Designing an SBCC Intervention for FBP Behavior Change

Step 3: Define Your Audience

Before designing any SBCC intervention, it is important to analyze the intended audience to gain a better understanding of who they are, including their current behaviors, and to decide which sub-segment or "primary audience" you will address. 

This same process is used when designing an intervention to improve FBP behavior. FBPs are similar to other audiences identified for SBCC in that they have their own set of needs, desires, biases and attitudes that need to be understood in order to identify SBCC solutions. The Audience Analysis is an important step to understand FBPs as an audience.

The following are the key steps to audience analysis:

 
1 Review Audience Information

Review what you collected in the situation analysis (either through the Performance Needs Assessment or the Literature Review) to understand:

  • Current levels of performance
  • Key barriers to quality service provision by category (Expectation, Ability, Opportunity and Motivation)
  • Total number of providers, geographic location and services provided
  • Socio-demographic characteristics like age, years of experience, education level and religion
  • Beliefs, attitudes, knowledge levels and current behaviors
  • Psychographic data like FBPs’ needs, aspirations, hopes, fears and habits
  • Other information as appropriate

Additional audience research may need to be gathered. See the Audience Analysis and Formative Research how-to guides for more guidance. 

 

2 Decide Whether to Segment

fbp-2Audience segmentation is the process of dividing the larger FBP audience into smaller groups or "segments" of similar individuals. Segmentation is important because different people respond differently to SBCC messages and interventions. It helps program teams better channel resources and narrow focus on a "primary audience." For programs working with providers, segmentation also helps better target monitoring, coaching and routine support supervision activities. If after the review of audience information it is determined that smaller groups with similar behaviors, needs, values and/or characteristics (segments) exist within the larger audience, it is best to segment.

One Method to Segment Providers – Population Services International

Population Services International (PSI) uses one method, adapted from the commercial pharmaceutical sector, to determine whether it is necessary to segment health providers before introducing a performance improvement approach. The approach uses two primary criteria: 1) Is there potential for health impact (i.e., are the providers working in a region or with clients who have a need for health improvement) and 2) Are the providers currently providing services or performing the desired behavior. Using these criteria, the segments are categorized in a Provider Segmentation Matrix:

Behaviors
High Potential/Low Behavior

These providers are working in high density communities highly populated by members of their intended audience (i.e., women of reproductive age or children under 5), but who see very few clients or are not consistently performing the desired behavior.

High Potential/High Behavior

These providers work in high-density communities and see high numbers of clients and are already providing good quality services. They are designated as "stars."

Low Potential/High Behavior

These providers have a low client load, perhaps because they are not located in an area where people demand services from FBPs or there is low population density, but they are providing high quality services to the small number of clients they see.

Low Potential/Low Behavior

These providers have a very low client load and for whatever reason are not offering services or performing the desired behavior.


Using this method, PSI determines whether there are distinct segments among the providers and which groups should be prioritized. Prioritized segments are providers who demonstrate both potential to improve health impact – in areas where there is demand for health services that is not already met – and who are not currently performing the desired behavior. This often results in prioritizing providers in the A and B quadrants.

3 Determine Segmentation Criteria

If segmentation is required, look at the audience and identify traits that make one sub group different from another. A significant difference is one that requires a different message or approach. These distinctions can be categorized by socio-demographic, geographic, behavioral and psychographic. See the table below for unique criteria for FBPs.

Socio-DemographicGeographicBehavioralPsychographic

  • Age
  • Gender
  • Ethnicity/language
  • Level of education and/or clinical training
  • Job satisfaction
  • Perceived level of autonomy
  • Years of service

  • Urban
  • Rural
  • Peri urban

  • Current behavior (high performer/low performer)
  • Barriers to behavior – Expectation, Ability, Opportunity, Motivation

  • Benefits sought through work/Reasons for being a provider
  • Attitudes/opinions about clients
  • Feelings about opportunities for career development

 
4 Segment the Audience

Segment your audience using criteria identified in Step Three. Consider using a segmentation table, such as the one below: 

 Download Segmentation Table Template

Potential Audiences

Potential Primary AudiencesPotential Influencing Audiences
Demographic Characteristics

Age, gender, years of training and years as a provider

Geographic Characteristics

Region, urban or rural, and area of conflict

Socio-Cultural Characteristics

Language, culture, place in society, religion, ethnicity and status in health facility

Behavioral Characteristics

Behaviors that affect or impact the challenge

Psychographic Characteristics

Personality, values, attitudes, interests, lifestyle and reasons for wanting to be a provider

Ideational Characteristics

May include knowledge, beliefs and attitudes about provider work, expectations and attitudes about clients served, perceived risk, self-efficacy, social support and influence, environmental supports and constraints, emotions, norms and self-image

 

5 Assess Proposed Audience Segments

Once segments have been selected, ensure they are valid and usable. Use a checklist to ensure each segment meets the criteria for effective segmentation. If a defined segment does not meet the criteria, it is best to drop it and consider other segments. 

