WHAT DO YOU NEED TO RESEARCH: THE BEHAVE FRAMEWORK

The BEHAVE framework provides four deceptively simple questions to be answered:

• Who are you trying to reach?
• What do you want them to do?
• What factors influence their behavior?
• Which actions will most effectively address these factors?
  BEHAVE presents these questions in the form of a statement:
  In order to help (a specific target audience) to (perform a specific behavior) we will focus on
  this benefit (something the target audience values). We will approach this through these
  factors: (e.g., self-efficacy, lowered barriers, enhanced health literacy, etc.), and use these
  activities (means of reaching the audience: media channels or other contact opportunities).
  *Research studies involving human subjects are examined and approved by an institutional
  review board (IRB) constituted for this purpose. IRB approval is based on a number of
  elements, all designed to protect human subjects from any type of abuse. A central issue
  during IRB review is evaluation of informed consent, i.e., are the participants full informed
  about the study and its risks and are they capable of giving consent based on this
  information.
  If you cannot fill in these gaps, then you have to do formative research. You might be able
  to lay the groundwork with published literature and/or unpublished research reports from
  reliable sources, such as government agencies. But most likely you will need to conduct
  qualitative research with the target audience on location in order to collect the specific
  information you need to create a communication strategy.
  Let’s see what is required for each question.
  Specific Audiences
  Primary Audience
  You start with a beneficiary in mind, the group of people most affected by the health
  problem. In some cases, this group is also the primary audience, defined as the group of
  people whose behavior you hope to influence through a communication intervention.
  Sometimes the beneficiaries—for example, infants and young children or persons with a
  mental disability—are incapable of acting for themselves. In that case, the primary audience
  is made up of those whose actions directly affect the health outcome. In this example,
  caregivers (mothers and others) are the primary audience whose behavioral change is
  sought to benefit the child or the person with the mental disability.
  Your research should determine if there are subgroups in the primary audience who would
  benefit from specific forms of communication. This segmentation might be based on
  demographic variables such as age, sex, or number of children; geographic location; ethnic
  identity; or experience with a particular illness or disability. Other variables such as
  educational level or literacy abilities, language use, and media preferences might be used to
  identify subgroups in terms of how and where they can be reached through particular media
  channels. And finally, and perhaps most importantly, the relationship of the primary

audience to the behavior in question provides very precise segments. These behavioral
segments include current practice; readiness to adopt a new behavior; and other
theoretically defined constructs such as needs for self-efficacy, perception of role models,
types of rewards sought, or barriers blocking the way.
Secondary Audience
Your research might have uncovered the need to work with a secondary audience (or even
tertiary audience) in order to reach or influence the primary audience. These people can be
seen as allies to support a behavioral change, or they might need to be convinced to
change their opinions, or even actions, before the primary audience will be free to act on its
own. Very often, healthcare professionals act as effective gatekeepers in a community.
They can help support a behavior change goal if they agree with it or prevent its adoption if
they disagree. For this reason, it is often critical to use the advocacy approaches described
earlier in this book before going forward with behavior change communications. Again, this
secondary group can be further segmented according to demographics, attitudes, theory-
based constructs, or need for training or educational outreach.
Behavior to Change
At the outset of our plan, we have an ideal behavior in mind. If we could convince the target
audience to practice this behavior, we believe that the health problem would be greatly
reduced. Let’s take hand washing, for example, as shown in Box 9–1.
Box 9–1 Hand-Washing Exercise
This exercise demonstrates what might be involved in carrying out an ideal behavior in
terms of time, supplies, and attitudes. Conduct yourself in a normal fashion in carrying out
the requested steps.
Step 1: State Your Current Behavior
A. Frequency. Approximately how many times a day do you wash your hands?
[Write number down] _
B. Steps. Go into a washroom and wash your hands. Keep track of everything you need to
perform the behavior as well as the steps you take. Keep track of how long you spend doing
this.

