How norms-shifting interventions foster community-level social and behavior change: new insights from a synthesis of realist evaluations of community-level interventions

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Publikašuvnnas:Global Health Promotion vol. 32, no. 4 (Dec 2025), p. 94
Váldodahkki: Igras, Susan
Eará dahkkit: Diakité, Mariam, Kohli, Anjalee, Carley Fogliani
Almmustuhtton:
International Union for Health Promotion and Education
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100 1 |a Igras, Susan  |u Formerly with Georgetown University, Center for Child and Human Development, Washington, DC, USA 
245 1 |a How norms-shifting interventions foster community-level social and behavior change: new insights from a synthesis of realist evaluations of community-level interventions 
260 |b International Union for Health Promotion and Education  |c Dec 2025 
513 |a Journal Article 
520 3 |a Social norms, the informal rules that influence behavior, play essential roles in shaping people’s behavior. Community-based norms-shifting interventions (NSIs) identify gender and other social norms linked to unhealthy behaviors and implement activities to promote collective change by encouraging communities to reflect on and question these norms. Though NSIs are gaining international traction in social and behavior change programming for health promotion, how change occurs needs to be clearly understood in African and other contexts. To build understanding and guidance for future NSI design, the applied-research Passages Project and collaborating non-governmental organizations in West and Central Africa conducted realist evaluations of four NSIs focused on adolescent/youth sexual and reproductive health, operating in Democratic Republic of Congo, Niger, and Senegal. The evidence base for the realist synthesis came from four quasi-experimental outcome evaluations and 19 rapid implementation studies, which confirmed the four program Theories of Change. The synthesis findings identified eight norms-shifting mechanisms common across NSIs: information provision; dialogical, experiential approaches; role modeling; safe spaces; within-community meetings; planned diffusion; cross-community meetings of change agents; and community-service linkages. NSIs directly, at times indirectly, engaged reference groups that uphold norms, explaining their theoretical roles operationally. These findings led to middle-range theory showing how NSI activities, mechanisms, and reference group engagement should, over time, lead to norms-shifting outcomes. Design implications include developing a fuller understanding of how program components, as norms-change mechanisms, lead to effects; being deliberate about when and how to engage reference groups; and recognizing systems complexity and the subsequent need for NSI implementation elasticity. 
651 4 |a Niger 
651 4 |a Congo-Democratic Republic of Congo 
651 4 |a Senegal 
653 |a Health promotion 
653 |a Behavior 
653 |a Group dynamics 
653 |a Communication 
653 |a Intervention 
653 |a Psychological safety 
653 |a Quasi-experimental methods 
653 |a Sexual behavior 
653 |a Information dissemination 
653 |a Social norms 
653 |a Schools 
653 |a Behavior change 
653 |a Reference groups 
653 |a Health behavior 
653 |a Children & youth 
653 |a Group norms 
653 |a Research design 
653 |a Community-based programs 
653 |a Implementation 
653 |a Learning 
653 |a Womens health 
653 |a Nongovernmental organizations--NGOs 
653 |a Husbands 
653 |a Community change 
653 |a Community 
653 |a Information sharing 
653 |a Rules 
653 |a Reproductive health 
653 |a Girls 
653 |a Social factors 
653 |a Behavior modification 
653 |a Change agents 
653 |a Collaboration 
653 |a Gender 
653 |a Couples 
653 |a Power-sharing 
653 |a Middle range theories 
653 |a Sexual health 
653 |a Health education 
653 |a Teenagers 
653 |a Community meetings 
653 |a Time use 
653 |a Leadership 
653 |a Puberty 
653 |a Qualitative research 
653 |a Evaluation Research 
653 |a Grandparents 
653 |a Behavior Standards 
653 |a Communication (Thought Transfer) 
653 |a Community Responsibility 
653 |a Child Development 
653 |a Cultural Awareness 
653 |a Child Rearing 
653 |a Child Health 
653 |a Females 
653 |a Early Adolescents 
653 |a Holistic Approach 
653 |a Gender Issues 
653 |a Interviews 
653 |a Evidence 
653 |a Adults 
653 |a Concept Mapping 
653 |a Focus Groups 
653 |a Social 
653 |a Adolescent Literature 
653 |a Communities of Practice 
653 |a Leaders 
653 |a Fidelity 
700 1 |a Diakité, Mariam  |u Formerly with Georgetown University, Center for Child and Human Development, Washington, DC, USA 
700 1 |a Kohli, Anjalee  |u Formerly with Georgetown University, Center for Child and Human Development, Washington, DC, USA 
700 1 |a Carley Fogliani  |u Formerly with Georgetown University, Medical Center Research Development Unit, Washington, DC, USA 
773 0 |t Global Health Promotion  |g vol. 32, no. 4 (Dec 2025), p. 94 
786 0 |d ProQuest  |t Healthcare Administration Database 
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856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3282964768/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch