Behavior Change and Communication

Key to Improving Public Health Programs

Published in English and Swahili for use in Tanzania, health workers can use these counseling cards to explain the risk of transmission of HIV from mother-to-child when no preventive actions are taken as well as infant feeding options for HIV-positive mothers.

Achieving sustainable shifts in the key behaviors of target groups requires gaining an understanding of what drives them: designing innovative, integrated, and multidimensional interventions and incorporating continuous monitoring and evaluation. To ensure messages and materials are effective, URC studies the needs and perceptions of the target audiences to develop effective communication messages. For example, developing counseling materials and job aids grounded in behavior change communications methodology contributes to improving the quality of health services. Supporting community mobilization activities with radio spots and local theater troupe performances fosters community-level participation and enables information dissemination.

Job aids—from checklists to algorithms—are widely used in health care in high-income countries. Over the past decade, URC has introduced a variety of these evidence-based tools to help health workers or caregivers in low- and middle-income countries perform health tasks and behaviors better.

Although job aids are not always the solution to performance problems, they can address lack of information or skills, reduce training time, reduce errors and uncertainty, reduce variability in performance, and often allow task shifting to lower-cadre workers without significantly reducing quality of performance.
URC draws on multiple sources of evidence to develop and test job aids: formative research using qualitative techniques such as focus groups, key informant interviewing, and pretesting; and experimental and quasi-experimental studies or pre-post research designs to measure the effectiveness of the job aid(s) as they are used over time. Throughout the testing process, job aids are revised as needed to improve them.

Communicating to Prevent and Reduce Underage Drinking in the United States

URC created the Too Smart To Start Ready, Set, Listen! game for SAMHSA’s Underage Drinking Prevention Initiative.

Together with ICF Macro, URC is supporting the US Department of Health and Human Services' Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Prevention in a project designed to prevent underage drinking. We are conducting state-of-the-art health communications research and implementation of outreach activities, conducting Town Hall meetings, developing culturally relevant publications, maintaining websites and online communications materials. Our work has received several Hermes Creative Awards from the Association of Marketing and Communication Professionals.

For more information, visit Underage Drinking Prevention Education Initiatives.

Current Projects

HIV and AIDS Comprehensive Care Initiative (HACCI)
Funded By: US Centers for Disease Control and Prevention through the President's Emergency Plan for AIDS Relief
Project Duration: 2008 to present

Building Human Resource Capacity to Support Prevention, Care, and Treatment: Strategic Information and Other HIV/AIDS Programs
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2008 to present

Essential Obstetric and Newborn Care (EONC) in Cotopaxi, Ecuador
Funded By: US Agency for International Development
Project Duration: 2009 to present

Health Promotion and Communication Project (HealthPro)
Funded By: US Agency for International Development
Project Duration: 2007 to present

South Africa Tuberculosis Program
Funded By: US Agency for International Development
Project Duration: 2009 to present

Increasing Access to HIV Testing and Counseling (HTC)
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2006 to present

Benin Integrated Family Health Project (Projet Intégré de Santé Familiale, PISAF)
Funded By: US Agency for International Development and the President’s Malaria Initiative through USAID for malaria activities
Project Duration: 2006 to present

Maternal and Newborn Health in Ethiopia Partnership (MaNHEP)
Funded By: Subaward from Emory University with funding from the Bill & Melinda Gates Foundation
Project Duration: 2009 to present

Promoting Malaria Prevention and Treatment (ProMPT)
Funded By: US Agency for International Development through the President’s Malaria Initiative
Project Duration: 2009 to present

Technical Assistance and Support Contract 3: Global Health (TASC3 Global Health)
Funded By: United States Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Afghanistan
Funded By: US Agency for International Development
Project Duration: 2008 to present

USAID Health Care Improvement Project (HCI) | Ethiopia
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Guatemala
Funded By: US Agency for International Development
Project Duration: 2008 to present

