Published Literature

Peer-reviewed articles and publications documenting the effectiveness of Barrier Analysis

Literature Review 2025

Barrier Analysis: A Literature Review

Davis, T.P. (2025). Draft.

A comprehensive critical review of the Barrier Analysis methodology, its theoretical foundations, the evidence generated from its application worldwide, and its strengths and limitations. Intended for public health professionals, program designers, and researchers considering or currently using BA in their work. Draws on peer-reviewed publications, organizational reports, training materials, and the grey literature.

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Health 2025

Comparing Barriers and Facilitators to Physical Activity Among Underrepresented Minorities

Alamilla, R.A., Kaushal, N., Bigatti, S.M., & Keith, N.R. (2025). International Journal of Environmental Research and Public Health, 22(2), 234.

Used BA alongside mixed methods to compare barriers and facilitators to physical activity among underrepresented minority populations in the United States, with implications for culturally tailored health promotion interventions.

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Health 2024

Determinants of Uptake of COVID-19 Vaccination Among Teachers in Uganda

Mukembo, A. (2024). South Journal of Health Research Africa, 5(3).

Applied BA to identify behavioral determinants of COVID-19 vaccination uptake among teachers in Uganda, a key population for school-based transmission prevention, using a cross-sectional study design.

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WASH 2024

Behavioural Determinants of Handwashing at Critical Times Among Mothers and Caregivers in Zimbabwe

Murendo, C., Benza, R., Gudyanga, N., Velani, B., & Gutusa, F. (2024). Cogent Public Health, 11(1), 2322826.

Applied BA to identify behavioral determinants of handwashing at critical times among mothers and caregivers in Zimbabwe, with implications for designing more effective WASH behavior change interventions.

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Nutrition 2023

Exclusive Breastfeeding: Barrier Analysis Among Omani Mothers

Al-Ghannami, S., Al-Mamari, S., Chekaraou, D., et al. (2023). Sultan Qaboos University Medical Journal, 23(2), 158–167.

Applied BA to identify key determinants of exclusive breastfeeding among mothers in Oman, revealing perceived self-efficacy and social norms as significant factors and informing targeted lactation support strategies.

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Health 2023

Barriers to Utilization of Postnatal Care Services within the First 48 Hours of Birth in North West Syria

Alkhatib, I., & Mehmet, N. (2023). Journal of Health Policy & Outcomes Research, 2/2023, 15.

Identified barriers to postnatal care utilization within the critical 48-hour window after birth among women in conflict-affected northwest Syria, informing health system strengthening in humanitarian settings.

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Health 2023

Determinants of Contraceptive Use Among Unmarried Young Women in Kakamega County, Kenya

Arlotti-Parish, E., Ajema, C., Mutea, L., & Ontiri, S. (2023). Adolescents, 3(3), 382–393.

Applied BA to understand behavioral determinants of contraceptive use among unmarried young women in Kenya, identifying social norms and access as key factors to address in adolescent reproductive health programming.

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Health 2023

Understanding Behavioral Determinants of Diabetic Retinopathy Screening and Treatment Among Bangladeshi Women

Kalam, M.A., Al Asif, C.A., Hasan, Md.M., et al. (2023). BMC Public Health, 23(1), 1667.

Used BA to identify barriers and enablers of diabetic retinopathy screening and treatment behaviors among women in Bangladesh, providing evidence to improve uptake of eye health services.

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Nutrition 2023

Determinants of Positive Food Procurement Practices in COVID-19 Affected Communities in Zimbabwe

Nyathi, C., Mavhudzi, T., Chikwiriro, C., & Maduwa, C. (2023). In COVID-19 in Zimbabwe (pp. 77–85). Springer.

Used BA to examine determinants of positive food procurement practices in COVID-19-affected communities in Chiredzi, Zimbabwe, informing nutrition-sensitive programming during public health emergencies.

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Health 2023

Enablers and Barriers to COVID-19 Vaccine Uptake in an Urban Slum in Lagos, Nigeria

Ozoh, O.B., Akinkugbe, A.O., Olukoya, M.A., & Adetifa, I.M.O. (2023). International Health, ihad009.

Conducted BA to identify enablers and barriers to COVID-19 vaccine uptake in a marginalized urban community in Lagos, Nigeria, informing equity-focused vaccine engagement strategies.

