UNICEF - Social and Behavioural Change Message Guide

for Preventing Childhood Lead Poisoning Using the REACH Framework A Social and Behavioural Change Message Guide Recognize Engage Act Habit Contextfor Preventing Childhood Lead Poisoning Using the REACH Framework A Social and Behavioural Change Message GuideAcknowledgements This report was developed by the global Social and Behaviour Change team of UNICEF, with special recognition to Ukasha Ramli and Lisa Tanaka. Guidance was provided by Abheet Solomon, Bret Ericson, Emily Nash and Katelyn Greer from the UNICEF Healthy Environments for Healthy Children global programme. Feedback was also provided by Paromita Hore, Director of Environmental Exposure Assessment and Education at the New York City Department of Health and Mental Hygiene. Feedback on the materials are welcome and can be shared to sbc@unicef.org and ceh@unicef.org. Disclaimers The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by UNICEF in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by UNICEF to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall UNICEF be liable for damages arising from its use. Social and Behaviour Change Climate & Environment Global Practice UNICEF Global Programme Division www.unicef.org www.sbcguidance.org © United Nations Children’s Fund (UNICEF) June 2026

Suggested citation: United Nations

Children’s Fund, A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework, UNICEF, New York, June 2026. https://ceh. unicef.org/events-and-resources/knowledgelibrary/social-and-behavioural-changemessage-guide-preventing ii

Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework, UNICEF, New York, June 2026. https://ceh. unicef.org/events-and-resources/knowledgelibrary/social-and-behavioural-changemessage-guide-preventing ii A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH FrameworkAcknowledgements ii

Introduction 1

1.1 The REACH framework 2

1.2 Why REACH works for lead communication 2

Core principles for lead messaging 3

2.1 Address the invisibility challenge 3

2.2 Balance threat and efficacy 3

2.3 Cultural and contextual adaptation 3

2.4 Emphasize prevention and early action 3

Using REACH components for message development 4

3.1 Recognize – Making lead visible 4

3.2 Engage – Building motivation 9

3.3 Act – Enabling protection 13

Application approaches 19

4.1 Component-specific messaging 20

4.2 Integrated comprehensive messaging 21

4.3 Campaign design considerations 22

Message examples by scenario 25

5.1 Occupational take-home scenario 26

5.2 Product purchase scenario 28

5.3 Pregnancy/Preparing for baby scenario 31

5.4 Toddler scenario 34 Conclusion 36 Annex 1 Sample messages by REACH components 38 Annex 2 Example a full campaign: Lead-Safe Futures 45 Annex 3 Global SBC lead materials 49 1 2 3 4 5 Contents© UNICEF/UN0702915/ZaidiEffective lead poisoning prevention messaging must bridge the gap between an imperceptible danger and concrete daily behaviours. This requires careful consideration of how messages are crafted to make abstract risks tangible, motivate

49 1 2 3 4 5 Contents© UNICEF/UN0702915/ZaidiEffective lead poisoning prevention messaging must bridge the gap between an imperceptible danger and concrete daily behaviours. This requires careful consideration of how messages are crafted to make abstract risks tangible, motivate action among competing priorities and enable families to protect their children with practical, feasible steps. This guide offers a practical approach to crafting lead poisoning prevention messages using the REACH framework, a social and behaviour change (SBC) messaging model. It is written for global use and should be adapted to local contexts before implementation. Wherever possible, conduct research – such as a knowledge, attitudes and practices study, social listening or rapid stakeholder interviews – to inform your strategy. This will help account for cultural norms, language and literacy, trusted messengers and the current level of awareness in your audience. For example, UNICEF conducted a global social community listening study on children’s environmental health to inform the REACH framework, with a focus on air pollution, extreme heat and lead poisoning in five countries. SBC is one pillar of a broader communication strategy to end childhood lead poisoning. It bridges the gap between technical risk information and the daily decisions made by individuals – turning insights on invisible hazards into clear actions. This guide centres on caregivers, but the same principles can be adapted for other audiences. For content aimed at additional audiences and advocacy purposes – such as policymakers or health workers – see Tool 5: Clear communication to prevent and address childhood lead poisoning. This guide forms part of the Toolkit to End Childhood Lead Poisoning, a primer on identifying, assessing and mitigating exposure. It is recommended to position SBC within the broader communication ecosystem – media relations, advocacy, risk communication and partner communications – so approaches are complementary rather than stand-alone. Lead poisoning presents unique communication challenges: it’s an invisible threat that silently damages

assessing and mitigating exposure. It is recommended to position SBC within the broader communication ecosystem – media relations, advocacy, risk communication and partner communications – so approaches are complementary rather than stand-alone. Lead poisoning presents unique communication challenges: it’s an invisible threat that silently damages children’s developing brains, with health impacts that may not appear for years. Unlike visible environmental hazards, lead contamination requires specialized approaches to help communities recognize risks and take protective action. 1 Introduction 1 A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH FrameworkThe REACH framework is a comprehensive behaviour change tool with five components: This guide focuses on the first three components (R-E-A) as they are most relevant for message development. The remaining components – Context and Habit – determine whether those messages translate into sustained practice.

