Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools
Identifieur interne : 000850 ( Istex/Corpus ); précédent : 000849; suivant : 000851Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools
Auteurs : Joseph Petraglia ; Christine Galavotti ; Nicola Harford ; Katina A. Pappas-Deluca ; Maungo MookiSource :
- Health Promotion Practice [ 1524-8399 ] ; 2007-10.
English descriptors
- KwdEn :
- American journal, Behavior change, Behavior change communication, Behavior change ideas, Behavioral, Behavioral change, Behavioral ecology, Behavioral intervention, Behavioral objective, Behavioral objectives, Behavioral research, Behavioral science, Behavioral theory, Behavioral trajectory, Board game, Board game phase, Change chart, Change game, Change tools, Change training tools, Christine galavotti, Creative process, Creative writers, Data summary grid, Data summary grids, Disease control, Facilitator, Formative assessment, Galavotti, Global health communication, Grid, Guide scriptwriters, Health promotion practice october, Lawrence erlbaum, Macro, Macro chart, March strategy, Maungo mooki, Medical facilities, Micro, Micro process, Modeling, Mopani junction, Nicola harford, Outcome expectation, Pathway, People change, Personal barrier, Petraglia, Priority population, Process evaluation, Public health, Reproductive health, Scriptwriter, Scriptwriting, Scriptwriting process, Serial drama, Serial dramas, Setback cards, Social dimension, Social facilitation, Speech acts, Storyline, Team character, Team lands, Trajectory, Transtheoretical model, Urban focus group.
- Teeft :
- American journal, Behavior change, Behavior change communication, Behavior change ideas, Behavioral, Behavioral change, Behavioral ecology, Behavioral intervention, Behavioral objective, Behavioral objectives, Behavioral research, Behavioral science, Behavioral theory, Behavioral trajectory, Board game, Board game phase, Change chart, Change game, Change tools, Change training tools, Christine galavotti, Creative process, Creative writers, Data summary grid, Data summary grids, Disease control, Facilitator, Formative assessment, Galavotti, Global health communication, Grid, Guide scriptwriters, Health promotion practice october, Lawrence erlbaum, Macro, Macro chart, March strategy, Maungo mooki, Medical facilities, Micro, Micro process, Modeling, Mopani junction, Nicola harford, Outcome expectation, Pathway, People change, Personal barrier, Petraglia, Priority population, Process evaluation, Public health, Reproductive health, Scriptwriter, Scriptwriting, Scriptwriting process, Serial drama, Serial dramas, Setback cards, Social dimension, Social facilitation, Speech acts, Storyline, Team character, Team lands, Trajectory, Transtheoretical model, Urban focus group.
Abstract
Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The Pathways to Change tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.
Url:
DOI: 10.1177/1524839907301402
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ISTEX:551203E69921C62450A7CEAB6BABD3A539DC4B9FLe document en format XML
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theory</term><term>Behavioral trajectory</term><term>Board game</term><term>Board game phase</term><term>Change chart</term><term>Change game</term><term>Change tools</term><term>Change training tools</term><term>Christine galavotti</term><term>Creative process</term><term>Creative writers</term><term>Data summary grid</term><term>Data summary grids</term><term>Disease control</term><term>Facilitator</term><term>Formative assessment</term><term>Galavotti</term><term>Global health communication</term><term>Grid</term><term>Guide scriptwriters</term><term>Health promotion practice october</term><term>Lawrence erlbaum</term><term>Macro</term><term>Macro chart</term><term>March strategy</term><term>Maungo mooki</term><term>Medical facilities</term><term>Micro</term><term>Micro process</term><term>Modeling</term><term>Mopani junction</term><term>Nicola harford</term><term>Outcome expectation</term><term>Pathway</term><term>People change</term><term>Personal barrier</term><term>Petraglia</term><term>Priority population</term><term>Process evaluation</term><term>Public health</term><term>Reproductive health</term><term>Scriptwriter</term><term>Scriptwriting</term><term>Scriptwriting process</term><term>Serial drama</term><term>Serial dramas</term><term>Setback cards</term><term>Social dimension</term><term>Social facilitation</term><term>Speech acts</term><term>Storyline</term><term>Team character</term><term>Team lands</term><term>Trajectory</term><term>Transtheoretical model</term><term>Urban focus group</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>American journal</term><term>Behavior change</term><term>Behavior change communication</term><term>Behavior change ideas</term><term>Behavioral</term><term>Behavioral change</term><term>Behavioral ecology</term><term>Behavioral intervention</term><term>Behavioral objective</term><term>Behavioral objectives</term><term>Behavioral research</term><term>Behavioral science</term><term>Behavioral theory</term><term>Behavioral trajectory</term><term>Board game</term><term>Board game phase</term><term>Change chart</term><term>Change game</term><term>Change tools</term><term>Change training tools</term><term>Christine galavotti</term><term>Creative process</term><term>Creative writers</term><term>Data summary grid</term><term>Data summary grids</term><term>Disease control</term><term>Facilitator</term><term>Formative assessment</term><term>Galavotti</term><term>Global health communication</term><term>Grid</term><term>Guide scriptwriters</term><term>Health promotion practice october</term><term>Lawrence erlbaum</term><term>Macro</term><term>Macro chart</term><term>March strategy</term><term>Maungo mooki</term><term>Medical facilities</term><term>Micro</term><term>Micro process</term><term>Modeling</term><term>Mopani junction</term><term>Nicola harford</term><term>Outcome expectation</term><term>Pathway</term><term>People change</term><term>Personal barrier</term><term>Petraglia</term><term>Priority population</term><term>Process evaluation</term><term>Public health</term><term>Reproductive health</term><term>Scriptwriter</term><term>Scriptwriting</term><term>Scriptwriting process</term><term>Serial drama</term><term>Serial dramas</term><term>Setback cards</term><term>Social dimension</term><term>Social facilitation</term><term>Speech acts</term><term>Storyline</term><term>Team character</term><term>Team lands</term><term>Trajectory</term><term>Transtheoretical model</term><term>Urban focus group</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The Pathways to Change tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.