Communication and Behavior Change in Underserved Communities: A Narrative Review of Educational Interventions

Abstract

Underserved communities continue to experience deep health gaps shaped by poverty, distance from services, language barriers, and social stigma. These barriers often overlap, leaving individuals to face multiple challenges simultaneously. Conventional health education has had limited impact in such contexts, mainly because programs are rarely designed with local realities in mind. This review brings together evidence on strategies to improve health communication and education in marginalized settings. Approaches that center the community stand out as most effective. Peer education, for example, has built on trust within social networks to improve HIV prevention and immunization uptake. In South Asia, women’s groups using Participatory Learning and Action (PLA) cycles achieved significant reductions in neonatal deaths by working collectively on health solutions. Messages embedded in cultural forms such as folk songs and community theater have been better received than formal lectures, while mobile health tools like SMS reminders have shown potential to expand reach despite ongoing digital divides. What determines success is not only the message itself, but whether it is culturally relevant, involves the community, can be sustained through local capacity, and is supported by policy and health systems. Interventions that meet these criteria are more likely to bring lasting change than short-term, top-down efforts.