SlideShare ist ein Scribd-Unternehmen logo
1 von 44
The Application of Behavioural
Science to Public Health
ADPH Webinar
Prof Jim McManus Hertfordshire County Council
Dr Angel Chater University of Bedfordshire
Dr Tim Chadborn PHE Behavioural Insights Team
Dr Amanda Bunten PHE Behavioural Insights Team
Michelle Constable Hertfordshire County Council
Objectives
Gain an overview of behavioural science.
Understand relevance and applicability of behavioural science in
public health.
Gain awareness of the Behavioural Science Strategy development
and relevance to ADsPH.
2
Timings
Time Description Presenter
11.00 Introductions and welcome Prof Jim McManus
11.05 Setting the scene Dr Tim Chadborn
11.10 Current directions in behaviour change theory Dr Angel Chater
11.20 Examples of the application of behavioural science Dr Amanda Bunten
11.30 Embedding behavioural science in Public Health Michelle Constable
11.40 Overview of the Behavioural and Social Science Strategy Dr Tim Chadborn
11.45 Respond to questions submitted All
12.00 Close Prof Jim McManus
3
What are the
facilitators and
barriers to the
uptake of weight
management
services?
How can we
design the
built/ lived
environment
to influence
health-related
behaviours?
Typical questions from policy teams
What are the drivers
of the provision of
brief advice to
patients by healthcare
professionals?
4
 Draws on insights from psychological research; primarily
behavioural economics and health psychology
 Can be applied at the individual, professional, community or
population level
 Used upstream and downstream in prevention and treatment
 Central role of robust evaluation to demonstrate effectiveness
 Small changes can have widespread impact
 Previous behaviour is best predictor of future behaviour
– not intentions or beliefs
Behavioural Science
5
6
Behavioural ‘Definitions’
Behaviour is anything a person does
in response to internal or external events.
(Hobbs, Campbell, Hildon & Michie, 2011)
Behaviour should be differentiated from its
determinants (self-efficacy, emotion) and its
outcomes (quality of life, cholesterol level).
Traditional Theories of Behaviour
• The Health Belief Model – Becker (1974) Importance of beliefs, perceived benefits &
barriers to action, self-efficacy, stimulus/ cue to action. Limitations: focused on
conscious decision making and ignores habits.
• Social Learning Theory, Social Cognitive Theory – Bandura (1977) Importance of
social environment, modelling and self efficacy Limitations: emphasis on conscious
decision making and reflective processes
• Theory of Reasoned Action / Theory of Planned Behaviour – Ajzen (1985)
Limitation: assume people act in a rational way at all times, not all behaviour is
planned.
• Stages of Change Model / Transtheoretical Model – Prochaska and DiClemente
(1997) Limitation: assumes behaviour change occurs in a linear fashion, progression
through a series of stages.
Limitations:
• Effectiveness of predicting behaviour change
• Intention-behaviour gap
• Not addressing automatic motivation, habits and impulsive behaviour.
Public Health England - Behavioural Insights MasterclassPublic Health England - Behavioural Insights Masterclass7
“..this review suggests that intentional
control of behaviour is a great deal
more limited than previous meta-
analyses of correlational studies have
indicated”
Changing Behaviours:
The limitations of changing minds
“Changing behaviour by changing
minds is unscaleable, increases
inequalities, not very effective”
(Professor Theresa Marteau)
(Slide adapted from one by Theresa Marteau)8
Resist Environments Change Environments
Change minds to…
(Slide adapted from one by Theresa Marteau)
Before After
Changing behaviours:
Two (not mutually exclusive) approaches
9
Two interacting systems
Dual Process Theory
Reflective
Slow
Effortful
Self-aware
Complete a tax form
17 x 24
Automatic
Fast
Effortless
Unconscious
Driving on an empty road
2 + 2
Kahneman, D. (2011). Thinking, fast and slow. Macmillan.
10
Health Psychology
Health Psychology and Behaviour Change
• The science of human behaviour and experience
• Aims to:
• Promote and maintain health
• Enhance the well-being of those affected by illness
• Improve the health care system and support health
policy formation
• Understanding how people think, feel and learn
can help us understand and predict how they will
act
If we can UNDERSTAND human behaviour, it
gives us insight into how to CHANGE human
behaviour
At the heart of behaviour [change] is the
person…
Bio-Psycho-Social Model
(Engel,1977,1980)
Strength of Health
Psychology lies in the
application of theoretically-
driven, evidence-based
science
Behavioural Science
12
Importance of Theory
• Key questions to ask when developing interventions
(individual, community or population based levels):
1. What things should be considered when trying to
understand and change behaviour?