</div></front></TEI><istex><corpusName>sage</corpusName><keywords><teeft><json:string>pathway</json:string><json:string>scriptwriter</json:string><json:string>change tools</json:string><json:string>behavior change</json:string><json:string>facilitator</json:string><json:string>macro</json:string><json:string>petraglia</json:string><json:string>macro chart</json:string><json:string>micro</json:string><json:string>grid</json:string><json:string>serial drama</json:string><json:string>speech acts</json:string><json:string>behavioral</json:string><json:string>galavotti</json:string><json:string>scriptwriting</json:string><json:string>behavioral science</json:string><json:string>micro process</json:string><json:string>behavioral trajectory</json:string><json:string>storyline</json:string><json:string>change game</json:string><json:string>behavioral theory</json:string><json:string>health promotion practice october</json:string><json:string>creative writers</json:string><json:string>behavioral objective</json:string><json:string>public health</json:string><json:string>data summary grid</json:string><json:string>change chart</json:string><json:string>behavioral ecology</json:string><json:string>formative assessment</json:string><json:string>behavior change communication</json:string><json:string>disease control</json:string><json:string>mopani junction</json:string><json:string>modeling</json:string><json:string>data summary grids</json:string><json:string>behavioral research</json:string><json:string>transtheoretical model</json:string><json:string>trajectory</json:string><json:string>change training tools</json:string><json:string>priority population</json:string><json:string>march strategy</json:string><json:string>global health communication</json:string><json:string>behavioral objectives</json:string><json:string>reproductive health</json:string><json:string>creative process</json:string><json:string>serial dramas</json:string><json:string>board game</json:string><json:string>board game phase</json:string><json:string>team character</json:string><json:string>medical facilities</json:string><json:string>guide scriptwriters</json:string><json:string>urban focus group</json:string><json:string>behavioral intervention</json:string><json:string>team lands</json:string><json:string>personal barrier</json:string><json:string>setback cards</json:string><json:string>maungo mooki</json:string><json:string>lawrence erlbaum</json:string><json:string>behavior change ideas</json:string><json:string>social dimension</json:string><json:string>christine galavotti</json:string><json:string>nicola harford</json:string><json:string>people change</json:string><json:string>behavioral change</json:string><json:string>scriptwriting process</json:string><json:string>social facilitation</json:string><json:string>process evaluation</json:string><json:string>american journal</json:string><json:string>outcome expectation</json:string></teeft></keywords><author><json:item><name>Joseph Petraglia</name><affiliations><json:null></json:null><json:string>E-mail: joseph@ghcomm.org</json:string><json:string>Emory University's Center for the Study of Public Scholarship in Atlanta, Georgia, joseph@ghcomm.org</json:string></affiliations></json:item><json:item><name>Christine Galavotti</name><affiliations><json:string>Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta, Georgia</json:string><json:string>Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta, Georgia</json:string></affiliations></json:item><json:item><name>Nicola Harford</name><affiliations><json:string>Harare, Zimbabwe</json:string><json:string>Harare, Zimbabwe</json:string></affiliations></json:item><json:item><name>Katina A. Pappas-DeLuca</name><affiliations><json:string>Division of Reproductive Health of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia</json:string><json:string>Division of Reproductive Health of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia</json:string></affiliations></json:item><json:item><name>Maungo Mooki</name><affiliations><json:string>Gaborone, Botswana</json:string><json:string>Gaborone, Botswana</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>entertainment-education</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>HIV/AIDS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>behavior change communication</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>behavior change</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>behavioral theory</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>behavioral science</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>training</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>scriptwriting</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>narrative intervention</value></json:item></subject><articleId><json:string>10.1177_1524839907301402</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The Pathways to Change tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.</abstract><qualityIndicators><score>6.704</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612.283 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>976</abstractCharCount><pdfWordCount>5128</pdfWordCount><pdfCharCount>30705</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>142</abstractWordCount></qualityIndicators><title>Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools</title><genre><json:string>research-article</json:string></genre><host><title>Health Promotion 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Tools</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Sage Publications</publisher><pubPlace>Sage CA: Los Angeles, CA</pubPlace><availability><p>SAGE</p></availability><date>2007</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools</title><author xml:id="author-1"><persName><forename type="first">Joseph</forename><surname>Petraglia</surname></persName><email>joseph@ghcomm.org</email><affiliation></affiliation><affiliation>Emory University's Center for the Study of Public Scholarship in Atlanta, Georgia, joseph@ghcomm.org</affiliation></author><author xml:id="author-2"><persName><forename type="first">Christine</forename><surname>Galavotti</surname></persName><affiliation>Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation><affiliation>Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation></author><author xml:id="author-3"><persName><forename type="first">Nicola</forename><surname>Harford</surname></persName><affiliation>Harare, Zimbabwe</affiliation><affiliation>Harare, Zimbabwe</affiliation></author><author xml:id="author-4"><persName><forename type="first">Katina A.