Table 8.

Further examples of messages from the table of content for script writers.

Message no	Focus area	Aspect	Communication objective (BCT)	Barrier	Enabler/motivator	Content/key message		Audience	Format	Comments
48	General	Memory, attention and decision making Environment	Modelling behaviour	Difficulties in maintaining a routine Poverty makes it difficult to maintain a moderate, regular lifestyle	Routine, balance and moderation = healthy lifestyle Lifestyle changes are not too complicated and within peoples’ reach	Scenario: conversation between someone who is drinking lal cha with no sugar and a friend/relative about healthy lifestyles.		Men and women Non-diabetic	Drama/conversation	Could have a woman and/or an older person
						Friend	Response
						Why are you drinking lal cha and no sugar?	I try not to have too much sugar. I also try to eat regularly and not too much. If I do have sweets just have a little bit. I don’t have oily food at home, but on certain occasions when I have pilou I will just have a little bit.
						So you try to keep to a routine?	When I can. I walk in the morning, eat regularly and have a balance of different types of food. I don’t smoke or eat many snacks.
						Is it hard to have this lifestyle?	No, you just have to be careful. When you start it is possible to continue. It is good for all the family, we all eat a moderate, balanced diet and I walk with my sister.
						When you are working can you do this?	Yes. I just plan things around my work. Everyone rich and poor needs to think about how they can have a healthy lifestyle and plan accordingly.
						And do you keep healthy?	Yes the doctor said I am very well, and I feel healthy. My blood pressure is good and I don’t have diabetes.
						Oh I have high sugar, or pre-diabetes, can I still do this?	Yes of course! See your doctor, but eating well and exercising regularly is important way of managing your health
						Key messages: - Strive for a moderate lifestyle; regular exercise and eating reasonable amounts, having small amounts of ‘unhealthy’ food - lifestyle changes are within people’s reach: rich and poor, male and female. - They help keep you healthy and manage illness
68	General (Diet, smoking)	Beliefs about consequences Environment, context and resources Social influences	Shaping knowledge	Religious beliefs and fate Poverty makes it difficult to maintain a moderate, regular lifestyle	Religious beliefs and responsibility Routine, balance and moderation = healthy lifestyle Lifestyle changes are not too complicated and within peoples’ reach Balance in food considered to be good Religion discouraging smoking	Doctor and an imam: - A balanced, regular lifestyle is healthy for diabetics and non-diabetics - Try to eat a balanced diet in moderation - Exercise everyday - Try to avoid bad habits like smoking and smokeless tobacco products - Draw on support from your families and communities - These changes are possible for everyone, rich or poor - Islam teaches we need to look after our bodies and health - We can change ourselves, our families and communities		Men and women Diabetic and non-diabetic	Straight information	Motivational message to encourage a moderate, healthy lifestyle
49	Care seeking	Beliefs about consequences	Health consequences Shaping knowledge: complications of diabetes	Wait until diabetes is bad before seeking care		The story of a diabetic: I suffered from some of the complications of diabetes. I went to the doctor due to having problems with my feet being red, warm, swollen and with cracks. The doctor helped treat my feet but also sent me for a blood test. I found I had diabetes. The doctor helped me to understand I can control my diabetes with medicine, diet and later exercise. If diabetes is left untreated like mine you can get many complications. Such as: foot problems, problems with eyesight, nerve damage and kidney damage. These are all very serious. The good news is that diabetes can be managed and prevented. It is better to seek help and make lifestyle changes before you get very sick Key points: If you delay seeking care and have diabetes you can get complications The complications of diabetes Diabetes can be prevented and managed		Men and women Diabetic	Personal story/account	A personal story or account about diabetes might motivate people to seek care and try to prevent diabetes It would be good if at least one of message 49 and 50 could be a female
72	Care seeking	Behavioural regulation	Goal setting		If treatment is planned in stages patients more likely to return and not feel overwhelmed	If you have diabetes it is sometimes easier to plan your treatment/behaviour change in stages. Talk to your doctor about this. - Example of planned behaviour could be: - Planned behaviour: - At the beginning: - Take medicine as advised - Exercise when can - Slowly reduce portions, fat and sugar - After a couple of weeks: - Walk everyday - Weigh self regularly - Talk to family about diet and cooking - Take medication - After one month: - Walking half an hour everyday - Family changing eating habits - Reduced fat, sugar and portion sizes - Taking medication regularly - Continue going for testing		Diabetic Men and women	Pros and cons	Check with medics if this is feasible We could also say that anyone can plan to change their behaviour
