Post by Naira Kalra, Doctoral Student, Johns Hopkins Bloomberg School of Public
I was fortunate enough to receive a scholarship to present my work at the Social and Behavior Change Communication (SBCC) summit in Addis Ababa in February 2016. The summit was a gathering of over 700 people from over 52 countries that were excited to share their experiences and celebrate their passion for human behavior, communication and health.
From cramming in as many sessions in a day, to meeting old friends and making some new ones- the three days went by far too quickly. The energy was palpable and it didn’t matter how old or young you were in the field of SBCC, the feeling was one best described by Kumi Naidoo as a “homecoming”.
However, with all the new information also came some questions that have lingered on. The experience definitely left me fascinated by the contradictions – making me realize how nascent and at the same time how developed the field of SBCC is.
Being at a critical stage in my research, where I’m beginning to explore research ideas for my doctoral thesis, the summit exposed me to new ideas, to the challenges of intervention work and to the desperate need for advancement in methods to evaluate complex interventions. In a fascinating Blue Sky session on ‘what counts as evidence in SBCC’, words like randomized control trials (RCT) were only brought up to be followed by complaints about how difficult they were to implement or how expensive and infeasible it was for practice organizations to carry them out. Where I expected us to debate the nuances of evaluation in the field, I found anecdotal evidence of impact and assumptions that if an intervention was shown to be effective using an RCT, it must work, with no regard to the quality of the RCT. The disparity in capacity and knowledge was striking, particularly when terms like propensity score matching or stepped wedge designs were introduced into conversations. Perhaps the struggle is not about methods advancement alone but also about access to the advancement in methods. It made me wonder why as a field of communication, we are not making an effort to simplify and communicate research methods outside the ivory towers of universities.
As a consumer of evidence, limited as it may be, the Summit also raised a few questions in my mind about the tussle between the desire to innovate and the desire to implement best practice. Leaving aside the challenges of transferability of interventions from one setting to another, if successfully adapted, does best practice encroach on the opportunity to creatively solve a public health problem? Is there a need to move from effectiveness to relative effectiveness?
I was also glad to see that theory was not forgotten in the world of SBCC. In a fascinating session on theory from http://internationalsbccsummit2016.sched.org/event/4jvg/provider-connectionaround the world, we discovered the different theoretical lenses with which we can view the challenges that complex human behaviors interacting with a dynamic social context can bring. But along with the simplicity that theory can bring comes the challenge of which theory is better? A question that Wienstein attempted to answer in 1993 still plagues the world of SBCC.
While the summit raised some of the issues that the field faces, many questions remain unanswered. Perhaps in two years when we meet again, there will be some answers and a whole new set of challenges to face.