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Behaviour Centred Design

Behaviour Centred Design

A general framework for behaviour change programming, founded in the latest behavioural science and design thinking.

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Behaviour Centred Design (BCD) has been developed over the past decade by academics from LSHTM’s Environmental Health Group. The approach combines evolutionary and environmental psychology and best marketing practice to design and test imaginative and provocative behaviour change interventions.

Resources

Those interested in BCD can take advantage of a number of resources and publications available on this website.

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About
About BCD
People
Team BCD
Projects
Projects BCD

The BCD approach has been used to change behaviour in a number of programs around the world.

Our projects  

Project Name: SuperAmma (‘SuperMom’)
Active Dates: 2009
Target Behaviour(s): Handwashing with soap after defecation
Target Population: Mothers of children under 5
Country: India (rural)
Funder(s): Wellcome Trust
Website: Superamma.org, https://www.youtube.com/watch?v=rZ7w3voJbuU
Description: Cluster randomized control trial of a handwashing with soap intervention in a rural Indian population. Successful in increasing handwashing rates from a state of near absence to sustained practice in nearly one-third of the target population.
Documentation:
1. Biran A, Schmidt W, Varadharajan K, Rajaraman D, Kumar R, Greenland K, Gopalan B, Aunger R, Curtis V (2014). "Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial." The Lancet Global Health 2(3): e145-e154.

2. Rajaraman D, Varadharajan K, Greenland K, Curtis V, Kumar R, Schmidt W, Aunger R and Biran A (2014). "Implementing effective hygiene promotion: lessons from the process evaluation of an intervention to promote handwashing with soap in rural India." BMC Public Health

Project Name: Komboni Housewives
Active Dates: 2011-13
Target Behaviour(s): Handwashing with soap, Use of ORS and zinc when child has diarrhoea, Exclusive breastfeeding until 6 months
Target Population: Mothers of children under 5
Country: Zambia
Funder(s): Absolute Return for Kids (ARK)
Website: Kombonihousewives.org
Documentation:
1. Greenland K, Chipungu J, Chilengi R and Curtis V (2016) Theory-based formative research on oral rehydration salts and zinc use in Lusaka, Zambia. BMC Public Health.

2. Greenland K, Chipungu J, Curtis V, Schmidt W, Siwale Z, Mudenda M, Chilekwa J, Lewis J, Chilengi R (2016). "Multiple behaviour change intervention for diarrhoea control in Lusaka, Zambia: a cluster randomised trial." The Lancet Global Health 4(12): e966-e977.

Kombonis
Project Name: 3P
Active Dates: 2015-present
Target Behaviour(s): Use, of and adherence to, oral PrEP
Target Population: Adolescent girls and young women
Country: South Africa
Funder(s): Gates Foundation
3P

Project Name: Nepal Food Hygiene Project
Active Dates: 2014-5
Target Behaviour(s): Handwashing with soap before serving food,
Target Population: Mothers of children under 5
Country: Nepal
Funder(s): WaterAid, Sanitation and Hygiene Applied Research for Equity
Website: Nepal Food Hygiene on DFID website
Documentation:
1. Gautam, Omprasad (2015) Food hygiene intervention to improve food hygiene behaviours, and reduce food contamination in Nepal: an exploratory trial. PhD thesis, London School of Hygiene & Tropical Medicine. DOI: 10.17037/PUBS.02531624

Nepal food hygiene

Project Name: Project Baduta
Active Dates: 2013-4
Target Behaviour(s): Exclusive breastfeeding, Reduced snacking, increased nutritional diversity
Target Population: 0-2 year olds and their mothers
Country: Indonesia
Funder(s): Global Alliance for Improved Nutrition
Website: Project Baduta website
Description: Trial of intervention to increase the use of affordable nutritious complementary foods, reduce use of industrial milks and support mothers to continue breastfeeding. Intervention uses ‘gossip’ to manipulate social norms.
Documentation:
White S, Schmidt W, Sahanggamu D, Fatmaningrum D, van Liere M, Curtis V.(2016). Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in East Java, Indonesia. Trop Med Int Health.

