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This study reconsiders traditional hierarchy models that posit a learning model of behavior change in which knowledge precedes attitudes, which in turn influence behavior. The case of contraception in Peru is considered and six possible knowledge, attitude, and practice permutations are developed. Contraceptive practice may precede detailed knowledge that may result in considerable misinformation. This misinformation may lead to dissatisfied users and discontinued use of health behaviors. Media campaigns designed to inform the public can create a more informed population of users, which in turn may create a more satisfied and hence sustainable user base. Assessing the fit of behavior change models is consistent with emerging work in development communication that has called for women's empowerment and informed choice to be cornerstones of health and development policy. The informed choice approach provides the basis for communication strategies that can more readily create a critical mass of support for such policies.
Valente et al. (Sun,) studied this question.