1. Resources needed to wash hands:
2. My hand-washing steps: (Your list might include the following: adjustment of clothing,
   removal of watch or ring, turn on tap, wetting hands, get soap, rubbing hands with soap and
   water, rinse, getting towel, etc.)
3. How long did I spend washing my hands? _ seconds/minutes
   Step 2: Identify Ideal Behavior
   A. Frequency of behavior. Write down the number of times you do the following
   (approximately). You need to wash your hands:
   Activity

Number of times a day
Prepare or help with meals
Before and after eating
After urinating or defecating
After sneezing or coughing
After touching or handling objects such as money, doorknobs, or anything with visible dirt
Total number of times you would ideally wash your hands: __
How does your current behavior compare with the ideal in terms of frequency?
B. Behavioral Steps

Compare your own behavior to the ideal behavior. How is it different?
How much time would you need every day to wash your hands correctly? Do you always
have access to water, soap, and disposable towels? What else can you do to properly clean
your hands? Compare the responses of the women in the class to the men. Any
differences? How would you formulate a behavioral objective based on this exercise?
Source: State of Illinois, Department of Public Health.
Over decades of social marketing, we have learned that “simple” behaviors, such as
washing your hands, are comprised of several small steps and require multiple resources to
complete. Any one of these steps (or resources) can be a limiting factor if people cannot
perform the behavior without it. Inversely, once the limiting step is taken (or resource
acquired) the remaining steps may follow in sequence without further input. We like to think
of this step as a behavioral lever. Health promoters need to know exactly which steps of a
behavior they are trying to change, and what factors can be used to predispose, enable, or
reinforce that step.
Identifying a Behavioral Lever
Through observations and questions, we determine what members of the primary audience
are doing and create a start-to-finish sequence for the behavior to be changed. To show
how this can work we introduce a new example, a development project to improve the
nutritional status of children in rural Bangladesh by feeding them vegetables. In
Bangladesh, similar to many other traditional countries, the men go to the public market to
purchase items while the women remain within the home compound. Table 9–1 shows the
behavioral steps we observed that were necessary to achieve the desired outcome of
feeding a child vegetable.
TABLE 9–1 Sequence of Steps to Feed Cooked Pumpkin to a Child
1 Woman sees pumpkins in market.

2. She thinks about cooking pumpkin.
3. She inventories other ingredients at home (oil, spices, possibly tomato sauce).
4. She asks husband to buy pumpkin, extra ingredients.
5. Husband brings pumpkin, extra ingredients home from market.
6. Woman cuts and cleans pumpkin.
7. She prepares cooking fire.
8. She cooks pumpkin according to her liking, with less spice.
9. She takes a portion of family pumpkin and sets aside for children.
10. She adds spice to remaining family portion.
11. She mashes child’s portion.
12. She feeds mashed pumpkin to child.
13. She believes this was a good thing to do based on child eating pumpkin and not getting
    sick later.
    From this example, the starting point of the behavioral sequence is that once thinking
    pumpkin is good for her child, and knowing the pumpkin is available, a woman asks her
    husband to purchase the vegetable in the market. So, if health communicators want more
    women to cook vegetables for their children in this setting, they need to begin by prompting
    more women to ask their husbands to bring something home.
    Is this level of analysis going to be worth the effort? That takes us to the next level of
    behavioral analysis.
    Behavioral Analysis Scale
    AED also developed a behavioral analysis scale2 that has been used extensively in
    international health communication programs. It appears in Table 9–2.
    The scale includes the health impact of the behavior, its ease and costs of performance,
    and other factors that influence adoption. Any behavior can be rated using this scale. The
    score may help determine the advisability of a behavioral intervention. It is important that
    formative research provides sufficient information to complete a behavior analysis scale for
    the intended behavior change. Box 9–2 shows our rating of the Bangladeshi example
    presented earlier.
    Focus the Behavioral Objective through Stages of Change (or TTM)
    You have selected what seems like an approachable and important behavior. How ready is
    your target audience to adopt it? As discussed in Chapter 8, Stages of Change (SOC)
    includes five distinct stages: precontemplation, contemplation, preparation, action, and
    maintenance. People at different points in the process of change can benefit from different
    interventions, matched to their stage at that time. One important goal of your research is to
    map these theoretical terms onto everyday descriptions of behavior. The Bangladesh
    example continues in Table 9–3.
    A specific message or media piece might be designed to encourage and facilitate individual
    change from one stage of behavior to the next. The reason for this specificity is that
    different stimuli motivate people to move from one stage to the next. For example,

