Communication for Change (C-Change) set out to develop support tools that would foster interactive communication among low-literacy adults and prompt engagement on HIV prevention issues, including encouraging individual and group-oriented problem solving. The Community Conversation Toolkit (CCT) was developed using participatory approaches with lower literacy audiences and was extensively pre-tested in southern and eastern Africa. The CCT is a social and behavior change communication (SBCC) resource that comprises a set of interactive communication components including role play cards, throw cubes, playing cards, dialogue buttons, finger puppets, and guides for facilitation and community mobilization. The CCT has been adapted for use in seven countries and is available in ten languages.This evaluation report looked at whether this toolkit elicited changes in behaviour and practices by participants around HIV prevention, and whether the processes of reflection and problem solving led to community-level action for HIV-prevention-related change.

The evaluation study found that “participants were able to recognise their own risks and felt empowered to change their behaviour, for example, insisting on using a condom or increasing dialogue with their partners and within their families and communities. The group dialogues encouraged critical reflection about contextual risks, enabling both community members and leaders to analyse risk factors in their communities.”Recommendations:the CCT is a well developed SBCC resource that fosters dialogue and critical reflection processes that contribute to the empowerment of HIV-vulnerable participants. As such, the CCT is suitable for replication in its current format the CCT is a versatile resource that can be utilized with literate adults as well as adults with lower literacy skills. Potential use with youth audiences should be explored, noting that the content of the present toolkit would need to take into account age-appropriateness in relation to content regarding sexuality the CCT complements existing HIV prevention activities and bolsters such activities by serving as a catalyst for spurring problem solving and action at individual, relationship, family, and community levels. It should thus be considered as a complementary resource to the work of organizations in facilitated or spontaneous situations the CCT is available in a range of languages and includes context-relevant adaptations in the form of localized proverbs and questions. These are suitable for reproduction for use in a wide range of communities in the countries for which they were developed. Demand for such upscaling has already been voiced in study countries the durability of the CCT was not assessed as part of this evaluation, and CCT components were only used four to five times by the dialogue groups. Reproducing the CCT would require additional research to determine durablity for more intensive use while the broad curriculum and facilitation style attached to the CCT dialogues is appropriate and leads to action outcomes, it is unclear whether there is an optimal number of ‘sessions’ or how participants could continue independently using the toolkits. Four sessions appear to be a suitable minimum. Strategies for expanding use within communities, and determining optimal intensity of use and ‘saturation’ per community, would need to be considered.