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Target Audience Barriers, Competition, and Motivators (Benefits) 231

with the overall goal of changing behavior of target populations (Patel &
Chapman, 2005).
PSI uses several PERForM research tools to plan, monitor, and evaluate its
programs. One such tool is the Tracking Results Continuously (TRaC) survey,
which informs programmers by routinely collecting data from cross-sections of
populations at risk of adverse health outcomes. The data from these surveys
provide information from populations about their behaviors, determinants of
behaviors, risks, sources of supply of product or service delivery, and exposure
to social marketing communication activities.

TA R GE T A UD IEN C E B A R R IER S, C O MP E TI TI O N, A ND
M OTI V ATO R S ( B ENEF I T S)

Barriers
There were many barriers for women, caregivers, and their families in treating
water in their home. These barriers included lack of knowledge about diarrheal
disease transmission, perceptions that the clarity of water indicated its safety,
government sensitivity to criticism, and traditional forms of water gathering
and use. At least one-third of Malagasy did not know that contaminated water
causes diarrhea. Many believed that their water source was only unsafe during
the rainy season and during cyclones, floods, and cholera episodes or that their
water source has never been contaminated and therefore did not need treatment
(PSI, 2007).
Other barriers to adopting home water treatment were the perceived costs.
It was thought that significant time was needed to learn how to treat water.
Materials were also needed, such as a vessel in which to treat and store clean wa-
ter. Such additional financial costs deterred many from adopting a new practice.
In addition, a baseline TRaC survey was undertaken in 2004 and a follow-
up survey in 2006 that found that self-efficacy, social norms, and availability
were significant in determining the use of an SWS product by mothers and care-
givers of children under 5. Self-efficacy represents the confidence an individual
has in his or her ability to perform a promoted behavior effectively. Those who
believe they can use SWS correctly were more likely to treat their water. Social
norms are perceived standards for behavior that people follow. In other words,
those who believe that others in their community use water treatment products
are more likely to use them themselves. Finally, the product needed to be made
widely available. A marketing intervention was designed to impact only those
behavioral determinants known to positively influence use.