information alone might prompt movement from precontemplation to contemplation, but
observational learning (seeing another perform the behavior with positive outcomes) or
seeing a complex task broken down into simpler steps might be necessary to motivate trial.
These stimuli are culturally determined. But, in general, the goal is to increase the number
of positive feelings a person has toward a behavior and reduce the number of objections.
Refer back to Table 8–2 for facilitators of change as you move through the stages.
Group Behavior Change
What if you are trying to change the behavior of a group? You have data that indicate that a
few people practice the behavior regularly; some are starting to do it; and there is a big
hump in the middle of people who have heard about it, but not tried yet it. Again, there’s a
tail at the end of people who haven’t heard about it yet at all. You decide you want to focus
on this modal behavior (the big hump in a distribution curve) and attempt to move these
people up one step to preparation or trial. This group based behavioral staging relies on the
Diffusion of Innovations theory3. Moving the majority might involve a trick, explained below.
Diffusion of Innovations describes how new ideas, products, or practices spread within a
group. Innovations that are easy to use and understand, that can be tried without
commitment, and that have visible results will diffuse more quickly than difficult changes
requiring an outlay of money or time, and that have results that are slow to see. Rogers
suggested that populations adopt innovations according to a bell-shaped curve, with about
5% to 10% being the vanguard, and 5% to 10% “lagging” way behind. Social marketing
efforts often target new products to what Rogers described as early adopters (the second
20%), and great effort is spent trying to determine the psychographic makeup (personality,
values, attitudes, interests, lifestyles) of this group.
TABLE 9–2 AED Behavior Analysis Scale
    CATEGORY
CATEGORY
Health Impact of the Behavior

1. No impact on health problem
2. Little impact
3. Some impact
4. Significant impact
5. Very significant impact
6. Eliminates the health problem
   Complexity of the Behavior (Ease/Difficulty)
7. Unrealistically complex (difficult)
8. Involves a great many elements
9. Involves many elements
10. Involves several elements
11. Involves few elements
12. Involves one element
    Positive Consequences (Effects) of the Behavior
13. None that mother could perceive
14. New perceptible consequences
15. Some consequences
16. Significant consequences
17. Very significant consequences
18. Major perceptible consequences
    Frequency of Behavior (Ease/Difficulty)
19. Must be done at unrealistically high rate to achieve any benefit
20. Must be done hourly
21. Must be done several times each day
22. Must be done daily
23. May be done every few hours
24. May be done occasionally and still have significant value
    Cost of Engaging in (Performing) the Behavior
25. Requires unavailable resources or demands unrealistic effort
26. Requires very significant resources or effort
27. Requires significant resources or effort
28. Requires some resources or effort
29. Requires few resources or little effort
30. Requires only existing resources
    Persistence (Duration)
31. Requires compliance over an unrealistically long period of time
32. Requires compliance over a substantial period of time
33. Requires compliance for a week or more
34. Requires compliance for several days
35. Requires compliance for a day
36. Can be accomplished in a brief time

Compatibility with Existing Practices

1. Totally incompatible
2. Very significant compatibility
3. Significant incompatibility
4. Some incompatibility
5. Little incompatibility
6. Already widely practiced
   Observability
7. Cannot be observed by any outsider
8. Is very difficult to observe
9. Is difficult to observe
10. Is observable
11. Is readily observable
12. Cannot be missed
    Similarity to Present Behaviors
13. Nothing like this is done now
14. An existing practice is slightly similar
15. An existing practice is somewhat similar
16. An existing practice is similar
17. Several existing practices are similar
18. Several existing practices are very similar