• What bio-psycho-social factors might be important?
2. What factors might influence uptake/engagement?
• What barriers/ facilitators might influence behaviour?
• Must move away from ‘common sense’ models of
behaviour change and draw on theory
Imagine you wanted to change physical activity behaviour
in an obese population to reduce diabetes and CVD risk…
What would you need to consider?? Hold that thought…
13
Now imagine a population of
Homer Simpsons!
Theory: COM-B
Capability
Motivation
Opportunity
Behaviour
Problem = Obesity
Target behaviour = Physical Activity
(Michie et al., 2011)
14
Behaviour
Capability
Psychological capability
Physical capability
Motivation
Reflective motivation
Automatic motivation
Opportunity
Social opportunity
Physical opportunity
Amore holistic model of
behaviour change – COM-B
 Capability, motivation and opportunity all need to be present for a behaviour to occur
 They all interact as part of a system
 Motivation must be stronger towards the target behaviour than competing behaviours
(Michie et al., 2011)
15
COM-B model
components
Definition
Psychological
capability
Knowledge, psychological skills (such as planning, attention,
strength and stamina) to engage in the necessary mental
processes (interpersonal skills, memory, attention, decision
processes).
Physical capability Physical skills, strength or stamina
Reflective motivation Active thought processes – attitudes and beliefs about what is
good or bad, the costs and benefits of doing something,
beliefs about consequences, goals, plans, and intentions.
Automatic motivation Less conscious thoughts processes that drive behaviour -
emotional reactions, desires (wants and needs), impulses,
drive states, habits, reinforcement, associative learning and
reflex responses.
Social opportunity Opportunity afforded by the social environment, social cues
and cultural norms, social acceptability and expectations.
Physical opportunity Opportunity afforded by the environment involving time,
resources, locations, cues.
16
(Michie et al., 2011)
Behavioural Economics
Standard Economic
Theory
• Consistently rational
(not emotional)
• Self-interested (not
altruistic)
• Utility maximisers
(the greatest amount
of value possible for
the budget)
• Takes the optimal
route to achieve
goals
• Subject to biases
• Subject to irrationalities
• Use heuristics (shortcuts) to
make decisions
• Context and time
dependent
(inconsistent)
• Emotional
‘Homo-economicus’ In reality
Behavioural Economics
18
19
Heuristics
Mental shortcuts or rules of
thumb to aid in problem solving
Cognitive Biases
Systematic thinking errors that
affect decisions and judgement
Anchoring
Availability
Loss Aversion
Status Quo
How can Behavioural Science be Utilised?
21
Defaults
We tend to ‘go with the flow’ of
a pre-set option
Salience
Our attention is draw to what
is novel and appears relevant
to us
Substitution
Easier to substitute a
behaviour than eliminate an
entrenched one
We are expecting you
at St Barts Hospital on
Sep 26 at 2.30. Not
attending costs NHS
£160 approx. Call
02077673200 if you
need to cancel or
rearrange.
What can it do for you?
 Help to achieve local and national public health outcomes
 Provide theoretically-driven, evidence-based programmes
 Provide low cost ways of enhancing existing systems or
processes
 Improve the effectiveness of delivery and outcomes of
training
 Provide rigorous, scientifically led evaluations
22
Analyse Advise Design Trial Train
 Behavioural
Analysis
 Policy  Interventions  RCTs  Masterclasses
 Literature
review
 Systematic
review
 Programmes
 Communication
 Mode of
delivery
 Programmes  Quasi-
experimental
studies
 Evaluation
 Qualitative
research
 Workshops
 Seminars
How can Behavioural Experts help?
Translation of evidence into practice
Building the Evidence
Health Checks
Increasing uptake of NHS Health
Checks
Health issue: Diabetes, CVD (heart attack and stroke), Kidney Disease and Dementia
Behavioural target: Increasing uptake of NHS Health Checks
Method: Altering the standard invitation letter and sending SMS messages
25
Control Treatment
DH led trial
NHS Health Check
You will receive a letter
about your NHS Health
Check.
Your NHS Health Check
is due tomorrow at
13.30.
vs.
+
Primer
Reminder
26
NHS Health Check: Results
18%
30%
0%
5%
10%
15%
20%
25%
30%
35%
40%
Standard letter and no texts Revised letter and primer and prompt
messages
Percentage uptake of NHS Health Checks
All reported results are statistically significant at p< 0.05 level.27
Antimicrobial Resistance
Reducing inappropriate antibiotic
prescribing
Health issue: Antimicrobial resistance
Behavioural target: Reducing inappropriate prescription of antibiotics in primary care
Method: Letter sent to the top 20% GP prescribers
28
AMR
29
“The great majority
(80%) of practices in
INSERT NHS AREA
prescribe fewer
antibiotics per head
than yours.”
30