1. Introduction 1.1 The REACH framework 1.2 Why REACH works for lead communication • Lead is invisible, tasteless and odourless. It requires special strategies to make it ‘visible’. • Its effects are largely asymptomatic.

People struggle to make the link between lead exposure and health effects. • Competing daily priorities often overshadow long-term health threats. • Knowledge alone doesn’t change behaviour. Emotional connection and practical skills are essential. Scan to explore the REACH Framework Applying Behavioural Science to Address Environmental Health Threats Affecting Children Framework REACH Scan to watch why lead poisoning is a danger to your child’s health Recognize Making invisible threats visible and understood

Engage Building motivation and emotional connection to protection Act Developing skills and confidence for protective behaviours Context Addressing structural barriers and enabling environments Habit Sustaining long-term protective behaviours A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework

21. Introduction

2 Core principles for lead messaging • Make the invisible visible: Lead contamination cannot be seen, smelled or tasted – creating a fundamental perception barrier • Convert abstract risks into tangible impacts: For example, instead of ‘parts per million’, use ‘affects reading ability/lowers IQ’ • Use concrete visualizations: Images like ‘Lead dust sticks to hands like invisible glue’ make the issue tangible • Create mental models: Help families understand exposure pathways 2.1 Address the invisibility challenge • Sufficient threat perception: Make risks immediate without causing paralysis • High efficacy messaging: Emphasize that protective actions work • Present hope alongside concern: Match every risk with a specific protection 2.2 Balance threat and efficacy • Use trusted messengers: Community health workers, religious leaders, respected mothers • Leverage cultural values: Family responsibility, child protection, community care • Address specific practices: Traditional medicines, cookware and cosmetics, occupational exposure 2.3 Cultural and contextual adaptation • Prevention focus: Empower parents to take concrete protective action rather than dwelling on the permanence of damage that could occur • Small actions matter: Emphasize efficacy of attainable measures, e.g., ‘Each meal with iron and calcium competes with lead absorption’ • Multiple sources: Address all sources and the exposure pathways in your context 2.4 Emphasize prevention and early action The REACH Framework applies to messaging on childhood lead poisoning because of the four following reasons: 3 A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework3 Using REACH components for message development © UNICEF/UN0743563/Mukut Objective: Lead cannot be seen, smelled or tasted, presenting a fundamental perception challenge. This invisibility means families may live with dangerous lead exposure for years

Using REACH components for message development © UNICEF/UN0743563/Mukut Objective: Lead cannot be seen, smelled or tasted, presenting a fundamental perception challenge. This invisibility means families may live with dangerous lead exposure for years without awareness. The RECOGNIZE component transforms abstract contamination data into concrete, personally relevant risk information that families can act upon. It creates clear links between everyday objects (e.g., peeling paint, glazed pottery), exposure behaviours (e.g., hand-tomouth activity, food storage) and specific outcomes (e.g., struggling in school, lost IQ points). It bridges the gap between scientific knowledge about lead hazards and community understanding, helping people identify where lead exists in their daily environment through vivid sensory details, and understand how exposure occurs and how it affects their children. 3.1 Recognize – Making lead visible The REACH Framework’s first three components can be applied flexibly in message development: · as individual focus areas for specific messages targeting particular barriers · as integrated elements within comprehensive messages · as a sequence for campaign development A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework 41 Green, Melanie C., and Timothy C. Brock, ‘The Role of Transportation in the Persuasiveness of Public Narratives’, Journal of Personality and Social Psychology, vol. 79, no. 5, November 2000, pp. 701–721; Thomas, Veronica L., and Jamie L. Grigsby, ‘Narrative Transportation: A systematic literature review and future research agenda’, Psychology & Marketing, vol. 41, no. 8, August 2024, pp. 1805–1819. Key messaging strategies

1. Make examples easy to recall and imagine Why it works How to apply The availability heuristic is a mental shortcut where people estimate the likelihood and importance of something based on how easily examples come to mind. When people can readily recall vivid instances of lead exposure or its consequences, they perceive the risk as more real and immediate. Memory is

