Introduction to

Theories of Communication Effects:

Ideation and
Communication for Social Change (CFSC)

A service of the
Communication Science & Research
Resource Group
 IDEATION
AND
INDIVIDUAL
BEHAVIOR CHANGE
D. Lawrence Kincaid and Maria Elena Figueroa
JHU/HCP/CCP/BSPH
HCP Seminar, April 23, 2004
 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.
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
 STRATEGIC
COMMUNICATION
PROGRAMS AFFECT MANY
INTERMEDIATE FACTORS
WHICH INFLUENCE
BEHAVIOR.
 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
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,
• has talked to others about it, and
• feels good about doing it.
 A predictive model of communication & change:
Influence of ideational elements on behavior
Implies
Knowledge simultaneous
Personal effect of all
Advocacy Attitudes
influences.

Social Self-
Support & Image
Influence BEHAVIOR

Emotions Perceived
Risk

Self-
Norms Implies
Efficacy
communication
can effect all
JOHNS HOPKINS
U N I V E R S I T

Center for Communication Programs

Y
influences.
A HEURISTIC MODEL OF COMMUNICATION AND HEALTH BEHAVIOR

C INSTRUCTION SKILLS & KNOWLEDGE

O
M IDEATION
COGNITIVE
M DIRECTIVE
Dissemination Beliefs
Promotion Attitudes
U Prescription
Values
Perceived Risk
N Subjective Norms INTENTION
Self-Image
I EMOTIONAL
Emotional Response
confirmation
C NONDIRECTIVE
Dialogue
Empathy BEHAVIOR
Counseling Self-Efficacy
A Entertainment SOCIAL
Social Networks Support & Influence
T Personal Advocacy
I
O PUBLIC
ENVIRONMENTAL
Advocacy
N Regulation SUPPORTS & CONSTRAINTS
Source:
Adapted from
Kincaid (2000)
MODES OF COMMUNICATION
FOR BEHAVIORAL CHANGE

INSTRUCTION

DIRECTIVE NONDIRECTIVE
Dissemination Dialogue
Promotion Counseling
Prescription Entertainment
Social Networks

PUBLIC
Advocacy
Regulation
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.
Cumulative increase in condom use among
male and female adolescents by level of
ideation
Tanzania, 2003
80 Percent

58
60

39
40
28

20 16
5
0
One Two Three Four Five
Ideation Quintile
Direct and Indirect Effects of Communication
on Condom Use in Tanzania 2003

0.12
AIDS Prevention Condom
Campaign Recall Use

N.S.
AIDS Prevention Condom
Campaign Recall Use

0.33 0.46

IDEATION
 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)
 Cumulative increase in condom use
among male adolescents in Zambia by the
number of ideational elements that apply
80 Percent

60
60

43
40
28
22
20
8

0
One Two Three Four Five
Number of Elements
 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
Cumulative increase in contraceptive use by
the number of ideational elements that apply
to married women in Tanzania
60 Percent Traditional Modern 54.5

50 43.9

40 33.0
30
20 13.7
7.6
10 4.2
1.1
0
0 1 2 3 4 5
6
Modern 0.5 1.2 3.2 8.3 26.2 35 46.1
Traditional 0.6 3 4.4 5.4 6.8 8.9 8.4

N = 5,401married women
Chi2; p<.001
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.
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.
 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.
Communication
for Social
Change
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
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.
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
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)
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
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
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
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
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,...
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.”
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
 Revised Model of the Convergence Model
with Emotional Response
PSYCHOLOGICAL PHYSICAL PSYCHOLOGICAL
REALITY REALITY REALITY
A B

Interpreting Perceiving INFORMATION Perceiving Interpreting

Feelings Feelings

Action Action

Emotional Collective Emotional

Response Response
Action

Understanding Believing Believing Understanding

Mutual
Agreement

MUTUAL
UNDERSTANDING

SOCIAL REALITY
and RELATIONSHIP
A&B
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
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)
 Integrated Model of CFCS
Catalyst

Community Dialogue External

Constraints
Collective Action and
Support

Individual Social
Outcomes Outcomes

Societal Impact
Figueroa & Kincaid, 2/2001
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)
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
 Catalyst
Internal Change
Stimulus Agent

Policies Technology

Innovation Mass Media

 Integrated Model of CFSC
Community Dialogue

External Constraints and Supports

Recognition of Identification &
a Problem Involvement of Clarification Expression of Vision of
Leaders & of Individual & the Future
Stakeholders Perceptions Shared Interests

Value for Continual Improvement

Conflict-Dissatisfaction
Disagreement

Consensus Options for Setting Assessment of

Action Plan
on Action Action Objectives Current Status

Collective Action
Assignment of Mobilization of
Responsibilities Organizations Implementation Outcomes Participatory
Evaluation
• Individuals
• Existing Community • Media • Outcomes vs.
Groups • Health Objectives
• New Community • Education
Task Forces • Religious
• Others • Other
 Social Outcomes
• Leadership
• Degree & Equity of Participation
• Shared Information
• Collective Self-Efficacy
• Sense of Ownership
• Social Cohesion
• Social Norms
 Individual Change
• Skills
• Ideation
Knowledge, Attitudes, Perceived
Risk, Subjective Norms, Self-Image,
Emotion, Self-Efficacy, Social
Influence, & Personal Advocacy
• Intention
• Behavior
 Interaction of Individual and Social
Outcomes on Health
Individual Health Behavior Change
NO YES

Maintenance Limited
NO of the status Health
quo Improvement
Collective
Change
Increased Self-sustained
potential for health
YES health improvement
improvement
“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

Looking ahead

Next Week:

Communication and Affect

Fear Management