14 research outputs found
How to design a complex behaviour change intervention: experiences from a nutrition-sensitive agriculture trial in rural India
Many public health interventions aim to promote healthful
behaviours, with varying degrees of success. With a lack
of existing empirical evidence on the optimal number or
combination of behaviours to promote to achieve a given
health outcome, a key challenge in intervention design
lies in deciding what behaviours to prioritise, and how
best to promote them. We describe how key behaviours
were selected and promoted within a multisectoral
nutrition-sensitive agriculture intervention that aimed to
address maternal and child undernutrition in rural India.
First, we formulated a Theory of Change, which outlined
our hypothesised impact pathways. To do this, we used
the following inputs: existing conceptual frameworks,
published empirical evidence, a feasibility study, formative
research and the intervention team’s local knowledge.
Then, we selected specific behaviours to address within
each impact pathway, based on our formative research,
behaviour change models, local knowledge and community
feedback. As the intervention progressed, we mapped each
of the behaviours against our impact pathways and the
transtheoretical model of behaviour change, to monitor the
balance of behaviours across pathways and along stages
of behaviour change. By collectively agreeing on definitions
of complex concepts and hypothesised impact pathways,
implementing partners were able to communicate clearly
between each other and with intervention participants.
Our intervention was iteratively informed by continuous
review, by monitoring implementation against targets
and by integrating community feedback. Impact and
process evaluations will reveal whether these approaches
are effective for improving maternal and child nutrition,
and what the effects are on each hypothesised impact
pathway