March 2016

Authors:

Shannon Gibbs, MPH Student

University of South Florida

John Collett

Senior Advisor, Hygiene Promotion and

Behaviour Change

World Vision International

Designing for Behaviour Change

Desk Review

2

© World Vision International 2016

Authors and contributors: Shannon Gibbs, John Collett, Kristie Urich

All rights reserved. No portion of this publication may be reproduced in any form, except for brief

excerpts in reviews, without prior permission of the publisher.

Published by the Water, Sanitation and Hygiene department on behalf of World Vision International

For further information about this publication or World Vision International publications, or for

additional copies of this publication, please contact wvi_publishing@wvi.org.

World Vision International would appreciate receiving details of any use made of this material in

training, research or programme design, implementation or evaluation.

Cover photo © World Vision/Jon Warren

3

CONTENTS

INTRODUCTION TO DBC .......................................................................................................................................... 4

PURPOSE OF THE DBC DESK REVIEW .................................................................................................................... 6

METHODS .......................................................................................................................................................................... 6

FINDINGS & RECOMMENDATIONS ......................................................................................................................... 6

TRAINING ..................................................................................................................................................................... 6

TRAINING APPROACH ........................................................................................................................................ 7

TRAINING RESOURCES ....................................................................................................................................... 9

TRAINING REQUIREMENTS ............................................................................................................................... 9

TIMING AND FUNDING ........................................................................................................................................ 10

LEADERSHIP SUPPORT & ORGANISATIONAL CAPACITY........................................................................ 11

MONITORING & EVALUATION .......................................................................................................................... 12

OTHER BARRIERS ..................................................................................................................................................... 13

LANGUAGE BARRIERS ....................................................................................................................................... 13

CHALLENGES DEVELOPING EVIDENCE-BASED BEHAVIOUR CHANGE ACTIVITIES ................. 13

SUMMARY AND CONCLUSIONS ............................................................................................................................ 14

APPENDIX 1: ONLINE SURVEY QUESTIONS ...................................................................................................... 16

APPENDIX 2: TERMS OF REFERENCE ..................................................................................................................... 18

4

INTRODUCTION TO DBC

With the realisation that improved knowledge and awareness alone usually do not result in

behaviour change, systematic efforts are being made to apply successful practices from the

field of social and behavioural change (SBC) in order to achieve better and more sustainable

behaviour change results and the desired improved health impacts from the investment in

programming. Development practice has typically focused on pre-awareness and knowledge

about why certain behaviours are important, but has been much less adept at moving people

toward the habitual practice of the focus behaviours. The Designing for Behaviour Change

(DBC) Framework, which is based on the social and behavioural theory of change model

‘Stages of Change’ (Prochaska,1991), is a 5-step process that assists behaviour change agents to organise existing information and to gather new information needed to design effective

behaviour change strategies. It requires the user to clearly state the desired behaviour and

to describe the priority group and the context in which the behaviour will be practiced. The

power of the DBC Framework lies in the formative research using the Barrier Analysis (BA)

Survey1, which requires the designer to dialogue with people from the priority group using a

scripted questionnaire to identify the reasons why some people find it difficult to practice

the behaviour being studied. From there, the designers formulate the Bridges to Activities

and finally select or design behaviour change activities that are purposefully designed to

address the significant barriers and motivators discovered through the formative research.

The DBC Framework is used to design behaviour change strategies in any sector including

health, nutrition, food security, water and sanitation, agriculture, natural resource

management, civil society and gender equity; and for any audience, such as mothers, youth,

farmers and pastoralists.

Photo: World Vision International

1 While the BA survey is the formative research method most commonly used in the DBC Framework, other formative research

methods such as Trials of Improved Practices may be needed when BA surveys are impractical – for example when the desired behaviour (or close to the desired behaviour) is not yet being practiced by anyone.

5

Training on how to use the DBC Framework requires five days, and an additional four days

are required to complete the full BA training (or seven days total if the DBC and BA

trainings are combined). To develop a behaviour change strategy using the DBC Framework

requires following the five steps shown in the figure below.

