Using Barrier Analysis to Inform Behavior Change Communication Strategy
Creators: name: Zafimanjaka, Maurice Gerald
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2010

description: Explanatory behavior change theories and models were adopted in health behavior to understand its determinants in order to better influence behaviors for a healthy community. Based on these explanatory theories and models, public health professionals use them to develop health interventions (Glanz and Rimer, 2005, p.5). For instance, awareness of toothache severity could be a determinant for some people to make a decision about a healthy behavior such as brushing their teeth regularly. So, if the level of this awareness is low, health behavior professionals try to raise awareness. However, there are many potential determinants and the professionals try to bring them to acceptable levels by influencing them in the appropriate direction. Gielen and MacDonald (2002) summarized Green and Kruter’s PRECEDE-PROCEED framework model as a tool to develop health behavior strategies. They note that health planners should identify the determinants that are strongly associated with the behavior or health problem of interest and the most changeable (pp. 416-418). This approach will help health planners to identify and plan the most cost-effective health behavior interventions. The barrier analysis approach, which draws its roots from several available cognitive-behavioral theories and models, brings a progress in the field application of health behavior sciences while including quantitative doers and non doers comparison. By identifying which potential determinants are actually powerful determinants for a specific behavior among specific target populations, the comparison of doers and non doers, barrier analysis approach provides sound information to public health practitioners in orienting efforts to address the most effective behavioral determinants when designing or reviewing their public health interventions (Davis, 2004). Additionally, comparing non doers with doers considers the changeability criterion suggested by Gielen and Mac Donald in 2002. Based on the idea of comparing two population groups (doers and non doers), we will borrow statistical techniques which are frequently used in epidemiology to make comparisons more scientific and detect the presence or lack of association between behavior and its potential determinants suggested by theories. Furthermore, this quantitative barrier analysis can be easily conducted in few days and with a simplified toolkit that can be used by field practitioners. In this paper, I will accomplish two objectives. First, I will do a review of the main behavioral theories and models underlying barrier analysis as well as doers and non doers comparison techniques. I will discuss the ecological model, the social cognitive theory, the theory of planned behavior/reasoned action, the health belief model (HBM), and the doers and non doers analysis. Then, I will present the barrier analysis methodology and behavior change communication planning through a case study on exclusive breastfeeding practice among biological mothers of children aged 0-5.9 months.