</forename><surname>Pappas-DeLuca</surname></persName><affiliation>Division of Reproductive Health of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation><affiliation>Division of Reproductive Health of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation></author><author xml:id="author-5"><persName><forename type="first">Maungo</forename><surname>Mooki</surname></persName><affiliation>Gaborone, Botswana</affiliation><affiliation>Gaborone, Botswana</affiliation></author></analytic><monogr><title level="j">Health Promotion Practice</title><idno type="pISSN">1524-8399</idno><idno type="eISSN">1552-6372</idno><imprint><publisher>Sage Publications</publisher><pubPlace>Sage CA: Los Angeles, CA</pubPlace><date type="published" when="2007-10"></date><biblScope unit="volume">8</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="384">384</biblScope><biblScope unit="page" to="393">393</biblScope></imprint></monogr><idno type="istex">551203E69921C62450A7CEAB6BABD3A539DC4B9F</idno><idno type="DOI">10.1177/1524839907301402</idno><idno type="ArticleID">10.1177_1524839907301402</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2007</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The Pathways to Change tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>entertainment-education</term></item><item><term>HIV/AIDS</term></item><item><term>behavior change communication</term></item><item><term>behavior change</term></item><item><term>behavioral theory</term></item><item><term>behavioral science</term></item><item><term>training</term></item><item><term>scriptwriting</term></item><item><term>narrative intervention</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-10">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/551203E69921C62450A7CEAB6BABD3A539DC4B9F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus sage not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" dtd-version="2.3" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">sphpp</journal-id><journal-id journal-id-type="publisher-id">HPP</journal-id><journal-title>Health Promotion Practice</journal-title><issn pub-type="ppub">1524-8399</issn><publisher><publisher-name>Sage Publications</publisher-name><publisher-loc>Sage CA: Los Angeles, CA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1177/1524839907301402</article-id><article-id pub-id-type="publisher-id">10.1177_1524839907301402</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Applying Behavioral Science to Behavior Change Communication: The <italic>Pathways to Change</italic> Tools</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Petraglia</surname><given-names>Joseph</given-names></name><aff>Emory University's Center for the Study of Public Scholarship
in Atlanta, Georgia, <email xlink:type="simple">joseph@ghcomm.org</email></aff></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Galavotti</surname><given-names>Christine</given-names></name><aff>Division of Reproductive Health at the Centers for Disease
Control and Prevention in Atlanta, Georgia</aff></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Harford</surname><given-names>Nicola</given-names></name><aff>Harare, Zimbabwe</aff></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pappas-DeLuca</surname><given-names>Katina A.</given-names></name><aff>Division of Reproductive Health of the Women's Health
and Fertility Branch at the Centers for Disease Control and Prevention in
Atlanta, Georgia</aff></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Mooki</surname><given-names>Maungo</given-names></name><aff>Gaborone, Botswana</aff></contrib></contrib-group><pub-date pub-type="ppub"><month>10</month><year>2007</year></pub-date><volume>8</volume><issue>4</issue><fpage>384</fpage><lpage>393</lpage><abstract><p><italic>Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The</italic> Pathways to Change <italic>tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.</italic></p></abstract><kwd-group><kwd>entertainment-education</kwd>
<kwd>HIV/AIDS</kwd>
<kwd>behavior change communication</kwd>
<kwd>behavior change</kwd>
<kwd>behavioral theory</kwd>
<kwd>behavioral science</kwd>
<kwd>training</kwd>
<kwd>scriptwriting</kwd>
<kwd>narrative intervention</kwd></kwd-group><custom-meta-wrap><custom-meta xlink:type="simple"><meta-name>sagemeta-type</meta-name><meta-value>Journal Article</meta-value></custom-meta><custom-meta xlink:type="simple"><meta-name>search-text</meta-name><meta-value>384
Applying
Behavioral Science to Behavior Change Communication: The Pathways to Change
Tools
SAGE Publications, Inc.200710.1177/1524839907301402
JosephPetraglia
PhD
Emory University's Center for the Study of Public Scholarship
in Atlanta, Georgia, joseph@ghcomm.org
ChristineGalavotti
PhD
Division of Reproductive Health at the Centers for Disease
Control and Prevention in Atlanta, Georgia
NicolaHarford
MA
Harare, Zimbabwe
Katina A.Pappas-DeLuca
PhD
Division of Reproductive Health of the Women's Health
and Fertility Branch at the Centers for Disease Control and Prevention in
Atlanta, Georgia
MaungoMooki
HND
Gaborone, Botswana
Entertainment-education
(EE) is a popular vehicle for behavior change communication (BCC) in many
areas of public health, especially in the developing world where soap operas
and other serial drama formats play a central role in encouraging people
to avoid risky behavior. Yet BCC/EE developers have been largely unable to
integrate behavioral theory and research systematically into storylines and
scripts, depending instead on external, technical oversight of what should
be an essentially local, creative process. This article describes how the
Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease
Control and Prevention has developed a set of tools through which creative
writers can exercise greater control over the behavioral content of their
stories. The Pathways to Change tools both guide scriptwriters as
they write BCC/EE storylines and help project managers monitor BCC/EE products
for theoretical fidelity and sensitivity to research.
entertainment-education
HIV/AIDS
behavior change communication
behavior change
behavioral theory
behavioral science
training
scriptwriting
narrative intervention
Every
behavior change communication (BCC) intervention developed or supported by
a public health organization gives a nod to behavioral theory. The language
of risk reduction, impediments to change, the importance of reinforcement,
and the
so-called
KAP-gap between knowledge and attitudes on one side and practices on the other
is found throughout the BCC literature. Furthermore, those who work on BCC
projects using popular media as a vehicle— entertainment-education (EE)
projects—demonstrate a clear concern for behavioral science and behavioral
research (Brooke, 1995; de Fossard, 1998; Japhet, 1999; McKee, Aghi, Carnegie,
& Shahzadi, 2003). Behavioral theory and research, it is thought, provide
information that helps the BCC/EE project to depict the lives of its fictional
characters in a realistic and authentic manner. And yet, the task of integrating
theory and research into the essentially creative process of BCC/EE has proven
difficult. However committed to research and theory developers of BCC/EE projects
may be, most would readily acknowledge that in practical terms, this com-
mitment is not systematically translated into the scripts of stories that
are designed to help people change risky behaviors. This is largely due to
a lack of tools that bridge the divide between the artistic world of story-
telling and the demands of a structured, science-based, public health intervention.