Figure 1

DESIGNING FOR BEHAVIOUR CHANGE FRAMEWORK

Step 1:

Behaviour

Statement

Step 2:

Priority

Group and

Influencing

Groups

Step 3:

Significant

Determinants

Step 4:

Bridges to

Activities

Step 5:

Activities

To promote this

behaviour

Among this

audience

Priority Group

Influencing

Group

The latter can

only be

determined

through

formative

research

We will focus on

these

determinants

These can only be

determined through

formative research

Comparing the

perspective of doers

and non-doers

And

promote

these

bridges to

activities

By implementing

these activities

Outcome

Indicators Process

Indicators

Step 1: Formulation of a clear and unambiguous behaviour statement which targets the priority group

Step 2: Description of the priority group [and influencing group(s) if identified by the

priority group during Step 3

Step 3: Formative research using the BA Survey which investigates up to 12 common behavioural determinants: 1) Perceived self-efficacy/skills; 2) Perceived social norms; 3)

Perceived positive consequences; 4) Perceived negative consequences; 5) Perceived

access; 6) Perceived susceptibility/risk; 7) Perceived severity; 8) Perceived action efficacy;

9) Cues for action/reminders;10) Perception of divine will; 11) Policy; and 12) Culture.2

Step 4: Formulation of the Bridges to Activities for the determinants found to be

significant in Step 3.

Step 5: Formulation of the behaviour change activities purposefully linked to the Bridges to Activities and the corresponding significant determinants and responses.

2 A final determinant ‘Universal Motivators’ is often included.

6

PURPOSE OF THE DBC DESK REVIEW

There are at least 25 development organisations known to be using the DBC Framework to

develop behaviour change strategies for targeted behaviours in sectors such as food

security, livelihoods, health, nutrition, education, and water, sanitation and hygiene (WASH).

While continuing to apply the DBC Framework for developing behaviour change strategies,

World Vision and several other organisations believe that now is a good time to take stock

of experience from the application of DBC Framework and BA by practitioners around the

world. This desk-based review will support the documentation of existing DBC strategies

and BAs and provide insight into how organisations are equipped and how they are utilising,

monitoring and evaluating their current DBC activities. It will also produce key recommendations to support the continued strengthening of the DBC Framework.

METHODS

To learn about the current state of Designing for Behaviour Change and Barrier Analysis

across multiple organisations, an external consultant was engaged to conduct an initial desk

research, involving a review of documents from multiple organisations. She then conducted

a qualitative desk review by using an online survey (see Appendix 1). Thirty-five responses

to the survey from 16 different organisations were received. The consultant followed up

with additional key informant interviews with 17 people from 10 organisations who had

responded to the online survey. Online survey results were analysed using the survey analytics software, and key informant interviews were analysed manually. Information from

both the surveys and the interviews were analysed to identify key findings and produce

recommendations.

FINDINGS & RECOMMENDATIONS

The review revealed that the DBC Framework is being used in 38 countries in more than a

dozen sectors. The major sectors using the Framework are maternal, newborn and child

health; nutrition; WASH; and agriculture. The results confirm that the DBC Framework is

applicable to a wide variety of sectors and behaviours. However, the survey revealed that 84

per cent of respondents had challenges when applying the DBC Framework. The research

highlighted some key findings that provide opportunities to strengthen DBC training, implementation and activity monitoring.

TRAINING

To become proficient in the use of the DBC Framework, most non-governmental

organisations (NGOs) arrange for their staff to participate in a five-day DBC training. Some

NGOs opt to combine this course with the four-day Barrier Analysis course in order to get

a more comprehensive understanding of how to implement a BA survey. A combined

course is typically seven days long. More than 90 per cent of respondents reported having

been trained in DBC, and more than 80 per cent reported receiving additional training in

Barrier Analysis. The quality of the training is critical in determining the successful use of the

DBC Framework in practical applications. Only slightly over 50 per cent of trained

respondents felt that they were fully knowledgeable in the DBC/BA process after receiving

7

training. This shows that the training covers a depth of knowledge, but many respondents

feel a need for more time or adjustments in the training to fully grasp the concepts to apply

adequately later.