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Health 2022

Behavioral Determinants for COVID-19 Vaccine Acceptance Among Students, Faculty, and Staff at a Rural Public University

Bauler, S., Hege, A., Davis, T., et al. (2022). Health Psychology and Behavioral Medicine, 10(1), 467–479.

Investigated behavioral determinants of COVID-19 vaccine acceptance at a rural US university using BA, identifying self-efficacy, social norms, and perceived risk as key factors influencing uptake decisions.

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Health 2022

Behavioural Determinants of COVID-19 Vaccine Acceptance in Rural Areas of Six Lower- and Middle-Income Countries

Davis, T.P., Yimam, A.K., Kalam, M.A., et al. (2022). Vaccines, 10(2), 214.

Conducted BA studies across six LMIC countries to identify behavioral determinants of COVID-19 vaccine acceptance in rural communities, providing cross-country evidence to inform targeted communication strategies.

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Nutrition 2022

State of Palestine: Investing in Assessment Positively Impacted Programming for Complementary Feeding

Emergency Nutrition Network. (2022). Field Exchange 68.

Describes how investment in BA-informed formative assessment positively shaped complementary feeding behavior change programming in the State of Palestine, illustrating the value of evidence-based program design.

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Nutrition 2021

Barrier Analysis for Adequate Daily Fruit and Vegetable Consumption Among Low-Income Residents of Hanoi, Vietnam and Ibadan, Nigeria

De Filippo, A., Meldrum, G., Samuel, F., et al. (2021). Global Food Security, 31, 100586.

Applied BA to understand barriers to adequate fruit and vegetable consumption among low-income urban residents in two cities across two continents, contributing to the evidence base for diet diversification programming.

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WASH 2021

Exploring Behavioral Determinants of Handwashing with Soap After Defecation in an Urban Setting in Bangladesh

Kalam, Md.A., Davis, T.P., Islam, Md.A., et al. (2021). Journal of Water, Sanitation and Hygiene for Development, 11(6), 1006–1015.

Explored behavioral determinants of handwashing with soap after defecation in an urban Bangladeshi setting using BA, identifying key enablers and barriers to inform context-specific WASH behavior change interventions.

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WASH 2020

The Determinants of Handwashing Behaviour Among Internally Displaced Women in Two Camps in the Kurdistan Region of Iraq

Zangana, A., Shabila, N., Heath, T., & White, S. (2020). PLOS ONE, 15(5), e0231694.

Identified behavioral determinants of handwashing among internally displaced women in Iraq using BA, providing evidence for WASH programming in humanitarian settings where standard approaches may be inadequate.

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Nutrition 2020

Barriers of Dietary Salt Reduction Among Hypertensive Patients

Khwaja, M. (2020). International Journal of Community Medicine and Public Health, 7(9), 3459.

Applied BA to identify barriers to dietary salt reduction among hypertensive patients, demonstrating the methodology's value in non-communicable disease prevention and chronic condition self-management.

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Nutrition 2020

Barriers and Facilitators of Exclusive Breastfeeding in Mwenezi and Chiredzi Districts, Zimbabwe

Moyo, G.T., Magaisa, T., Pagiwa, A., et al. (2020). World Nutrition, 11(3).

Conducted BA in two districts of Zimbabwe to identify barriers and facilitators of exclusive breastfeeding, providing findings to inform community-based behavior change communication and social support interventions.

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Nutrition 2019

Barrier Analysis of Infant and Young Child Feeding and Maternal Nutrition Behaviours Among IDPs in Syria

Perera, S.M. (2019). Field Exchange 59, 18.

Applied BA to study infant and young child feeding and maternal nutrition behaviors among internally displaced persons in northern and southern Syria, demonstrating the feasibility of BA in active conflict settings.

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Health 2018

Demand-Side Determinants of Timely Vaccination of Oral Polio Vaccine in Uttar Pradesh, India

Choudhary, M., Solomon, R., Awale, J., & Dey, R. (2018). BMC Infectious Diseases, 18(1), 222.

Examined demand-side behavioral determinants of timely oral polio vaccine uptake in social mobilization network areas of the CORE Group polio project in India, informing immunization communication strategies.

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Health 2018

Increasing Aspirin Adherence in Pregnant Women at Risk for Preeclampsia

Olszewski, S. (2018). Boston University Open Research.