In 2000, the Centers for Disease Control and Preven- tion (CDC) developed
MARCH (Modeling and Rein- forcement to Combat HIV/AIDS) as a behavior change
strategy suitable for sub–Saharan Africa (Galavotti, Pappas-DeLuca,
& Lansky, 2001). Supported primarily by the Global AIDS Program of the
CDC, the MARCH strategy has to date been introduced to teams working in Botswana,
Ethiopia, Ghana, Guyana, Uganda, and
Authors'
Note: Please address correspondence to Joseph Petraglia, Global Health Communication,
418 Claire Drive, Atlanta, GA 30307;
385
The Authors
Joseph Petraglia, PhD, is codirector of Global Health Commu- nication and
a research associate at Emory University's Center for the Study of Public
Scholarship in Atlanta, Georgia. Christine Galavotti, PhD, is chief of the
Applied Sciences Branch in the Division of Reproductive Health at the Centers
for Disease Control and Prevention in Atlanta, Georgia. Nicola Harford, MA,
is a development communications con- sultant based in Harare, Zimbabwe, where
she provides tech- nical assistance to behavior change communications projects
throughout sub–Saharan Africa. Katina A. Pappas-DeLuca, PhD, is a
behavioral scientist in the Division of Reproductive Health of the Women's
Health and Fertility Branch at the Centers for Disease Control and Prevention
in Atlanta, Georgia. Maungo Mooki, HND, is a media management and com- munications
consultant and the managing editor of the Makgabaneng organization in Gaborone,
Botswana. Zimbabwe. MARCH has two basic components: The first uses serial
drama to model for listeners the kinds of behavioral challenges faced by people
and communities where HIV and AIDS dominate many aspects of life. Such modeling
presents alternative ways of thinking and acting by providing audiences with
the opportunity to identify with characters facing situations that are rec-
ognizable and “authentic” (Petraglia, 1998). By portray- ing realistic
characters in culturally relevant situations, MARCH serial dramas (currently
developed using print and radio media) illustrate the difficulties people
encounter when they attempt to change their behavior. These dramas model the
social, linguistic, and perfor- mance skills needed to avoid risk, to support
others as they try to change, or to live positively with HIV/AIDS. The second
component of MARCH promotes commu- nity-level reinforcement activities that
stimulate social and structural changes and complement the cognitive, affective,
and behavioral changes modeled in the drama. This article focuses on the Pathways
to Change tools designed to support the first component of MARCH: the serial
drama. Of course, the storytelling tradition in Africa is well established
(Panford, Nyaney, Amoah, & Aidoo, 2001), and in each of the countries
where the MARCH strategy has been undertaken, local creative tal- ent has
been readily available. MARCH has drawn on this talent to create serial dramas
such as Makgabaneng
(in
Botswana) and Mopani Junction (in Zimbabwe), which have been remarkably successful
in terms of gain- ing a wide and enthusiastic listenership (Pappas-DeLuca
et al., 2003). This is important because a serial drama that does not appeal
to its audience as a drama is unlikely to garner the attention necessary to
succeed as a behavioral intervention. Nevertheless, linking the art of serial
drama to the science of behavior change, we have found, requires structure
and support because most scriptwriters are unaccustomed to the demands that
behavioral intervention makes on the writing process. We would argue that
Pathways to Change tools provide one means of bridging this gap between art
and science. ~ KEY PRINCIPLES UNDERLYING THE PATHWAYS TO CHANGE TOOLS The
Pathways to Change tools seek to support the application of three behavior
change theories or princi- ples at the heart of MARCH EE programs: (a) behavioral
ecology, or understanding the environment in which change occurs; (b) social
cognitive theory; and (c) the transtheoretical model of change. Articles written
by Galavotti and colleagues (2001, 2005) provide a more extended discussion
of MARCH's theoretical back- ground and objectives. Behavioral Ecology A simple
model of behavioral ecology may be concep- tualized as a series of three concentric
circles labeled “individual,” “social,” and “environmental.” In the inner- most circle lies the individual person. This person is an agent
capable of making decisions based on his or her knowledge, prior experience,
appraisal of a situation, and ability to deal with it. Of course, people live
within a fam- ily and a community, and this social dimension of a person's
behavioral ecology plays a large role in shaping how the person represents
the world, and its possibilities and limitations, to himself or herself. Moving
farther out, this social dimension is embedded in the environment— the
cultural, structural, and material contexts that shape local realities and
set up physical and logistical barriers that must be overcome if behavior
change is to be achieved. Social Cognitive Theory Two psychosocial constructs
that are prominent in Bandura's (1986, 1997) articulation of social learning
theory and that have received extensive scientific valida- tion are outcome
expectation and self-efficacy. Outcome expectations are beliefs that a given
behavior will lead
386
to certain
outcomes. These anticipated outcomes can be powerful incentives, or disincentives,
for engaging in behaviors. Expectations can involve personal, social, or material
outcomes. For example, positive outcome expectations might include expectations