Figure 2: Countries using the DBC Framework

COUNTRIES USING THE DBC FRAMEWORK

Afghanistan Kenya Philippines

Bangladesh Lebanon Rwanda

Bolivia Liberia Senegal

Burkina Faso Madagascar Sierra Leone

Burundi Malawi Somalia

Cambodia Mali South Sudan

DRC Mozambique Sudan

Ethiopia Nepal Tajikistan

Ghana Nicaragua Tanzania

Guatemala Niger Timor L’Este

Haiti Nigeria Uganda

Honduras Pakistan Zambia

India Peru Zimbabwe

Indonesia

TRAINING APPROACH

A majority of respondents felt that the training is often a rushed and hurried event that tries

to compress too much information into a short time span. While five days may seem like a

long time, the training curriculum is long and the concepts new to most attendees. The rush

to complete the training in the allotted time leaves the participants not feeling fully

comfortable with the concepts. This also leaves little time for sufficient practical application

within the training. Survey respondents expressed the wish to have more time for practical application of concepts. The most difficult part of the process is developing the behaviour

change activities -- the last step in the process. Because this step happens on the last day of

the training, there is sometimes less time to practice the skill of developing these activities,

which is exacerbated by the fact that participant’s energy levels are low after four days of

intense learning. More than 50 per cent of respondents expressed wanting more time during

the training devoted to field-based practice. While the existing training already includes one

day devoted to fieldwork practicum, respondents expressed the need for more time. Many

respondents felt the need for additional coaching and mentoring in order to be able to apply

the principles learned during training into their fieldwork and to come up with appropriate

8

behaviour change activities for the Bridges to Activities and the corresponding significant

determinants and responses.

The majority of respondents said that they received no follow-up training. Once training is

complete there is little follow through to make sure that the Framework is being

implemented properly.

Recommendations:

Pre-reads and e-learning

Since the DBC/BA learning material is very dense and relatively new to most participants, it

is recommended to provide opportunities for pre-reading or e-learning before attending the

training. Assuming the participants studied the material provided, they might be better

prepared for training and more prepared for practical application. To ensure that attendees

review the provided material a pre-test could be a prerequisite to participating in training.

This could help to serve as an incentive as well as a tool to help solidify learning.

Mentors

One way to support staff in internalising and effectively utilising the concepts learned during

training is with the use of mentors. Pairing new learners with people who have successfully

used the DBC Framework or conducted a BA survey in the field provides an opportunity

for continued growth and learning.

Additional participatory elements

One way to build confidence among participants would be to expand existing participatory

elements already provided in the training. If some of the content is covered through pre-

reading or e-learning, this could potentially open up space in the training for additional

practical learning opportunities.

Follow-up or refresher training

Another way to strengthen the training approach would be to provide follow-up or

refresher trainings to those who have already received an initial training. This second

training should be offered to those who have already tried to apply what they learned in the

first training and have proven that they intend to use what they learn. This would provide

those who are not as comfortable with the process, or those who have encountered

obstacles, to strengthen their knowledge of the practice. This could also be a time to share

lessons learned and document good DBC practices. There are currently DBC practitioners’

share-and-learn webinars (co-hosted by World Vision) taking place that could serve as a

potential platform for continued learning.

Focused activity training

Since many respondents cited a perceived lack of ability to create evidence-based activities

and implement them in the field, perhaps a focused activity training session would help in

this area. This additional training could help solidify the concepts and help participants feel

more comfortable applying DBC principles in their day-to-day work.

9

TRAINING RESOURCES

The training for DBC and BA covers a lot of new concepts and ideas. One common thought

amongst the respondents is that the training curriculum is large and difficult to reference for

later use. While the manual was never intended as a reference tool, many respondents

recommended organising and indexing the training manual for easier future reference. The

new information and concepts from DBC can be difficult to internalise and immediately

apply, so a reference guide is important to solidify DBC and BA concepts.

Key informant interviews revealed that training is perceived to lack adaptability to cultural

contexts, specifically learning styles and cultural environment -- including language, local

customs and communication norms. Each culture will learn differently and having one set training programme makes it difficult to adapt to an areas’ particular cultural environment.

It is important to note that it is not realistic to adapt each training contextually, but this

perception must be taken into account during training and to consider ongoing support for

implementers.

Recommendations:

Developing a DBC practitioners’ field guide

One idea to overcome some of the issues with the existing training resources is to revise

the current manual into a field guide. A manual for field use should be a well-indexed and

easy-to-use guide for implementation. It may be beneficial to include input from field

workers when developing this guide.

Multi-cultural review of training

While it may not be possible to create a training approach that is relevant to every cultural

context, it is advisable that the cultural and organisational context be taken into

consideration when reviewing the training manual. One way to do this may be to consider

having a multi-cultural panel when revamping the current training materials. Another idea

would be to have pre-planning with local staff before a training session to assure that

essential cultural adaption is addressed – such as local language, norms and customs that

may have an impact on DBC field application.