Why it works How to apply The availability heuristic is a mental shortcut where people estimate the likelihood and importance of something based on how easily examples come to mind. When people can readily recall vivid instances of lead exposure or its consequences, they perceive the risk as more real and immediate. Memory is enhanced by emotional content, sensory details and personal relevance. By creating memorable mental images of lead exposure scenarios, we ensure these risks remain cognitively ‘available’ when families make daily decisions. This can be further enhanced with narrative transportation theory.1 Stories bypass psychological defences against threatening information because people process them as experiences rather than arguments. When families later encounter situations from the story (e.g., seeing peeling paint, watching their child play), the narrative automatically resurfaces, making the threat cognitively ‘available’ precisely when protection decisions matter. Craft messages with vivid sensory details even though lead itself is invisible. Use unexpected comparisons that surprise and stick in memory. Include specific details about texture, appearance or behaviour that people can visualize. Connect to emotionally charged moments like a child putting objects in their mouth. Create mental images that will spontaneously come to mind in relevant situations. For example, when someone sees peeling paint, they should automatically think of your message about lead danger. When format allows, frame these vivid details within brief story moments: ‘Maria watched her toddler pick at the sweet-tasting paint chips near the old door, then lick his fingers clean’ creates stronger recall than ‘Children eat paint chips containing lead’. ‘Ahmed’s baby crawled through the dust where his work boots had been, leaving tiny handprints everywhere before sucking her thumb’ is more memorable than ‘Lead dust spreads from work boots’. Even single narrative sentences enhance memory: ‘Fatima noticed her daughter’s eyes were rimmed with the same black kohl her grandmother had applied to her as a baby, the powder leaving dark smudges on the child’s fingers’ versus ‘Kohl contains lead

from work boots’. Even single narrative sentences enhance memory: ‘Fatima noticed her daughter’s eyes were rimmed with the same black kohl her grandmother had applied to her as a baby, the powder leaving dark smudges on the child’s fingers’ versus ‘Kohl contains lead that children can ingest’. The goal is to ensure that when families encounter these real-life situations, your message automatically surfaces in their mind, whether delivered as vivid facts or brief stories.

3. Using REACH components for message development

RECOGNIZE

5 A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH FrameworkLead hides in everyday things

2. Replace abstract concepts with concrete visualizations Why it works How to apply Research shows that concrete language is more likely to be understood, remembered and acted upon because it works both visually and verbally, making the concrete concept easier to retrieve later.2 When we make the abstract tangible through comparisons to familiar objects or experiences, we activate sensory and motor areas that abstract concepts cannot reach.

Transform all numerical or technical information into physical comparisons people encounter daily. Instead of discussing particle sizes in microns, compare it to familiar objects like human hair or grains of sand. Similarly, convert time frames into meaningful life events. For example, instead of ‘chronic exposure’, talk about ‘from crawling to walking to starting school’. Use physical actions people can imagine themselves doing. Make quantities relatable by comparing to familiar volumes, e.g., a sugar packet-worth of dust rather than grams. Always ask yourself: can someone picture this in their mind without any technical knowledge?

RECOGNIZE

3. Using REACH components for message development

2 Begg, Ian, ’Recall of meaningful phrases; Journal of Verbal Learning and Verbal Behavior, vol. 11, no. 4, August 1972, pp. 431–439.

A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework

63. Connect unfamiliar lead risks to familiar dangers Why it works How to apply Analogies help people understand new information by mapping it onto existing knowledge structures.

When faced with an unfamiliar hazard like lead poisoning, people need cognitive anchors – familiar concepts that provide a ready-made framework for understanding. Unlike simply making messages more concrete, analogies borrow entire mental models about how threats behave. This allows audiences to reason about lead without requiring technical knowledge of toxicology or environmental health. For example, if people understand how germs spread, you can borrow that model to explain how invisible lead dust moves through the home. If people understand how debt accumulates, you can use that model to explain how lead builds up in the body. Layered analogies are especially effective: one analogy illustrates invisibility (e.g., germs, smoke), another illustrates accumulation (e.g., debt, layers of dirt) and another illustrates irreversibility (e.g., scars, broken glass). Each analogy adds a facet of understanding, building a complete picture of risk. Identify what similar threats or processes your audience already understands well. This might include germs and infections, food poisoning, traditional beliefs about contamination, or how smoke from fires spreads and lingers. Build explicit bridges between these familiar concepts and lead exposure using phrases such as ‘just like…’ or ‘similar to…’. For example: ‘Lead dust spreads through your home like cooking smoke’ or ‘Lead builds up in the body like sand in an hourglass’. Ensure that the analogy matches the aspect of lead you want to emphasize: if highlighting the invisible spread of lead through touch, compare to germs; if emphasizing irreversibility, compare to scars. Always clarify where the analogy ends to avoid misconceptions – for instance, lead doesn’t multiply like germs.