Reduction of 3·3% in top 20% - equates to 0.83% across all GPs
Estimated 73,406 fewer antibiotic items dispensed
Cost of £4,335 - saving £92,356 in just prescription costs
Quality Premium allocated up to £23m to reduce prescriptions by 1%
2014 2015
Letter reduced
prescriptions
Letter
Letter reduced prescriptions
in control group
Rateofantibioticsdispensedper1,000weightedpopulationforstudyperiod,with95%CI
AMR: Results
Hallsworth, M., Chadborn, T., Sallis, A., Sanders, M., Berry, D., Greaves, F., Clements, L. and
Davies, S.C., 2016. Provision of social norm feedback to high prescribers of antibiotics in general
practice: a pragmatic national randomised controlled trial. The Lancet, 387(10029), pp.1743-1752
Food Environment
Encouraging Healthy Food and Drink
Purchasing
Health issue: High rates of obesity
Behavioural target: Make the Healthy choice the Easy Choice
Method: Product placement and pricing promotions on sales of food and drink within 3
NHS food environments
31
Three studies of choice architecture
32
Sales of water by 22 bottles a day
Proportion of total water sales by
12%
23% in confectionary sales
63% in water and 67% in
fruit sales
No effect on crisps 12%
Approx reduction of 14
kcals per drink
Embedding Behavioural Science
in Public Health
NICE Guidance
Public Health commissioning - lifestyle factors
NICE Guidance PH6, PH49 and LGB7
o Develop a local behaviour change policy and
strategy
o Commission interventions at population,
community, and individual levels
o Embed behaviour change all programmes from initial planning to
evaluation
34
National Developments
Health Psychology in Public Health Network
o Network launched in 2014 to build on the synergy between
health psychology and public health agendas.
 Behavioural Sciences Strategy for Public Health
o Strategy for all public health organisations being developed by a
range of partners: ADPH, PHE, HPPHN, FPH, LGA, BPS
 Campaign for Social Sciences – The Health of People
o Launched in 2017 - How the social sciences can improve
population health
35
Local Opportunities
Explore shared agendas
Different approaches to embedding behaviour change in
England
oJointly funded posts – Warwickshire
oEmploy a behaviour change specialist – Herts, Solihull
oFund a PhD
oInterns, MSc & PhD training placements, secondments
oDiscrete pieces of research for MSc or Doctoral
students
oCommission research, consultancy, training
oJoint funding bids
oAcademic evaluations
36
Interventions and Collaborations
37
Hertfordshire – Active Herts
 Joint Sport England funding bid – PH, CCGs,
Herts Sports Partnership
 Systematic review (Howlett et al. 2016)
 Evidence based intervention developed
 Behaviour Change training for those delivering
interventions
 Academic evaluation of behaviour change
constructs, level of activity, wellbeing and fidelity
Interventions and Collaborations cont.
38
Hertfordshire Health Improvement Service
 Stop Smoking Service delivering weight management
intervention
 Health Psychologist input:
o Development of service spec.
and evaluation of bids ensure behaviour
change embedded in intervention
o Developing training plan including
behaviour change
(Dixon & Johnston 2011)
o Comprehensive evaluation framework
ABehavioural and
Social Sciences Strategy
40
Proposal
• develop a framework strategy for maximising
the contribution of behavioural science to the
protection and improvement of the public’s
health and wellbeing in England;
• with a particular focus on enhancing the
effectiveness of public health interventions
and reducing health inequalities through
better application of behavioural science.
41
Toward a behavioural sciences strategy
for public health and wellbeing in
England
A prospectus for conversation
and development
February 2017
Conversation Event – Fri 17th March 2017
42
Potential objectives
1. Enhanced pre-service curricula
2. Strengthened in-service training
3. Guidance on approaches and frameworks
4. Inclusion in governance processes
5. Improving access to evidence
6. Capacity through networks and procurement
7. Community of evidence and practice
8. Advise on research priorities
Questions and Next Steps
Further learning opportunities
Health Psychology in Public Health Network: http://www.hpphn.org.uk
Online training http://www.bct-taxonomy.com/
Teaching, training & events http://www.ucl.ac.uk/behaviour-change
Public Health England’s Behavioural Insights Masterclasses: Tim.Chadborn@phe.gov.uk
Behavioural Economics Seminars at the London School of Economics
http://www.lse.ac.uk/LSEHealthAndSocialCare/events/BehavioralEconomicsSeminars.aspx
Behavioural Economics Events http://be-events.org/
Campaign for Social Sciences: YouTube: The Health of People: Part 2
Recommended Reading
Chater, A. & Cook, E. (2014). Health Psychology. London: Pearson.
(Chapter 3, Intervention Design: Changing Health Behaviour.)
Kahneman, D. (2011). Thinking, fast and slow. Macmillan.