of material rewards such as good health or prosperity; social rewards might
include increased status, recognition, and support; and personal rewards might
include ful- fillment of the role of good mother or responsible son. Alternatively,
negative outcome expectations associ- ated with specific behaviors could include
loss of a job (material), rejection by family (social), or a sense of shame
or inadequacy (personal). The other key psychosocial principle central to
social learning theory that MARCH highlights is self-efficacy, or people's
confidence in their ability to perform a certain behavior. As self-efficacy
beliefs increase, people are more willing to attempt behaviors and to persist
in behavior change efforts in the face of setbacks. Behavioral Trajectory
The transtheoretical model of behavior change (often called the “stages
of change” model) provides a heuristic for describing the progression
people go through when changing a behavior (Prochaska, Redding, Harlow, Rossi,
& Velicer, 1994). The model proposes five stages through which people
move in their process of change. The first stage, “precontemplation,” is when a person is not think- ing of changing the behavior because of either
a lack of knowledge or lack of will. From the point at which a person begins
to think about changing his or her behav- ior, he or she enters the “contemplation” stage. Next, when people develop a tentative plan of action for chang- ing
their behavior, they are in the “preparation” stage. This stage
is generally followed by an attempt at behav- ior change in which the person
is said to move into the “action” stage of the model. Once action
is taken and a successful change occurs over time, the final and what many
consider to be the most difficult stage— “maintenance”—is
entered. Although the five stages are sequential, moving through the stages
of change is almost never a straightforward process—people may suffer
setbacks at any point. Factors such as one's self-efficacy or social support
are critical in overcoming setbacks and taking up the challenge of behavior
change anew. A behavioral trajectory, therefore, plots the path that a person
takes through the stages of change. In MARCH serial dramas, characters destined
to model a specific behavior change (i.e., a transitional char- acter) must
move through the stages of change in a plau- sible manner and at a believable
pace. Below, we suggest how the Pathways to Change training tools put the
notion
of
behavioral trajectory and other behavioral principles into dialogue with both
behavioral research and the creative nature of storytelling. APPLICATION OF
THE PATHWAYS TO CHANGE TOOLS Pathways to Change is comprised of three tools:
a game, a chart, and a behavior change adherence (BCA) routine. The use of
all of these tools is predicated on for- mative research to ascertain the
behavioral context of reproductive and sexual health within the priority popu-
lation. A basic formative assessment will consist of a range of instruments,
including surveys of basic knowl- edge, attitudes, and practices; focus groups
with partici- pants from the priority population; in-depth interviews with
community and opinion leaders; and a summary of recent findings from epidemiological
and behavioral research. The assessment is expressed in the form of a data
summary grid: a simplified list of bulleted data grouped according to an intervention's
behavioral objec- tives (e.g., “reduce stigma toward people living with
HIV/AIDS,” “seek testing services,” and “reduce the
number of partners”). The brief excerpt in Figure 1 gives an example
of a data summary grid format that scriptwrit- ers draw on to create their
storylines using Pathways to Change. The data summary grids enable creative
writers and other local stakeholders to use the Pathways to Change game and
chart to (a) demonstrate how key concepts from behavioral science can be used
to generate narratives that are entertaining yet behaviorally sound and (b)
acquaint themselves with relevant data from the formative assess- ment and
apply them in character-appropriate ways. The Pathways to Change Game The
game is the more complex of the two Pathways to Change training tools and
has two distinct phases: a board game and a story writing phase. At the outset
of the board game phase, a moderator divides participants into two teams of
two or more players. To start, teams are dealt a series of cards that, taken
together, describes the character they will represent in the game. For example,
Team 1's character may be “Fatima, an uneducated 34- year-old woman
who has never married but has three children by the same man. She lives in
a village that is economically stable but has no medical facilities other
than a clinic that is staffed only by a nurse. Her behav- ioral objective
is to prevent mother-to-child transmission of HIV.” Team 2's character
might be “Theo, a 23-year- old apprentice truck driver who has a steady
girlfriend in his hometown but nevertheless seeks out commercial
387
FIGURE
1 Excerpt From Zimbabwe's Data Summary Grid, 2002
sex
workers when he is on the road. His hometown is a township outside a major
city with many, albeit expen- sive, medical facilities. His behavioral objective
is to seek voluntary counseling and testing.” With these characters
in mind, the two teams play a board game (shown in Figure 2) in which they
roll a die to move along a pathway of squares toward a finish line. Most squares
are marked with a B (for “barrier”) or an F (for “facilitator”).
