bcc in medical education and nursing education

bcc in medical education and nursing education

1. BEHAVIORAL CHANGE COMMUNICATION

2. INTRODUCTION The 6 th report on world health situation states that health has to be attained & cannot be imposed ; thus the 1 st requirement for attainment of health is a commitment by both people and the govt . Adequate education in general is essential for the development of this commitment.

3. HEALTH EDUCATION The process by which individuals and groups of people learn to behave in a manner conducive to the promotion ,maintenance or restoration of health (John M Last) The declaration of Alma-Ata(1978) emphasized the need for individual and community participation. The dynamic definition is as follows: “A process aimed at encouraging people to want to be healthy , to know how to stay healthy , to do what they can individually and collectively to maintain health , and to seek help when needed”.

4. IEC IEC can be defined as an approach which attempts to change or reinforce a set of behavior in a target audience regarding a specific problem in a predefined period of time. It is multidisciplinary and client centered in its approach. Embodied in IEC is the process of learning that empowers people to make decisions, modify behaviors and change social conditions.

5. Activities are developed based upon needs assessments, sound educational principles, and periodic evaluation using a clear set of goals and objectives

6. BEHAVIOUR CHANGE COMMUNICATION(BCC) Studies revealed that traditional IEC methods have stopped giving information and creating awareness but BCC is characterized by its direct approach towards changing behavior.

7. BCC BCC is an interactive process with communities (as integrated with an overall program) to develop tailored messages and approaches using a variety of communication channels to develop positive behaviors; promote and sustain individual, community and societal behavior change; and maintain appropriate behaviors. Behavior change objectives refer to intended changes in the audience’s actual behavior.

8. BCC Behavior change communication (BCC) is the strategic use of communication to promote positive health outcomes, based on proven theories and models of behavior change. BCC employs a systematic process beginning with formative research and behavior analysis, followed by communication planning, implementation, and monitoring and evaluation. Audiences are carefully segmented, messages and materials are pre-tested, and both mass media and interpersonal channels are used to achieve defined behavioral objectives.

9. BCC must be research based, client centered, benefit oriented, service linked, professionally developed, and linked to behavior change

10. Objectives of BCC activities Major objectives for health are to enable people: To define their own problems and needs To understand what they can do about these problems with their own resources combined with outside support To decide on most appropriate action to promote healthy living and community well being

11. Importance of BCC Increase in knowledge and attitude of the people BCC helps to trigger and stimulate people for adopting positive behavioral approaches BCC promotes appropriate and essential attitude change As BCC strategies and messages are tailored for specific target groups, these strategies are efficient and effective. BCC approaches are more sustainable and acceptable BCC helps to increase learning and skills It improve aptitudes and feeling of self-adequacy

12. Levels of BCC At individual-level BCC helps in learning, mindfulness, convictions, and sentiments about wellbeing practices. It plays a significant role in deciding wellbeing conduct. • At community-level BCC approach stimulates community to take ownership towards the approach. Additionally, it will also help the community to replicate the positive practices in bigger level. • At national level BCC will play a significant role in lobbying & advocacy of certain practices. These approaches will support and encourage government and other stakeholders to bring a positive whim among all the citizens for adopting positive behavioural practices.

13. 13 Defining tasks and educational objectives Planning an evaluation system Preparing and implementing an educational programme Implementing evaluation Principles of BCC The Educational Spiral

14. Principles BCC should be integrated with the goal and objective of the program Formative BCC assessments must be carried out while developing BCC messages Target population must participate during BCC development Key and direct stakeholders need to be involved from the design stage of BCC Pre-testing must be done for effective BCC materials BCC programs must involve planning for monitoring and evaluation. BCC strategies must be positive and action oriented.

15. STEPS OF BCC

16. Insights BCC has its roots in behavior change theories BCC practitioners use a combination of theories and practical steps that are based on field realities, rather than relying on any single theory or model. Rationale behind “staging” people is to tailor therapy to a person’s needs at his/her particular point in the change process.

17. Insights When changing behavior, the individual, community, or institution goes through a series of steps, sometimes moving forward, sometimes moving backward, and sometimes skipping steps. Even when new behaviors have been adopted, the individual, community, or institution, under certain circumstances, may revert to old behaviors.

18. Presentation 2

19. Steps in Developing Behavior Change Communication 1. State program goals 2. Involve stakeholders 3. Identify target populations 4. Conduct formative BCC assessments 5. Segment target populations 6. Define behavior change objectives 7. Define BCC strategy and M&E plan 8. Develop communication products 9. Pretest 10. Implement and monitor 11. Evaluate 12. Analyze feedback and revise

20. Role of BCC in HIV/AIDS Increase knowledge : BCC can ensure that people are given the basic facts about HIV and AIDS in a language or medium that they can understand and relate to . Stimulate community dialogue: BCC can encourage community and national discussions on the basic facts of HIV/AIDS & the underlying factors that contribute to the epidemic, such as risk behaviors and risk settings, environments and cultural practices related to sex and sexuality .

21. Role of BCC in HIV/AIDS Promote essential attitude change: BCC can lead to appropriate attitudinal changes about, for eg , perceived personal risk of HIV infection, belief in the right to and responsibility for safe practices and health supporting services etc . Advocate for policy changes: BCC can lead policymakers and opinion leaders toward effective approaches to the epidemic. Improve skills and sense of self-efficacy: It can focus on teaching or reinforcing new skills and behaviors, such as condom use, negotiating safer sex and safe injecting practices .

22. Role of BCC in HIV/AIDS Create a demand for information and services: BCC can spur individuals and communities to demand information on HIV/AIDS and appropriate services. Reduce stigma and discrimination: Communication about HIV prevention and AIDS mitigation should address stigma and discrimination and attempt to influence social responses to them .

23. Role of BCC in HIV/AIDS Promote services for prevention and care : BCC can promote services for STIs, intravenous drug users (IDUs), orphans and vulnerable children (OVCs); voluntary counseling and testing (VCT) for mother-to-child transmission (MTCT); support groups for PLHA; clinical care for opportunistic infections; and social and economic support.

24. BCC GOALS FOR HIV/AIDS Program goal : Reduce HIV prevalence among young people in urban settings in country . Behavior change goals: Increase condom use Increase appropriate STI care-seeking behavior Delay sexual debut Reduce number of partners

25. BCC goals: Increase perception of risk or change attitudes toward use of condoms Increase demand for services Create demand for information on HIV and AIDS Create demand for appropriate STI services Interest policymakers in investing in youth-friendly VCT services (services must be in place) Promote acceptance among communities of youth sexuality and the value of reproductive health services for youth (services must be in place)

26. CHALLENGES BCC vs. IEC . In practice, IEC has often resulted in the production of discrete communication materials. The use of the term BCC is part of an effort to establish communication as strategic and integrated into entire programs. Integrating BCC into all programs . BCC is a component of all successful interventions and must be included in their original design. However, in reality this doesn’t always happen.

27. Limited training resources Political and physical environments. In some countries, geography and populational diversity can complicate the development of BCC programs. This is especially the case where vast distances must be covered, or multiple languages and cultural traditions included, in a single country program.

28. Sustainability. To be effective, BCC strategies and components must evolve constantly to meet the changing needs of target populations. This requires the continuous input of human and financial resources. Budgets . Linkages and coordination. For BCC to be effective, their messages and information should be coordinated. Building and maintaining linkages and coordination is an ongoing challenge.