USAID Health Care Improvement Project (HCI) | Global
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Mali
Funded By: US Agency for International Development
Project Duration: 2009 to present

USAID Health Care Improvement Project (HCI) | Namibia
Funded By: US Agency for International Development
Project Duration: 2008 to present

USAID Health Care Improvement Project (HCI) | Nicaragua
Funded By: United States Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Tanzania
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Uganda
Funded By: US Agency for International Development
Project Duration: 2007 to present

Underage Drinking Prevention Education Initiatives (UADPEI)
Funded By: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention
Project Duration: 2009 to present

Integrated Infectious Disease Capacity Building Evaluation (IDCAP)
Funded By: Accordia Global Health Foundation
Project Duration: 2008-present

Multi-Sector Alliance Program (Alianzas II)
Funded By: US Agency for International Development through Research Triangle International
Project Duration: 2010 to present

PrevenSIDA
Funded By: United States Agency for International Development
Project Duration: 2010-present

TB CARE II
Funded By: United States Agency for International Development (USAID)
Project Duration: 2010 to present

USAID Primary Health Care Project in Iraq (PHCPI)
Funded By: US Agency for International Development
Project Duration: 2011-2015

Partnership for the Community Management of Child Health (Prise-C)
Funded By: U.S. Agency for International Development (USAID)
Project Duration: 2010 to present

Diagnosis and Management of Severe Febrile Illness: Tibu Homa
Funded By: US Agency for International Development
Project Duration: 2011 to present

Control and Prevention of Malaria (CAP-Malaria) Project
Funded By: US Agency for International Development Regional Development Mission for Asia (USAID RDMA)
Project Duration: 2011 to present

Georgia Tuberculosis Prevention Project (TPP)
Funded By: US Agency for International Development (USAID)
Project Duration: 2011 to present

Past Projects

Malaria Control in Cambodia (MCC) Project
Funded By: US Agency for International Development
Project Duration: 2007-2011

Infant and Young Child Nutrition (IYCN)
Funded By: US Agency for International Development
Project Duration: 2006-2011

Food and Nutrition Interventions (NuLife)
Funded By: US Agency for International Development through the President’s Emergency Plan for AIDS Relief
Project Duration: 2008-2011

Nongovernmental Organization Service Delivery Program in Bangladesh
Funded By: US Agency for International Development/Bangladesh
Project Duration: 2002-2006

Benin Integrated Family Health Project (PROSAF)
Funded By: US Agency for International Development/Benin
Project Duration: 1999-2006

El Salvador Strengthening Health Project Technical Assistance and Support Contract 2 (TASC2)
Funded By: US Agency for International Development
Project Duration: 2006–2009

Eritrea Technical Assistance and Support Contract 2 (TASC2)
Funded By: US Agency for International Development/Eritrea
Project Duration: 2003–2006

Partnerships for Health Reform Project and Partners for Health Reformplus
Funded By: US Agency for International Development
Project Duration: 1995–2005

Primary Health Care Operations Research Project (PRICOR) I and II
Funded By: US Agency for International Development
Project Duration: 1981–1991

Technical Information on Population for the Private Sector
Funded By: US Agency for International Development
Project Duration: 1985-1990

Water and Sanitation for Health
Funded By: US Agency for International Development
Project Duration: 1988–1994

Quality in Health (Calidad en Salud)
Funded By: US Agency for International Development
Project Duration: 1999-2009

Haiti Voluntary Agencies for Child Survival Project
Funded By: US Agency for International Development
Project Duration: 1989-1995

Jamaica Adolescent Healthy Lifestyles (JA-STYLE)
Funded By: US Agency for International Development/Jamaica
Project Duration: 2005-2010

Malawi Support to AIDS and Family Health Project
Funded By: US Agency for International Development
Project Duration: 1994-1998

Mozambique Primary Health Care Support Project
Funded By: US Agency for International Development
Project Duration: 1994-1999

