Behavior Change is more than Communication

I’ve sometimes been asked by those who have just started learning about behavior change for good references to show others its importance.  I think this question in its simplest form confuses the issue and reduces the scope of the contributions a robust applied behavior science can make.  The distinction for me is between the need for behavior change, which seems obvious, and behavior change communication, which needs justification.  For example, if most people in a village don’t use a toilet, the argument for behavior change seems strong–we want to change the behavior of those not using toilets.  However, what’s less clear is that behavior change *communication* is needed.  Certainly, we can inform people about the dangers of pathogens in human waste and encourage them to build toilets, but this is far from the only approach we can take.  We could instead focus on providing subsidies, improving business models, training sales teams, coming up with better toilet designs, building shared toilet facilities, encouraging local regulations that require toilets to be constructed, or getting the government to pay to build household toilets for free.

We can look more broadly than just changing behaviors, as we could do other things like vaccinate people against these pathogens or (in sci-fi land at the moment) somehow alter bodies to produce fecal matter free from pathogens or that dissolves when contacting the air or some other crazy solution.  The point is that there are many ways to deal with complex issues, and behavior change communication (or even behavior change!) are not always the answer.

However, in many cases, we do want to change a behavior as a way to address a larger issue.  It is important not to jump directly to behavior change communication, though, as this neglects much of the power of behavioral science.  A great recent example of this is a handwashing behavior change program in schools.  The goal was to encourage kids to wash their hands after using the toilet, but rather than run an educational campaign, the team altered the environment by creating a bright, painted path from the toilets to the handwashing station to draw the attention of the kids.  No one ever told the kids anything about the intervention, but handwashing rates went from 4% at baseline (with no infrastructure provided) to 18% by providing handwashing infrastructure to 68% with a footpath and painting (and even increased slightly 2 and 6 weeks later!).  Education could have complemented this intervention (currently being tested), and this doesn’t prove that education alone wouldn’t have worked (but lots of other poor results cast doubt on its effectiveness), but this certainly shows that changing behavior need not only involve education.

This is just a part of the power of my research group’s approach, Behavior Centered Design.  While the approach does include understanding the executive function of the human brain (the part associated with education and planning in most behavior change communication interventions), it also takes a comprehensive look at behavior motivations, “unconscious” actions, the role of the body, and the roles of the social, biological, and physical environment on producing behavior in “behavior settings.”  Solutions are more than just behavior change, and behavior change is more than just behavior change communication.