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The Integrated Gateway Model: A Catalytic Approach to Behavior Change
International Journal of Gynecology & Obstetrics (2015)
  • Hilary Schwandt, Western Washington University
  • Joanna Skinner
  • Adel Takruri
  • Douglas Storey
Objectives To develop and test an Integrated Gateway Model of behaviors and factors leading to subsequent positive reproductive, maternal, and child health behaviors.
Methods A secondary analysis was conducted using previously published household survey data collected from men (n = 5551; 2011) and women (n = 16 144; 2011) in Nigeria and women in Egypt (n = 2240; 2004–2007). The number of health behaviors each potential gateway behavior predicted was assessed by multivariate regression, adjusting for potential confounders. The influence of gateway factors on gateway behaviors was tested via interaction terms. Gateway behaviors and factors were ranked by the number of health outcomes predicted, both separately and synergistically.
Results The key gateway behavior identified in both datasets was spousal communication about family planning, whereas the key gateway factor was exposure to family planning messages.
Conclusions The model could facilitate innovative research and programming that in turn might promote cascades of positive behaviors in reproductive, maternal, and child health.
  • Behavior change,
  • Egypt,
  • Gateway behavior,
  • Gateway factor,
  • Gateway moment,
  • Health communication,
  • Nigeria,
  • Reproductive health
Publication Date
May 13, 2015
Publisher Statement
Copyright © 2015 Published by Elsevier Ireland Ltd. doi:10.1016/j.ijgo.2015.05.003
Citation Information
Hilary Schwandt, Joanna Skinner, Adel Takruri and Douglas Storey. "The Integrated Gateway Model: A Catalytic Approach to Behavior Change" International Journal of Gynecology & Obstetrics (2015)
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