Summary
The episode works through four questions that students find difficult when they apply social and behavioural theory in global health. It applies the Health Belief Model to an invented bed net program to show how constructs are filled in with local content and why the decision-making unit matters, and it uses World Health Organization figures on noncommunicable disease and Statistics Canada research on the healthy immigrant effect to examine the limits of the epidemiologic transition and its movement across borders. Sarah places an invented case in the AIDS Risk Reduction Model, mistakes knowledge about HIV for labelling one's own behaviour as high risk, and corrects the error. The hosts then rank the kinds of evidence that global programs report, discuss the published evaluation of the Cameroon social marketing campaign, and work a harder example in which an invented measles campaign passes from a crisis configuration of actors to long-term prevention and the Health Belief Model's constructs must be filled in again. The episode ends with a disagreement about how far Trials of Improved Practices can change a recommended behaviour, drawing on Cochrane reviews of handwashing with soap and with ash and on the global definition of a basic hygiene service.