TRAINING REQUIREMENTS

Training covers a large amount of material in a short amount of time, and those who attend should be prepared to fully understand the concepts presented to them. Currently there

are no defined minimum requirements on who can attend the training and there are few

preparatory materials. It is imperative that the right people receive the training – those who

are best equipped and empowered to grasp and apply the concepts.

Recommendations:

Trainee vetting

Attendees should have the ability to apply the DBC process once it is learned. Sending

people who are unable to follow through with the training is a waste of time and resources.

Before accepting people to attend the training, their capacity to use the training in their

10

work should be verified. One way of doing this could be to require a commitment in writing

from a manager or supervisor to confirm that the attendee will be able to apply the DBC

Framework in their work. The supervisors of prospective trainees could also be provided

with a list of recommended prerequisite competencies to help assure that the most

appropriate staff are selected to participate.

Leadership endorsement

Respondents also noted that their leaders often do not understand the importance of the

DBC Framework for behaviour change. Facilitating leadership buy-in should be an important

part of introducing DBC to the organisation. This could be done through a short training for

leaders within the organisation, or by ensuring that all DBC trainees have the full support of

their managers (see more on leadership buy-in below). The latter could be done by

requiring a manger or supervisor’s signature in advance of training, as well as a commitment

to support the attendee after the DBC training.

TIMING AND FUNDING

Respondents perceive the DBC process as rigorous and time consuming. After conducting

this desk review, at least three respondents indicated that their organisations are not finding

the time to develop and implement activities. This shows a need for more adequate planning

and time allotted to the DBC process. These interviewees noted that there is a perceived

reluctance to change programming after the DBC Framework is completed.

Funding is also a challenge. Once research is complete, it can be difficult to find funds to implement activities or redesign a programme. As a result, at least three organisations

surveyed have started the DBC process, but have not fully implemented activities. The

trainings are useful, but the DBC approach is not always being put fully into practice.

Recommendations:

Assure adequate planning time

It is important that all participants in the training understand the amount of time they will

need to implement DBC/BA in their own programmes. They must be willing to commit the

time and energy to developing and implementing DBC/BA in their own programmes. After

the training, the attendees should meet with their supervisor and map out how they will use

what they learned. They will need to work together to ensure that the attendee has adequate time to plan and implement these new approaches. Leadership buy-in prior to the

training is critical to ensure this empowerment occurs post-training.

Starting the process early

Many respondents attended the training and tried to implement DBC/BA even though their

organisation already had interventions in place. It is important that organisations start the

DBC process as early as possible in the programme cycle, working with stakeholders early

on to ensure buy-in. It is highly recommended to arrange for the DBC/BA training during

the first year of a new project.

Clear funding guidelines

11

Many participants have completed their DBC training and then discovered they cannot apply

what they have learned because there is no funding to implement the proposed behaviour

change activities. If an organisation cannot guarantee funding for full DBC implementation

prior to DBC training, it would be better to delay training until they have the funding in

place. It is also important that attendees realise that the new activities are intended to

replace old activities that are ineffective. Hence there could be cost-savings or minimal

change to their behaviour change programming budget. Funding guidelines should include

proof points showing that the application of DBC can result in cost-saving because the

behaviour change strategy specifically targets only those determinants found to be

significant.

Staffing considerations

Having a behaviour change advisor post hired within the implementing organisation would

bridge the gap between training and implementation, providing on-site support and

mentoring for staff seeking to utilise DBC. (See more on staffing in following section.)

LEADERSHIP SUPPORT & ORGANISATIONAL CAPACITY

A key component to having successful implementation of the DBC Framework is leadership

support. Respondents noted the importance of having one person responsible for

overseeing the behaviour change process from beginning to end. Respondents also cited

that DBC champions amongst supervisors and leaderships are a significant factor in creating

a favourable environment for DBC implementation. Without support and understanding from managers and supervisors, DBC will likely not be implemented effectively. Having

managers who understand the DBC process and the positive effect it can have on

programme outcomes is vital, and they can be an ally to advocate to the leadership for the

necessity of evidence-based behaviour change programming.

The need for organisational capacity building was a common theme amongst those

interviewed. Not everyone implementing DBC activities will participate directly in the

training, so it is important that DBC staff champions are equipped to train and empower

implementing staff to facilitate DBC activities well.

