. Women’s actions are subordinated to the desires of male partners as well as social perceptions about the proper role of women. Identifying the role of gender norms (what purpose they serve) and finding alternative norms to replace the dominant “negative” norm helps to understand how change may be possible.
Back to top
Community Organization Models (Community)
These models emphasize the active involvement of community members from a wide range of sectors. Community organization activities are implemented with communities rather than for them. A key guiding question for implementation is: Who else can we invite to join us for this activity? Whose collaboration and/or assistance can we seek? A central premise is that community organization is fundamental to promote and maintain changes. This is why, as discussed in Modules 2 and 4, it is critical to identify partners interested in common issues. Local partnerships offer tremendous resources to design and implement activities, as well as commitment to continuing programs. Here it is fundamental to bring them together in each stage of the process and assess strengths and contributions in ways that avoid duplication and maximize reach and sustainability.
Back to top
Social Capital and Social Network Theories (Interpersonal and Community)
Social capital refers to the social resources of a community - networks, institutions, and attitudes that can be mobilized to promote positive change. The first step is the identification of existing social networks in a community that are well-respected, trusted, and reach significant segments of the population. Many communities have women’s groups that meet on a regular basis and are highly involved in community organizing and mobilizing for issues of priority even outside of their community. Programmers should also consider their implementation partners as part of an existing social network that is a social resource to be cultivated and nurtured. Consistent communication and collaboration among partners helps strengthen social networks. Social networks require reciprocal, “give and take,” relationships. These social resources allow for reaching people through credible and effective networks. Module 4 offers examples of how social capital and social networks are fundamental to the success of a program by expanding platforms and encouraging participation from various actors. Communities particularly with dense associational life (organizations/networks) and high levels of trust and social connection offer plenty of opportunities. The development and cultivation of partnerships coupled with the tapping into local social networks need to be constant processes throughout the life of a communication program.
Back to top
Theories of Change (Individual, Interpersonal, and Community)
A Theory of Change is a “concrete statement of plausible, testable pathways of change that can both guide actions and explain their impact" (Kubisch et al., 2002). A Theory of Change is laid out with a logic model, a visual representation that charts (or maps) a path from the problem to be addressed, to the inputs (available resources), then outputs (activities and participation) to finally arrive at outcomes (short, medium and long-term results), which ideally will lead to impact (long-lasting change). A Theory of Change brings underlying assumptions to the surface so that the reasoning behind an intervention can be assessed and adjusted, if necessary. Theories of Change inform all stages of the process. From Module 1 – the situation analysis – to Module 5 – evaluation and replanning, theories are always present. Just as they inform our thinking at the beginning of the process by directing our attention to causes and possible solutions to specific problems, they are useful to understand if, at the end, theoretical models were correct in terms of understanding and predicting change. Programs offer evidence to test and refine theoretical arguments, and thus, plan future actions.
Back to top
Socio-Ecological Theory (Community)
Socio Ecological models integrate multiple levels of influence on health behaviors and norms and are noted for emphasizing the interdependence of environmental settings and life areas. It assumes that barriers and opportunities to change exist at the individual, group/community, social, and structural/system levels. Understanding how various factors at these levels affect the problem at stake as well as offer ideas for possible solutions is critical to determine courses of actions. However, trying to develop more complex programs to affect social and behavioral change also increases the complexity of assessing the different influences on the assumed change. If challenges are grounded in multiple levels, typically, interventions at all levels may be necessary. Yet given time constraints and limited resources, it is necessary to select plausible actions at specific levels, and link to and collaborate with other programs that are addressing the other issues already.
Socio-ecological theory helps to understand barriers/problems at the beginning of the process and determine points of entry into the social ecology of a given challenge. It also contributes to understanding the impact of a given multi-prong program at multiple levels, as discussed in Module 5. For example, an intervention aimed at changing gender norms around HIV testing may decide to educate people (individual/group level), promote safe spaces for women’s groups to discuss HIV-related issues (social), and ensure privacy in interactions with health staff through legal decisions (policy). During the evaluation stage, it would be necessary, then, to assess the impact at various levels and determine if there were changes, and how they affected HIV testing decisions. This is also helpful to assess possible positive synergy among actions at various levels.
Back to top