The role of partners, parents and friends in shaping young women's reproductive choices in Peri-urban Nairobi: a qualitative study.

BACKGROUND: Contraceptive use among young women in Nairobi remains low despite high general knowledge of family planning (FP) methods. This paper draws on social norms theory to explore the role of key influencers (partners, parents and friends) in women's FP use and how women anticipate normative reactions or sanctions. METHODS: A qualitative study with 16 women, 10 men and 14 key influencers across 7 peri-urban wards in Nairobi, Kenya. Interviews were conducted during the COVID-19 pandemic in 2020 by phone. A thematic analysis was conducted. RESULTS: Women identified parents, specifically mothers, aunts, partners, friends and healthcare workers as key influencers on FP. Their interactions with these key influencers varied based on trust, the information they needed about FP, and whether they perceived a key influencer to perpetuate or challenge existing social norms on FP. Mothers were perceived to understand the social risks of using FP and thus could advise on discreet FP use, and aunts were trusted and approachable sources to impartially describe the benefits and drawbacks of FP. Although women identified partners as key FP decision makers, they were cognisant of possible power imbalances affecting a final FP choice. CONCLUSIONS: FP interventions should consider the normative influence key actors have on women's FP choices. Opportunities to design and deliver network-level interventions which seek to engage with social norms surrounding FP in order to challenge misconceptions and misinformation among key influencers should be explored. Intervention design should consider dynamics of secrecy, trust and emotional closeness that mediate discussions of FP to address changing norms. Further training to change norms held by healthcare providers about why women, in particular unmarried young women, access FP should be provided to reduce barriers for FP access.

Women's decisions to use family planning (FP) are influenced by social norms, the unwritten rules of appropriate actions within social networks, and are shaped by advice and information received from key influencers­important individuals who shape what is acceptable within social networks. The aim of this study was to understand how key influencers uphold and transmit information and norms about FP, and explore who women consult as they make FP decisions and why they consult these key influencers.We interviewed 16 women, 10 partners and 14 key influencers in peri-urban Nairobi, Kenya.We found that key influencers for decisions about FP included mothers, aunts, partners, friends and healthcare providers. In making a decision about FP use, women consulted key influencers based on who they deemed trustworthy to keep their FP use secret and described less trust to speak with men about FP in their social networks. Mothers understood the social risks of using FP and so could advise on its discreet use, and aunts were approachable sources of impartial information about FP. Although women identified partners as key decision makers, they were aware that power imbalances might affect final FP choices.Our findings underscore the importance of FP interventions working with women's social networks and to address social norms influencing women's decisions in using FP. Interventions to change FP norms should consider dynamics of secrecy, trust and emotional closeness that affect FP discussions among women's networks.

Use of digital media for family planning information by women and their social networks in Kenya: A qualitative study in peri-urban Nairobi.

Access to information about family planning (FP) continues to have financial, physical and social barriers among young women living in Kenya. This paper draws on social norms theory to explore how young women and their social networks access FP information on digital media (e.g., WhatsApp, websites). Qualitative phone interviews were conducted with 40 participants - young women, their partners and key influencers - in seven peri-urban wards in Nairobi, Kenya. Data were analyzed using thematic analysis. Findings suggested that young women, their partners and key influencers predominately accessed FP information online through their informal networks, but identified healthcare workers as the most trusted sources of FP information. In digital spaces, participants described being more comfortable sharing FP information as digital spaces allowed for greater privacy and reduced stigma to talk about FP openly. Our findings highlight the importance of digital media in disseminating FP information among young women and their networks, the differences in norms governing the acceptability to talk about FP online vs. in-person and the significance of targeting misinformation about FP in digital media spaces.

Convince Yourself to Do the Right Thing: The Effects of Provided Versus Self-Generated Arguments on Rule Compliance and Perceived Importance of Socially Desirable Behavior.

One way to enhance rule compliance is to provide people with arguments explaining why the desired behavior is important. We argue that there might be another, potentially more effective way to enhance rule compliance: ask people to generate arguments in favor of the rule themselves, which can trigger a process of self-persuasion. We compared the effects of providing arguments, asking respondents to generate arguments themselves, and a combination of both approaches on rule compliance and the perceived importance of the rule. A field experiment revealed that rule compliance was higher in all experimental conditions compared to a control condition, with the highest level of rule compliance in the conditions that either presented the arguments or asked people to generate arguments themselves. Yet the rule was only evaluated as more important compared to the control condition, when people generated arguments themselves. This study suggests that rule compliance and perceived importance of this rule can be enhanced by easy low-cost interventions.

Values determine the (in)effectiveness of informational interventions in promoting pro-environmental behavior.

Informational interventions (e.g., awareness campaigns, carbon footprint calculators) are built on the assumption that informing the public about the environmental consequences of their actions should result in increased pro-environmental intentions and behavior. However, empirical support for this reasoning is mixed. In this paper, we argue that informational interventions may succeed in improving people's knowledge about the negative environmental consequences of one's actions, but this knowledge will not gain motivational force if people do not consider protecting the environment an important personal value. In an experiment, we measured individual differences in value priorities, and either presented participants a movie clip that portrayed the negative environmental consequences of using bottled water, or a control movie. As predicted, we found that the environmental movie improved recipients' knowledge of the negative environmental impact of bottled water, but this knowledge only resulted in concomitant changes in intentions and acceptability of related policies among participants who strongly endorsed biospheric (i.e. environmental) values, while having no effect on those who care less about the environment. Interestingly, the results suggest that although informational interventions are perhaps not always successful in directly affecting less environmentally-conscious recipients, they could still have beneficial effects, because they make those who strongly care about the environment more inclined to act on their values.

The importance of demonstratively restoring order.

Contrary to what is often assumed, order is not the strongest context for encouraging normative behavior. The strongest context effect on normative behavior comes from cues that clearly convey other people's respect for norms. Ironically, this show of respect necessitates some contrasting disrespect that is being restored. Using civic virtues (such as helping behavior) as a prototype of normative behavior, the three field experiments described in this paper reveal the impact of normative cues on civic virtues. Results show that the strongest effect on making people follow prosocial norms in public places emanates from seeing order being restored, rather than just order being present. The robust and surprisingly large effects show that observing other people's respect for one particular norm (as evidenced in their restoring physical order) makes it more likely that the onlooker follows other norms as well. This implies that prosocial behavior has the highest chance of spreading when people observe order being restored. There are clear policy implications: create low cost "normative respect cues" wherever it is desirable to increase conformity to norms.

The spreading of disorder.

Imagine that the neighborhood you are living in is covered with graffiti, litter, and unreturned shopping carts. Would this reality cause you to litter more, trespass, or even steal? A thesis known as the broken windows theory suggests that signs of disorderly and petty criminal behavior trigger more disorderly and petty criminal behavior, thus causing the behavior to spread. This may cause neighborhoods to decay and the quality of life of its inhabitants to deteriorate. For a city government, this may be a vital policy issue. But does disorder really spread in neighborhoods? So far there has not been strong empirical support, and it is not clear what constitutes disorder and what may make it spread. We generated hypotheses about the spread of disorder and tested them in six field experiments. We found that, when people observe that others violated a certain social norm or legitimate rule, they are more likely to violate other norms or rules, which causes disorder to spread.