Recommendations:

Provide leadership training

Provide a shortened training on DBC/BA to help develop champions for DBC amongst

organisational leaders. A one-day training currently exists to help organisation leaders

understand DBC/BA.

Designated project leader

Having one person who will follow the project through from beginning to end is critical to

the success of implementing DBC. With one person acting as a project leader, there is more

likely to be follow-through on the implementation of the activities. However, it is important

that whoever takes on this role has a clear understanding of the expectations of the role

and that relevant activities are reflected in job descriptions and/or performance agreements.

Hiring a behaviour change specialist

12

When possible, an organisation should invest in hiring a behaviour change specialist to help

guide the direction and implementation of behaviour change activities. Having a dedicated

staff person should help to build capacity with the NGO.

Champions

When it is not possible to have a paid staff person, or when organisational size and reach

requires additional support, clearly identified DBC champions can support organisational

capacity and advocate for the use of the DBC Framework. Having one person nominated as

the focal point of an office who can be in charge of DBC implementation, progress follow-

up, and sharing learning will help to build capacity within an office. Again, champions should

have a clear understanding of the expectations of the role, and this should be reflected in

their performance agreements.

MONITORING & EVALUATION

To date, monitoring and evaluation of DBC/BA activities and programmes has not been

consistent. While 70 per cent of respondents indicated that they were currently monitoring

their behaviour change programming activities, only 29 per cent had conducted any

assessments or evaluations of DBC and/or BA activities.

The lack of proper evaluations and assessments leaves the process open to uncertainty

about its benefits. Without proper documentation of evaluation, many will not be persuaded

to use the DBC Framework or see its value.

Recommendations:

Investing in monitoring and evaluation

Ongoing monitoring throughout the implementation activities should not be neglected. As in

any project, it is critical to track the progress of implementation and the initial results, and

to make necessary adjustments. Evaluations are also important for each individual

programme, as well as for the success of the DBC in general. Organisations should be

encouraged to invest the time and energy required for evaluating the effectiveness of their

behaviour change strategy. This should be emphasised during training, and organisations

should plan on allocating sufficient resources for both monitoring and evaluation.

Sharing of monitoring and evaluation outcomes

A step to helping with the evaluation process would be to emphasise a discussion of

monitoring and evaluation during the training. This could be done as part of the training, or

could simply be included in the field guide. Another idea would be to create a space where

organisations can share how they are evaluating the process and what the findings have

been, or to pool resources, in partnership with other DBC implementing organisations and

an academic institution, to conduct a field-evaluation of the effectiveness of the DBC

Framework approach on achieving sustainable behaviour change.

13

OTHER BARRIERS

LANGUAGE BARRIERS

Over 50 per cent of the people interviewed noted the difficulty of translating the BA

questionnaire into local languages. Finding staff that can accurately translate documents from

their original form into the local language is often difficult. Sometimes, things don’t translate

appropriately and important pieces can be lost during this process.

Recommendations:

Working groups

One idea to overcome this challenge is to form a working group to explore the issues and

develop guidelines to mitigate translation challenges. Also, during the training process, trainees should be made aware of these issues so that they can plan for the costs associated

with hiring a local translator. A generic BA questionnaire could be created in the local

language so that the essence of the research questions are standard. Generic questionnaires

already exist in Haitian Creole, DRC Swahili, Hausa and Tetun.

CHALLENGES DEVELOPING EVIDENCE-BASED BEHAVIOUR

CHANGE ACTIVITIES

A common theme from respondents in the online survey, as well as interviewees, was the

difficulty of coming up with appropriate behaviour change activities when applying the DBC

Framework in field projects after training. There was difficulty noted in the matching

activities to the Bridges to Activities, as well as difficulty in being creative when it came to

developing the activities. Developing activities is a critical part of the process and it is vital

that users of the DBC Framework be able to develop and describe appropriate behaviour

change activities.

Recommendations:

Training modifications

The lessons on activities in the current DBC curriculum could be strengthened. Also, the

training schedule could be organised such that the day focused on activities occurs after a

short rest period during training so trainees’ minds are fresh. Finally, it is worthwhile to

explore whether to design a stand-alone course on how to design evidence-based activities.

Team Work

Working with a small group of people to develop these activities (and Bridges to Activities)

is one way to help overcome this problem. It is easier to get creative when there is a safe

space to share ideas and work together to determine the best solutions.

Using the FSN Network Behaviour Bank

One way to help this process is to bolster the use of the FSN Network’s Behaviour Bank.