Weitere ähnliche Inhalte

Was ist angesagt?

Intro to public health 1
Intro to public health 1Intro to public health 1
Intro to public health 1cecilewis
 
Sociology 3 health behaviour
Sociology 3 health behaviourSociology 3 health behaviour
Sociology 3 health behaviourmonaaboserea
 
Epidemiology Introduction
Epidemiology Introduction Epidemiology Introduction
Epidemiology Introduction KULDEEP VYAS
 
Function , Core competencies and scope of public health
Function , Core competencies and scope of public healthFunction , Core competencies and scope of public health
Function , Core competencies and scope of public healthsirjana Tiwari
 
The social ecological model
The social ecological modelThe social ecological model
The social ecological modeltrieducation
 
Social Determinants of Health
Social Determinants of HealthSocial Determinants of Health
Social Determinants of HealthChad Leaman
 
Basic concepts in medical sociology
Basic concepts in medical sociologyBasic concepts in medical sociology
Basic concepts in medical sociologyRizwan S A
 
Sociology and psychology in public health
Sociology and psychology in public healthSociology and psychology in public health
Sociology and psychology in public healthUniversity of Khartoum
 
Public health ethics
Public health ethicsPublic health ethics
Public health ethicsAshok Pandey
 
Public health: Definition & Concept
Public health: Definition & ConceptPublic health: Definition & Concept
Public health: Definition & ConceptMona Gupta
 
Public health model
Public health modelPublic health model
Public health modelSoumya Sahoo
 
Causation in epidemiology
Causation in epidemiologyCausation in epidemiology
Causation in epidemiologySoyebo Oluseye
 
Ethical Issues Related to Health Promotion
Ethical Issues Related to Health PromotionEthical Issues Related to Health Promotion
Ethical Issues Related to Health PromotionJacey Mitchell
 
Public health concept, i ketut swarjana
Public health concept, i ketut swarjanaPublic health concept, i ketut swarjana
Public health concept, i ketut swarjanaswarjana2012
 
The Challenges of Global Health
The Challenges of Global HealthThe Challenges of Global Health
The Challenges of Global HealthPuneetKour8
 
Introduction to health promotion and population health
Introduction to health promotion and population healthIntroduction to health promotion and population health
Introduction to health promotion and population healthAbduh Ridha
 

Was ist angesagt? (20)

Intro to public health 1
Intro to public health 1Intro to public health 1
Intro to public health 1
 
Sociology 3 health behaviour
Sociology 3 health behaviourSociology 3 health behaviour
Sociology 3 health behaviour
 
Epidemiology Introduction
Epidemiology Introduction Epidemiology Introduction
Epidemiology Introduction
 
Function , Core competencies and scope of public health
Function , Core competencies and scope of public healthFunction , Core competencies and scope of public health
Function , Core competencies and scope of public health
 
The social ecological model
The social ecological modelThe social ecological model
The social ecological model
 
Social Determinants of Health
Social Determinants of HealthSocial Determinants of Health
Social Determinants of Health
 
Basic concepts in medical sociology
Basic concepts in medical sociologyBasic concepts in medical sociology
Basic concepts in medical sociology
 
Sociology and psychology in public health
Sociology and psychology in public healthSociology and psychology in public health
Sociology and psychology in public health
 
Public health ethics
Public health ethicsPublic health ethics
Public health ethics
 
Public health: Definition & Concept
Public health: Definition & ConceptPublic health: Definition & Concept
Public health: Definition & Concept
 
Introduction to epidemiology
Introduction to epidemiologyIntroduction to epidemiology
Introduction to epidemiology
 
Public health model
Public health modelPublic health model
Public health model
 
Measuring health
Measuring healthMeasuring health
Measuring health
 
Causation in epidemiology
Causation in epidemiologyCausation in epidemiology
Causation in epidemiology
 
PRECED/PROCEED MODEL
PRECED/PROCEED MODEL PRECED/PROCEED MODEL
PRECED/PROCEED MODEL
 
Ethical Issues Related to Health Promotion
Ethical Issues Related to Health PromotionEthical Issues Related to Health Promotion
Ethical Issues Related to Health Promotion
 
