Using social norms theory for health promotion in low-income countries (original) (raw)
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Prevention Science, 2019
Some harmful practices are sustained by social norms-collective beliefs about what people expect from each other. Practitioners and researchers alike have been investigating the potential of social norms theory to inform the design of effective interventions addressing these practices in low-and middle-income countries. One approach commonly used to facilitate social norms change is community-based dialogs and trainings. This approach has often been criticized for not being cost-effective, as it usually includes a relatively small number of direct participants and does not allow for scaling-up strategies. In spite of some evidence (as for instance, the SASA! Program) that community dialogs can achieve social norms change, little exists in the literature about how exactly participants in community dialogs engage others in their networks to achieve change. In this paper, we look at the potential of Borganized diffusion^as a cost-effective strategy to expand the positive effects of community-based interventions to participants' networks, achieving sustainable normative shifts. We provide quantitative evidence from three case studies-Community Empowerment Program in Mali, Change Starts at Home in Nepal, and Voices for Change in Nigeria-showing that participants in community-based interventions can be effectively empowered to share their new knowledge and understandings systematically with others in their networks, eventually facilitating social norms change. Future community-based interventions intending to achieve social norms change would benefit from integrating ways to help participants engage others in their network in transformative conversations. Doing so has the potential to generate additional impact with little additional investment.
Challenges to changing health behaviours in developing countries: A critical overview
Social Science & Medicine, 2012
This overview of recent research on health behaviour change in developing countries shows progress as well as pitfalls. In order to provide guidance to health and social scientists seeking to change common practices that contribute to illness and death, there needs to be a common approach to developing interventions and evaluating their outcomes. Strategies forming the basis of interventions and programs to change behaviour need to focus on three sources: theories of behaviour change, evidence for the success and failure of past attempts, and an in-depth understanding of one's audience. Common pitfalls are a lack of attention to the wisdom of theories that address strategies of change at the individual, interpersonal, and community levels.
South African Journal of Science, 2017
In the effort to address behavioural risk factors-which contribute significantly to the global burden of disease-there is a growing movement in public health towards the use of interventions informed by behavioural science. These interventions have the benefit of being amenable to testing in randomised controlled trials, are cost-effective and, when scaled up, can have significant public health benefits. A subset of these interventions attempts to change behaviour by shifting social norms perception (what I think everyone else does and thinks). We surveyed the work on social norms intervention and considered its applicability to issues of public health in South Africa. Social norms interventions have widespread and significant potential to address issues of public health in South Africa; policymakers should look to these interventions as cost-effective tools to address key issues. More broadly, we advocate for an expansion of the use of behavioural science in developing public policy in South Africa. Significance: • The application of behavioural science to issues of public health will contribute to evidence-based policy efforts in South Africa.
Social and Personality Psychology Compass, 2008
We have known for a long time that people are often motivated to conform to the wishes of groups. Such peer influence can shape human behavior through the creation of social norms, and the frequency of some health behaviors (e.g., alcohol use) may depend on the perception of these norms. We discuss the influence of perceived social norms, especially normative misperceptions on health behaviors. We then describe social norms campaigns that are intended to reduce risky health behaviors by 'debiasing' perceptions of behavioral norms, and we point out practical problems and faulty theoretical assumptions of such interventions. A better alternative might be to develop interventions that debias misperceptions of injunctive norms or affective norms, although such alternatives have not yet been adequately tested. Still, we present the theoretical grounding for these different approaches and preliminary data suggesting that they could be successful in reducing risky health behaviors.
Behavioural mHealth in developing countries: what about culture
Non-communicable diseases (NCDs) such as diabetes and cardio-vascular diseases are a serious global health problem of modern times. The burden is especially high in developing countries which account for more than 80% of NCD-related deaths (Lozano et al., 2012). With this NCDs are slowly but surely outgrowing infectious diseases in terms of its impacts on morbidity and mortality in developing countries. These are grim facts, but fortunately the answer to the question of how to deal with the NCD epidemic is already well established in the research literature and beyond: Live a healthy life – which most commonly translates to get active and eat healthily (Sallis et al., 2016; World Health Organization, 2014). And this is where the problem lies. Rapid urbanisation and development made many forms of work- and travel-related physical activity unnecessary for many people living in developing countries (Lachat et al., 2013). Additionally, healthy local foods are increasingly replaced by processed foods high in salt, sugar and fat (Baker & Friel, 2014). In light of the struggles of fragmented and under resourced health-care systems that cannot cope with the increasing burden of NCDs, interventions that promote healthy lifestyles are urgently needed.
Health is in the eyes of the beholder: The impact of social norms on perceived health dispositions
As a field for the expression of broader cultural ideologies, health practices are also submitted to social regulations that are legitimized through widely valued and shared standards actualized in mundane judgements. This article proposes to analyse how cultural ideologies, here operationalized as social norms, can influence judgments of health states and behaviours. This process was analysed through two independent studies using impression management tasks. Participants were asked to judge a target in accordance with socially valued characteristics not directly related to health dispositions: level of attractiveness (Study 1) and level of orientation towards the future (Study 2). Results illustrate the influence of broader and implicit ideologies on the evaluations of a target’s general health state and the attribution of health behaviours. The findings invite a more systematic analysis of the relationships between dominant sets of values and norms and health-related judgements.