4. Provide specific local references Why it works How to apply Psychological distance affects risk perception across

if emphasizing irreversibility, compare to scars. Always clarify where the analogy ends to avoid misconceptions – for instance, lead doesn’t multiply like germs.

4. Provide specific local references Why it works How to apply Psychological distance affects risk perception across four dimensions: geographic, temporal, social and hypothetical. The closer a threat feels on any of these dimensions, the more seriously people take it.3

When risks are localized to specific places, people and practices in one’s own community, they shift from hypothetical to real. Local references also leverage place identity, such as a person’s emotional connection to their neighbourhood and community. Specific examples prevent the common cognitive bias of ‘it won’t happen to me’ by showing it’s already happening in familiar places. Map lead exposure risks to specific, named locations in your community that people pass daily. Reference local industries, construction patterns or historical events that created contamination. Name specific products sold in local markets or practices common in the area. Use local terminology and reference points rather than generic descriptions. Include time frames relevant to the community, for example ‘when the battery recycling plant opened’ or ‘pipes installed in the early 1900s’. Partner with trusted local voices who can provide community-specific examples and share them via more personal media channels such as videos, blogs or niche local interest sites. Make it impossible for people to think lead exposure only happens elsewhere.

3. Using REACH components for message development

RECOGNIZE

3 Trope, Yaacov, Nira Liberman and Cheryl Wakslak, ‘Construal Levels and Psychological Distance: Effects on representation, prediction, evaluation, and behavior’, Journal of Consumer Psychology, vol. 17, no. 2, April 2007, pp. 83–95.

7 A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH FrameworkLead can be in everyday items like toys There are many sources of lead exposure

3. Using REACH components for message development RECOGNIZE A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework

89

Objective: Knowledge about lead risks rarely translates into protective action because environmental health threats compete with immediate daily concerns like food, shelter and income. The ENGAGE component creates emotional resonance that elevates lead prevention from an abstract future risk to an immediate priority. It connects lead protection to what people value most deeply, which is their children’s success, family prosperity and community well-being. This component transforms intellectual understanding into emotional commitment, providing the motivational fuel necessary to overcome barriers and sustain protective behaviours even when they require effort or sacrifice. 3.2 Engage – Building motivation Key messaging strategies

1. Focus on individual children, not statistics Why it works How to apply The identifiable victim effect proposes that we respond more strongly to individual stories than to statistics about many people.4 This occurs because our emotional systems evolved to respond to specific, identifiable individuals in our social groups, not abstract numbers.

When we hear about one child’s struggle with lead poisoning, we automatically mentally simulate their experience, activating empathy and protective instincts. Statistics, conversely, trigger analytical thinking which suppresses emotional response. A single face and story engages emotional processing in ways that the phrase ‘10,000 affected children’ does not. Always personalize messages by using ‘your child’ rather than ‘children’ in general. Create specific scenarios caregivers can visualize, e.g., their own child struggling to read, falling behind in school or missing developmental milestones. When sharing examples, include specific names, ages and details that make the child real. Avoid statistics in emotional appeals; save numbers/figures to bolster credibility, but lead with individual impact. Help caregivers visualize their

struggling to read, falling behind in school or missing developmental milestones. When sharing examples, include specific names, ages and details that make the child real. Avoid statistics in emotional appeals; save numbers/figures to bolster credibility, but lead with individual impact. Help caregivers visualize their specific child’s vulnerability, where they play, what they touch, their daily routines, etc. Make it impossible to think ‘this affects other people’s children, not mine’.

2. Emphasize protecting potential rather than preventing loss Why it works How to apply Message framing research shows that gain framing affects behaviour differently than loss framing, depending on the type of action.5 For prevention behaviours that maintain health, gain framing (‘protect your child’s brilliant mind’) often outperforms loss framing (‘prevent brain damage’).

This is because prevention behaviours feel more certain when framed as preserving something good rather than avoiding something bad. Additionally, positive framing reduces psychological reactance, which is the defensive response triggered by fear appeals. When focused on protecting potential, caregivers feel empowered rather than threatened, maintaining self-efficacy while acknowledging risk. Frame lead prevention as safeguarding children’s natural abilities and future opportunities rather than avoiding deficits. Use language about ‘protecting’, ‘preserving’ and ‘maintaining’ rather than ‘preventing’, ‘avoiding’ or ‘stopping’. Connect to positive developmental trajectories – talk about children reaching their full potential, achieving dreams or maintaining their natural curiosity. When you must mention negative outcomes, immediately pivot to the positive alternative that protection enables. Build messages around aspirations caregivers already hold rather than introducing new fears. Test different framings with your audience, as cultural context affects whether gain or loss framing resonates more strongly.

