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Covid-19 has shown beyond doubt the important role that our behavior and cultural contexts can play in the face of health challenges. More and more governments are beginning to look seriously at designing and implementing public health interventions informed by behavioral and cultural insights (BCI). However, evaluating these interventions to ensure they are working as intended can be difficult, especially when time and money are limited.
WHO/Europe has just published “Guidelines for evaluating complex conditions in behavioral and culturally informed health interventions”. It provides detailed information on how to assess the effectiveness and sustainability of BCI interventions, particularly in situations where conclusive evidence is difficult or impossible to meet. Instead, using contribution analysis as a starting point, this new WHO guide guides readers through the process of creating evidence-based claims for intervention effects.
“Exploring the costs, effects and outcomes of interventions that seek to influence people’s health behaviours, their daily lives or the uptake of health services is critical. Only in this way can we learn and improve, avoid unintended negative effects and replicate successful interventions,” said Kathryn Bach Habersat, Regional Adviser on Behavioral and Cultural Insights at WHO/Europe.
The interactive assessment guide was developed, tested and improved in collaboration with several partners and has been implemented in 3 different countries in the WHO European Region.
Miguel Tello de Arriaga, Head of the Readiness, Health and Safety Unit at Portugal’s Directorate General of Health, explains: “Throughout the COVID-19 response in Portugal, the Directorate General of Health has used micro-influencers. To communicate about public health and social measures. The WHO/Europe BCI evaluation guide has provided us with a useful and comprehensive tool to support our efforts to evaluate and refine interventions, now looking at how to use them in settings beyond Covid-19.
Removing unwanted effects
Evaluation is a critical component of any intervention. The evaluation process involves examining and documenting the results of the intervention, what is working well and what could be improved. These insights can be used to continually improve, scale up, or replicate successful interventions. Using a theory-based method helps to systematically examine all relevant factors and reach reliable findings. In the new guidelines, this model is based on contribution analysis.
The evaluation should be sensitive to unintended negative (or positive) effects. Specifically, the BCI evaluation guidelines emphasize safety, trust, and social cohesion as key factors that should always be examined alongside the goals set for the intervention. In this way, the impact of behavioral and culture-based interventions on society is better documented and understood.
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