Project Baduta
Project Name: Respect Campaign
Active Dates: 2015-17
Target Behaviour(s): Handwashing with soap
Target Population: Mothers of children under five
Country: Nigeria
Funder(s): WSSCC
Respect
Project Name: Lusaka Sanitation Demand
Active Dates: 2016-present
Target Behaviour(s): Latrine improvement
Target Population: Landlords
Country: Zambia
Funder(s): Sanitation and Hygiene Applied Research for Equity
 

Project Name: Exercise Promotion in Cancer Patients
Active Dates: 2012-15
Target Behaviour(s): Walking
Target Population: Prostate cancer patients
Country: UK
Documentation:

Doyle, Ciaran. (2015). Evaluation of a Home-Based Walking Exercise Program on Fatigue and Health Related Quality of Life in Prostate Cancer Patients Undergoing Radiation Therapy: A Pilot Study. (DrPH), London School of Hygiene and Tropical Medicine, London.   

 
Project Name: Hand Hygiene Compliance Improvement
Active Dates: 2014-present
Target Behaviour(s): Handwashing with soap
Target Population: Nurses
Country: USA
Funder(s): GoJo Industries
 

BCD has also been used in a number of projects with various commercial and creative clients not reported here.

Publications
Scientific Papers
Publications List
BCD Resources
BCD Paper
This peer-refereed paper provides a brief, non-technical introduction to the approach.
BCD Manual
For behaviour change practitioners, the BCD Manual is a user-friendly means of learning how to use BCD during the program development process.
BCD Guide
For researchers, the BCD Guide provides a more theoretical foundation for BCD.
BCD Infographic
The BCD Infographic is a simple, graphically-oriented introduction to the main tenants of the approach.
BCD Formative Research Protocols
These Protocols provide a wide range of techniques for eliciting information during formative research fieldwork.
Evidence of impact
"Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial."
Biran A, Schmidt W, Varadharajan K, Rajaraman D, Kumar R, Greenland K, Gopalan B, Aunger R, Curtis V (2014)
The Lancet Global Health 2(3): e145-e154
"Implementing effective hygiene promotion: lessons from the process evaluation of an intervention to promote handwashing with soap in rural India."
Rajaraman D, Varadharajan K, Greenland K, Curtis V, Kumar R, Schmidt W, Aunger R and Biran A (2014)
BMC Public Health
Theory-based formative research on oral rehydration salts and zinc use in Lusaka, Zambia
Greenland K, Chipungu J, Chilengi R and Curtis V (2016)
BMC Public Health
"Multiple behaviour change intervention for diarrhoea control in Lusaka, Zambia: a cluster randomised trial."
Greenland K, Chipungu J, Curtis V, Schmidt W, Siwale Z, Mudenda M, Chilekwa J, Lewis J, Chilengi R (2016)
The Lancet Global Health 4(12): e966-e977
Food hygiene intervention to improve food hygiene behaviours, and reduce food contamination in Nepal: an exploratory trial
Gautam, Omprasad (2015)
PhD thesis, London School of Hygiene & Tropical Medicine. DOI: 10.17037/PUBS.02531624
Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in East Java, Indonesia
White S, Schmidt W, Sahanggamu D, Fatmaningrum D, van Liere M, Curtis V.(2016)
Trop Med Int Health
Experimental pretesting of hand-washing interventions in a natural setting
Judah G, Aunger R, Schmidt WP, Michie S, Granger S, Curtis V
American Journal of Public Health. 2009 October 24: 05-11
‘Tooth-brushing as routine behaviour.’
Aunger, Robert (2007)
International Dental Journal 57 (5): 364-376
Theoretical frameworks
‘The Evo-Eco approach to behaviour change’
Aunger, Robert and Valerie Curtis (2014)
Applied Evolutionary Anthropology, ed. by David Lawson and Mhairi Gibson. Springer
‘Planned, motivated and habitual hygiene behaviour: an eleven country review.’
Curtis, Valerie, Lisa Danquah and Robert Aunger (2009)
Health Education Research 24(4): 655-673
‘Stage models of behaviour change’
Sniehotta, Falko and Robert Aunger (2010)
Health Psychology (2nd edition), edited by David P French, A Kaptein, K Vedhara and John Weinman. Oxford: Wiley/Blackwell
A New Approach to Studying the Effects of Modern Technologies on Human Behavior
Aunger, Robert (2010)
‘Three roads to cultural replication’. Evolutionary Psychology and Information Systems Research. Edited byNed Kock. New York: Springer Verlag, pp. 341-354
Motivational mismatch: Evolved motives as the source of – and solution to – global public health problems
Curtis, Valerie and Robert Aunger (in press)
Practical Uses of Evolutionary Psychology, ed. by Craig Roberts. Oxford University Press
Serotonin-a link between disgust and immunity?
Rubio-Godoy, M., R. Aunger, and CURTIS V. (2007)
Medical Hypotheses 68(1): 61-66
The anatomy of motivation: An evolutionary ecological approach
Aunger, Robert and Val Curtis (2013)
Biological Theory 8:49-63
Three kinds of psychological determinants for hand-washing behaviour in Kenya
Aunger, Robert, Wolf-Peter Schmidt, Ashish Ranpura, Yolande Coombes, Peninnah Mukiri Maina, Carol Nkatha Matiko and Valerie Curtis (2010)
Social Science and Medicine 70: 383-391
‘Kinds of behaviour’
Aunger, Robert, and Valerie Curtis (2008)
Biology and Philosophy 23(3):317-345
‘Disgust as an adaptive system for disease avoidance behaviour’
Curtis, Valerie, Míchèal DeBarra and Robert Aunger (2011)
Philosophical Transactions of the Royal Society B: Biological Sciences 366: 389-401
Why disgust matters
Curtis, V. (2011)
Philos Trans R Soc Lond B Biol Sci
‘Infection cues and disgust sensitivity’
De Barra, Míchèal, Robert Aunger, Diana Fleischman, and Valerie Curtis (submitted)
Journal of Personality and Social Psychology
Evidence that disgust evolved to protect from risk of disease
CURTIS V, AUNGER R and RABIE T (2003)
Proceedings of the Royal Society Biology Letters Supplement, 2003, 0144
Dirt, Disgust, and Disease: Is Hygiene in Our Genes?
Curtis, V and Biran, A
Perspectives in Biology and Medicine, 44.1, 2001
Hygiene: How myths, monsters and mothers-in-law can promote behaviour change
CURTIS V. (2001)
Journal of Infection 2001: 43: 75 – 79
Dirt and Disgust: a Darwinian perspective on hygiene
Curtis V, Voncken N and Singh S
Medische Antropologie 11 (1) 143-158 1999
Resources
BCD publication

