Effective Health Communication Strategies

Effective health communication strategies use a systematic process and behavioral theory to develop and carry out communication activities that promote and sustain healthy behavior.

The highest quality, most accessible health care services are pointless if people do not know about them or want them. For family planning, effective behavior change communication (BCC) activities raise awareness about family planning, motivate individuals to seek services, and help them to successfully use their contraceptive method of choice. BCC programs also encourage couples to discuss their fertility desires and help to make contraceptive use a community norm. To promote and sustain healthy behavior, one communication product or campaign is not enough. BCC must be ongoing.

BCC Programs Follow Systematic Processes and Models

Most systematic BCC programs follow a similar process, beginning with analysis and progressing through program design, development and pretesting of messages and materials, implementation and monitoring, and, finally, to evaluation. (See the P-Process from the Center for Communication Programs.)

Many BCC programs now recognize that changing health behavior extends beyond simply reaching the individual; these newer sociecological models of BCC acknowledge the influence of interpersonal relationships, community norms, and the broader environment on people’s health and their health behavior. BCC programs also have evolved over time to become more participatory, focusing on engaging and involving people and communities to define who they are, what they want, and how they can achieve the desired change.

In addition to involving the audience, BCC programs engage other key stakeholders throughout the program process. Stakeholders may include the Ministry of Health, NGOs, health care professionals’ associations, research organizations, schools, faith-based groups, and the media. Involving key stakeholders wins “buy-in” from all groups that have something to contribute or who could stand in the way.

Theories Inform Behavior Change Communication

Behavioral theories help programs to understand why people behave as they do and how they change their behavior. With this understanding, programs develop strategies that reinforce healthy behavior or change unhealthy behavior. Two types of behavioral theories are important for BCC programs—theories of behavioral prediction and theories of behavior change.

  • Predictive theories address why people change behavior. They identify the internal and external factors that prompt people to perform (or not perform) a health-related behavior Using information obtained through initial research with the intended audience, program staff design messages and activities to eliminate the key negative factors and/or reinforce the key positive factors.
  • Behavior change theories explain how people change behavior. They describe the stages, or steps, that individuals may go through as they change their behavior. For example, the widely known Diffusion of Innovation Theory proposes that people adopt a new idea or behavior (an innovation) through a five-stage process: knowledge, persuasion, decision, implementation, and confirmation. Identifying the intended audience’s current stage of behavior change helps tailor approaches and messages that move them to the next stage.

Using a Mix of Communication Channels Works Best

Strategic BCC programs use a mix of mass media, interpersonal, and community-based communication channels to enhance the effect of a BCC program. Together, the three reinforce each other.

  • Mass media channels include radio and television, widely circulated newspapers and magazines, billboards and bus advertising, and in some places the Internet. By definition, these media reach large audiences. Advantages of mass media: Good for showing large audiences what healthy behavior looks like.
  • Interpersonal channels are often one-to-one communication, such as counseling and telephone hotlines. Advantages: Can be more credible and specific because it takes place face-to-face with trusted sources.
  • Community channels include rallies, public meetings, street theater, and local newspapers and radio stations. Advantages: Good for spreading new ideas through social networks and, over time, encouraging widespread support throughout the community.


Read more about strategic behavior change communication programs in the Population Reports issue on “Communication for Better Health” and the High-Impact Practice brief on Health Communication.