3.2 : Scientific foundation of behavior change:

                                  3.2 : Scientific foundation of behavior change:

 Behavior change is a complex process based on several theories of Psycho-Sociology and Anthropology area that were developed since 1950.

They were developed from findings of different studies conducted in the  field  meaning that all those theories are evidence- based.                                              

 Currently we have at least one hundred theories related to Behavior change.          

     Analysis of these different theories shows that there are two main trends of theories on Behavior change:

Some theories target  individual as  “engine” for Behaviour change i.e   for changing behaviour, the individual  should  have  the risk perception for Health  linked to the problem,  and then to have a benefit ( Motivation / future ambitions ) for changing.

Example of theories :  Health Belief Model  / Reasoned action Theory / Motivation to protect him self  Theory /AIDS Risk Reduction .

Other theories target environment ( social environment – society-family )   as “engine” for Behavior change  i.e. the society / the

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environment in which lives the individual will positively or negatively influence ( = social pressure )the individual to Behavior change.

Example of theories:   Social Ecology Model / Social Network Theory.                                                                                                  

For example: Peer education:    Peer educators are a way very effective for Behaviour change among Young people, Schools, Prisons, Sex workers,  Soldiers.                                      

Therefore, taking into account both trends, Behaviour change is influenced  by a combination of both trends of theories and not a single trend of  theory. It is important to note that there is no dominant theory on the other theories.                                                                                                                       

Briefly, in Behaviour change process, the individual  could   decide himself to change his behavior ,  based on awareness on the Health problem, his experience  in decision making  and his capacity to implement the decision made ( =   Predisposing factors ). Besides his environment ( community / family / friends ) should be favourable to Behavior change ( = Reinforcing factors ).

Furthermore, the existence of support systems ( = Enabling factors )  helping the individual in the Behavior change  process like Health system in terms of availability-accessibility- quality of Health services: : Ex Voluntary Counselling  and Testing for HIV (VCT)  / Prevention of Mother to Child  Transmission of HIV (PMTCT ) / ART accessible, Communication system in terms of accessibility of the communication  channels : Ex. Radio-TV – Journals is needed. 

Shortly, Behavior change is influenced by:

-          Awareness on the Health problem and risk perception for Health linked to the problem,

-          To have a motivation  ( Benefit ) for the individual for changing,

-          To have  a favourable environment  for  Behaviour change,

-          Existence of supporting systems ( Health system and Communication system ).

Thus, Behaviour change requires an individual commitment for changing, a favourable environment for changing as well as existence of support systems.

These three components can be influenced, each one, by the following  factors (Positively or negatively):

- Socio-economic factors: education - acceptable purchasing power.

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- Government policy: If the politico-administrative authorities are involved in the fight against  diseases (For example : HIV/AIDS), the community will also be involved.

- Gender (relationship between men and women) and cross-generation relationship: male dominance on

     female mainly for sexual intercourse/ Family planning , and this can constitute a barrier  to behaviour change  in  those areas.                                                    

- Spirituality/religion: some religious authorities may constitute a barrier to behaviour change for some health problems ( FP,HIV/AIDS).

- Culture: culture may constitute a barrier to behaviour                                  

change in  some health problems (Taboo on sexuality:                                       

lack of preparation for the sexual life in the family).

To allow the success of a Health Programme within the framework of Behavior  Change,  all these factors mentioned above should positively facilitate “ Behavior Change process “ for any Health Programme for which Behavior Change is needed.