Applied BA to identify barriers to aspirin adherence among pregnant women at risk for preeclampsia, demonstrating the methodology's utility in improving medication compliance in high-risk obstetric populations.

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Agriculture 2018

Barrier Analysis as a Tool to Inform Extension Activity Planning: Insights from Guatemala

Seiler-Martinez, A., Murphrey, T.P., Wingenbach, G., & Lombardini, L. (2018). Journal of International Agricultural and Extension Education, 25(2), 7–10.

Demonstrated BA as a tool for informing agricultural extension activity planning in Guatemala, identifying behavioral determinants of technology adoption among smallholder farmers to improve extension program design.

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WASH 2017

Barriers to Latrine Use for Defecation Among Mothers of Children Less Than 59 Months

Daniel, S., Subramanian, J., Sharmine, E., et al. (2017). International Journal of Community Medicine and Public Health, 4(2), 565–571.

Identified behavioral barriers to latrine use for defecation among mothers of young children in India, providing evidence to inform open defecation elimination programs and WASH behavior change communication.

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Health 2016

Barrier Analysis: Using Quality Improvement Methodology to Decrease Health Disparities in Recurrent Preterm Birth

Abbott, J., Smith-Lin, C., O'Toole, R., & Lee-Parritz, A. (2016). American Journal of Obstetrics and Gynecology, 214(1), S70.

Applied BA within a quality improvement framework to identify and address health disparities in recurrent preterm birth management, demonstrating its value in clinical settings beyond its traditional community health applications.

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Health 2016

Barrier Analysis to Improve Utilization of a Novel Cervical Cancer Screening Program in Rural Senegal

Aspros, N., Komarek, T., Dibaya, C., et al. (2016). Annals of Global Health, 82(3), 384.

Used BA to improve uptake of cervical cancer screening in rural Senegal, identifying key behavioral determinants and informing targeted interventions to increase program coverage among women in underserved areas.

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Health 2015

Transition from the Lactational Amenorrhea Method to Other Modern Family Planning Methods in Rural Bangladesh

Kouyaté, R.A., Ahmed, S., Haver, J., et al. (2015). Evaluation and Program Planning, 50, 10–17.

Applied BA to understand barriers to transitioning from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh, with implications for behavior change communication program design.

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Nutrition 2016

Consumption of Iron-Rich Foods Among Adolescent Girls in Nepal: Identifying Behavioural Determinants

Acharya, A., Rana, P.P., Pun, B.K., & Thapa, B. (2016).

Identified behavioral determinants affecting iron-rich food consumption among adolescent girls in Nepal using BA, contributing evidence to address micronutrient deficiency through targeted behavior change communication.

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Health 2013

Explosive Ordnance Risk Education and Barrier Analysis

Fletcher, K., & McGrath, I. (2013). Geneva International Centre for Humanitarian Demining (GICHD).

Demonstrated the application of BA to improve Explosive Ordnance Risk Education (EORE), identifying behavioral determinants of safe practices in mine-affected communities and providing a framework for evidence-based risk education programming.

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Nutrition 2010

Barrier Analysis of Exclusive Breastfeeding in Ruyigi and Cancuzo Provinces, Burundi

Francisco, J.E.V. (2010).

Conducted BA to identify behavioral determinants of exclusive breastfeeding in two provinces of Burundi, providing evidence to inform community-based lactation support and behavior change programming.

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Nutrition 2023

Use of the Designing for Behaviour Change Framework to Address Barriers to Animal Source Feeding in Children 8–23 Months in Bangladesh

Kalam, M.A., Asif, C.A.A., Stormer, A., et al. (2023). Maternal & Child Nutrition, e13472.

Applied the DBC framework and BA to identify barriers to and enablers of animal source food feeding to young children in the Bandarban Hill District of Bangladesh, with implications for nutrition-sensitive agriculture programming.

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Nutrition 2021

A Qualitative Analysis of Facilitators and Barriers to Breastfeeding Among Black Mothers in the Greater New Haven Area

Tran, V.D-V. (2021).

Applied BA framework to identify facilitators and barriers to breastfeeding among Black mothers in the United States, addressing health equity gaps and informing culturally responsive lactation support programs.

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Impact Metrics

Key statistics highlighting the reach and impact of Barrier Analysis

50+
Countries where Barrier Analysis has been implemented
200+
Behavior change projects informed by Barrier Analysis
30+
International organizations using Barrier Analysis

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