Introduction toTheories of Communication Effects:

Ideation and Communication for Social Change (CFSC)

A service of the

Communication Science & ResearchResource Group

IDEATIONAND

INDIVIDUAL BEHAVIOR CHANGE

D. Lawrence Kincaid and Maria Elena FigueroaJHU/HCP/CCP/BSPH

HCP Seminar, April 23, 2004

Strategic Communication

•. . . is based on a combination of facts, ideas, and theories integrated by a visionary design to achieve verifiable objectives by affecting the most likely sources and barriers to behavioral change with the active participation of stakeholders and beneficiaries.

Factors Influencing Behavior

•LIST OF FACTORS, NO MODEL

•1991: Seminar: Fishbein, Bandura, Triandis,

Kanfer, Becker, Middlestadt

1. Intentions to perform the behavior

2. Environmental contraints preventing the behavior

3. Skills necessary to perform the behavior

4. Behavioral beliefs and perceived consequences (attitudes)

5. Perceived normative pressure

6. Self-image: self-standards and sanctions

7. Emotional reactions

8. Self-efficacy (perceived capability and confidence)

NO CONSENSUS REGARDING A CAUSAL MODEL LINKING THESE FACTORS TO BEHAVIOR

STRATEGIC COMMUNICATION

PROGRAMS AFFECT MANY INTERMEDIATE FACTORS

WHICH INFLUENCE BEHAVIOR.

Ideation

. . . refers to new ways of thinking and the diffusion of those ways of thinking by means of social interaction in local, culturally homogeneous communities.

Source: DEMOGRAPHYCleland & Wilson, 1987

The likelihood of someone adopting and sustaining a new behavior is much higher when she or he:

• has gained sufficient knowledge about it,• has developed a positive attitude towards it, • has talked to others about it, and• feels good about doing it.

How is ideation related to communication and behavior change?

Center for Communication ProgramsU N I V E R S I T Y

OHNS HOPKINS OHNS HOPKINS J J

A predictive model of communication & change:Influence of ideational elements on behavior

Knowledge

Attitudes

Self-Image

Perceived Risk

Self-Efficacy Norms

Emotions

Social Support & Influence

Personal Advocacy

BEHAVIOR

Implies simultaneous effect of all influences.

Implies communication can effect all influences.

COMMUNICATION

ENVIRONMENTALSUPPORTS & CONSTRAINTS

enabling

SKILLS & KNOWLEDGE reinforcement

Attitudes

INTENTION

BEHAVIOR

INSTRUCTION

NONDIRECTIVE Dialogue Counseling Entertainment

Social Networks

PUBLIC Advocacy Regulation

DIRECTIVE Dissemination Promotion Prescription

Source: Adapted from Kincaid (2000)

A HEURISTIC MODEL OF COMMUNICATION AND HEALTH BEHAVIOR

confirmation

IDEATIONCOGNITIVE Beliefs Values Perceived Risk Subjective Norms Self-Image EMOTIONAL Emotional Response Empathy Self-EfficacySOCIAL Support & Influence Personal Advocacy

INSTRUCTION

DIRECTIVE Dissemination Promotion Prescription

NONDIRECTIVE Dialogue Counseling Entertainment Social Networks

PUBLIC Advocacy Regulation

MODES OF COMMUNICATION FOR BEHAVIORAL CHANGE

• 1. Knowledge of condom brands• 2. Perceived efficacy of condoms for AIDS • prevention • 3. Social approval for condom use• 4. Discussion of condom use with others• 5. Condom use self-efficacy • 6. Social influence to use condoms• 7. Personal condom use advocacy

• 8. Impulsivity• 9. Motivation for sex• 10. Perceived norm of condom use.

Ideational Elements Related to Condom Use in Tanzania 2003

Cumulative increase in condom use among male and female adolescents by level of

ideation Tanzania, 2003

28

39

58

5

16

0

20

40

60

80

One Two Three Four Five

Ideation Quintile

Percent

Direct and Indirect Effects of Communication on Condom Use in Tanzania 2003

AIDS Prevention Campaign Recall

Condom Use

0.12

AIDS Prevention Campaign Recall

Condom Use

N.S.