Public health concept, i ketut swarjana
Public health concept, i ketut swarjanaPublic health concept, i ketut swarjana
Public health concept, i ketut swarjana
 
The Challenges of Global Health
The Challenges of Global HealthThe Challenges of Global Health
The Challenges of Global Health
 
Introduction to health promotion and population health
Introduction to health promotion and population healthIntroduction to health promotion and population health
Introduction to health promotion and population health
 
Global health
Global healthGlobal health
Global health
 

Ähnlich wie Applying Behavioural Science to Public Health

Theories and-models-frequently-used-in-health-promotion
Theories and-models-frequently-used-in-health-promotionTheories and-models-frequently-used-in-health-promotion
Theories and-models-frequently-used-in-health-promotionDanzo Joseph
 
Obesity- Tipping Back the Scales of the Nation 19th April, 2017
Obesity- Tipping Back the Scales of the Nation 19th April, 2017Obesity- Tipping Back the Scales of the Nation 19th April, 2017
Obesity- Tipping Back the Scales of the Nation 19th April, 2017mckenln
 
ImagineCare: Empowering Patients with Behavioral Science and Technology
ImagineCare: Empowering Patients with Behavioral Science and TechnologyImagineCare: Empowering Patients with Behavioral Science and Technology
ImagineCare: Empowering Patients with Behavioral Science and TechnologyLiz Griffith
 
Prevention: Why and how does it work? Considerations to strengthen HIV behavi...
Prevention: Why and how does it work? Considerations to strengthen HIV behavi...Prevention: Why and how does it work? Considerations to strengthen HIV behavi...
Prevention: Why and how does it work? Considerations to strengthen HIV behavi...Australian Federation of AIDS Organisations
 
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptxINTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptxbakanangemmahpholoan
 
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptxINTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptxbakanangemmahpholoan
 
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...Rebekah McKay-Smith
 
Behavior Sciences in Dentistry
Behavior Sciences in DentistryBehavior Sciences in Dentistry
Behavior Sciences in DentistryVineetha K
 
Health behaviour and health education for family medicine postgraduates
Health behaviour and health education for family medicine postgraduatesHealth behaviour and health education for family medicine postgraduates
Health behaviour and health education for family medicine postgraduatesChai-Eng Tan
 
social and behavior change communication approach in public health
social and behavior change communication approach in public healthsocial and behavior change communication approach in public health
social and behavior change communication approach in public healthAleena Maskey
 
behavioural models in health promotion
behavioural models in health promotionbehavioural models in health promotion
behavioural models in health promotionBala Vidyadhar
 
65 muster2014 Briggs
65 muster2014 Briggs65 muster2014 Briggs
65 muster2014 BriggsMuster2014
 
Planning and evaluation.pdf
Planning and evaluation.pdfPlanning and evaluation.pdf
Planning and evaluation.pdfNuhaminTesfaye
 
Critique on ''translating Vision into Practice'' articles
 Critique on ''translating Vision into Practice'' articles Critique on ''translating Vision into Practice'' articles
Critique on ''translating Vision into Practice'' articlesAmbika Rai
 

Ähnlich wie Applying Behavioural Science to Public Health (20)

Theories and-models-frequently-used-in-health-promotion
Theories and-models-frequently-used-in-health-promotionTheories and-models-frequently-used-in-health-promotion
Theories and-models-frequently-used-in-health-promotion
 
Obesity- Tipping Back the Scales of the Nation 19th April, 2017
Obesity- Tipping Back the Scales of the Nation 19th April, 2017Obesity- Tipping Back the Scales of the Nation 19th April, 2017
Obesity- Tipping Back the Scales of the Nation 19th April, 2017
 
ImagineCare: Empowering Patients with Behavioral Science and Technology
ImagineCare: Empowering Patients with Behavioral Science and TechnologyImagineCare: Empowering Patients with Behavioral Science and Technology
ImagineCare: Empowering Patients with Behavioral Science and Technology
 
How Health Psychology can contribute to environmental health
How Health Psychology can contribute to environmental healthHow Health Psychology can contribute to environmental health
How Health Psychology can contribute to environmental health
 
Unit 2 ch by sn
Unit 2 ch by snUnit 2 ch by sn
Unit 2 ch by sn
 
Prevention: Why and how does it work? Considerations to strengthen HIV behavi...
Prevention: Why and how does it work? Considerations to strengthen HIV behavi...Prevention: Why and how does it work? Considerations to strengthen HIV behavi...
Prevention: Why and how does it work? Considerations to strengthen HIV behavi...
 
