How Norms-Shifting Interventions Foster Social Norms Change: A Realist Synthesis of Four Community Level Interventions

"Building a body of systematically gathered information and experience with NSI norms-change mechanisms, change agents, and reference group engagement can help further clarify good practice in NSI design."

Between 2017 and 2020, the United States Agency for International Development (USAID)-funded Passages Project supported four community-based norms-shifting interventions (NSIs) in three countries that worked to improve adolescent and youth sexual and reproductive health (AYSRH). By analysing how change happened in these projects - how new social norms began to take hold - this paper offers considerations for designing NSIs so future interventions are more strategic in their norms-shifting strategies to support behaviour change.

The Passages Project employs a Realist Evaluation approach, which uses programme theories of change to understand and test how project activities lead to a series of intermediate changes that eventually lead to outcomes. The Realist Synthesis focused on norms change mechanisms defined as having two interlinked parts: (i) the NSI activities, including the social change agents who implement activities and (ii) the subsequent changes in the reasoning of the receiving community.

The realist synthesis compared four Passages-supported NSIs (see also Related Summaries, below):

• Transforming Masculinities - implemented in the Democratic Republic of the Congo (DRC) as Masculinité, Famille, et Foi (MFF), with activities including training of, and outreach by, gender champions, as well as linkages to services. Norms-shifting aims included: power-sharing within young couples vis-à-vis family planning; and men and women being non-violent in their communication and other actions.
• Husbands' Schools - implemented in Niger, with activities including training of, and outreach by, "model husbands", as well as linkages to services. Norms-shifting aims included: power-sharing within young couples vis-à-vis reproductive health; and women's support by men and power-sharing expressed as community norm.
• Girls' Holistic Development - implemented in Sengal, with activities including community reflection on girl issues, empowerment of grandmothers as community advocates and advisors to young girls, and engagement of teachers-grandmothers-girls. The norms-shifting aim was collective community reflection vis-à-vis girls, cohesion in intention, and then action.
• Growing Up Great! - implemented in DRC, with activities including after-school clubs for younger girls and boys, parent video-reflection sessions, and teacher-provider and adolescent exchanges. The norms-shifting aim was gender-equitable attitudes by parents and among parent peers, teachers, and healthcare providers.

Overall, the Realist Synthesis showed that all four NSIs worked strategically with trained social change agents and change mechanisms within the project activities to build and diffuse over time new ways of thinking about adolescent health, gender, and social wellbeing. These activities with trusted community actors led to the emergence of new community change agents, including reference groups, and growing community support for behaviour change.

The synthesis highlighted that the objective of an NSI is to influence community-level beliefs (or norms) about what is expected and acceptable behaviour of its members - which, when aligned, will support individual opinions and behaviour change. To achieve this, community-based NSI focus less on personal knowledge and self-efficacy improvements and more on group dialogues, including intergenerational dialogues, around normative expectations and their link to health outcomes.

The report identifies eight change mechanisms used to foster norms shifting (see table 1 on page 11 of the report). Some of these NSI mechanisms are direct, such as using dialogical activities to foster social comparison and learning or role modeling to legitimise new behaviours in front of the community. Others act to amplify change, such as diffusion processes designed to spread new norms and behaviours to other community members who do not directly participate in project activities or including community-services linkages. However these mechanisms are employed, project- and community-level change agents are key to facilitating supportive processes of social change.

The four NSIs reflect similarities in social change agent types: project staff, community volunteers, and reference groups. All projects began activities with NSI staff who were trained on the specific animation function they performed in the project, which also included some level of personal values-reflection activities vis-à-vis norms. New community change agents emerged later in implementation. Motivated by information and ideas circulating from project activities, these individuals changed their thinking and willingness to advocate for change and consequently took on role modeling new ways of communicating and acting that foster norm shifting.

For example, reference groups include those who influence young peoples' attitudes and AYSRH actions. They are often peers and family. NSIs reach these reference groups either directly or indirectly via diffusion. In the process, reference groups assimilate new ideas and attitudes, allowing them to play opinion-setting and legitimisation roles for norms-shifting. They may, for example, publicly disseminate new ideas and model new behaviours, which helps build social solidarity in favour of behaviour change.

In short, this Realist Synthesis has led to a middle-range theory explaining how project activities and their change mechanisms, including change agents, foster shifts in community reasoning that grow over time via diffusion effects and information feedback loops, leading to behavioural and normative changes. For a visual representation of the process, see figure 4 on page 14 of the report.

Based on the analysis, the report offers recommendations for designing community-based NSIs that work with very young adolescents and young adults:

1. Ensure a complete understanding of the norms-change mechanisms.
2. Take the time to build the technical and interpersonal skills of staff and community change agents, including through reflection activities that examine their values, perceptions, beliefs, and actions.
3. Be deliberate in who, how, and when to integrate reference groups into change theories and NSI strategies.
4. Be aware that not all reference groups need to be engaged at the same time or in the same way.
5. Recognise systems complexity, and be realistic about what level of change is feasible within the project resources and timeline.
6. Allow for flexibility; over time, community needs change, and so should the NSI.
7. Be prepared to adjust: Build in regular review of activities and data, feedback loops, and consultative processes.