Introduction to Theories of Communication Effects: Ideation and

1. Introduction to Theories of Communication Effects: Ideation and Communication for Social Change (CFSC) A service of the Communication Science & Research Resource Group

2. IDEATION AND INDIVIDUAL BEHAVIOR CHANGE D. Lawrence Kincaid and Maria Elena Figueroa JHU/HCP/CCP/BSPH HCP Seminar, April 23, 2004

3. Strategic Communication • . . . is based on a combination of facts, ideas, and theories integrated by a visionary design to achieve verifiable objectives by affecting the most likely sources and barriers to behavioral change with the active participation of stakeholders and beneficiaries.

4. Factors Influencing Behavior • 1991: Seminar: Fishbein, Bandura, Triandis, Kanfer, Becker, Middlestadt • LIST OF FACTORS, NO MODEL 1. Intentions to perform the behavior 2. Environmental contraints preventing the behavior 3. Skills necessary to perform the behavior 4. Behavioral beliefs and perceived consequences (attitudes) 5. Perceived normative pressure 6. Self-image: self-standards and sanctions 7. Emotional reactions 8. Self-efficacy (perceived capability and confidence) NO CONSENSUS REGARDING A CAUSAL MODEL LINKING THESE FACTORS TO BEHAVIOR

5. STRATEGIC COMMUNICATION PROGRAMS AFFECT MANY INTERMEDIATE FACTORS WHICH INFLUENCE BEHAVIOR.

6. Ideation . . . refers to new ways of thinking and the diffusion of those ways of thinking by means of social interaction in local, culturally homogeneous communities. Source: DEMOGRAPHY Cleland & Wilson, 1987

7. How is ideation related to communication and behavior change? • The likelihood of someone adopting and sustaining a new behavior is much higher when she or he: • has gained sufficient knowledge about it, • has developed a positive attitude towards it, • hastalked to others about it, and • feels good about doing it.

8. J J OHNS HOPKINS OHNS HOPKINS A predictive model of communication & change: Influence of ideational elements on behavior Implies simultaneous effect of all influences. Knowledge Personal Advocacy Attitudes Social Support & Influence Self-Image BEHAVIOR Perceived Risk Emotions Self-Efficacy Implies communication can effect all influences. Norms U N I V E R S I T Y Center for Communication Programs

9. Attitudes SKILLS & KNOWLEDGE reinforcement IDEATION COGNITIVE Beliefs Values Perceived Risk Subjective Norms Self-Image EMOTIONAL Emotional Response Empathy Self-Efficacy SOCIAL Support & Influence Personal Advocacy INTENTION confirmation BEHAVIOR enabling ENVIRONMENTAL SUPPORTS & CONSTRAINTS A HEURISTIC MODEL OF COMMUNICATION AND HEALTH BEHAVIOR C O M M UNICATION INSTRUCTION DIRECTIVE Dissemination Promotion Prescription NONDIRECTIVE Dialogue Counseling Entertainment Social Networks PUBLIC Advocacy Regulation Source: Adapted from Kincaid (2000)

10. MODES OF COMMUNICATION FOR BEHAVIORAL CHANGE INSTRUCTION DIRECTIVE Dissemination Promotion Prescription NONDIRECTIVE Dialogue Counseling Entertainment Social Networks PUBLIC Advocacy Regulation

11. Ideational Elements Related to Condom Use in Tanzania 2003 • 1. Knowledge of condom brands • 2. Perceived efficacy of condoms for AIDS • prevention • 3. Social approval for condom use • 4. Discussion of condom use with others • 5. Condom use self-efficacy • 6. Social influence to use condoms • 7. Personal condom use advocacy • 8. Impulsivity • 9. Motivation for sex • 10. Perceived norm of condom use.