BCD Resources

BCD Paper
This peer-refereed paper provides a brief, non-technical introduction to the approach.

BCD Manual
For behaviour change practitioners, the BCD Manual is a user-friendly means of learning how to use BCD during the program development process.

BCD Guide
For researchers, the BCD Guide provides a more theoretical foundation for BCD.

BCD Infographic
The BCD Infographic is a simple, graphically-oriented introduction to the main tenants of the approach.

BCD Formative Research Protocols
These Protocols provide a wide range of techniques for eliciting information during formative research fieldwork.

BCD Checklist
The BCD Checklist is a tool for understanding the causes of behaviour that can be used in collaboration with formative research, behavioural observation, theory of change development and other tasks.

Webinars

The following links are to a series of six roughly hour-long webinars about BCD theory and process for designing behaviour change programs, with a focus on hygiene, and some general background on behaviour change.

WaterAid BCD Webinar 1
WaterAid BCD Webinar 2
WaterAid BCD Webinar 3
WaterAid BCD Webinar 4
WaterAid BCD Webinar 5
WaterAid BCD Webinar 6

A set of lecture notes to accompany these webinars are also available as a set of pdfs below:

Evidence of impact

"Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial." 
Biran A, Schmidt W, Varadharajan K, Rajaraman D, Kumar R, Greenland K, Gopalan B, Aunger R, Curtis V (2014) The Lancet Global Health 2(3): e145-e154

"Implementing effective hygiene promotion: lessons from the process evaluation of an intervention to promote handwashing with soap in rural India."
Rajaraman D, Varadharajan K, Greenland K, Curtis V, Kumar R, Schmidt W, Aunger R and Biran A (2014), BMC Public Health

Theory-based formative research on oral rehydration salts and zinc use in Lusaka, Zambia
Greenland K, Chipungu J, Chilengi R and Curtis V (2016), BMC Public Health

"Multiple behaviour change intervention for diarrhoea control in Lusaka, Zambia: a cluster randomised trial."
Greenland K, Chipungu J, Curtis V, Schmidt W, Siwale Z, Mudenda M, Chilekwa J, Lewis J, Chilengi R (2016), The Lancet Global Health 4(12): e966-e977

