Constraints to Knowledge Gain and Behavior Change in Response to a Multi-media Health Education Project in Gambia, West Africa

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Doctor of Philosophy (PhD)
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McDivitt, Judith A.

This dissertation examines the role of information in bringing about knowledge and behavior change in health in a developing country. It specifically considers the constraints to change provided by the physical, social, and cultural context in which this information is introduced. The primary questions asked were: Under what conditions and for whom does mass-mediated health information lead to knowledge and does knowledge lead to health behavior change? Conditions hypothesized included factors at the level of the individual (e.g., access to material goods and time, contact with health workers) and compound or village characteristics (e.g., compound wealth, social support, level of development in the village). The research studied a multi-media campaign providing information about the treatment of infant diarrhea in The Gambia, West Africa. The study used survey responses from a stratified sample of 677 rural mothers. The data base included responses from interviews done before and over the first eighteen months of the campaign. The analyses were performed in steps, first testing the relationship between knowledge and practice (or mass media exposure and knowledge) while controlling for possible interviewer bias and other extraneous factors, then examining the interaction effect of the independent variable and each of the hypothesized conditioning factors. Overall, most of the conditioning relationships were not statistically significant and, of those that were, most showed a pattern opposite to that hypothesized. For knowledge and behavior, the major finding was that level of development in the village is a condition significantly affecting the relationship between knowledge about an oral rehydration solution and its use. Social support, family literacy and mother's status also provided positive, although not statistically significant, conditions. For radio exposure and knowledge, mothers with interpersonal sources of information were expected to be more likely to learn from the radio than mothers without interpersonal sources. However, radio exposure only made a significant difference in knowledge for mothers without other sources of information, indicating that the mass media can act as alternative sources of information for those without access to other sources. The most important constraint to knowledge was access to information, rather than situational factors such as wealth, education, or village characteristics. (Abstract shortened with permission of author.)

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