12. Cumulative increase in condom use among male and female adolescents by level of ideationTanzania, 2003 Percent Ideation Quintile

13. 0.12 AIDS Prevention Campaign Recall Condom Use N.S. AIDS Prevention Campaign Recall Condom Use 0.33 0.46 IDEATION Direct and Indirect Effects of Communication on Condom Use in Tanzania 2003

14. Ideational Elements Related to Condom Use in Zambia • 1. Knows where to purchase condoms • 2. Knows at least three ways to protect self • from HIV/AIDS • 3. Has positive attitude towards people who • use condoms • 4. Has talked with at least three people about • safe sex • 5. Has an above-average sense of confidence • regarding ability to use condoms even • when facing opposition from partner (13-19 year-old males)

15. Cumulative increase in condom use among male adolescents in Zambia by the number of ideational elements that apply Percent Number of Elements

16. Ideational elements related to contraceptive use among women in Tanzania 1. No. of modern FP methods known 2. Respondent’s approval of FP 3. Discussion of FP with husband 4. Husband’s approval of FP practice 5. Talks about FP with friends 6. Advocates FP to others Note: 1996 DHS, Women ages 15-49

17. Cumulative increase in contraceptive use by the number of ideational elements that apply to married women in Tanzania 54.5 43.9 33.0 13.7 7.6 4.2 1.1 6 N = 5,401married women Chi2; p<.001

18. CUMULATIVE RISK ANALYSIS These elements affect behavior in much the same way that risk factors affect the probability of getting a disease: The greater the number of factors that apply to an individual, the greater the likelihood that he/she will get the disease.

19. Each one of these influences is strongly related to adoption and continuation of modern contraceptive use. When they are summed into a combined index, they are highly predictive of contraceptive behavior.

20. CONCLUSION The more ideational elements that apply to someone, the greater the probability that they will adopt a health behavior. In Tanzania, from only 0.5% modern method use for women with no ideational elements to 46.1% for women with all six.

21. Communication for Social Change

22. Development Communication • What is the role of communication in national development? • Two competing paradigms: • Information transfer (one-way/vertical) process (from experts/north to unskillful/south) • Participatory (horizontal) communication (emphasis in dialogue) among community members • New theoretical approaches, participatory communication and communicative • action

23. First decade of development (1960’s) Modernization theory the dominant paradigm. • Urbanization and • industrialization  economic growth. • Focus on capital-intensive technology,  undermining of agriculture. • Focus on individual; traditional attitudes and behavior constrain development. • Literacy and mass media to help masses break free of traditional views.

24. First decade of development (1960’s) The Bullet Theory of Communication. • The Diffusion of Innovations • sets the stage (Rogers, 1962) • Persuasive messages will have direct and uniform impact on people, … and will produce a climate of acceptance of the innovation • Mass media seen as “magic” multipliers • of development benefits

25. Second decade of development (1970’s) Post-Modernism, Dependency theory (LA scholars) • Modernization increased • concentration of income and power • Shift from individual to social and structural barriers to change • Emphasis on active participation, self-determination, self-reliance, sustainability • The Pedagogy of the Oppressed sees the light (Freire, 1970)

26. Second decade of development (1970’s) Criticisms to DOI • Pro-innovation • Pro-persuasion • Top-down flow • of messages • and decisions • Issues of • access, content and code

27. Second decade of development (1970’s) Alternative roles of communication for development • Dialogue, the correct method; … working with rather than for the people, concept of concientizaçao (Freire) • Communication as support for development • Local media for enhancing dialogue and action; folk media • People-initiated (rather than expert-initiated) activity at the local level

28. Development with a human face The 1980’s+ Another Development Economic  Social • Emphasis on non-material • indicators of development (access to health care, nutrition, sanitation) • Shift from industrialization to human action within sociocultural, political and economic contexts • Focus on participatory decision-making • Attention to gender and gender gaps

29. Development with a human face The 1980’s+ Communication for the participative society • Some new functions for this role (Bordenave 1989) • Help in the development of a community’s cultural identity • Act as vehicle for citizen self-expression • Facilitate problem articulation • Serve as tools for diagnosis of community’s problems • Issue of alternative media vis a vis centralized/ mainstream media

30. Into the 90’s (20+ years later) • Participatory communication critical for development • Vertical communication acceptable/ desirable in specific contexts • Community participation, a process with intrinsic value • Efforts to better study and measure community participation, competence, • leadership,...