Rapid Expansion of Nutritional Recuperation Services for Malnourished Children in Nigerien Facilities
Funded By: American Jewish World Services, US Agency for International Development Office of Foreign Disaster Assistance, and UNICEF
Project Duration: 2005-2007

Peru Strengthening Health Institutions Project, MaxSalud Component
Funded By: US Agency for International Development/Peru
Project Duration: 1994-1999

Quality Assurance Project (QAP) I, II, and III
Funded By: US Agency for International Development
Project Duration: 1990-2008

Romania Health Care Reform Program
Funded By: US Agency for International Development /Romania
Project Duration: 2005-2008

PreventAIDS
Funded By: US Agency for International Development
Project Duration: 2005-2008

TASC2 Tuberculosis: South Africa
Funded By: US Agency for International Development/South Africa
Project Duration: 2004-2009

Development of a Population and Family Health Improvement Project in the Solomon Islands
Funded By: Asian Development Bank
Project Duration: 1994-1995

Campaign for Our Children Media Initiative
Funded By: Maryland Governor’s Council on Adolescent Pregnancy
Project Duration: 1997

Communications Training and Capacity Building
Funded By: US Department of Health and Human Services, Office for Substance Abuse Prevention
Project Duration: 1989-1992

Career Development Center for Drug Abuse Administration
Funded By: National Institute on Drug Abuse
Project Duration: 1975–1980

Prevention Education and Knowledge Application Technical Assistance (Center for Substance Abuse Prevention: Communications Team)
Funded By: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention (CSAP)
Project Duration: 1992-2002

Department of the Navy: Drug Demand Reduction Program
Funded By: Tennessee Valley Authority
Project Duration: 1993-1995

Education Programs of the National Heart, Lung and Blood Institute and the National Heart, Lung and Blood Institute Campaign
Funded By: US National Institutes of Health, National Heart, Lung, and Blood Institute
Project Duration: 1987–1993 and 1997–2002

Health Communications Initiative for the Prevention of Underage Alcohol Use
Funded By: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
Project Duration: 2004-2009

Substance Abuse and Mental Health Administration Hispanic/Latino Initiative
Funded By: US Substance Abuse and Mental Health Administration
Project Duration: 1999-2005

National Center for Alcohol Education State Trainer Development Workshops
Funded By: US National Institute for Alcohol Abuse and Alcoholism
Project Duration: 1973–1981

National Drug Abuse Center for Training and Resource Development
Funded By: US National Institute for Alcohol Abuse and Alcoholism
Project Duration: 1979-1982

Technical Assistance for the National School Resource Network
Funded By: US Department of Justice, Office of Juvenile Justice and Delinquency Prevention
Project Duration: 1979-1982

Naval Alcohol Rehabilitation Center Project
Funded By: US Department of the Navy
Project Duration: 1983-1986

National Clearinghouse for Alcohol and Drug Information (NCADI)
Funded By: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention
Project Duration: 1987-2007

National Clearinghouse for Alcohol Information
Funded By: US National Institute for Alcohol Abuse and Alcoholism
Project Duration: 1984-1987

New and Emerging Issues Project
Funded By: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention
Project Duration: 1992-1998

UNICEF Malawi and New York
Funded By: UNICEF
Project Duration: 2008-2010

Substance Abuse and Mental Health Services Administration Conference Exhibit Program
Funded By: Substance Abuse and Mental Health Services Administration
Project Duration: 2003-2006

Too Smart To Start
Funded By: US Department of Health and Human Services (SAMHSA), Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention (CSAP)
Project Duration: 2001-2004

Weight Control Information Network
Funded By: US National Institute of Diabetes and Digestive and Kidney Diseases
Project Duration: 1994-2005

Technical Assistance and Support Contract 2 (TASC2): Global Health
Funded By: United States Agency for International Development
Project Duration: 2004–2009

Technical Assistance and Support Contract (TASC2) Tuberculosis
Funded By: United States Agency for International Development (USAID)
Project Duration: 2004–2009