The positive deviance approach: challenges and opportunities for the future.

Area of Science:

• Global Health
• Developmental Psychology
• Behavioral Science

Background:

• The positive deviance (PD) approach is an alternative to needs-based development strategies.
• Traditional PD for childhood malnutrition identifies successful practices in well-growing children to teach mothers of malnourished children.
• Interventions like 'hearth' facilitate skills-building but may not address all behavioral determinants.

Purpose of the Study:

• To propose and test "booster PD inquiries" to better understand and target behavioral determinants in interventions.
• To share early experiences of the PD approach in HIV/AIDS and food security programs.
• To encourage program-learners to identify and modify critical behavioral determinants for improved health outcomes.

Main Methods:

• Studying children who thrive despite adversity to identify uncommon, effective practices.
• Designing interventions, such as 'hearth' programs, to transfer these behaviors.
• Proposing "booster PD inquiries" during implementation to confirm behavioral determinants and refine interventions.

Main Results:

• The PD approach may act as a catalyst, accelerating change through community engagement, awareness, problem-solving, and behavior adoption.
• Early experiences with PD in HIV/AIDS and food security programs are shared.
• The attributable benefit of PD within programs requires further quantification.

Conclusions:

• Health outcomes dependent on multiple behaviors can benefit from explicitly modifying behavioral determinants.
• Maintaining program quality, especially at scale, is crucial.
• Further exploration and testing of PD's role in various program contexts are recommended.