Timing & Salience of Information
Information is presented in a targeted way, at a specific time, or through a particular agent.
In the case of incorrect beliefs—one of the primary challenges in RH in low-resource settings—we can use the provision of information to correct false expectations or judgments. Information and education, alone, are not behavioral interventions: they are key components of “rational” decision-making in the standard economic model. However, information becomes behavioral when varying the timing or presentation of the same information results in different behavior. This concept is well established in the context of marketing.
“Teachable moments” have been proposed by the public health community as events or circumstances which can lead individuals to positive behavior change (Lawson & Flocke, 2009). However, there is little empirical evidence about the effectiveness of using these “moments,” particularly in RH.
- Nepali women who receive health education immediately after delivering are more likely to use contraception six months later, compared with those who received education three months after delivery (Bolam et al., 1998).
- It has been also suggested that pregnancy may be a teachable moment for expectant fathers (Bond, 2010), but this has not been tested.
A Cochrane review of the effects of feedback on physician performance and patient health outcomes in OECD countries finds that feedback to doctors is more effective when given promptly, is clearly meant for a specific person, is ‘actionable’, and is non-punitive Jamtvedt et al., 2006). The improvements due to feedback have not necessarily been large, but they are often greatest where current practice is farthest from the standard of care (Flottorp et al., 2010). Feedback typically has greater effects on the process of care than on health outcomes (Van de Veer et al., 2010).
Studies have also found that the source and presentation of information is important. A growing body of work indicates that information conveyed through social networks is effective at encouraging behavior change (Duflo & Saez, 2003; Bandiera & Rasul, 2006).
- In a randomized experiment in Bangladesh, conducting community discussions in the homes of opinion leaders , at central points in villages’ social networks, was five times more effective at increasing take up of modern contraceptives than conventional field worker visits (Kincaid, 2000).
- Similarly, the portrayal of information through entertainment or a personal experience may be absorbed better than statistics and facts. For example, Kearney and Levine (2014) find that exposure to 16 and Pregnant, a popular show on MTV which purports to show the difficulty of being a teen mother in the US, contributed significantly to a sharp decline in teen births.
More generally, behavioral economics suggests that—within the context of oral or written materials—the order of concepts and word choice can impact how information is received. However, to our knowledge, there have been no rigorous evaluations of small word variations in the context of reproductive health. Further research is necessary to identify the optimal timing and presentation of RH education and counseling for adolescents, women, and men.