Twenty-four per cent of respondents were unaware of the bank and another 24 per cent

were aware of it but had never visited it. Only 10 per cent of respondents have ever

14

uploaded their BA’s to the bank. An intentional discussion should be held among

stakeholders, with a potential working group, to explore how to better leverage the

Behaviour Bank as a learning, sharing and collaboration space for DBC and BAs, with

particular focus on activity planning.

Mentors

Having someone experienced in creating and implementing activities mentor a new trainee

would be a good way to help them learn how to develop activities. The DBC trainer’s scope

of work could include additional days post-training to provide remote support to the

trainees to develop BA questionnaire, answer questions, interpret BA results, review

bridges to activities, and the behaviour change activities. This could also be done by hired

behaviour change staff when possible.

SUMMARY OF FINDINGS

This desk review reveals that the DBC Framework has been used and/or is in use by

approximately 25 organisations in 38 countries. Respondents confirm that, in spite of

challenges, the DBC Framework and the accompanying BA survey has the potential to be a

highly effective and impactful method for developing evidence-based behaviour change

activities. Although the review did not set out to compare DBC with other new and

emerging behaviour change approaches (e.g. Communication for Behaviour Impact

(COMBI), Evo-Eco, FOAM & SaniFOAM, IBM-WASH, and RANAS), from the limited

information available on the application of these approaches, it appears that DBC has been

more widely applied.

Figure 3: Survey respondents rank the perceived impact that DBC and/or BA

have had on their organisation's behaviour change programming.

The DBC Framework can be applied in any sector and to a multitude of behaviours.

Furthermore, DBC training materials are freely available in the public domain and there are

qualified and experienced trainers. The possibilities for the use of DBC/BA are expanding

too early

to know

19% no impact

7%

some impact

44%

high impact

30%

Perceived Degree of Impact

15

and people working in various sectors (education, peace building, gender-based violence

reduction, civil society building, and disaster risk reduction) are using the DBC Framework.

As a desk review, there are obvious limitations to this review, and the findings show that

there is a need for further evaluation. The next step in the process would be to follow up

with more definitive evaluation and research, ideally as a field-based research project.

Even though impact evaluations are not consistently conducted on DBC activities, the ones

that have been done provide evidence that determinant-based activities have a positive

impact on target behaviours. With over 70 per cent of users acknowledging at least some

impact, the DBC approach is providing a new way to effect behaviour change. The challenge

is to make sure that people are using the approach correctly to ensure its success. There

are elements of the approach that can be bolstered or added to in order to create more

impact. This includes modification to training materials and activities, and looking more

closely at funding and timing, leadership endorsement, capacity building, and monitoring and

evaluation. For those that choose to use the DBC Framework, and work to apply it in an

effective manner, there is great potential to create long-lasting behavioural change.

16

APPENDIX 1: ONLINE SURVEY QUESTIONS

1. Please provide the following information, as it will help us in analysing how different organisations

have applied DBC, and will provide us with the information we need to follow up with you for a

more in-depth interview, should it be needed. Organisation Name, Your Name, Your Email

2. Has your organisation used the Designing for Behaviour Change (DBC) Framework and/or Barrier

Analysis (BA) for designing any behaviour change strategies? yes no

3. In what countries has your organisation used DBC and/ or BA?

4. In what sector(s) has your organisation used DBC and/or BA?

5. When did your organisation begin applying the DBC and/or BA?

6. Are you still using DBC and/or BA? yes no

7. Have you ever received training in DBC? yes no

8. When and where were you first trained?

9. Who trained you?

10. Did your training focus only on DBC theory, or did you begin to apply the theory to your work?

Theory only Theory and practical application

11. How many days did your training last?

12. How many others from your organisation received this training (either at the same time as you

or separately)?

13. Did you have any later follow-up training? yes no If yes, indicate the nature of the follow-up

training

14. Please rank your knowledge, skills and experience of DBC

None Little Some Full (able to supervise, train and mentor others)

15. Have you trained others in the DBC Framework? yes no if yes, who have you train and what

materials did you use?

16. Have you ever received training in Barrier Analysis (either along with your DBC training or at

separate time)? yes no

17. When and where were you first trained?

18. Who trained you?

19. Did your training focus only on DBC theory, or did you begin to apply the theory to your work?

Theory only Theory and practical application

20. How many days was your first training?

17

21. How many others from your organisation received this training (either at the same time as you

or separately)?

