Behaviour change...CPD Session

24th February 2014, 1-3pm, County HallJim McManus Director of Public Health

Jim.mcmanus@hertfordshire.gov.uk

Slides for the Behaviour Change Taster workshop from Hertfordshire Public Health Service

What is this?

• A taster session on Behaviour Change• Designed to elicit your views about

– what you are doing, – what you could do and – what support you need

• Gives you an update on policy and practice

• Gives you some things to think about

Current Applications

• Public Health (various)• Driver speeding and behaviour• Young People• Drug and Alcohol recovery• Offending behaviour• Recycling behaviour• Pro social behaviour

Content• Why should we care?• What are you doing?• Benefits, challenges• Policy Context• Some useful methods and tools• Standards and effectiveness• What can Public Health do for you?• Next steps

Why should you care?

• Benefits of behaviour change• What do you think they are?• Why is it important in policy terms?• What do you need to make the best of it?

What are you doing?

• In small groups discuss– What are you doing on behaviour change?– What tools do you use?– What theory/methods do you use?– What challenges do you face?– What would be your ideal five things to

achieve in behaviour change and what stops you?

Feedback on benefits and challenges

– What are you doing on behaviour change?– What tools do you use?– What theory/methods do you use?– What benefits do you get?– What challenges do you face?– What would be your ideal five things to

achieve in behaviour change and what stops you?

Policy Context

• Lot of interest• “nudge” “behaviour change” offending,

recycling, finance, organ donation, health• Not a lot of clear guidance or evidence on

“how to”• Needs a framework “what to do, how to do

it, how to know it works”

Locating behaviour change 1

• Psychology

• Different schools, benefits and drawbacks– Cognitive approaches– Behavioural approaches

• Some outdated theories

• Economics

Locating behaviour change 2

• Behaviour can be automatic, conscious and deliberate, habitual, non habitual, reflected

• Behaviour can be influenced by a range of cues – emotional, visual, cognitive, memory

• Behaviour can be learned and unlearned• Often focus on cognitive and forget the

behavioural side itself (behaviourism)

Locating behaviour change 3

• Lots of pet theories• No magic bullet• Different things for different issues• Need some useful methods and tools• Standards and effectiveness• What can Public Health do for you?• Next steps

http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=BqnAoLGXhXXz6M&tbnid=Yelc6c9EGv_puM:&ved=0CAgQjRw&url=http://www.adderfilms.co.uk/theadders/Who%20on%20earth%20Adders.html&ei=0LjbUqr9MJO4hAfG7oG4Ag&psig=AFQjCNGg7NRifl9nqGWykAMDAOkR-UE8rQ&ust=1390217808888765

Michie, 2011

A first step at a ready reckoner for behaviour change tools and methods

A ready reckoner for behaviour change tools and methods

Population Level Group Level Individual Level

 “Automatic”processes

 “Conscious” processes

 “Automatic”processes

 “Conscious” processes

 “Automatic”processes

“Conscious” processes

 

Choice Architecture

Advertising e.g. change4 lifePolicy which influences behaviour (e.g. smoking ban)

Choice Architecture 

Groupwork for behaviourTargeted social marketing 

•Choice Architecture•Package design

Motivational interviewingBehaviourism approachesBehaviour change support e.g. Health TrainersTargeted social marketing

We still have gaps and weaknesses in science and tools across all of these (i.e. the science is still developing)

© Copyright 2014 Herts CC

Tools you need

1. A framework for quality, commissioning and evaluation

2. A “roadmap” of which tool or approach works when

3. Methods which work1. E.g. http://www.behaviourworksaustralia.org

4. Training

Tools you need 1

• New guidance, focus on quality standards and outcomes...a roadmap for quality

http://www.nice.org.uk/nicemedia/live/14347/66181/66181.pdf

Tools you need 1 continued

• NICE Recommends a policy and strategy• Recommends a commissioning framework• Do we want to work together on this or

separately?

Adobe Acrobat Document

We have embedded the NICEGuidance here...double click on the Icon

Tools you need 1: Principles for effective interventions (NICE)

1. base interventions on a proper assessment of the target group, where they are located and the behaviour which is to be changed: careful planning is the cornerstone of success

2.  work with other organisations and the community itself to decide on and develop initiatives

3. build on the skills and knowledge that already exists in the community, for example, by encouraging networks of people who can support each other

4. take account of – and resolve – problems that prevent people changing their behaviour (for example, the costs involved in taking part in exercise programmes or buying fresh fruit and vegetables, or lack of knowledge about how to make changes)

5. base all interventions on evidence of what works

6. train staff to help people change their behaviour

7. evaluate all interventions.

Tools you need 1: Principles for effective interventions (Michie)

• 1. Identify the target behaviour/s • 2. Understand the target behaviour/s in

context • 3. Consider full range of possible

intervention functions • 4. Identify specific behaviour change

techniques

Tools you need 2: A roadmapA first step at a ready reckoner for behaviour change tools and methods

A ready reckoner for behaviour change tools and methods

Population Level Group Level Individual Level

 “Automatic”processes

 “Conscious” processes

 “Automatic”processes

 “Conscious” processes

 “Automatic”processes

“Conscious” processes

 

Choice Architecture

Advertising e.g. change4 lifePolicy which influences behaviour (e.g. smoking ban)

Choice Architecture 

Groupwork for behaviourTargeted social marketing 

•Choice Architecture•Package design

Motivational interviewingBehaviourism approachesBehaviour change support e.g. Health TrainersTargeted social marketing

We still have gaps and weaknesses in science and tools across all of these (i.e. the science is still developing)

© Copyright 2014 Herts CC

Michie’s Behaviour Change Wheel 2011 (1)

Michie’s Behaviour Change Wheel 2011 (2)

Michie’s Behaviour Change Wheel 2011 (3)

Tools you need 3: methods which work• Evidence

– www.evidence.nhs.uk– Campbell collaboration

http://www.campbellcollaboration.org/– Ask for an evidence search “how to” session

from Public Health• Case studies

– Do something different www.dsd.me

Recent tools

• Collection of papers, economists, psychologists etc look at how behaviour science can be used to help design policy initiatives health, education, environment, personal finances and worker remuneration.

Behaviour change wheel (Michie)

• Behaviour change wheel step by step powerpoint• http://www.behaviourworksaustralia.org/wp-content/uploads/2012/11

/BWA_Michiefinal.pdf

• Behaviour change Wheel article • http://www.implementationscience.com/content/6/1/42/

• Behaviour Works Australia• http://www.behaviourworksaustralia.org/

Tools you need 4: Training

• Behaviour change methods training• Evidence searching and use training

What can public health do for you? • Training• Support with evidence searching• Finding effective interventions• Helping with setting outcomes and criteria

for evaluations• Finding you external experts• Helping you work through NICE guidance• Appraising case studies you have found

Next Steps

• Working on a behaviour change policy and Strategy? What do you think?

• What else?

Thanks

• Jim.mcmanus@hertfordshire.gov.uk