51	Exercise	Professional role and identity Emotion, Skills	Shaping knowledge Health consequences	Lack of knowledge that exercise can help prevent diabetes Able to integrate walking into everyday routine People who exercise seen as educated Not walking seen as ‘lazy’ Too cold to swim	Lack of time to exercise/walk People who exercise seen as educated Not walking seen as ‘lazy’ Men: Swim, do push-ups, walk, some sports in the past Women: walk, stretch, swim	Exercise is very important. Exercise will make your heart beat faster and increase blood flow and oxygen to your muscles and organs. It can help to prevent diabetes, control your weight, as well as decrease the risk of heart problems and blood pressure and is good for your general well being. It also helps to control diabetes. Exercise stimulates brain chemicals and can make you feel happier. Exercise is for not just for the educated and affluent. It should be done whether you have diabetes or not, are rich or poor, old or young, man or woman. Everyone should aim to do half an hour exercise a day. It is important to make exercise a priority and try to do some everyday. Everyone can find a type of exercise they like or can do. There are many types of exercise. Exercises include: walking, running, sports, swimming, riding bicycle etc. If it is too cold to swim, walk. You can try different types of exercises too. Make time to exercise – try to walk places instead of getting transport, instead of watching TV do some exercise!		Men and women Diabetic and non-diabetic	Dr: Straight information
52	Exercise	Environment, Social influences, Memory/attention, Emotions	Modelling behaviour Social support	Women feel judged/shamed walking outside Women feel unsafe walking alone Lack of time to exercise/walk Exercise viewed as not a normal thing to do	Walking with other people Walking with friends feels good Able to integrate walking into everyday routine	Scenario Two females walking together – they talk to another female neighbour and try to encourage her to join them.		Women Non-diabetic	Drama	Keep as females: it would be good if we can try and encourage females to encourage each other
						Question	Response
						Where are you walking?	We are walking for health reasons. We also enjoy walking together.
						Do you have diabetes?	No. It is always good to walk. Walking can prevent diabetes.
						As a woman doesn’t it look bad? Do you feel safe?	Women need to walk too. By walking together we feel safer. If women all walk then we will change how people think about women walking. We see exercise as a normal thing to do.
						Do you have time to walk?	We walk every morning as part of our routine. We also think of when we can walk – sometimes we walk instead of getting transport.
						Is it not tiring?	At first it was hard, but now we enjoy it and you feel better in the long-term. It is also fun to walk together
						Final message – try to encourage other women to walk, that way everyone will benefit and we can change public responses. Exercise will then be seen as normal.
57	Stress	Environment, context Memory, attention and decision making	Pros and cons	Not dealing with the root causes of stress Coping mechanisms: smoking, taking pills		In the last message we spoke about ways people deal with stress. Now we are going to talk about the pros and cons (good and bad points) about each. Some people when they are stressed will take sleeping pills, smoke and take pain killers. Pros/why you do it: The reasons people do this are: - will help them sleep sometimes and take away pain - gives some relief in the short term Cons/why you maybe shouldn’t rely on this: - These might help in the short term but won’t help in the long-term - Smoking is very bad for your health - Taking too many pills can be harmful (Pros outweigh pros) The other coping mechanisms: talking to others, exercising, looking at the bigger picture, exercise and some religious rituals. Cons/reasons people don’t it: - Might be harder to do in the short term - May not think of it/may not be obvious Pros/reasons to do them: - Better long-term solutions that you can do - Exercising is good for your physical health - Talking to people you trust can help relations and give long-term support (Pros outweigh cons)		Men and women Diabetic and non-diabetic	Straight information	Could be a doctor
58	Stress	Social influences	Modelling behaviour Social support	Others will know their problems if they talk about them	Coping mechanisms: talking to others People of the village come together to help those in need e.g. if sick	Scenario: female very distressed because her son is sick and she has money problems. She has a discussion with her neighbours who are very supportive and offer support, encouraging her to talk to them and they offer practical support. - Key messages: - support one another - sometimes just listening helps - talk to people you trust		Men and women Diabetic and non-diabetic	Drama
60	Diet	Environmental context and resources Memory, attention and decision Social influences Beliefs about consequences	Modelling behaviour Pros and cons	Availability of ‘unhealthy’ food inside and outside the home Convenience of eating outside the home Habit of snacking inside and outside the home Social gatherings and meeting in tea shops	‘Home-cooked’ food believed to be healthy and ‘outside’ food unhealthy	Scenario: two men outside of the home and one wants to go for snacks and sweet tea, the other wants to go home and have food at home. They discuss the pros and cons of eating outside the home and		Men Non-diabetic	Drama
						1st man: pros of eating outside	2nd man: response, cons
						There is so much food outside, it is very convenient	Yes that is true, but a lot of it is also fried and unhealthy. At home we can decide better what to eat.
