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Developing strategies for behavioral change communication – Looking beyond lockdown

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Amidst the Coronavirus (COVID-19) pandemic some major changes are witnessed in the climate of the country– not just environmental but also economic. At the moment, foremost transformation is needed in society’s health behavior. The pandemic is increasing the burden on our health infrastructure and while the government and other organizations have been continuously working towards containing the impact of COVID-19, a critical element for decreasing its transmission in the absence of vaccination and treatment is extensive and rapid behavior change. Washing and sanitizing hands, maintaining social distance, covering mouth while sneezing and coughing are proving to be the major steps in preventing the spread of disease. Thus, we can say that it is not the biological characteristics of the virus that are the most dangerous for the humankind, but the perilous effect of the virus’s dependency on how people either accelerate or decelerate its spread.

Massive crowding of migrant workers at Anand Vihar ISBT in Delhi and Bandra in Mumbai, a religious gathering at Markaz, people concealing their travel histories and misbehaving with health workers, frontline workers and police officials only goes to show how important it is to use social and behavioral science to formulate behavior change communication and strategies supporting COVID-19 response. A study by ‘The Lancet’ on monitoring behavioral insights related to COVID-19 states that a perceived lack of consistency, fairness, objectivity, empathy, or sincerity in crisis response in the public could lead to distrust and fear among the community. Easy to understand measures, which include all the aforesaid components and their communication through trusted mediums along with provisioning for necessary services are perceived well by the community at large. Such measures will lead to informed choices and help develop an understanding of the same. Models of crisis and risk communication can be used to comprehend the risk perceptions for further planning and strategizing effective crisis response.

The Government of India has effectively used digital and social media platforms, television, radio, creative mediums such as caller tunes, songs, dance, and webinars to disseminate information, maintain the consistency of the messages while also addressing mental health during the times of COVID-19. Even after all these efforts, there is a need to produce the right messaging around COVID-19, more so because the level of risks varies from person to person, thereby, requiring effective communication strategies.

Witnessing the recent incidents in light of the current scenario, India needs to create a knowledge base about what drives behavior and the role of communication in mitigating the crisis. Stigmatization, misinformation on social media, herd behavior (people stocking food items, medicines, and even toilet papers), public perception of risk, protective and preparedness behaviors are challenges for public health communication which needs to be monitored. Although, public health crisis from previous pandemics, such as Ebola and Influenza, have helped us to get an insight into social behavior and public psychology, yet a lot has changed over time. When dealing with pandemics involving viruses, the ways in which information is gathered, and the outreach activities undertaken hold the utmost importance. National teams can work on cross-sectional studies that allow them to monitor the variables over time, assess the relationship (if any) between them, and gain an insight into the implications of interventions. These insights can be used by journalists to support media reporting while identifying their audience behavior and to develop a narrative for information sharing leading to positive behavioral changes.

Secondly, risk communication and community engagement focussed on changing community perceptions are important making presentation of the messages, related to the pandemic, an imperative aspect of the communication plan. Various evolution theories have suggested that compassion enables people to feel superior to other animals and supports group cohesion. Thus, compassion as a tool for societal bonding and duty of care spirit needs to be inculcated so that negative response to COVID-19 curative/preventive measures can be mitigated. As a result, this will help in developing an understanding among people with travel histories to self-isolate themselves without risking healthcare workers and people around them.

Thirdly, to establish authority and trust with the community it is important to reach out to as many people as possible on a regular basis. A participatory and community-based approach in preparing community action plans and communication strategies is essential. Efforts for information dissemination strategies by District Administration from different parts of the country should be appreciated. Whether it is “Break the Chain” campaign by Government of Kerala, a police officer talking about Coronavirus using a PA system and riding a horse covered in coronavirus themed painting in Andhra Pradesh or officers accompanied by men dressed in costumes of Hindu Mythological character ‘Yama’ to spread awareness among people about the consequence of violating police instruction in Telengana. Uniformed cops danced to teach hand washing steps in Punjab while in Kolkata and Pune they sang popular songs to cheer fellow citizens. These strategies have been effective in keeping people inside their homes during the lockdown. These responsive, transparent, and consistent messaging in local languages using community-based networks, involving key influencers and dissemination of information through local entities have a major role to play. Looking beyond the future of lockdown, there is a need for a long term communication strategy, as the world after post-COVID-19 will change. Preventive measures taken during COVID-19 will become the new normal.

Lastly, the use of the Health Belief Model, originally developed in the 1950s, in the country’s risk communication plan needs to be explored. It is one such model of social behavior based on a person’s readiness to change their own behavior. It states that behavior change is dependent upon perceived susceptibility (changing behavior unless they are at risk), perceived severity (change in behavior depends on the consequence), perceived benefits (getting benefits from the change in behavior) and perceived barriers (they perceive it to be hard to do change the behavior which has been adapted over time). It recognizes that huge efforts are needed to make people actually change their behavior, incorporating two more elements in the model i.e. cues to action and self-efficacy. External events that help in encouraging the desire to make a health change comes under the cues of action while self-efficacy is dependent on one’s belief to make health-related change.

Prime Minister of India, himself addressing the public at large and daily briefing by the Ministry of Health and Family Welfare about COVID-19 showcase that the Government of India is constantly trying to disseminate the correct information to decrease fear and distrust among citizens. This is the right time to develop, improve, and implement community-centered communication strategies for developing an informed and supportive community that owns the responsibility of its actions and leaves no one behind to make India COVID-19 free.

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Aishwarya Choubey is a young professional, NITI Aayog.

Disclaimer:  Views expressed are personal.

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