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptxINTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
 
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptxINTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
INTERVENTION STRATEGIES AND APPROCHES IN HEALTH PROMOTION (2).pptx
 
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...
 
Behavior Sciences in Dentistry
Behavior Sciences in DentistryBehavior Sciences in Dentistry
Behavior Sciences in Dentistry
 
Behaviour change
Behaviour changeBehaviour change
Behaviour change
 
Health behaviour and health education for family medicine postgraduates
Health behaviour and health education for family medicine postgraduatesHealth behaviour and health education for family medicine postgraduates
Health behaviour and health education for family medicine postgraduates
 
social and behavior change communication approach in public health
social and behavior change communication approach in public healthsocial and behavior change communication approach in public health
social and behavior change communication approach in public health
 
behavioural models in health promotion
behavioural models in health promotionbehavioural models in health promotion
behavioural models in health promotion
 
The Scope of Health Behavior
The Scope of Health Behavior The Scope of Health Behavior
The Scope of Health Behavior
 
Public mental health : implementing in local systems
Public mental health : implementing in local systemsPublic mental health : implementing in local systems
Public mental health : implementing in local systems
 
65 muster2014 Briggs
65 muster2014 Briggs65 muster2014 Briggs
65 muster2014 Briggs
 
Planning and evaluation.pdf
Planning and evaluation.pdfPlanning and evaluation.pdf
Planning and evaluation.pdf
 
Critique on ''translating Vision into Practice'' articles
 Critique on ''translating Vision into Practice'' articles Critique on ''translating Vision into Practice'' articles
Critique on ''translating Vision into Practice'' articles
 
Welcome and introduction
Welcome and introductionWelcome and introduction
Welcome and introduction
 

Mehr von Professor Jim McManus AFBPsS,FFPH,CSci, FRSB, CPsychol

Mehr von Professor Jim McManus AFBPsS,FFPH,CSci, FRSB, CPsychol (20)

Public Service Leadership models and diverse communities
Public Service Leadership models and diverse communitiesPublic Service Leadership models and diverse communities
Public Service Leadership models and diverse communities
 
Social and Behavioural Science and Public Health: Covid-19 and beyond
Social and Behavioural Science and Public Health: Covid-19 and beyondSocial and Behavioural Science and Public Health: Covid-19 and beyond
Social and Behavioural Science and Public Health: Covid-19 and beyond
 
HEalth and care of older people in the post covid world
HEalth and care of older people in the post covid worldHEalth and care of older people in the post covid world
HEalth and care of older people in the post covid world
 
175 years of Directors of Public Health: Reflections
175 years of Directors of Public Health: Reflections175 years of Directors of Public Health: Reflections
175 years of Directors of Public Health: Reflections
 
Public Health and Devolution
Public Health and DevolutionPublic Health and Devolution
Public Health and Devolution
 
Poverty and integrated working
Poverty and integrated workingPoverty and integrated working
Poverty and integrated working
 
Levelling up and Health Inequalities 2022.pptx
 Levelling up and Health Inequalities 2022.pptx Levelling up and Health Inequalities 2022.pptx
Levelling up and Health Inequalities 2022.pptx
 
Monkeypox public health response national immunisation conference 2022.pptx
 Monkeypox public health response national immunisation conference 2022.pptx Monkeypox public health response national immunisation conference 2022.pptx
Monkeypox public health response national immunisation conference 2022.pptx
 
Public Health and the Church: Public Health perspecives
Public Health and the Church: Public Health perspecivesPublic Health and the Church: Public Health perspecives
Public Health and the Church: Public Health perspecives
 
Public health and the church: theological groundings
Public health and the church: theological groundingsPublic health and the church: theological groundings
Public health and the church: theological groundings
 
Local Community Action on Poverty
Local Community Action on PovertyLocal Community Action on Poverty
Local Community Action on Poverty
 
Emerging from the pandemic: insights for the Church
Emerging from the pandemic: insights for the ChurchEmerging from the pandemic: insights for the Church
Emerging from the pandemic: insights for the Church
 
Behavioural Sciences, Infectious Diseases and Pandemics
Behavioural Sciences, Infectious Diseases and PandemicsBehavioural Sciences, Infectious Diseases and Pandemics
Behavioural Sciences, Infectious Diseases and Pandemics
 
Behavioural Sciences and Public Health
Behavioural Sciences and Public HealthBehavioural Sciences and Public Health
Behavioural Sciences and Public Health
 
Why is Public Health important after the Pandemic?
Why is Public Health important after the Pandemic?Why is Public Health important after the Pandemic?
Why is Public Health important after the Pandemic?
 
Resilience trauma-pastoral-recovery
Resilience trauma-pastoral-recoveryResilience trauma-pastoral-recovery
Resilience trauma-pastoral-recovery
 
Resilience and coping beyond the pandemic
Resilience and coping beyond the pandemicResilience and coping beyond the pandemic
Resilience and coping beyond the pandemic
 
power of behavioural science in the public health response to coronavirus bsphn
power of behavioural science in the public health response to coronavirus  bsphnpower of behavioural science in the public health response to coronavirus  bsphn
power of behavioural science in the public health response to coronavirus bsphn
 
Hertfordshire vaccine engagement tools may 2021
Hertfordshire vaccine engagement tools may 2021Hertfordshire vaccine engagement tools may 2021
Hertfordshire vaccine engagement tools may 2021
 
Faith communities and pandemic flu 2009
Faith communities and pandemic flu 2009Faith communities and pandemic flu 2009
Faith communities and pandemic flu 2009
 

Kürzlich hochgeladen

Case Report Peripartum Cardiomyopathy.pptx
Case Report Peripartum Cardiomyopathy.pptxCase Report Peripartum Cardiomyopathy.pptx
Case Report Peripartum Cardiomyopathy.pptxNiranjan Chavan
 
Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!ibtesaam huma
 
Glomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxGlomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxDr.Nusrat Tariq
 
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...saminamagar
 
Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?bkling
 
PERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptx
PERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptxPERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptx
PERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptxdrashraf369
 
Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Mohamed Rizk Khodair
 
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxSYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxdrashraf369
 
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...rajnisinghkjn
 
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
PULMONARY EDEMA AND  ITS  MANAGEMENT.pdfPULMONARY EDEMA AND  ITS  MANAGEMENT.pdf
PULMONARY EDEMA AND ITS MANAGEMENT.pdfDolisha Warbi
 
Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.ANJALI
 
Informed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxInformed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxSasikiranMarri
 
Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...rajnisinghkjn
 
COVID-19 (NOVEL CORONA VIRUS DISEASE PANDEMIC ).pptx
COVID-19  (NOVEL CORONA  VIRUS DISEASE PANDEMIC ).pptxCOVID-19  (NOVEL CORONA  VIRUS DISEASE PANDEMIC ).pptx
COVID-19 (NOVEL CORONA VIRUS DISEASE PANDEMIC ).pptxBibekananda shah
 
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...DrGoharMushtaq
 
BIOLOGICAL ASSAY OF ANTIBIOTICS , VITAMIN D , DIGOXIN & INSULIN
BIOLOGICAL ASSAY  OF ANTIBIOTICS , VITAMIN D , DIGOXIN  & INSULINBIOLOGICAL ASSAY  OF ANTIBIOTICS , VITAMIN D , DIGOXIN  & INSULIN
BIOLOGICAL ASSAY OF ANTIBIOTICS , VITAMIN D , DIGOXIN & INSULINHasnat Tariq
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptkedirjemalharun
 
Hematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsHematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsMedicoseAcademics
 

Kürzlich hochgeladen (20)

Case Report Peripartum Cardiomyopathy.pptx
Case Report Peripartum Cardiomyopathy.pptxCase Report Peripartum Cardiomyopathy.pptx
Case Report Peripartum Cardiomyopathy.pptx
 
Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!
 
Glomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxGlomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptx
 
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in dwarka DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...call girls in Connaught Place  DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
call girls in Connaught Place DELHI 🔝 >༒9540349809 🔝 genuine Escort Service ...
 
Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?
 
PERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptx
PERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptxPERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptx
PERFECT BUT PAINFUL TKR -ROLE OF SYNOVECTOMY.pptx
 
Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)
 
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxSYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
 
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 6 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
 
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
PULMONARY EDEMA AND  ITS  MANAGEMENT.pdfPULMONARY EDEMA AND  ITS  MANAGEMENT.pdf
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
 
Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.
 
Informed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxInformed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptx
 
Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
Dwarka Sector 2 Call Girls ( 9873940964 ) Book Hot And Sexy Girls In A Few Cl...
 
COVID-19 (NOVEL CORONA VIRUS DISEASE PANDEMIC ).pptx
COVID-19  (NOVEL CORONA  VIRUS DISEASE PANDEMIC ).pptxCOVID-19  (NOVEL CORONA  VIRUS DISEASE PANDEMIC ).pptx
COVID-19 (NOVEL CORONA VIRUS DISEASE PANDEMIC ).pptx
 
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
The New Standard of Care__Leveraging the Benefits of SGLT2 Inhibitors Across ...
 