Box 9–2 Application of Behavioral Analysis Scale to Bangladesh Example
“Woman asks her husband to bring pumpkin home for her to cook for her children.”
Scores run from lowest (1) to highest (6).
Health impact
4
Positive consequences
4
Compatibility

3
Frequency
6
Persistence
6
Costs
4
Similarity
5
Complexity
3
Average score: 4.4
It is recommended that we promote this behavior based on this analysis. From start to finish
the process is somewhat complex and the people are not in the habit of cooking pumpkin
daily or even weekly. However, even if pumpkin is cooked only once every two weeks and
is included in the child’s diet only three to five times every two weeks, it will have a very
significant health impact.
TABLE 9–3 Bangladesh Example of Stages of Change for Target Behavior
Behavioral goal: Mothers will feed mashed cooked pumpkin (or a more preferred orange
vegetable) to children 6 to 12 months of age at least once every other week while pumpkin
is in season.
Precontemplation: Were aware of the positive effects of cooked vegetables, and that
cooked pumpkin was being eaten by children in this age group with no ill effects.
Contemplation: Had thought about cooking/feeding pumpkin for their own 6- to 12-month-
old child.
Ready-to-act: Expressed a commitment to cooking pumpkin for their child at their next
opportunity and knew how they would go about it.
Action: Cooked and fed pumpkin to their child at least once.
Maintenance: Cooked and fed pumpkin (or other seasonal orange vegetable) every other
week for the past few months and intended doing so indefinitely.
Your formative research can both determine a diffusion spectrum for a group and describe
the characteristics of each segment. The “doers” (see later) are ahead of an adoption curve,
while the non-doers are everyone else, beginning with the majority in the middle. Your goal
might be to target the early adopters of other, even completely unrelated, behaviors to get
them to perform the new behavior (e.g., getting people who use fluoride toothpaste to try
using sunscreen, or people who built latrines for their homes in Bangladesh to try feeding

vegetables to their children). Your first goal is not to move the majority, but rather to move
the innovators, the “doers,” a much smaller audience. If you can get them to adopt the
behavior, according to diffusion theory, there is a very strong chance that others will follow
their lead. Hence, the trick mentioned earlier is that to move about 50% of the population
forward, you might target your (paid) communication efforts on the leading 10% to 20%,
relying on word of mouth, buzz, and other ways that information moves around a society to
carry the rest. Gladwell described this process as thought-leader (“maven-based”)
promotion.4 Some marketing database companies have commercialized segment analysis
using this strategy.*
Identifying Benefits (and Barriers)
People perform a behavior when it benefits them. Barriers (or perceived costs) keep them
from acting. You must identify a benefit that is really important, or several benefits
combined, that can offset the barriers [one or several] to tilt the “scales” toward adoption of
the behavior. The benefit is often implicit-that is, not actually perceived by the primary
audience. How do you learn about what your intended audience perceives to be barriers
and benefits?
Doer and Non-Doer Research
One way is to seek out the people who already perform a desirable behavior, the “doers,” is
described in Chapter 8. To conduct this kind of research, you can identify people using a
Stages of Change (SOC) assessment. People who are maintaining or have tried and
repeated the behavior would be the positives (doers) for the focus behavior.
You also want to interview people who have contemplated the behavior but not performed
it. (You want to weed out simple lack of information as a reason for avoiding the behavior,
because that is easily corrected.) How could comparing the doers and non-doers help you
know what really influences the behavior? Can you determine the most important barriers to
the non-doers and the benefits that have motivated the doers? You will next develop
concepts based on these ideas. Put in a more positive light, your goal is to learn from doers
what makes their behavior more fun, easy, and popular than not performing the behavior.5
If we are talking about a soft drink or a videogame, a bunch of teenagers could probably tell
us the features. But when working with a culture unlike our own, or when attempting to
promote a behavior that seems the opposite of fun, easy, and popular—such as colon
cancer screening—we need to use these terms as metaphors and work with Social
Cognitive Theory (SCT) or the Integrative Model (IM).
*http://www.smrb.com/web/guest/core-solutions/tipping-point-segments
Self-Efficacy
A seminal construct in both SCT and the IM is self-efficacy. Simply put, self-efficacy is an
individual’s belief that he or she can adopt a new behavior, such as quitting smoking. Self-
efficacy is constructed from knowledge and skills (behavioral capability), expectations of
what the outcome of performing the behavior will be, the value placed on getting these
results (expectancies), and the reinforcement given to the individual to perform the
behavior. The individual may directly build self-efficacy for a complex behavior by mastering
a series of simpler steps or by observing others experience the behaviors and outcomes.
This last concept, observational learning, also referred to as modeling, is the lynch pin for
applying SCT to communications interventions. People can learn, rehearse, and gain