22. Did you have any later follow-up training? yes no If yes, indicate the nature of the follow-up

training

23. Please rank your knowledge, skills and experience of BA

None Little Some Full (able to supervise, train and mentor others)

24. Have you trained others in BA? yes no if yes, who did you train and what materials did you

use?

25. For how many different behaviours has your organisation used DBC and/or BA to design

behaviour change strategies?

None Few 1-3 Many 3 or more

26. Have you ever visited the Food Security and Nutrition (FSN) Network Behaviour Bank? (The

website where people post the results of their BA studies)

Yes, I have visited it

Yes, and I have entered my organisation's BA results in the Behaviour Bank

NoI'm not aware of the Behaviour Bank.

27. Please can you provide a list of behaviours studied, including the location and date of completion

of the DBC Framework and BA survey?

28. Rank the impact that DBC and/or BA have had on your organisation's behaviour change strategy.

Too early to know Negative Impact No Impact Some Impact High Impact

Can you describe this impact?

29. What recommendations would you make to strengthen DBC and/or BA?

30. Are you currently monitoring your behaviour change programming activities? yes no If yes,

what monitoring tools do you use?

31. Have you conducted any assessments or evaluations of DBC and/or BA activities? yes no If

yes, when and what kind of evaluation?

32. Were there any challenges applying DBC and/or BA? yes no If yes, please explain the

challenges and how they were resolved?

18

APPENDIX 2: TERMS OF REFERENCE

Desk review of experience with the application of the Designing for Behaviour Change Framework

Description of assignment

An estimated 20 to 30 development organisations are thought to be using the Designing for

Behaviour Change (DBC) Framework to develop behaviour change strategies for targeted

behaviours in sectors such as food security, livelihoods, health, nutrition, education and water,

sanitation and hygiene (WASH). The formative research stage in the DBC process typically uses the

Barrier Analysis (BA) Survey to discover the significant determinants for behavioural change.

In 2013, with help from Bonnie Kittle (DBC Master Trainer and co-author of the DBC and BA

training curriculum), World Vision started training WASH staff from 17 African countries on DBC

and BA. To date World Vision has completed about 30 DBCs with another 20 or so planned or in

progress. GOAL International has made similar progress with DBC for WASH and other sectors. If

other organisations have made this kind of progress there could be a few hundred completed BA

surveys and DBC Frameworks to date.

The Food Security & Nutrition Network has a Behaviour Bank where DBC/BA practitioners can

post their completed BA and Doer/Non-Doer survey results. As of 27 April 2015, there were 68

entries from 8 organisations and 11 countries, covering 35 behaviours. Behaviours that had multiple

BAs were hand washing, exclusive breast feeding, complementary feeding, antenatal care visits, and

safe storage of drinking water. For hand washing (probably the most studied of WASH-related

behaviours), World Vision has found at least 25 BAs - about half of these not yet posted in the

Behaviour Bank (including those from World Vision).

While continuing to apply DBC for developing behaviour change strategies, World Vision and

several other organisations believe that now is a good time to take stock of experience from the

application of DBC and BA by practitioners around the world. This desk-based review will support

the documentation of existing DBCs strategies and BAs and help us understand how organisations

are equipped, utilising, monitoring and evaluating their current DBC activities.

Goal and objectives

Goal: Assure the quality of DBC and BA processes and strengthen it into the future.

Objectives:

1) Assess current capacity and application of DBC and BA across multiple organisations

2) Collect and compile by country and subject, completed DBC Frameworks, BA

questionnaires and data tabulation spread sheets

3) For the completed DBC Frameworks and BA surveys, identify for the significant

determinants which responses and bridges to activities are the same

4) Identify how organisations are monitoring and evaluating the effectiveness of behaviour

change activities developed with the aid of the DBC Framework

5) Develop recommendations to strengthen DBC and BA moving forward

Roles and responsibilities

Shannon Gibbs, MPH GDM (expected May 2016), University of South Florida: Fulfil duties

per ToR

World Vision International:

19

Overall coordination

Managerial supervision and mentorship

Provision of materials and contacts for review and interview

Review, input and sign-off on final report

Partner organisation: GOAL International -- Provision of materials and contacts for review and

interview, input into review progress, and input into final report

Stakeholders

Bonnie Kittle, Independent DBC consultant

Cathy Stephen, WASH Adviser, Plan UK

Emily Bostick, East Africa Regional Technical Adviser for Health, Catholic Relief Services

