What influences health behavior? Learning from caregivers of young children in Viet Nam.

Globally, the caregiving behaviors that contribute to good nutritional status are well understood; but it is not clear why some caregivers perform these behaviors while others do not. This formative qualitative research was designed to improve understanding about what distinguishes caregivers who practice optimal behaviors from those who do not. This study is a one-time, cross-sectional baseline assessment of factors that affect nutrition-related behavior change. It took place in a rural northern province in Viet Nam. One hundred caregivers of children 6 to 17.9 months of age from five communes were interviewed. None of the five communes were included in the larger prospective study designed to test the impact of the Community Empowerment and Nutrition Program (CENP). Four behaviors were examined: feeding the child "positive deviant" foods, feeding the child during diarrheal episodes, washing the child's hands, and taking the child to the health center when ill. Results indicate that for all four behaviors, favorable social norms distinguished those who practiced each behavior from those who did not. Positive, reinforcing beliefs and attitudes were important determinants of every behavior except handwashing Likewise, self-efficacy differentiated doers from non-doers for all behaviors except feeding during diarrheal episodes. Findings from this research suggest that fathers and in-laws of non-doers are more likely to fail to advise mothers about infant feeding and health than they are to provide negative advice. By discovering what distinguishes those who practice optimal behaviors from those who do not, researchers, program planners, and others are better equipped to develop targeted interventions that lead to positive behavior change.