Each barrier or facilitator square is further marked by a small p (“personal”),
s (“social”), or e (“environmental”); thus, a barrier
is always either a Bp, Bs, or Be, and a facilitator is always either an Fp,
Fs, or Fe. When a team lands on one of the barrier or facilitator squares,
it is required to consult its data summary grid to find a datum from the formative
assessment that fits the square's assignation. For instance, if Team 1 lands
on a Bp square, it will consult the “Prevention of Mother-to- Child
Transmission” chapter of the data summary grid for some bit of information
that could pose a personal barrier to Fatima as she seeks to attain her behavioral
objective. For example, it may select the datum reading “Few people
in rural communities believe that there is a link between a mother's health
and that of her unborn child.” If the moderator confirms that Team 1's
reasons for selecting this datum as a personal barrier are sound, he or she
writes the barrier on a card and gives it to Team 1 to keep until the end
of the game. The squares marked with a ? indicate that the team that lands
on them has to draw a “Question Card.” These cards ask a wide
range of general knowledge questions (not necessarily from the formative
assessment, but questions that local stakeholders think everyone should know
about HIV/AIDS). Conversely, if the team lands on a “Setback” square, it just collects a setback card, which will be used in the storyline
writing phase to indicate a reversal in the character's progress toward his
or her behavioral objective. By the time both teams have completed the board
game phase by moving along a pathway and reaching the finish line, they will
have collected a mix of behav- ioral facilitators, barriers, and setback cards
relevant to their specific character and his or her behavior change
388
FIGURE
2 Pathways to Change Game objective. Teams are now ready for the storyline
writing phase of the game. In this phase, teams are given about an hour in
which to write a brief story about their char- acter that integrates the barrier,
facilitator, and setback cards they possess. The Pathways to Change Chart
As a result of repeated exposure to the Pathways to Change game, scriptwriters
gain a greater familiarity with the formative assessment as expressed in the
data sum- mary grids and consider how this assessment provides information
about barriers and facilitators to behavior change that dramatic characters
might face. Introducing the Pathways to Change chart at this point reminds
team members that behavior change is a process that occurs in stages and that
their goal is to create a realistic model of behavior change with which the
audience can identify. The chart, shown in Figure 3, is a grid whose vertical
col- umn sets out the five stages of change and whose hori- zontal axis provides
a timeline.
Using the chart, the moderator helps each team plot the storylines written
as a result of the game. Once the storyline has been plotted, the moderator
asks the users to identify (a) where barriers and facilitators influenced
the trajectory, (b) how setbacks are reflected in the tra- jectory, and (c)
areas of the trajectory that are implausi- ble given what we know about how
people change. By using the Pathways to Change game and the chart in succession,
scriptwriters acquire an appreciation both for the complexity of behavior
change and for their jobs as developers of a serial drama that entertains
as well as models realistic behavior change for the audience. The Pathways
to Change BCA Routine The challenge for a MARCH scriptwriting team does not
stop at learning how behavior change principles can be integrated into an
entertaining narrative. The challenge continues in figuring out whether the
team is, indeed, modeling these elements and revealing to the listeners how
characters are thinking, feeling, reacting, and moving
389
FIGURE
3 Pathways to Change Chart toward their behavioral objectives. Our response
to this challenge is reflected in the Pathways to Change BCA routine, which
centers on the notion of speech acts. Although the term speech act comes out
of linguistics and literary theory (Austin, 1975; Searle, 1985), it has a
more generic usage that is very valuable in BCC/EE pro- jects that depend
on language as a means of intervention. The notion of a speech act is meant
to call attention to the distinction between what language says and what lan-
guage does. All utterances have these two dimensions, and we usually find
little reason to distinguish between them. In BCC/EE projects, however, it
is critical that we ensure that the words we script actually correspond to
the behavior change ideas being put forth. Ironically, this is something that
creative writers are sometimes trained to avoid, having been encouraged to
believe that good writ- ers show rather than tell. In literary practice, this
dictum may be true, but in a BCC/EE intervention using dialogue, behaviors
revealed by showing must be accompanied by telling; audiences must actually
hear behavior revealed in what characters say. The BCA routine makes operational
two distinct levels at which scriptwriters must integrate behavior change
concepts into the serial drama. The “macro” level sets out a character's
behavioral trajectory over
time, guides the overall development of the storyline, and keeps it in line
with broad theoretical objectives. The “micro” level serves to
guide scriptwriters in actu- ally putting words in the characters' mouths
and ensures that what the storyline was designed to model at the macro level
is executed in the dialogue. Used consistently and conscientiously, a three-part
BCA routine (a macro chart, a micro process, and a coordinating tool that
bridges the macro and micro process) enables BCC/EE implementers and managers
to plan for, monitor, and evaluate the behavioral integrity of scripts. The
macro chart for mapping the behavioral trajectory. MARCH projects require
a tool that enables scriptwriters to track each transitional character's behavioral
trajec- tory over time and across stages of change; this macro chart, therefore,
looks identical to a completed Pathways to Change chart (Figure 3) but is
used in a very different way. A macro chart for a character named Sam, for
instance, will plot a line representing key junctures and events of Sam's
behavioral trajectory. These junctures and events reveal a particular stage
of change or a tran- sition point between stages. For instance, the first
time Sam refuses to go to a brothel with his friend Martin may mark a transition
from the preparation stage to the
390
action
stage. In this case, the scriptwriting team will put a bullet on the macro
chart at the approximate time in the storyline that it plans for this event
to occur and within the appropriate stage of change. As the actual sto- ryline
is written over time, the timing of events may shift slightly, although the
sequencing remains unchanged. The micro process notation system. As noted
above, a speech act is a bit of dialogue that reveals something about a character's
progress toward his or her behavioral change objective. If Sam, for instance,
were to say to Martin, “Hey, man, I just got my paycheck—let's
find some girls and party!” the listener would know that Sam is not
concerned that this sort of behavior is risky. Conversely, if he were to think
aloud, “When I drink too much, I end up waking up next to a stranger.
