There are many different models that someone can use to develop and implement a public health education campaign.  The University of Texas El Paso listed 26 different models that could be used.  I’m not going to go through each model here, but over the next several weeks, I will write a post about some of these models and why I feel they need to go further to include diverse populations.

I’ll start with the Social Learning Theory.  This theory states that a person learns through modeling the behavior change in others (Bandura, 1971).  How to we best model behavior?  A person would need to see someone like themselves modeling the correct behavior.  Think about a major movie star or sports star doing something on television or the Internet, if this highly successful person is doing it, maybe I should do it too.  That can lead to both good and bad behaviors depending on what is seen.  One major problem is, the star may not care about the outcome.

Bandura (1971) says that besides modeling, the change in behavior requires some kind of social influence.  We can look at a common model of social influence with peer pressure during our teenage years.  If the social pressure from their peers is stronger than the parental influence, the teenager will follow their peers.  Another example is smoking.  The United States went from allowing smoking inside many places of business to smokers being relegated to the outdoors at a certain distance away from the building due to peer pressure and good messaging from public health (CDC, 2016).

The model has four steps that lead to a change is behavior: attention, retention, reproduction, and motivation.  Will the person or group you want to influence pay attention to the modeling?  Will what is being modelled easily be replicated?  Could the person or group understand the behavior enough to replicate it themselves?  Is the behavior that is being modeled providing motivation for others to do it?

Now add to this you need to change the behavior of a diverse group who you don’t understand the culture of and may not even speak the same language.  Nowhere in this model does it account for cultural factors.  Maybe the culture you wish to change the behavior of is influenced in a whole different way than by modelling the behavior.  If modelling does work, will you be able to get the right people to model the behavior.  The group may have specific influences that you may not be aware of.

Not to say this model isn’t useful, it is.  However, I think we need to look deeper at these models and understand where they need improvement.  When looking to save lives with our messages, we need to look a beyond just what we know, even in the groups we understand well.  I move to add culture as something we need to analyze along with the message.  No use eating a bit of shoe leather learning the hard way.