31. Re-examining the role of communication in development • Rockefeller Foundation meetings (1997, 1998, 2000) explored new communication strategies for social change • Group defined CFCS as “a process of public and private dialogue through which people define who they are, what they want and how they can get it.”

32. Re-examining the role of communication in development Premises of CFSC Conferences, RF: • Sustainability; owners of process and content of communication • CFSC empowering, horizontal • Communities as agents of their change • From persuasion to dialogue and debate • Shift in outcomes; social norms, • culture, supportive environment

33. Revised Model of the Convergence Model with Emotional Response PSYCHOLOGICAL REALITY A PHYSICAL REALITY PSYCHOLOGICAL REALITY B INFORMATION Interpreting Perceiving Perceiving Interpreting Feelings Feelings Action Action Emotional Response Emotional Response Collective Action Understanding Believing Believing Understanding Mutual Agreement MUTUAL UNDERSTANDING SOCIAL REALITY and RELATIONSHIP A & B

34. Effective dialogue • Effective dialogue (Rapoport, 1967) occurs when: • Participants listen to one another (paraphrasing to the other’s satisfaction) • Each acknowledges the conditions to accept the other’s argument as valid • Each acknowledges the similarity of both points of view • Dialogue can lead to disagreement when each person’s interests and values are in • conflict

35. Supportive theories and models Social systems (1990) Group Dynamics (1968, 1996) Conflict Resolution (1988, 1999) Leadership (1998) Quality Improvement (1992, 1986) Future search (1992, 1995)

36. Integrated Model of CFCS Catalyst External Constraints and Support Community Dialogue Collective Action Individual Outcomes Social Outcomes Societal Impact Figueroa & Kincaid, 2/2001

37. CFSC Model Not a model for Social Change Social change: the transformation of the overall structure represented by the change in the distribution of resources (educational, economic, power, discursive)

38. CFSC Model • Participatory processes as the one described in the model can be conducive to SC by: enabling people to critically decide where they want to go and how increasing community organization for collective action

39. Catalyst Internal Stimulus Change Agent Policies Technology Innovation Mass Media

40. Integrated Model of CFSC Community Dialogue Recognition of a Problem Identification & Involvement of Leaders & Stakeholders Expression of Individual & Shared Interests Vision of the Future Clarification of Perceptions Conflict-Dissatisfaction Disagreement External Constraints and Supports Value for Continual Improvement Consensus on Action Options for Action Setting Objectives Assessment of Current Status Action Plan Collective Action Assignment of Responsibilities Mobilization of Organizations Participatory Evaluation Implementation Outcomes • Individuals • Existing Community • Groups • New Community • Task Forces • Others • Media • Health • Education • Religious • Other • Outcomes vs. • Objectives

41. Social Outcomes • Leadership • Degree & Equity of Participation • Shared Information • Collective Self-Efficacy • Sense of Ownership • Social Cohesion • Social Norms

42. Individual Change • Skills • Ideation • Knowledge, Attitudes, Perceived • Risk, Subjective Norms, Self-Image, • Emotion, Self-Efficacy, Social • Influence, & Personal Advocacy • Intention • Behavior

43. Interaction of Individual and Social Outcomes on Health Individual Health Behavior Change NO YES Limited Health Improvement Maintenance of the status quo NO Collective Change Increased potential for health improvement Self-sustained health improvement YES

44. “Those who authentically commit themselves to the people must re-examine themselves constantly.” “… they almost always bring with them the marks of their origin: their prejudices and their deformations, which include a lack of confidence in the people’s ability to think, to want and to know.” Paulo Freire, 1970

45. Looking ahead Next Week: Communication and Affect Fear Management