. . . I should try to stay out of bars,” the listener would know that
he is aware of the problem and thinking about how to handle it. By using speech
acts as a means of conveying charac- ters' thoughts and feelings, scriptwriters
can structure dialogue that tells the listener not only where characters are
in terms of behavioral change but also about common barriers and facilitators
to behavioral change that are rel- evant in their community. The micro process
is simply a means of coding speech acts that signal the attitudes, beliefs,
and interpersonal relationships that MARCH is trying to model. In MARCH we
use seven types of speech acts: A. Speech revealing specific psychosocial
variables (e.g., risk perception, outcome expectation, and self- efficacy)
that signal the character's stage of change. B. Speech revealing helpful and
unhelpful metacognition (e.g., “When I'm really angry, I'm not able
to think straight” or “Before I confront her, I better think through
what I really want to say”). C. Speech illustrating social facilitators
or barriers (e.g., requests for, offers of, or denial of help, support, or
empathy). D. Speech modeling both positive and negative debate and negotiation
(e.g., arguments, exchange of ideas, and problem solving). E. Speech articulating
both positive and negative beliefs, attitudes, desires, or fears relating
to the behavioral objective. F. Speech unambiguously signaling an intention
to act. G. Speech in which an environmental or structural bar- rier or facilitator
is identified. Using this coding system during and after the scriptwrit- ing
process requires the scriptwriting and production team members to consider
questions such as “Where in the dialogue do we signal at what point
characters are in
terms
of their stage of change?” “Where do we model useful social interaction
and support?” and “Are we making characters' thoughts and feelings
about how they are experiencing their behavior change explicit?” The
coordinating tool for linking the macro chart to the micro process. It is
necessary to integrate behavior change information at the trajectory level
to specific bits of dialogue found in the script; thus, a third tool is needed
to coordinate these two levels. The coordinat- ing tool (Figure 4) is a blown-up
segment of the macro chart that zooms in on the section of the storyline cur-
rently under development and provides scriptwriters with a more usable piece
of the macro chart to guide their micro process notation. As with the Pathways
to Change game and chart, creative writers' collaborative use of the BCA routine
teaches and reinforces otherwise abstract concepts. For instance, a discussion
in which the micro process is undertaken might go something like this: Writer
1: In this scene, Sam is in precontemplation, and in previous scenes we've
shown that he does not believe he is at risk of HIV and that he sees nothing
wrong with going to commercial sex workers. As we can see, most of the codes
we have written on the coordinating tool until now are A and E. Writer 2:
Yes, but because we can see from the macro chart that Sam needs to start moving
toward the con- templation stage, perhaps we should have some social facilitation
going in this next scene. So we'll need to script a C type of speech act soon
. . . well, maybe not in scene 46 but definitely no later than scene 48. Also,
this social facilitation might come in the form of an argument he has with
his older brother who tells him that going to brothels is an embarrassment
to the family. Hmmm . . . that might give us a chance to model a good argument
against casual sex—that's one of those D speech acts as well as a C
speech act. We kill two birds with one stone! Of course, this imagined exchange
is a bit stilted, but it demonstrates several key points about undertaking
the BCA routine, especially the micro process. For instance, it shows how
the codes help structure the behavior change content of the scenes, but they
do not dictate the dramatic content. Second, with practice, the codes can
provide a shorthand for talking about what has to hap- pen in terms of behavior
change without getting theoret- ical. Finally, note that a single speech act
can serve multiple purposes; for instance, an interior monologue can not only
show reflection on one's thinking (B), but also model problem solving (D).
In other words, using
391
FIGURE
4 The Coordinating Chart codes for speech acts helps structure the behavior
change elements in the drama before writers move on to actually scripting
the dialogue. DISCUSSION This article has outlined both the challenges we
have faced in developing theoretically sound and research-sensitive BCC/EE
and our response to those chal- lenges. In setting out the Pathways to Change
tools, we have sought to illustrate how they can be used to address several
key junctures in intervention design and imple- mentation in areas such as
building local scriptwriter capacity to use behavioral theory and research,
develop- ing the product, and monitoring the theoretical integrity of
scripts. Although we believe that aspects of our approach are applicable to
any behavior change intervention, this explication of Pathways to Change tools
may be useful primarily to readers as a case study: an account of how one
project has approached the integration of behavioral science with narrative
forms such as serial drama. This is not to say that use of the Pathways to
Change tools has always been seamless or that scriptwriters are always eager
to embrace the approach to BCC/EE that the tools are designed to structure.
Among scriptwriters work- ing on Mopani Junction in Zimbabwe, for instance,
there seemed to be a persistent desire to script sensational and exceptional
events to explain sudden behavior changes rather than using the more mundane
barriers and facilita- tors identified during the research. We frequently
noted
392
scriptwriters'
tendency to make the passage from stage to stage too neat and to treat setbacks
as dramatically awk- ward obstacles in an otherwise linear path. In Zimbabwe
and elsewhere, the scriptwriting teams had to be periodically reminded to
keep on top of the macro and coordination charts throughout the 18-month production
period and encouraged to integrate a range of useful speech acts for each
scene rather than just build- ing the dialogue around a couple of key speech
acts. Related to the issue of speech acts, some writers con- tinue to find
it difficult to convey the full range of psy- chosocial and social influences
on characters using words. Conveying decision-making processes and the operation
of supportive or unsupportive social norms through dialogue, for instance,
is a novel challenge for many writers. This also seemed to be the case in
Ghana and Uganda at the outset of the respective dramas. Most fundamentally,
perhaps, in a few instances, scriptwriters—and especially older and
more experi- enced scriptwriters—have complained that the Pathways to
Change tools hinder their creativity. Younger writers, on the other hand,
seem to adopt the Pathways to Change approach with relative ease; this may
be due to the fact that they are newcomers to the genre of serial drama as
well as to the tools and thus have fewer expectations that can be confounded.
