This presentation developed by Michelle Constable and Jim McManus, explores how health psychology can help the work of Environmental Health Officers and was part of an introductory workshop for the Environmental Health Profession organised by the Beds and Herts Branch of the Chartered Institute of Environmental Health

1. Understanding Behaviour: how
Health Psychology can contribute
to Environmental Health
Beds and Herts Branch of the Chartered Institute of
Environmental Health, 23 Sept 2014
Michelle Constable
Health Psychologist in Training
&
Jim McManus
Director of Public Health

2. Content
• Lets start a conversation!
• What is health psychology?
• Models of behaviour change
• Communication
• How to communicate your message
• Things to consider when planning a project

3. Lets start a conversation!
• What does current practice look like?
• What tools/support are available?
• What methods/theories do you use?
• How do you communicate your
messages?
• What challenges do you face?

4. Health Psychology?
• Promotion and maintenance of health
• Prevention and treatment of illness
• Cause and diagnostic relationship of health and
illness
• Health care system and health policy
• Consultancy
• Teaching and training

5. Areas Health Psychologists research
• Health cognitions/beliefs
• Communication
• Risk behaviours – smoking/alcohol
• Health protective behaviours
• Long term conditions – coping/resilience
• Stress
• Implementation of evidence based practice

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

7. Models of
Behaviour change

8. Determinants of health

9. Next Slides
• We gratefully acknowledge the permission of
UCL Centre for Behaviour Change to use some
of their slides on the COMB model and
behaviour change wheel, and we recommend
their training. http://www.ucl.ac.uk/behaviour-change
• We hope to organise their training for
Hertfordshire agencies soon

10. The COM-B Model
Michie S, M van Stralen, West R (2011) The Behaviour
Change Wheel: A new method for characterising and
designing behaviour change interventions. Implementation
Science, 6, 42.

11. Michie, 2011

12. The Behaviour Change Wheel

13. Again
• Our thanks to UCL colleagues for permission to
use the preceeding slides
http://www.ucl.ac.uk/behaviour-change

14. Environmental Health
• Many environmental problems rooted in
behaviour
• Consider the behaviour you are trying to target
• Contextual factors may facilitate or constrain
e.g. availability of recycling bins
• Costs may outweigh motivation – need to
consider infrastructure
• What is the evidence base?

15. Communication

16. Brief intervention
A
3 step
30 second
systems based
approach

17. Make Every Contact Count (MECC)
• Offering brief advice on healthy lifestyles
opportunistically, smoking, weight, physical activity
• Giving information about importance of behaviour
change
• Simple advice and signposting
• Aims to reduce health inequalities
• Encourages patient to take responsibility for own health
• http://learning.nhslocal.nhs.uk/feature-list/making-every-contact-
count
• http://www.alcohollearningcentre.org.uk/eLearning/IBA/

18. MOTIVATIONAL INTERVIEWING
What is MI?
MI is a collaborative, goal-orientated style of
communication which pays particular attention
to the language of change. It’s aim is to
strengthen personal motivation and commitment
to a specific goal (like increasing physical
activity) by exploring the person’s own reasons
for change.

19. FEATURES OF MI
• MI’s style is conversational and accepting
• It’s a shared decision making conversation
• It’s collaborative and solution focussed
• EQUALITY- They are the expert in their own
behaviour but you have the skills and
knowledge to help them!

20. THE TASK OF MI CONVERSATIONS
• Identify when behaviour is inconsistent
with the client’s goals or ambitions.
• Focus where there is a discrepancy
between their values i.e. I don’t want to
smoke and their current behaviour i.e.
smoking.
• It’s very hard to be resistant to someone
who is trying hard to understand you.
• With MI we don’t necessarily wait for the
client to be ready for change, MI is good
for people who are in two minds.

21. Instead of…Could you?
Have you thought of…?
TRY
• How might you best go about that?
• What would that be like for you?
• What are your thoughts?
• What strengths do you have?
• How confident are you in making this change?
• Where should the focus of our conversation be
today, to make it as helpful as possible for you?

22. Clear messages?
• Importance of clear information
• Stoke-on-Trent study
• Readability assessment
• Identify jargon
• Patient/public involvement group
• Lower then anticipated reading age

23. Things to consider in the planning
phase
1. Base interventions on a proper assessment of the target
group, where they are located and the behaviour that is to be
changed
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 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.

24. Next steps?
• Consider psychological factors when setting up
a project/intervention
• Review the evidence to see what works
• Think about the skill mix within your team
• Work with partners
• Communication is key to success
• Contact the Public Health Service
• Health Psychology in Public Health Network

25. Thank you!
Jim.mcmanus@hertfordshire.gov.uk
michelle.constable@hertfordshire.gov.uk