Agha Sohail
Behavior Design Lab, Stanford University, Stanford, CA 94305, USA.
Vaccines (Basel). 2022 Aug 5;10(8):1261. doi: 10.3390/vaccines10081261.
The lack of capacity for the design and implementation of behavioral interventions in low-and-middle income countries (LMICs) has been recognized by the World Health Organization (WHO) and other global health institutions. There is a need to task-shift, to translate social and behavioral science concepts into "practitioner-friendly" models-models which can be used by intervention designers, implementers, and evaluators with limited technical and financial resources. We illustrate the use of the Fogg Behavior Model (FBM), a model identified as being easy for practitioners to adopt in low-resource settings. The study uses data across four different behaviors in Nigeria, Pakistan, and India. The behaviors examined are COVID-19 vaccine uptake, condom use, iron folate use, and modern contraceptive use. The data are from surveys of healthcare workers (HCWs), married men, women of reproductive age, and adolescents, respectively. The FBM states that behavior happens when both motivation and ability are present, and a prompt occurs. In other words, persons with high motivation and high ability are the first to adopt a behavior. We created a categorical variable for motivation and ability and tested whether high motivation and high ability are associated with a greater likelihood of adopting a behavior. In Nigeria, HCWs with high motivation and high ability had 27 times higher odds of being vaccinated. In Pakistan, married men with high motivation and high ability had 35 times higher odds of condom use with their wives. In India, women with high motivation and high ability had 9 times higher odds of iron folate use. In Nigeria, adolescents and young women with high motivation and high ability had 8 times higher odds of contraceptive use. The study findings suggest that the FBM has the potential to be applied in low resource settings for the design, implementation, and evaluation of behavioral interventions. Rigorous testing of the FBM using data from experimental or quasi-experimental studies is recommended.
世界卫生组织（WHO）和其他全球卫生机构已经认识到低收入和中等收入国家（LMICs）在设计和实施行为干预方面缺乏能力。有必要进行任务转移，将社会和行为科学概念转化为“对从业者友好”的模式——这些模式可供技术和资金资源有限的干预设计者、实施者和评估者使用。我们举例说明了福格行为模型（FBM）的应用，该模型被认为便于从业者在资源匮乏的环境中采用。该研究使用了来自尼日利亚、巴基斯坦和印度的四种不同行为的数据。所考察的行为包括新冠疫苗接种、避孕套使用、铁叶酸使用和现代避孕方法使用。数据分别来自医护人员（HCWs）、已婚男性、育龄妇女和青少年的调查。FBM指出，当动机和能力都具备且有提示时，行为就会发生。换句话说，动机高且能力强的人最先采取某种行为。我们为动机和能力创建了一个分类变量，并测试高动机和高能力是否与采取某种行为的可能性更大相关。在尼日利亚，动机高且能力强的医护人员接种疫苗的几率高出27倍。在巴基斯坦，动机高且能力强的已婚男性与妻子使用避孕套的几率高出35倍。在印度，动机高且能力强的女性使用铁叶酸的几率高出9倍。在尼日利亚，动机高且能力强的青少年和年轻女性使用避孕方法的几率高出8倍。研究结果表明，FBM有潜力应用于资源匮乏的环境中，用于行为干预的设计、实施和评估。建议使用来自实验性或准实验性研究的数据对FBM进行严格测试。