						The fried food such as shingaras, puris etc. are so tasty	Yes that is true. But too many are unhealthy. We can try to only go there occasionally.
						But I am in the habit of going to the tea shop and it is very sociable, we see are friends there.	Ok, lets go and just get some lal cha without sugar. We can still see our friends. Later we can eat at home.
						But at home there is also unhealthy food!	This is true! But we can decide better what we eat. Let’s go to my house and we can have some fruit and lal cha and then later we can have some dinner.
						Key messages: - moderate the amount of time you eat outside the home - you can go out and eat less fried food - at home you have more control over what you eat
61	Diet	Social influences	Shaping knowledge Social support	Cooking: women may cook with lower levels of oil etc. Family not supporting different/healthy eating habits	Cooking: women cooking with high levels of oil etc., men asking for it Family supporting different/healthy eating habits Shopping: men shop, women can intervene	Straight information: Families usually eat together. Everyone in the family has a role in eating well and changing eating habits. They include:		Men and women Non-diabetic and diabetic	Straight information	Could be a song, poem, or different voices from a family or a doctor
						Men	Men/husbands usually shop. Talk to your wife about what you will buy. Try to buy lots of vegetables and fruit. Get vegetable oil instead of ghee. Get cheaper more healthy sources of protein such as fish, eggs and chicken instead of meat. If possible get brown rice and flour.
						Women	Women/wives/daughter in-laws do most of the cooking. Talk to your husband about what they should buy. Try to cook with lots of vegetables and make salads. Only cook with as much oil as you need. Avoid deep frying food. Explain to your family why you are cooking like this. Food can still be tasty with lots of flavour.
						Older: in-laws	You have lots of influence. Encourage members of the family to shop and cook well. Praise healthy food and cooking.
						Younger: children	You can encourage your parents to shop and cook well. Explain to them why it is important.
						Key messages:All the family need to be involved in changing eating practices - Good cooking and eating practices benefits the whole family
74	Smoking	Knowledge Social influences	Shaping knowledge Health consequences	Overall lack of awareness regarding the link between smoking and ill health. No awareness of the link between smoking and diabetes Smoking perceived to be common among certain groups: farmers, younger people etc.	Stigma: smoking in front of elders, women etc. Not acceptable to smoke in public spaces (bus, mosques etc) Family: less likely to smoke if it is not done in the family Family: discouraging smoking/encouraging to give up Peer pressure to smoke Religion discouraging smoking Quitting because of work Less likely to smoke with age	Straight information about smoking and perceptions of smokers: - Perceptions of people who smoke: mostly men, young, farmers, students, rural areas. - It is more men than women who smoke, but all different types of people smoke. They also may take other tobacco products. - There is some stigma regarding smoking, for example people will not smoke in front of their elders, women and in spaces such as the mosque. - It is important not to smoke in front of people as passive smoking can also cause harm to those around them. - Family and peer groups have an important role in not smoking – people are less likely to start smoking if their friends and family don’t smoke. We can also encourage each other to stop smoking. - People may also give up smoking because of their age, health, religious reasons and because of their work. - It is good to be motivated to give up smoking. There are also health consequences of smoking. - Reminder of the consequences of smoking: - People who smoke are at increased risk of diabetes, cancer, lung diseases, heart diseases, brain stroke and poor circulation, erectile dysfunction in males and infertility in women, tooth and gum disease. - Diabetics who smoke are less able to control their diabetes. Smokers with diabetes have a higher risk for complications of diabetes such as: heart and kidney disease, poor blood flow in the legs and feet that can lead to ulcers and infections, eye problems and damaged nerves		Men and women Diabetic and non-diabetic	Doctors voice	Perceptions of smoking and stigma is taken from the formative research
77	Smoking	Beliefs about capabilities Memory, attention and decision process Social influences	Modelling behaviour Shaping knowledge Social support	Belief that can only give up smoking by quitting completely Addiction to smoking	Family: less likely to smoke if it is not done in the family Family: discouraging smoking/encouraging to give up	Scenario: an uncle discovers his nephew smokes. His nephew admits he does but does not know how to stop as he is addicted. The uncle offers family support and also gives tips for giving up smoking. - Tips for giving up smoking: - You need to be personally motivated, think of the reasons you don’t want to smoke - Distract yourself with other things: talk to other, sport, work - You can cut down slowly the number of cigarettes you smoke every day until or stop completely - Keep trying eventually you will be able to give up - You can try and stop smoking with someone else - Change routines associated with smoking/do other things: exercise, namaj, talk to people - Spend time with friends/family who do not smoke - Key messages: - ways to give up smoking - family support to give up smoking		Men Non-diabetic	Drama