mastery of behavior by watching role models, usually within a dramatic context, work
through behavior change, and evaluate for themselves whether the modeled behaviors are
desirable or not. Your formative research can be used to identify all of the elements
comprising SCT constructs, including information for role models, role model stories, etc.
Communication Intervention
Where and when are the best ways to communicate with your intended audience? This is a
question of space and time and takes into consideration the kind of media you think will also
accomplish your purpose.
Settings
Settings include places where either the audience will need to go to make contact with your
communication (e.g., a healthcare facility, shopping mall, bar or restaurant in town, a
special event), or places where the media can be brought to them (such as radio or
television programs, online environments, etc.). The time aspect is very important because
a place that seems like a good setting for your audience might be impractical if they will not
be attentive to your message or be unable to use the information they receive in a timely
manner. Most people cannot remember phone numbers or other information given out
during drive-time radio shows or on the back of busses, for example. The credibility of the
setting to the audience is also important. For example, it has been popular to disseminate
STD prevention information in the bathrooms of bars and restaurants. Younger people (who
are the intended audience) find this setting more credible than warnings of their parents at
home, for example.
Channels
It is easy to confuse settings with channels. Think of your home as a setting. There are
many media channels that can come into your home, such as television, the Internet, direct
mail, radio, etc. These are channels. But these channels can also be received in other
settings, like the public library. How you react to the same message conveyed by the same
channel might vary if you see it in the privacy of your home, or in a public setting like a
library. The National Cancer Institute (NCI) describes several different channels, as noted in
the following sections.6
Interpersonal Channels and Groups
Interpersonal channels include healthcare providers, clergy, teachers, and others who will
interact with the intended recipient in person. The strength of interpersonal channels is that
people tend to trust the spokesperson and will possibly be ready to listen to what they say.
Face-to-face channels are most effective when trying to help someone learn a skill; they
need to trust the spokesperson in order to adopt a new attitude or belief. On the other hand,
two-way discussion is necessary to cement a behavioral intention. Interpersonal
approaches can be used with groups, particularly if discussion among group members is
part of the communication strategy. To ensure the quality of health communication using
interpersonal channels, it often is necessary to develop training and media supports. The
major limitation of this channel is its reach.
Organizational or Community Channels

Similar to other group communication channels, there is more formality and structure when
dealing with business organizations, voluntary agencies, or religious groups. They can be a
very effective partner for disseminating advocacy messages or health communication that is
not too detailed. Bringing health communication into a trusted setting also reinforces the
credibility of the message and lends a sense of community norms to the suggested
behavior. Normally you would develop a whole “kit” to support working with partners such
as businesses or other community groups to keep messages focused and align the timing
of dissemination to coincide with mass media, if used.
Mass Media
Media that reach large populations, either individually or in huge markets, have become
even more diverse in recent years. Because there is so much to cover about this topic,
Chapter 11 is devoted to new and traditional media choices to carry different forms of health
communication. Mass media are known to be effective in raising awareness and
knowledge, prompting health information seeking, and changing attitudes. When
entertainment approaches are used (see Chapter 10), health communicators are often able
to achieve vicarious learning, outcome expectancy, and self-efficacy through thoughtful use
of role models demonstrating good behaviors and rewards or bad behaviors and negative
consequences.
You will want to make sure your research provides the information for you to be able to
select appropriate settings, channels, and media (Table 9–4).
TABLE 9–4 Criteria for Selecting a Communication Channel
Examples of channels: radio programs, TV shows, Internet websites, social media sites,
print (mass media or micro media), outdoor advertising (billboards, buses), viral or buzz
channels, intermediary distribution (e.g., doctor’s office video, print materials).

