Part A: Positive Deviance model

Positive Deviance is a method applied to behaviour and social change using observation in a community, there individuals who portray uncommon but effective attributes or methods that make it possible for them to answers to issues. This approach is made possible event with them having similar issues and not having extra resources than the rests. Such people may be called positive deviants.

The same project was applied in Vietnam with a focus to reduce malnutrition in children aged below 5 years (Mackintosh, et al, 2002). In the communities, about 1,200 from a total 2000 were suffering from malnutrition. The success of the model is reliant on a number of factors. The first one is positive deviance itself and the method used to feed the children.

Phase 1: Behaviour Influence Focus

The village formed a committee who later chose volunteers from the community to help facilitate the project. They went through training to weigh children, and measure height. The program had to comprise all of the children young and old be it they were healthy or not; hence the method positive deviance.

Children in poorer families were noted to be well nourished than their counterparts in less poorer families. Their different behaviour of the children and families were noted to be the main cause of this; how food was prepared, eating and caring for children (Gardam, et al, 2009; Marra, et al, 2010). Additionally, hygiene in the food and body-wise was in focus. This method assesses nutrition as a general method of eating behaviors, and assesses the impact brought about by them; social and cultural issues are of great significance.

Observations noted that well-nourished children ate high levels of protein shrimp and crab and greens; they eat small portions of food; they had well managed eating trends and managed diets and had tight hygienic trends.

Phase II: Behaviour Influence Practice

The team had to focus and apply ‘positive’ behaviors and involve other parties like grandparents, and fathers. They came up with behaviour change programmed with laid emphasis on practice and not knowledge. This aimed at impacting behaviour and not just offering details which showed to be a vital aspect in instilling an enduring change of behaviour (Positive Deviance Initiative, 2010). This method of focusing on behaviour and not just giving information was provided a lasting behaviour change in issues handled by positive deviance method. The method comprised of the families practiced together to ‘positive’ behaviour; make sure maintenance of change of behaviors; and acquire visible results. Several children enrolled; over 1000 children and over 80% acquired positive results.

Phase III: Scaling up

The project had acquired successful outcome after a year of its inception, scaling was done in 2 processes. First of all it grew three-fold from 4 – 14 villages and secondly, the news got to several other regions and bodies who wanted to learn the method.

The new bodies and villages learned the method in 4 stages; the conceptual model, observation of behaviors, meeting to learn of issues that arise and physical practice. They then went back to their locations to spread what they have learned. Due to this, the project acquired over 2.2 million people in close to 260 villages. From this, close to 50,000 children went through the method. The method’s success was mainly due to practices applied showed a number of primary principles of behaviour. These principles are vital to human behaviour.

Part B: Brain stimulation Method Appropriateness of the Positive Deviance Approach to Smoking Cessation in New South Wales Prisons

The Positive Deviance method was applied in a smoking cessation program for prisoners in New South Wales. The program proved to be successful displaying positive deviant behaviour in the study of population that went down by 20 percent in close to a year (Awofeso et al, 2008). Additionally, three months after the program ended, about 70 percent of the participants still did not go back to smoking.

The positive deviance program is an appropriate method that comes in handy in difficult issues that are based in culture. The method is useful to a health practitioner and the prevalent culture like smoking. The most important aspect that leads to this effectiveness are the ideas and actions that arise from positive deviance process. As opposed to brainstorming which ideas that are presented are later filtered, the program strengthens the group to be aware and get knowledge from the positive deviants from the group itself and then respond (Canadian Positive Deviance Project, 2010). This results to subsequent behavioral change. As one may notice, it is not common for one to note a similar action that results to sustained change; however, advancement is basically an outcome of several processes that connect in a number of ways. This reality may not be good for health worker who are common in using the tenets of evidence-based medicine and who attribute the randomized controlled trail as the most effective evidence. The positive deviants may at times be messy, the relationship and external appearance may seem uncontrollable; however this is what one may anticipate from an effective strategy for a difficult issue (Zimmerman et al, 2001).

Brain Stimulation

A targeted brain stimulation leads to rise in craving for smoking. This method may similarly be used to reverse the effects. The cues related to smoking for prisoners like seeing other people smoke evokes the craving to smoke when one tries to quit (Eldridge & Cropsey, 2009). There are several ways that may be applied to reduce smoking like pharmacologic treatments for instance nicotine patches, and hypnosis. Research has shown that the decline of the activity in the brain charged with smoking may be useful in cessation.

The brain stimulation method is a non-invasive method that applies electromagnetic currents to focus on certain brain areas (Berntson, et al, 2009; Long & Jones, 2005). With regard to the frequency used, it can help to limit or motivate the activity. The recommended frequency is (10 Hz) directed to the superior frontal gyrus. Through learning how the brain impacts craving reactions, methods for used to reduce smoking are vital. Research has shown that brain stimulation may be successfully done with the help of smoking cues. These cues may vary but have been effective in limiting smoking.

However, the high frequency stimulation brought to a decline crave for smoking when the participants were taking regard to nonsmoking cues (de Viggiani, 2007). Additionally, the urge to smoke to meet a certain crave, a rewarding influence that assists smokers was partly blocked using high frequency stimulation. The impact has been positive.

Conclusion

The paper has been able to focus on positive deviant method in Vietnam in helping children with nutritional needs. The method makes use of behavioral techniques to reduce the negative impact and so is the method in reducing smoking effect in New Wales. Additionally, the paper focusses on brain stimulation in reducing smoking in prisons. This brain stimulation is made effective through smoking cues techniques. These methods have proved effective in use of behavioral science to affect a certain tendency.

References

Awofeso N, Irwin T & Forrest G (2008). Using positive deviance techniques to improve smoking cessation outcomes in New South Wales prison settings. Health Promotion        Journal of Australia, 19(1): 72-73.

Berntson, et al (2009).Handbook of Neuroscience for the Behavioral Sciences, Volume 2. New       York: John Wiley & Sons.

Canadian Positive Deviance Project. (2010). Home Page. Author. Retrieved on 11th November 2013 from <www.positivedeviance.ca>.

de Viggiani N (2007). Unhealthy prisons: exploring structural determinants of prison health.        Sociology of Health & Illness, 29(1): 115-135.

Eldridge GD & Cropsey KL (2009). Smoking Bans and Restrictions in US Prisons, and Jails    Consequences for Incarcerated Women. American Journal of Preventive Medicine, 37(2):        S179-S180.

Long CG & Jones K. (2005). Issues in running smoking cessation groups with forensic psychiatric inpatients: Results of a pilot study and lessons learnt. The British Journal of         Forensic Practice, 7(2): 22-28.

Gardam, M.A., C. Lemieux, P. Reason, M. van Dijk and V. Goel (2009). “Healthcare-Associated        Infections as Patient Safety Indicators.” Healthcare Papers 9(3): 8—24.

Mackintosh, U.A.T., D.R. Marsh and D.G. Schroeder (2002). “Sustained Positive Deviant       Childcare Practices and Their Effects on Child Growth in Vietnam.” Food and Nutrition     Bulletin 23(4): 16—25.

Marra, A.R., L.R. Guastelli, C.M.P. de Arau? jo, J.L. Saraiva dos Santos, L.C.R. Lamblet, M. Silva et al. (2010). “Positive Deviance: A New Strategy for Improving Hand Hygiene          Compliance.” Infection Control and Hospital Epidemiology 31(1): 12—20.

Positive Deviance Initiative (2010). Home Page. Boston, MA: PDI Tufts University School of   Nutrition. Retrieved March 12, 2010. <www.positivedeviance.org>.