Ongoing support as they use the tools, however, suggests that complaints about
con- strained creativity generally give way to an appreciation for the depth
of creativity that remains available. In the words of experienced scriptwriter
Tafadwa Njovana, For me it was like being thrown into the deep end. You had
to learn a lot of new concepts very quickly and learn how to interact with
people that do not come from an artistic background . . . [people] who come
from the scientific side, the behavior change side. But all of us are the
better for it. (Riber, 2004) Challenges aside, we have also been surprised
by some of the ways in which scriptwriters have taken own- ership of Pathways
to Change tools to serve purposes we had not originally anticipated. For instance,
whereas we intended the game to be used exclusively as a training tool that
introduces a number of key principles, we have found that some writing teams
continue to play the game, even after the drama is on the air, not only using
research in the data summary grids, but also drawing on scriptwriters' own
thinking about personal, social, and environmental barriers and facilitators.
Members of the writing team have reported that when they are bogged down thinking
through a set of difficult scenes, playing the game using the actual characters
in question provides a way of helping them break through creative impasses.
In
short, although scriptwriter adoption and use of the Pathways to Change tools
may require monitoring and guidance from a lead editor, from the perspective
of the MARCH project leader, the consistent and correct use of the Pathways
to Change tools provides a reasonably transparent means of ensuring that the
serial dramas are conveying the behavior change ideas as intended. In terms
of process evaluation, the tools permit MARCH project leaders and managers
to assess whether charac- ters are modeling the kinds of thought, behavior,
and dis- cussion they are expected to model and that plausible barriers and
facilitators that motivate behavior change are made evident. Keeping track
of all this information and archiving the Pathways to Change BCA routines
provide a good deal of the information needed to assess the effec- tiveness
of the serial drama and to determine whether lis- teners are using transitional
characters as role models to help them change their own risk behaviors. CONCLUSION
Many health professionals in Africa and elsewhere acknowledge the importance
of BBC/EE in helping people make sense of their lives and the health risks
that endan- ger them, yet the tenets of behavioral science have proven difficult
to integrate into the actual scripts. When we first undertook the MARCH project,
tools promoting this inte- gration were unavailable; guidelines and techniques
cre- ated for use in some other BBC/EE projects either gave practical advice
on the scriptwriting process independent of research or behavioral science,
or they reiterated the importance of making theory- and science-based inter-
ventions without providing much in the way of practical scaffolding. The Pathways
to Change tools, we believe, go some way toward making BCC/EE more behaviorally
sound and amenable to process evaluation. These tools rein- force the premise
that creative writers can see their job of scripting behavior change as entirely
compatible with their desire to tell interesting stories. They do this not
only by introducing new vocabulary and a behavioral worldview but also by
helping writers articulate and inte- grate many technical aspects of behavior
change that are often ignored.
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Cambridge, UK</source>: <publisher-name>Cambridge University Press</publisher-name> .</citation></ref></ref-list></back></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Applying Behavioral Science to Behavior Change Communication: The Pathways to Change Tools</title></titleInfo><name type="personal"><namePart type="given">Joseph</namePart><namePart type="family">Petraglia</namePart><affiliation></affiliation><affiliation>E-mail: joseph@ghcomm.org</affiliation><affiliation>Emory University's Center for the Study of Public Scholarship in Atlanta, Georgia, joseph@ghcomm.org</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christine</namePart><namePart type="family">Galavotti</namePart><affiliation>Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation><affiliation>Division of Reproductive Health at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nicola</namePart><namePart type="family">Harford</namePart><affiliation>Harare, Zimbabwe</affiliation><affiliation>Harare, Zimbabwe</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Katina A.</namePart><namePart type="family">Pappas-DeLuca</namePart><affiliation>Division of Reproductive Health of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation><affiliation>Division of Reproductive Health of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maungo</namePart><namePart type="family">Mooki</namePart><affiliation>Gaborone, Botswana</affiliation><affiliation>Gaborone, Botswana</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Sage Publications</publisher><place><placeTerm type="text">Sage CA: Los Angeles, CA</placeTerm></place><dateIssued encoding="w3cdtf">2007-10</dateIssued><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Entertainment-education (EE) is a popular vehicle for behavior change communication (BCC) in many areas of public health, especially in the developing world where soap operas and other serial drama formats play a central role in encouraging people to avoid risky behavior. Yet BCC/EE developers have been largely unable to integrate behavioral theory and research systematically into storylines and scripts, depending instead on external, technical oversight of what should be an essentially local, creative process. This article describes how the Modeling and Reinforcement to Combat HIV/AIDS project at the Centers for Disease Control and Prevention has developed a set of tools through which creative writers can exercise greater control over the behavioral content of their stories. The Pathways to Change tools both guide scriptwriters as they write BCC/EE storylines and help project managers monitor BCC/EE products for theoretical fidelity and sensitivity to research.</abstract><subject><genre>keywords</genre><topic>entertainment-education</topic><topic>HIV/AIDS</topic><topic>behavior change communication</topic><topic>behavior change</topic><topic>behavioral theory</topic><topic>behavioral science</topic><topic>training</topic><topic>scriptwriting</topic><topic>narrative intervention</topic></subject><relatedItem type="host"><titleInfo><title>Health Promotion Practice</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1524-8399</identifier><identifier type="eISSN">1552-6372</identifier><identifier type="PublisherID">HPP</identifier><identifier type="PublisherID-hwp">sphpp</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>8</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>384</start><end>393</end></extent></part></relatedItem><identifier type="istex">551203E69921C62450A7CEAB6BABD3A539DC4B9F</identifier><identifier type="DOI">10.1177/1524839907301402</identifier><identifier type="ArticleID">10.1177_1524839907301402</identifier><recordInfo><recordContentSource>SAGE</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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