Three lessons on sparking behavior change through interpersonal communication

Interpersonal communication is an essential component of social and behavior change communications. It can be effective at addressing long-standing challenges to product use and can help change a mindset from “I like it” to “I want it”, ultimately leading to product use. This progression is shown in the diagram below, where interpersonal communication activities move consumers from awareness to action.

In India, the use of short-acting methods of contraception is low, as is the use of ORS and zinc together as a first-line treatment for childhood diarrhea. Research conducted by SHOPS Plus identified key barriers to use of these products among the urban poor in India. Barriers to use of ORS and zinc included lack of awareness of zinc and lack of provider recommendations to use the combined treatment. Barriers to the use of short-acting methods included various myths and misconceptions about the effects of oral contraceptive pills. With these barriers in mind, SHOPS Plus designed interpersonal communication approaches to promote the use of ORS and zinc and to increase knowledge of family planning products.

Between January and October, SHOPS Plus  team  piloted 22 interpersonal communication approaches  to identify which were most effective, and which had the highest potential for scaling up through the project’s private and public sector partners . It used fun and playful activities such as a treasure hunt, quiz, street plays, and virtual reality games. A downloadable technical brief details the lessons from the pilots.

Spend wisely by giving consumers lots of time to interact and absorb key messages

Interpersonal communication activities are more cost-intensive than mass and digital media because they involve higher levels of engagement with smaller audience groups, often scattered widely across a geographical area. SHOPS Plus designed its prototypes to be sensitive to this and keep the cost of reaching each participant within US$ 1. Our experience suggests that activities conducted at places where the participants had a longer time to interact with our products and absorb key messages were more successful in reaching a larger number of people at relatively low cost. Activities to promote combined use of ORS and zinc for childhood diarrhea conducted in and around child health clinics and hospitals, for example, had large numbers of people with their children waiting to consult the doctors. Not only did they participate willingly, but participation of the paramedic staff and pharmacists at such places could answer caretaker questions, resolve lingering doubts, and increase overall credibility of the messages.

Scale more easily with smart location choices and technology-aided activities 

By their nature, interpersonal communication activities are frequently designed to be small in scope and tailored to specific community characteristics. As a result, scaling them across large states or regions is frequently challenging. SHOPS Plus learned that activities which can be conducted in limited space and any time during the day, and can be conducted with a smaller number of people (10-15) are easier to scale than activities that require higher preparation time, larger amount of resources, and bigger number of participants.

“Bindaas Binita” is a good example of scaling. This activity was hosted at beauty parlors, where women waiting for appointments were given headphones that had family planning messages loaded onto them. The messages informed listeners of the SHOPS Plus helpline where they could call to ask additional questions.  Women had sufficient time to listen to the messages, consider them, and then talk about contraception and related issues with other women around them. Parlor owners were very willing to give permission for the activity as it did not interfere with the parlor’s business operations, and actually helped keep their customers engaged while they waited. The density of beauty parlors in residential areas and shopping centers then makes the activity scalable, and the preloaded messages could be easily replicated.

Create meaningful engagement by leveraging key influencers

The ultimate goal of interpersonal communication activities is to move consumers down the persuasion funnel from awareness all the way to action. To do this effectively, the activity must engage the consumer in a meaningful way, so it is easy for them to receive and remember the message. SHOPS Plus found that endorsement from the key influencers and change agents was key in moving consumers from awareness or interest in a product to desire and action. These trusted members of the community, such as beauticians and pharmacists, allowed the participants to ask questions and helped resolve lingering doubts, so consumers were reassured and felt confident in the product.

Through these activities, the team in India generated knowledge on how to successfully use interpersonal communication to increase health behaviors. These learnings will be described in greater detail in a forthcoming report to be published in 2020.