• Which channels the target audience uses and can easily access.
• Which channels they say they like.
• Which channels are more effective for communicating audio or visual messages.
  For any channel, ask the following:
• Is it a credible source of information or motivation for the target audience?
• Does the format lend itself to the content of the message?
• Can it provide the reach (coverage of the population) that you need?
• Will messages be seen or heard frequently enough to achieve your communication goals?
• Does it allow treatment of a subject in depth, or provide a “big idea” and “wow” factor?
• Do gatekeepers and other community leaders monitor the channel or provide direct or
  indirect oversight?
  Logistical and budget considerations will be treated in depth in Chapter 13. Some media are
  much more costly to produce, while others cost more to air or disseminate. The calculus
  comes down to costs per view, client reached, or product sold.

Using Social Marketing to Organize Your Formative Research
If you are using a social marketing approach to develop a communication intervention, you
will need all the information described earlier and more. For example, in addition to benefits
and barriers, you would think about how the costs of the behavior need to be offset by the
benefits, how location (or place) influences behavior, in addition to promotional strategy.
You will need to gather information to develop a new product, or present a behavior, so that
its positioning is favorable to your target audience. You must be sure it has the right
benefits, the price is right, it is convenient to do or obtain, and it is well promoted.
A tool based on the one developed by the Turning Point Collaborative* to identify social
marketing research needs appears in Box 9–3.
RESEARCH METHODS
Typically, scientists learn a method (or two) in graduate school and then continue that
method throughout their research careers. Social and public health scientists are no
exception. Here we outline a spectrum of methods that can be used for formative research.
Anthropological Methods
Anthropologists study health behavior in its cultural context. Their work contains the
richness necessary to begin developing hypotheses about behavioral antecedents and what
might prompt behavior change. Ethnography is the study a group of people and their life-
ways, typically over a long period of time. The term is used to describe what cultural
anthropologists do and the body of research that they produce. Now, rather than taking
years to research a problem, many programs have anthropologists train community
members to conduct ethnographic research in a much shorter time frame (rapid
assessment process, RAP),7 or to conduct participatory8 data collection with the target
audiences. While it does take time and effort to learn how to do ethnography well, it has
become standard to use rapid ethnographic concepts and methods in behavior change
communication projects. These include a positive deviance approach, and techniques such
as on-site observation, group and in-depth interviews, and various categorization tools (e.g.,
free listing, pile sorting). We review these methods and the kinds of information they
produce next.
*Turning Point was a project funded by the Robert Wood Johnson Foundation and the W.K.
Kellogg Foundation to improve public health management at the state level. States selected
a management strategy to master and disseminate among others. Illinois, Maine,
Minnesota, New York (Lead), North Carolina, and Virginia formed the National Excellence
Collaborative in Social Marketing. They produced a tailored version of CDCynergy, and
several supporting tools, with guidance from CDC’s Division of Health Communication,
AED, and the Florida Social Marketing Prevention Center. For more information, see
http://www.turningpointprogram.org/
Behavioral Observations
Because most health marketing programs attempt to change a behavior, an important place
to start is observing the behavior is in the setting where it is practiced. Sending trained
observers into homes and communities to watch what goes on, usually over several hours
for several days in a row, helps identify behavior patterns, alternative products, or obstacles
to adopting new behaviors. It is important that the presence of the observer does not