Food hygiene intervention to improve food hygiene behaviours, and reduce food contamination in Nepal: an exploratory trial
Gautam, Omprasad (2015), PhD thesis, London School of Hygiene & Tropical Medicine. DOI: 10.17037/PUBS.02531624

Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in East Java, Indonesia
White S, Schmidt W, Sahanggamu D, Fatmaningrum D, van Liere M, Curtis V.(2016), Trop Med Int Health

Experimental pretesting of hand-washing interventions in a natural setting
Judah G, Aunger R, Schmidt WP, Michie S, Granger S, Curtis V, American Journal of Public Health. 2009 October 24: 05-11

‘Forming a flossing habit: An investigation into the psychological determinants of habit formation’
Judah, G, Sood B, and Aunger B, British Journal of Health Psychology

‘Tooth-brushing as routine behaviour.’
Aunger, Robert (2007), International Dental Journal 57 (5): 364-376

Theoretical frameworks

‘The Evo-Eco approach to behaviour change’
Aunger, Robert and Valerie Curtis (2014), Applied Evolutionary Anthropology, ed. by David Lawson and Mhairi Gibson. Springer

‘Planned, motivated and habitual hygiene behaviour: an eleven country review.’
Curtis, Valerie, Lisa Danquah and Robert Aunger (2009), Health Education Research 24(4): 655-673

‘Stage models of behaviour change’
Sniehotta, Falko and Robert Aunger (2010), Health Psychology (2nd edition), edited by David P French, A Kaptein, K Vedhara and John Weinman. Oxford: Wiley/Blackwell

A New Approach to Studying the Effects of Modern Technologies on Human Behavior
Aunger, Robert (2010), ‘Three roads to cultural replication’. Evolutionary Psychology and Information Systems Research. Edited byNed Kock. New York: Springer Verlag, pp. 341-354

Motivational mismatch: Evolved motives as the source of – and solution to – global public health problems
Curtis, Valerie and Robert Aunger (in press), Practical Uses of Evolutionary Psychology, ed. by Craig Roberts. Oxford University Press

Serotonin-a link between disgust and immunity?
Rubio-Godoy, M., R. Aunger, and CURTIS V. (2007), Medical Hypotheses 68(1): 61-66

The anatomy of motivation: An evolutionary ecological approach
Aunger, Robert and Val Curtis (2013), Biological Theory 8:49-63

Three kinds of psychological determinants for hand-washing behaviour in Kenya
Aunger, Robert, Wolf-Peter Schmidt, Ashish Ranpura, Yolande Coombes, Peninnah Mukiri Maina, Carol Nkatha Matiko and Valerie Curtis (2010), Social Science and Medicine 70: 383-391

‘Kinds of behaviour’
Aunger, Robert, and Valerie Curtis (2008), Biology and Philosophy 23(3):317-345

‘Disgust as an adaptive system for disease avoidance behaviour’
Curtis, Valerie, Míchèal DeBarra and Robert Aunger (2011), Philosophical Transactions of the Royal Society B: Biological Sciences 366: 389-401

Why disgust matters
Curtis, V. (2011), Philos Trans R Soc Lond B Biol Sci

‘Infection cues and disgust sensitivity’
De Barra, Míchèal, Robert Aunger, Diana Fleischman, and Valerie Curtis (submitted), Journal of Personality and Social Psychology

Evidence that disgust evolved to protect from risk of disease
CURTIS V, AUNGER R and RABIE T (2003), Proceedings of the Royal Society Biology Letters Supplement, 2003, 0144

Dirt, Disgust, and Disease: Is Hygiene in Our Genes?
Curtis, V and Biran, A, Perspectives in Biology and Medicine, 44.1, 2001

Hygiene: How myths, monsters and mothers-in-law can promote behaviour change
CURTIS V. (2001), Journal of Infection 2001: 43: 75 – 79

Dirt and Disgust: a Darwinian perspective on hygiene
Curtis V, Voncken N and Singh S, Medische Antropologie 11 (1) 143-158 1999

Updates
Updates list
Updates List
Behaviour Centred Design used to guide programming around COVID-19 public health responses around the world

Behaviour Centred Design is being used to guide programming around COVID-19 public health responses around the world. 

This guide shows how governments in LDICs can use this approach effectively.

Contact
Contact BCD

Contact us by email on BCDFrame@gmail.com