I’ll be working in Nandaime, Nicaragua where there are limited health services provided by the government, and the infrastructure is poor with little indoor plumbing. I will be jointly collaborating with Carrie McCracken, the director of Viva Nicaragua, Dr. Cruz, the director of the Children’s Wellness Fund and the primary physician at the local clinic in Nandaime in order to improve dental hygiene in this community. Before a program can be implemented though, the behavioral determinant needs to identified. I’ll be using the Barrier Analysis Tool to identify the behavioral determinant so more effective change messages, strategies and activities can be created. This tool has been used by Food for the Hungry in projects in Haiti, Kenya, and Bolivia to discover key barriers to behavior change regarding breastfeeding, other nutritional practices, latrine use, HIV/AIDS behaviors and other intervention areas. The interview questions and focus group questions used in the Barrier Analysis tool focus on eight determinants: perceived susceptibility, perceived severity, perceived action efficacy, perceived self-efficacy, cues for action, perceived social acceptability, perception of Divine will, and positive and negative attributes of the behavior.
From the earliest stages, this project has been created with local community partners, Children’s Wellness Fund and Viva Nicaragua, and the objectives have been defined conjunctly. As a community based research project, the outcomes of this project will directly benefit the local community by creating a health education program for a specific school. This health education program will continue long after the life of the project as one of the primary goals has been to ensure the sustainability of the program. Facilitators in the Children’s Wellness Fund will be involved throughout the whole project and will learn the Barrier Analysis Tool. Therefore, they can utilize the tool in the future to determine why other healthy behaviors aren’t followed or reluctantly followed.