TIPs (Trials of Improved Practices)
Trials of Improved Practices.
TIPs was developed by the Manoff Group, and was first used in the late 1970’s and early 1980’s in nutrition programming.
Very broad range of health-related behaviours. Not so suitable for behaviours that:
- Stretch over a long time (e.g. breastfeeding).
- Are rare or unpredictable behaviours (e.g. health-seeking for uncommon diseases).
- Face strong external barriers (e.g, poor policies).
- Require collaboration or approval of many different actors.
Focus within the process
TIPs can be used to define new behaviours / practices / products / services and test whether they are acceptable and feasible, as well as to adapt them on the basis of research / piloting at household level, before promoting them. The TIPs approach has some similarities to Product research in social marketing.
TIPs can be used by program planners to pretest the actual practices that a programme will promote. In essence the procedure consists of a series of visits in which the interviewer (project team) and the participant (potential user) analyze current practices, discuss what could be improved, and together reach an agreement on one or a few solutions to try over a trial period; and then assess the trial experience together at the end of the trial period. The results are moved directly into program design. TIPs enables the people who are the focus of behaviour-change interventions to participate actively in the analysis of barriers and enablers to change, as well as identifying feasible and acceptable options for change.
Supporting BC theories
No particular theories are mentioned. TIPs is based on understanding people’s preferences, capabilities, obstacles and motivations. This is close to the FOAM determinants (Opportunities (obstacles) Abilities (capabilities), Motivation (preferences and motivation)).
About 1 week for trials, plus preparatory work (step 1 below) and analysis/design workshop (steps 5 and 6 below).
Qualitative research skills, intervention and product/behaviour design skills, no specialist skills required in communications.
Case studies and examples
- Shifting Nutrition and Hygiene Behaviors in Sierra Leone Utilizing Trials of Improved Practices, SPRING and HKI, 2017.
- Conducting trials of improved practices in Madagascar, Research Brief, USAID Hygiene Improvement Project, 2007, (improvement of hygiene behaviours).
- The Power of Counseling: Changing Maternal, Infant, and Young Child Nutrition and Family Planning Practices in Dhamar, Yemen, Assabri AM, Cooper C, Al-Gendari KA, Pfitzer A, Galloway R, Maternal and Child Health Integrated Program (MCHIP), Maternal and Child Survival Program (MCSP), USAID, 2015.
The following steps were used in implementing TIPs in Sierra Leone – Shifting Nutrition and Hygiene Behaviors in Sierra Leone Utilizing Trials of Improved Practices, SPRING and HKI, 2017.
|STEP 1||Create and prioritize a menu of evidence-based behavioral options using existing data and knowledge of the local context based on literature survey, key-informant interviews and a small number of household interviews.
Prepare communications materials to explain the selected behaviours at household level.
|STEP 2||Visit selected (volunteer) households to do interviews and observations so as to understand the household’s context and current behaviors.|
|STEP 3||Return to the same households to advise and negotiate one to two new specific behaviors that the household is willing to try.|
|STEP 4||Return again to the same households a week to 10 days later to:
- Understand which behaviors households were able and not able to do.
- Learn about the most important barriers and enablers to the suggested behaviors.
- Solicit suggestions from the participants about how to modify and promote the behaviors.
|STEP 5||Analyze the findings to understand which behaviours are acceptable and feasible, what modifications to make to proposed behaviours, what are the key motivators for adopting the behaviours and what barriers and enablers to address.|
|STEP 6||Build a behaviour-change framework based on Step 5 (in the Sierra Leone example, the DBC Framework was used - so involved identifying bridges to activities and BC activities).|
The approach does not provide specific contents for this step.