3. Using REACH components for message development

ENGAGE

4 Jenni, Karen, and George Loewenstein, ‘Explaining the Identifiable Victim Effect’, Journal of Risk and Uncertainty, vol. 14, no. 3, May 1997, pp.

whether gain or loss framing resonates more strongly.

3. Using REACH components for message development

ENGAGE

4 Jenni, Karen, and George Loewenstein, ‘Explaining the Identifiable Victim Effect’, Journal of Risk and Uncertainty, vol. 14, no. 3, May 1997, pp. 235–257. 5 Gallagher, Kristal M., and John A. Updegraff, ‘Health Message Framing Effects on Attitudes, Intentions, and Behavior: A meta-analytic review’, Annals of Behavioral Medicine, vol. 43, no. 1, February 2012, pp. 101–116. 9 A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework3. Connect to existing values and daily concerns Why it works How to apply Cultural cognition theory shows that people filter risk information through their existing values and group identities.6 Messages that align with these values are accepted, while those that conflict are rejected regardless of scientific evidence. When lead poisoning prevention is connected to values people already prioritize, such as educational success, religious duty, family honour and economic prosperity, it becomes consistent with their worldview rather than challenging it. This value alignment also helps overcome present bias by making future risks feel relevant to current identity and immediate social standing. Conduct formative research to identify the core values in your target community. Frame lead poisoning prevention as a way to fulfil these values rather than as a separate health behaviour. Use language and concepts from these value systems. For example, if education is paramount, talk about lead poisoning prevention as ‘investing in your child’s academic future’. Connect to daily concerns that already occupy mental space. If families worry about school fees, emphasize that lead poisoning prevention protects the educational investment. Identify trusted messengers who embody these values and can authentically connect lead prevention to community priorities. Utilize more intimate and familiar communications channels like blogs or videos from parent-focused messengers, local media and community networks

emphasize that lead poisoning prevention protects the educational investment. Identify trusted messengers who embody these values and can authentically connect lead prevention to community priorities. Utilize more intimate and familiar communications channels like blogs or videos from parent-focused messengers, local media and community networks to tell the human-centred stories that make lead messaging resonate. Navigate cultural practice conflicts with respect When cultural or religious practices themselves involve lead exposure (such as sindoor, kohl/surma, traditional medicines or ceremonial items), messaging requires exceptional sensitivity. Direct prohibition often fails and can alienate communities, making them less receptive to all lead prevention messages. Instead, adopt a harm reduction approach that honours cultural significance while protecting health. Frame alternatives as safer ways to maintain tradition rather than abandoning practices entirely. For example, rather than never use kohl, many families now reserve traditional kohl for special religious occasions and use pharmacy alternatives daily. Provide culturally appropriate substitutes where possible – for example, home-made kajal from soot instead of leadcontaining surma, or turmeric paste instead of sindoor for daily use. Partner with religious and cultural leaders who can interpret health protection as fulfilling religious duties to protect children. When complete alternatives aren’t culturally acceptable, focus on risk management: minimal use, immediate handwashing, keeping products away from children and never using on children directly. Acknowledge the emotional and spiritual importance of these practices while providing practical ways to reduce exposure. This approach maintains trust and keeps families engaged with the broader lead prevention message rather than dismissing all guidance as culturally insensitive. 6 Kahan, Dan, ‘Fixing the Communications Failure’, Nature, vol. 463, no. 7279, 21 January 2010, pp. 296–297.

ENGAGE

3. Using REACH components for message development A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework

104. Create appropriate urgency without panic Why it works How to apply Temporal construal theory explains how psychological distance in time affects decision-making.7 Distant future threats trigger abstract thinking, while

A Social and Behavioural Change Message Guide for Preventing Childhood Lead Poisoning Using the REACH Framework

104. Create appropriate urgency without panic Why it works How to apply Temporal construal theory explains how psychological distance in time affects decision-making.7 Distant future threats trigger abstract thinking, while immediate threats prompt concrete action. Excessive urgency can, however, trigger panic or defensive denial, which arises not from the risk itself but from how the risk is communicated. Communication that conveys uncertainty or fear without providing clear, constructive guidance can provoke this response.

Effective messaging creates ‘optimal urgency’ that is close enough to motivate action but not so immediate as to cause paralysis. The concept of ‘sensitive periods’