Effects of participation and sense of community on change agents in an Indonesian sanitation behaviour change communications program

Abstract

Social and behaviour change programs often require “change agents” to effectively disseminate messages to target populations on issues ranging from sanitation to alcohol. How these programs select and utilise change agents – e.g. peer educators, community health workers, sales agents and counsellors – helps determine how effective they are. The setting for this quasi-experimental PhD study was the High 5 Kelurahan project designed to address five key sanitation behaviours, managed by the Cipta Cara Padu Foundation in Indonesia. This study utilised a mixed method approach to produce evidence for the effects of previous participation and sense of community (SOC) on 69 change agents engaged in the High Five program. A simple one-way between groups ANOVA test revealed that the Sense of Community Index (SCI) scores were statistically different across the three project locations. Following this, stepwise multiple regression analysis showed a small effect of previous participation by change agents on their subsequent participation in High Five community outreach activities, however SOC had no significant effect. A non-statistical comparison of SCI scores with changes in individual behaviour and health impact revealed that project locations where change agents with higher SCI scores were active also had higher rates of behaviour change and health impact. From the nine interviews of change agents, all responded that previous participation in similar programs was a factor in their High Five participation. 30 per cent of responses also identified the perceived ability to change the community as a factor. The quantitative and qualitative results were triangulated to produce a richer understanding of the role of change agents. This research will help governments, non-profits and businesses to better understand how change agents influence social and behaviour change programs in communities and improve interventions aiming to address a range of public policy issues.