Etsegenet Hailu, Health and Nutrition Programme Director, Food for the Hungry, Ethiopia

Franck Flachenberg, Environmental Health Technical Adviser, Concern Worldwide

Gillian McKay, Global Behaviour Change Adviser, GOAL International

John Collett, Senior Adviser, Hygiene Promotion & Behaviour Change, World Vision

International

Mary DeCoster, TOPS Senior Specialist for Social & Behavioural Change Programmes, Food

for the Hungry

Action plan

Conduct desk review of journals and publications for existing research on WASH-related

behaviours using BA

Contact and interview all organisations known to be or thought to be using DBC and BA in

their behaviour change programming to know what they’ve done, what’s worked well (good

practices), lessons learned (recommendations about any changes they made), and what

difference DBC has made to their programme outcomes. An interview guide/ prompt will be

developed beforehand for review and approval (letter of introduction to be provided)

Compile the following for collections of DBC Frameworks and BA surveys on the same or

similar behaviour

o BA survey questionnaires (with date and location where BA was carried out)

o For significant determinants record the percentage points difference between Doers

and Non-Doers for each significant response

o Bridges to Activities for similar significant responses

o Activities for similar Bridges to Activities

o Significant influencing groups

o Behaviour change monitoring and evaluation results

Liaise with the FSN Network Behaviour Bank to enter BA and Doer/Non-Doer survey

results that have not been included in the Bank

Produce a final report covering background, methodology, findings, conclusions and

recommendations (detailed outline to be provided)

Prepare a presentation for sharing the findings of the review with interested parties

Expected deliverables

Summary of key findings from desk review

Collection of significant determinants, significant responses, bridges to activities, activities

and significant influencing groups for common behaviours

Collection of DBC/BA good practices and lessons learned

Collection of DBC/BA monitoring tools and evaluations

Final report covering background, methodology, findings, conclusions and recommendations

20

Presentation

Timeline

Start date: 1 August 2015

End date: 10 December 2015

August September October November December

1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

Project orientation and

work plan detail

development

X X X

Literature review X X X X

Schedule interviews X X X

Conduct interviews X X X X

Interview analysis X X X X

Report writing X X X

Report review X X

Final revisions, review

and presentation X

X

21

FOR FURTHER INFORMATION, PLEASE CONTACT:

WVI Offices WVI Regional Offices

World Vision International

Executive Office

Waterview House

1 Roundwood Avenue Stockley Park

Uxbridge, Middlesex UB11 1FG, UK

World Vision Brussels & EU

Representation ivzw

18, Square de Meeûs

1st floor, Box 2

B- 1050 Brussels, Belgium

+32.2.230.1621

World Vision International

Liaison Office

7-9 Chemin de Balexert

Case Postale 545

CH-1219 Châtelaine

Switzerland

+41.22.798.4183

World Vision International

United Nations Liaison Office

919, 2nd Avenue, 2nd Floor

New York, NY 10017, USA

+1.212.355.1779

East Africa Office

Karen Road, Off Ngong Road

P.O. Box 133 - 00502 Karen

Nairobi, Kenya

Southern Africa Office

P.O. Box 5903

Weltevredenpark, 1715

South Africa

West Africa Office

Hann Maristes

Scat Urbam n° R21

BP: 25857 - Dakar Fann

Dakar, Senegal

East Asia Office

Bangkok Business Centre

13th Floor, 29 Sukhumvit 63 (Soi Ekamai)

Klongton Nua, Wattana, Bangkok 10110

Thailand

South Asia & Pacific Office

750B Chai Chee Road #03-02

Technopark @ Chai Chee

Singapore 469002

Latin America and Caribbean Regional Office

P.O. Box:133-2300

Edificio Torres Del Campo, Torre 1, piso 1

Frente al Centro Comercial El Pueblo

Barrio Tournón

San José, Costa Rica

Middle East and Eastern Europe Regional Office

P.O Box 28979

2084 Nicosia, Cyprus

© World Vision International 2016

World Vision is a Christian relief, development and advocacy organisation dedicated to working with children,

families and communities to overcome poverty and injustice. Inspired by our Christian values, World Vision is

dedicated to working with the world's most vulnerable people. World Vision serves all people regardless of

religion, race, ethnicity or gender.