Using behaviour change within the current economic, social and cultural context

Abstract

The concept of changing behaviour towards healthier choices has long been an aim of public health, encapsulated previ- ously in all those sporting metaphors such as goals, targets and my favourite, the sticky wicket. But now there is a stronger focus on how to motivate behaviour to reach those goals. this conference examined the value of change programmes, who we are trying to change (and why) and ways of engaging all those involved. the who and why is easy: two-thirds of British adults are overweight or obese, and smoking, alcohol and accidents claim many deaths. Inequalities of health still loom large, with a 12-year gap in life expectancy between the highest and lowest UK areas. the current emphasis is to make partnerships with patients to help them seize responsibility for their health. this re-balancing includes moving public health back into local government and uniting specialists within Public Health england (PHe) since April 2013. PHe aims to define good practice and to improve the evidence base. the health trainer programme is central to this, with evidence already of sustained improvement, for example, in reducing falls in the over 65s in Dudley by 38%.The new focus on behaviour change programmes reflects the growing evidence base on where to target attempts to modify behaviour - and a switch from the nanny state concept to forming partnerships with patients, the general public, industry and, most importantly, well-defined target populations. this conference provided inspiration and tools for how we should approach behavioural change, featuring presentations from a variety of speakers, including Shirley Cramer CBe, Chief executive RSPH; Dr Sunjai Gupta, PHe; Michael Hallsworth, Cabinet office; Paul Lincoln, National Institute for Health and Clinical excellence (NICe); Claire McDonald, National Health Service (NHS) & PHe; Professor Susan Michie, University College London (UCL); John Nawrockyi, Greenwich LA; Graham Rushbrook, RSPH and and RBe Associates; and Dr Helen Walters, Greater London Authority (GLA).Reducing avoidable deaths in non-communicable disease, particularly those mediated by diet, remains a major challenge. our ancient physiology makes us better equipped for famine than for plentiful food environments. In addition to tools such as the Nuffield Ladder of options for restrictions or incentives, we need to recognise 'teachable moments'. Also, environmental effects on behaviour are stronger than most people expect, from the arrangement of chairs in a meeting room to whether stairs are an attractive option. We can learn from commercial social marketing: one key, as in anti-smoking policies, is gauging when the desired behaviour has become a 'permitted' social norm. But changing food habits means combating the ruthless target- ing by those who understand the allure of immediate gratification. …