title: The Integrated Gateway Model: a catalytic approach to behavior change.
abstract: OBJECTIVE
  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=16144; 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.
authors.affiliation: Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; Fairhaven College of Interdisciplinary Studies, Western Washington University, Bellingham, USA. Electronic address: Hilary.Schwandt@wwu.edu.
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Schwandt
authors.affiliation: Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Skinner
authors.affiliation: Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Adel
authors.initials: A
authors.lastname: Takruri
authors.affiliation: Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Storey
mesh_terms: D000293:Adolescent; D000328:Adult; D032763:Behavior Control / Q000379:methods*; D002648:Child; D003268:Contraception Behavior / Q000523:psychology; D004534:Egypt; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006285:Health Planning / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D015999:Multivariate Analysis; D009549:Nigeria; D055815:Young Adult
keywords: Behavior change; Egypt; Gateway behavior; Gateway factor; Gateway moment; Health communication; Nigeria; Reproductive health