My first project was a large-scale nutrition intervention across countries in South Asia and Sub-Saharan Africa. The project was focused on child stunting, a major challenge in developing contexts which carries severe health and developmental implications even in adulthood. While several factors feed into designing policy and interventions to combat stunting, behavioral factors play a major role in enabling or obstructing the success of programs. This project was aimed at uncovering these behavioral drivers that impact nutrition outcomes in children to ensure program success.
As I went through the project material, my supervisor introduced me to the COM-B model, which is short for the Capability, Opportunity, Motivation, Behavior model. The COM-B was devised by Susan Michie, Maartje M van Stralen, and Robert West to identify what needs to change for a behavior change intervention to be effective. It locates behavior as a system comprising three essential conditions - capability, opportunity, and motivation – which interact over time with positive and negative feedback loops. Essentially, the model represents the observation that at any point of time, a behavior will occur only when the person concerned has the capability and opportunity to engage in the behavior and is more motivated to engage in it than any other competing behavior.[1]
The COM-B model has been used extensively in diagnosing and designing behavior change interventions in healthcare.[2] The advantage of using the COM-B model is that it allows the recognition of the several drivers of behavior, and how behavior change can be induced by modifying at least one of the components.[3]
This was my first time learning about and applying the COM-B model. As I started digging deeper and analyzing the qualitative data from the field, I found that the COM-B model was a very effective and encompassing framework to locate and organize barriers and enablers for certain behaviors. It can also aid a systematic design of interventions and policy responses that impact the individual drivers of behavior.
I hope to continue applying the COM-B model in my future projects!
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[1] Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science : IS, 6(1), 42–42. https://doi.org/10.1186/1748-5908-6-42
[2] Wakida, E. K., Obua, C., Rukundo, G. Z., Maling, S., Talib, Z. M., & Okello, E. S. (2018). Barriers and facilitators to the integration of mental health services into primary healthcare: a qualitative study among Ugandan primary care providers using the COM-B framework. BMC Health Services Research, 18(1), 890–890. https://doi.org/10.1186/s12913-018-3684-7
[3] Michie et al. (2011)
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