interfere with the routine behavior of the person or persons being watched. It can take a
fairly long time for people to become comfortable with an outsider watching them. Even with
the rash of reality television programs and video-cams documenting so much of what we
do, the vast majority of people prefer their privacy. For this reason, observations are usually
limited to short stints of time or very specific interactions (e.g., handwashing [Box 9–1]), at
least in the United States. In other countries, health communicators often work with
observers who are local health workers or educated near peers of the subjects in order to
minimize the intrusiveness of observation.
Asking Questions: In-Depth Interviews
People are much more comfortable talking about what they do than having someone watch
them do it. In-depth interviews are sometimes used to discuss highly personal topics, and
usually at a stage of research where the program does not yet feel sufficiently informed to
use a group format. The in-depth interview requires the interviewer to create a comfortable,
nonjudgmental relationship with the person being interviewed. The researcher may use a
topic guide or work from very open-ended questions.
Communications researchers typically conduct individual interviews either as a first step in
the development of a focus group protocol (i.e., a group interview guide), or to interview key
informants, such as gatekeepers. These informants work with members of the community,
or influence them in some way, and hence have a great deal of pertinent information to
share.
An individual, in-depth interview is easier to arrange than trying to organize a focus group,
because it can be done in the respondent’s home, office, or location of their choosing (even
on street corners for the homeless). At times, individual interviews are the only choice,
especially when preservation of anonymity is paramount.
Ethnolinguistic Techniques9
Ethnolinguistic techniques have been popularized by RAP and other rapid ethnographic
tools as a quick way of understanding how another group of people organizes their world
into different cognitive categories.
Box 9–3 Market Research Planning Worksheet (Modeled after Turning Point Social
Marketing Collaborative)
In order to help (primary target audience) to (perform key behavior):
Key Marketing Decision #1
Whose Behavior Needs to Change?
What Do We Already Know?
Information Needed
Identify the primary target audience.
Who influences them? (secondary target audience)
Other community influencers? (tertiary target audience)
Key Marketing Decision #2

What Is the Target Audience Doing INSTEAD of the Recommended Behavior?
Existing Info
Information Needed
Are they using another product instead of the recommended product? What and how?
How widespread is this practice; how long has it been practiced?
Key Marketing Decision #3
What Are the Key Benefits of the New Behavior or Product?
Existing Info
Information Needed
What benefits would the primary audience gain from adopting the recommended behavior?
Are there benefits to the secondary and tertiary audiences?
Key Marketing Decision #4
What Costs and Other Barriers Must be Addressed?
Existing Info
Information Needed
What is the target audience asked to give up or exchange for the benefits?

• What other barriers prevent them from performing the new behavior?
• Perceived risk
• Self-efficacy
• Availability
• Access
• Social norms
• Skills
• Policies
  Key Marketing Decision #5
  Where Should We Place the Product/Behaviors?
  Existing Info
  Information Needed
  If the product is tangible, where is the best place(s) to make it available?
  If it is a behavior, where does it make the most sense to promote it?

Key Marketing Decision #6
What Promotional Strategies Should We Use?
Existing Info
Information Needed
Are there time-limited opportunities that would support our program?
Are there influential personalities to support the program? Who else is credible with the
target audience(s)?
What media channels are best for this kind of communication?
Source: http://www.cdc.gov/communication/cdcynergy.html
Free Listing
In free listing, a respondent is asked to list out all the examples of a particular kind of thing
that they know about. For example, you might ask for a list of “appropriate foods for young
children,” “the most important qualities in a spouse or partner,” or “flu symptoms.” The
researcher records these items, usually on separate index cards. After a number of
respondents are asked, the researcher should have a fairly large stack of cards. (If your
respondents cannot read, you will need to use pictures or find another way of representing
their ideas.) Not all topics are suitable to free listing. People are often unaware of what they
know or don’t know and are not accustomed to analyzing their own behavior and are often
unable to call up their “reasons” for doing something or not.
Pile Sorting and Ranking
For pile sorting, you need to have individual items available on separate cards, with the item
on the front and a number on the back. You ask respondents to sort the cards into piles.
Often, you would begin by asking respondents to generate the categories themselves. For
example, if respondents were given a stack of cards with pictures of food and asked to put
them in piles, many American students would sort them into “foods I like” and “foods I don’t
like,” followed possibly by the learned categories of “good for you” and “not good for you,” or
the original four or five food groups. Other people might sort the foods into those
appropriate for breakfast, lunch, or dinner. Still others might divide them up according to
another medical system, such as “hot and cold”