Development and Evaluation of Effectiveness of a Universal Behavior Change Communication (UBCC) Model

A BSTRACT Background: Universal Behavior Change Communication (UBCC) is a comprehensive communication model, with participant-centric messages, applicable to varied social and clinical pathologies. Objective: To develop and evaluate the effectiveness of the UBCC model. Methodology: A multiphase mixed-method study from June 2022 to July 2023. Phase I and III were conducted in urban field practice areas, where two Galis each were selected using simple random sampling. Phase II was conducted in urban and rural using systematic random sampling for household selection. Data were collected by face-to-face interviews. Basic communication framework was developed in Phase I using comprehension and retention analysis on “Anemia Mukt Bharat.” Model content and implementation processes were finalized in Phase II, targeting parental coronavirus disease 2019 (COVID-19) vaccine hesitancy. Effectiveness was evaluated in Phase III by extrapolating the model to other health issues, where reliability and validity were assessed. Binary logistic regression and Chi-square tests were applied for analysis. Results: In Phase I, participants had higher odds of retaining subdomains of perceived susceptibility (aOR = 5.7, P < 0.001), perceived severity (aOR = 1.8, P = 0.02), perceived benefits (aOR = 7.5, P < 0.001) and convenience (aOR = 3.8, P = 0.003). The Ebbinghaus retention curve showed higher residual knowledge in the group where repetition was done. The addition of regional statistics in Phase II had higher vaccine acceptance ( P = 0.001). The choice of implementer ( P = 0.377) and place of implementation ( P = 0.099) showed no significant difference. Phase III demonstrated positive behavior change in “cloth washing practices” ( P = 0.003) and “footwear practice” ( P = 0.001). The model had good internal consistency (Cronbach’s α =0.893), substantial test-retest reliability (ICC = 0.69-0.78), and satisfactory content validity index (0.94). Conclusion: There is a need to apply resource-saving UBCC model with high validity and reliability, across various levels of health care system.