Developing appropriate illustrations
Counseling for behavior change
Improving health provider skill
reminder materials


Behavior-Centered Programming

The Manoff Group's Behavior-Centered Programming is a practical and effective approach to changing behaviors (and thereby achieving program objectives) at the individual, community and organizational levels. Behavior-Centered Programming can be adapted for any health issue. It provides opportunities for families, health workers and influential community members to participate in formulating and testing proposed practices, program strategies and activities, messages, materials and products. Our central technique for doing this, developed by the Manoff Group, is called Trials of Improved Practices (TIPs). Using TIPs ensures that strategies and activities are tailored to the local environment and are both acceptable and feasible.

The results are impressive. Significant improvements in both behavior and health have occurred in projects assisted by the Manoff Group that have been formally evaluated, including: Indonesia Nutrition Communication/Behavior Change Project, Egypt Healthy Mother/Healthy Child Project, Applied Nutrition Project (Dominican Republic), Zlatna, Romania Lead Project, Social Marketing of Vitamin A [167KB pdf], Peru Hygiene Improvement [188KB pdf] and the Indonesia Weaning Project.

Applying the behavior-centered approach

Behavior-Centered Programming normally includes the following steps:
  • Review existing information on the health problem and related behaviors
  • Identify the main groups who will solve the problem. (These may include mothers, fathers, mothers-in-law, community leaders and health workers.)
  • Conduct in-depth research with the participant groups. (This research is predominantly qualitative and frequently includes TIPs).
  • Define each group's current behaviors, ideal behaviors and feasible behaviors.
  • Analyze barriers and resistance to changing behavior (as well as motivating factors and supports for improved [more healthful] behaviors).
  • Develop a comprehensive behavior change strategy to move people from their current behavior to improved behaviors. This is done with the collaboration of partners.
Behavior-change communication (BCC) activities are a key component of this strategy and help:
  • Address barriers and resistances to new behaviors.
  • Provide information and specific strategies.
  • Motivate participant groups to action.
The overall behavior-change strategy may also include recommendations on training, policy changes, service improvements, new technologies, community mobilization and other appropriate actions based on the behavioral analysis. During implementation, we consult with participant groups periodically to make adjustments to the strategy, activities, communication channels, materials and messages.