IDEATION

0.33 0.46

Ideational Elements Related to Condom Use in Zambia

• 1. Knows where to purchase condoms• 2. Knows at least three ways to protect self• from HIV/AIDS• 3. Has positive attitude towards people who• use condoms• 4. Has talked with at least three people about • safe sex• 5. Has an above-average sense of confidence• regarding ability to use condoms even• when facing opposition from partner

(13-19 year-old males)

Cumulative increase in condom use among male adolescents in Zambia by the number of ideational elements that apply

28

43

60

8

22

0

20

40

60

80

One Two Three Four Five

Number of Elements

Percent

1. No. of modern FP methods known

2. Respondent’s approval of FP

3. Discussion of FP with husband

4. Husband’s approval of FP practice

5. Talks about FP with friends

6. Advocates FP to others

Ideational elements related to contraceptive use among women in

Tanzania

Note: 1996 DHS, Women ages 15-49

Cumulative increase in contraceptive use by the number of ideational elements that apply

to married women in Tanzania

0

10

20

30

40

50

60 Percent Traditional Modern

Modern 0.5 1.2 3.2 8.3 26.2 35 46.1

Traditional 0.6 3 4.4 5.4 6.8 8.9 8.4

0 1 2 3 4 5

1.14.2

7.613.7

33.0

43.9

54.5

6

N = 5,401married womenChi2; p<.001

CUMULATIVE RISK ANALYSIS

These elements affect behavior in much the same way that risk factors affect the probability of getting a disease:

The greater the number of factors that apply to an individual, the greater the likelihood that he/she will get the disease.

Each one of these influences is strongly related to adoption and continuation of modern contraceptive use. When they are summed into a combined index, they are highly predictive of contraceptive behavior.

The more ideational elements that apply to someone, the greater theprobability that they will adopt a

health behavior.

In Tanzania, from only 0.5% modern method use for women with no ideational elements to 46.1% for women with all six.

CONCLUSION

Communication for Social Change

Development Communication

• What is the role of communication in national development?

• Two competing paradigms:• Information transfer (one-way/vertical) process (from experts/north to unskillful/south)• Participatory (horizontal) communication (emphasis in dialogue) among community members

• New theoretical approaches, participatory communication and communicativeaction

First decade of development (1960’s)

• Urbanization andindustrialization economic growth.

• Focus on capital-intensive technology, undermining of agriculture.

• Focus on individual; traditional attitudes and behavior constrain development.

• Literacy and mass media to help masses break free of traditional views.

Modernization theory the dominant paradigm.

First decade of development (1960’s)

• The Diffusion of Innovations sets the stage (Rogers, 1962)

• Persuasive messages will have direct and uniform impact on people, … and will produce a climate of acceptance of the innovation

• Mass media seen as “magic” multipliersof development benefits

The Bullet Theory of Communication.

Second decade of development (1970’s)

• Modernization increased concentration of income and power

• Shift from individual to social and structural barriers to change

• Emphasis on active participation, self-determination, self-reliance, sustainability

• The Pedagogy of the Oppressed sees the light (Freire, 1970)

Post-Modernism, Dependency theory (LA scholars)

Second decade of development (1970’s)

• Pro-innovation• Pro-persuasion• Top-down flow

of messages and decisions

• Issues of access, content and code

Criticisms to DOI

Second decade of development (1970’s)

• Dialogue, the correct method; … working with rather than for the people, concept of concientizaçao (Freire)

• Communication as support for development• Local media for enhancing dialogue and

action; folk media• People-initiated (rather than expert-initiated)

activity at the local level

Alternative roles of communication for development

The 1980’s+

• Emphasis on non-materialindicators of development (access to health care, nutrition, sanitation)

• Shift from industrialization to human action within sociocultural, political and economic contexts

• Focus on participatory decision-making• Attention to gender and gender gaps

Another DevelopmentEconomic Social

The 1980’s+

• Some new functions for this role (Bordenave 1989)

- Help in the development of a community’s cultural identity

- Act as vehicle for citizen self-expression - Facilitate problem articulation - Serve as tools for diagnosis of community’s problems

• Issue of alternative media vis a vis centralized/ mainstream media

Communication for the participative society

Into the 90’s (20+ years later)

• Participatory communication critical for development

• Vertical communication acceptable/ desirable in specific contexts

• Community participation, a process with intrinsic value

• Efforts to better study and measure community participation, competence,leadership,...