Consider using this segmentation analysis checklist to assess audience segments.

Homogeneous YesWhat it Means: The members of the audience segment are similar in a relevant way. Why It is Important: This is the basis of audience segmentation - that the members of each segment are similar in terms of needs, values and/or characteristics. 
Heterogeneous YesWhat it Means: Each segment is relatively unique, as compared to the other segments that have been identified. Why It is Important: This demonstrates that the broader audience has been effectively divided into sets of differing communication needs.
Measurable YesWhat it Means: Data from the situation analysis or other research should indicate the size of the audience segment. Why It is Important: Measurements allow programs to evaluate whether to focus on a particular element.
Substantial YesWhat it Means: The audience segment is large enough, in terms of potential impact on public health, to warrant the program's attention. Why It is Important: Programs should have a minimum expectation for the impact of their investment. Therefore, programs should only consider segments that are big enough or important enough to impact public health.
Accessible YesWhat it Means: The audience segment is reachable, particularly in terms of communication and access to products or services needed to address the problem. Why It is Important: Each segment needs to be able to be reached and communicated with efficiently.
Actionable/Practical YesWhat it Means:  The program is able to implement a distinctive set of messages and interventions for each audience segment. Why It is Important: The program must have the resources and ability to address the segments identified.
Responsive YesWhat it Means: Each audience segment can be expected to respond better to a distinct mix of messages and interventions, rather than a generic offering. Why It is Important: If the segment will not be more responsive to a distinct approach, then the segment can probably be combined with another similar segment.

Adapted from Criteria for Market Segmentation

6 Prioritize Audience Segments 

Deciding which segments to prioritize and how to approach them is critical. If the program team identified more audience segments than it can or needs to reach, narrow the list and finalize which segments the program will focus on. Ultimately, the decision about which segments to prioritize is based heavily on available resources and program goals. Some questions to consider when prioritizing audience segments are:

  • How much does this segment impact the overall program objectives?
  • How easy are they to reach?
  • Do they have significantly different views about their work than their peers?
  • How ready are they for behavior change?
  • What stage in the behavior change process are they currently?

More details on How to Do Audience Segmentation

 

7 Create FBP Audience Profiles

An audience profile may enable you to obtain a personal sense of the people to be reached through your SBCC efforts. Focus first on the primary audience and think about what you know about them. Then draw an outline of a person who is a typical member of this audience and write a brief description of a single person as a composite of the group.

This profile could describe the FBP's geographic location, gender, age, cadre, years/level of training, concerns, current behaviors, years of service, where she gets information, what motivates her to be a FBP, current performance, beliefs, values or family situation.

Include findings from the performance assessment such as: the identified barriers and facilitators to improved performance considering the performance factors (Expectation, Opportunity, Ability and Motivation) and anything you know about specific motivational factors to perform well.

You might write “a day in the life” of the provider as a way to capture what is most important to the individual and to better understand their day-to-day experience as a FBP. This profile should be based on data including that gathered during the situation analysis and the performance gap assessment.

Remember: Audience profiles are needed for each prioritized audience segment.

 NOTE:  If you have determined that FBP motivation is heavily influenced at other levels (health system, community, organization, family and peers), identify which individual(s) are the most critical secondary (influencing) audience(s) and develop a profile for them as well.

Record your selected audiences, audience segments, and audience profiles in the Step 3 section of the SBCC Strategy Template.


Resources

Sample FBP Profile

© 2015 Lucian Alexe/Reproductive Health Supplies Coalition, Courtesy of Photoshare

Name: Chime

Location: A clinic in a semi-urban environment serving a population of 9,000.

Type: Head Nurse at a Level 2 Primary Health Care clinic. She climbed the ranks at the health center quickly and has been in her current position for years. In total, she has been a nurse for 18 years.

Incentives: She mostly sees the same cases every day and no longer feels inspired by her work. She is frustrated with the clients who never listen to her advice and who keep engaging in unhealthy behaviors.

Education: She completed a college degree in the capital city.

Family Life: She is 42 and has children.

Services Provided: She feels the clinic provides good care under the circumstances but she prefers to take her own children to a private provider.

Why She Is a FBP: She became a nurse because her little brother died of pneumonia without any access to health care.

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