Re-examining the role of communication in development

• Rockefeller Foundation meetings (1997, 1998, 2000) explored new communication strategies for social change

• Group defined CFCS as “a process of public and private dialogue through which people define who they are, what they want and how they can get it.”

Re-examining the role of communication in development

• Sustainability; owners of process and content of communication

• CFSC empowering, horizontal

• Communities as agents of their change

• From persuasion to dialogue and debate

• Shift in outcomes; social norms, culture, supportive environment

Premises of CFSC Conferences, RF:

Revised Model of the Convergence Model with Emotional Response

PSYCHOLOGICAL REALITY

A

PHYSICAL REALITY

PSYCHOLOGICAL REALITY

B

Interpreting

CollectiveAction

MutualAgreement

MUTUALUNDERSTANDING

Understanding

Action Action

Perceiving INFORMATION Perceiving

UnderstandingBelievingBelieving

Interpreting

Feelings

EmotionalResponse

SOCIAL REALITYand RELATIONSHIP

A & B

Feelings

EmotionalResponse

Effective dialogue

Effective dialogue (Rapoport, 1967) occurs when:

• Participants listen to one another (paraphrasing to the other’s satisfaction)

• Each acknowledges the conditions to accept the other’s argument as valid

• Each acknowledges the similarity of both points of view

Dialogue can lead to disagreement when each person’s interests and values are in conflict

Supportive theories and models

• Social systems (1990)

• Group Dynamics (1968, 1996)• Conflict Resolution (1988, 1999)• Leadership (1998)• Quality Improvement (1992, 1986)• Future search (1992, 1995)

Societal ImpactSocietal Impact

CatalystCatalyst

Community DialogueCommunity Dialogue

Collective ActionCollective Action

IntegratedIntegrated Model of CFCS Model of CFCS

Figueroa & Kincaid, 2/2001

IndividualIndividualOutcomesOutcomes

External External Constraints Constraints

and and SupportSupport

SocialSocialOutcomesOutcomes

CFSC Model

• Not a model for Social Change

Social change: the transformation of the overall structure represented by the change in the distribution of resources (educational, economic, power, discursive)

CFSC Model

• Participatory processes as the one described in the model can be conducive to SC by:

enabling people to critically decide where they want to go and how

increasing community organization for collective action

Catalyst

Change Agent

Innovation

Policies

Mass Media

Technology

Internal Stimulus

Community Dialogue

Collective Action

Recognition of a Problem

Identification & Involvement of

Leaders & Stakeholders

Clarification of

Perceptions

Expression of Individual &

Shared Interests

Vision of the Future

Assessment of Current Status

SettingObjectives

Action PlanConsensus on Action

Options for Action

Assignment of Responsibilities

• Media• Health• Education• Religious• Other

Outcomes

Va

lue

fo

r C

on

tin

ua

l Im

pro

ve

me

nt

Conflict-Dissatisfaction

• Individuals• Existing Community Groups• New Community Task Forces• Others

Mobilization of Organizations

Disagreement

Implementation

• Outcomes vs. Objectives

Participatory Evaluation E

xter

nal

Co

nst

rain

ts a

nd

Su

pp

ort

s

Integrated Model of CFSC

Social OutcomesSocial Outcomes

• Leadership• Degree & Equity of Participation• Shared Information• Collective Self-Efficacy• Sense of Ownership• Social Cohesion• Social Norms

Individual ChangeIndividual Change

• Skills• Ideation Knowledge, Attitudes, Perceived Risk, Subjective Norms, Self-Image, Emotion, Self-Efficacy, Social Influence, & Personal Advocacy • Intention• Behavior

Interaction of Individual and Social Outcomes on Health

Maintenanceof the status

quo

Limited Health

Improvement

Self-sustained health

improvement

Increased potential for

health improvement

Individual Health Behavior Change

Collective Change

NO

NO

YES

YES

“Those who authentically commit themselves to the people must re-examine themselves constantly.”

“… they almost always bring with them the marks of their origin: their prejudices and their deformations, which include a lack of confidence in the people’s ability to think, to want and to know.”

Paulo Freire, 1970

Next Week:

Communication and Affect

Fear Management

Looking ahead