BIOLOGICAL ASSAY OF ANTIBIOTICS , VITAMIN D , DIGOXIN & INSULIN
BIOLOGICAL ASSAY  OF ANTIBIOTICS , VITAMIN D , DIGOXIN  & INSULINBIOLOGICAL ASSAY  OF ANTIBIOTICS , VITAMIN D , DIGOXIN  & INSULIN
BIOLOGICAL ASSAY OF ANTIBIOTICS , VITAMIN D , DIGOXIN & INSULIN
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.ppt
 
Hematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsHematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes Functions
 
Epilepsy
EpilepsyEpilepsy
Epilepsy
 

Applying Behavioural Science to Public Health

  • 1. The Application of Behavioural Science to Public Health ADPH Webinar Prof Jim McManus Hertfordshire County Council Dr Angel Chater University of Bedfordshire Dr Tim Chadborn PHE Behavioural Insights Team Dr Amanda Bunten PHE Behavioural Insights Team Michelle Constable Hertfordshire County Council
  • 2. Objectives Gain an overview of behavioural science. Understand relevance and applicability of behavioural science in public health. Gain awareness of the Behavioural Science Strategy development and relevance to ADsPH. 2
  • 3. Timings Time Description Presenter 11.00 Introductions and welcome Prof Jim McManus 11.05 Setting the scene Dr Tim Chadborn 11.10 Current directions in behaviour change theory Dr Angel Chater 11.20 Examples of the application of behavioural science Dr Amanda Bunten 11.30 Embedding behavioural science in Public Health Michelle Constable 11.40 Overview of the Behavioural and Social Science Strategy Dr Tim Chadborn 11.45 Respond to questions submitted All 12.00 Close Prof Jim McManus 3
  • 4. What are the facilitators and barriers to the uptake of weight management services? How can we design the built/ lived environment to influence health-related behaviours? Typical questions from policy teams What are the drivers of the provision of brief advice to patients by healthcare professionals? 4
  • 5.  Draws on insights from psychological research; primarily behavioural economics and health psychology  Can be applied at the individual, professional, community or population level  Used upstream and downstream in prevention and treatment  Central role of robust evaluation to demonstrate effectiveness  Small changes can have widespread impact  Previous behaviour is best predictor of future behaviour – not intentions or beliefs Behavioural Science 5
  • 6. 6 Behavioural ‘Definitions’ Behaviour is anything a person does in response to internal or external events. (Hobbs, Campbell, Hildon & Michie, 2011) Behaviour should be differentiated from its determinants (self-efficacy, emotion) and its outcomes (quality of life, cholesterol level).
  • 7. Traditional Theories of Behaviour • The Health Belief Model – Becker (1974) Importance of beliefs, perceived benefits & barriers to action, self-efficacy, stimulus/ cue to action. Limitations: focused on conscious decision making and ignores habits. • Social Learning Theory, Social Cognitive Theory – Bandura (1977) Importance of social environment, modelling and self efficacy Limitations: emphasis on conscious decision making and reflective processes • Theory of Reasoned Action / Theory of Planned Behaviour – Ajzen (1985) Limitation: assume people act in a rational way at all times, not all behaviour is planned. • Stages of Change Model / Transtheoretical Model – Prochaska and DiClemente (1997) Limitation: assumes behaviour change occurs in a linear fashion, progression through a series of stages. Limitations: • Effectiveness of predicting behaviour change • Intention-behaviour gap • Not addressing automatic motivation, habits and impulsive behaviour. Public Health England - Behavioural Insights MasterclassPublic Health England - Behavioural Insights Masterclass7
  • 8. “..this review suggests that intentional control of behaviour is a great deal more limited than previous meta- analyses of correlational studies have indicated” Changing Behaviours: The limitations of changing minds “Changing behaviour by changing minds is unscaleable, increases inequalities, not very effective” (Professor Theresa Marteau) (Slide adapted from one by Theresa Marteau)8
  • 9. Resist Environments Change Environments Change minds to… (Slide adapted from one by Theresa Marteau) Before After Changing behaviours: Two (not mutually exclusive) approaches 9
  • 10. Two interacting systems Dual Process Theory Reflective Slow Effortful Self-aware Complete a tax form 17 x 24 Automatic Fast Effortless Unconscious Driving on an empty road 2 + 2 Kahneman, D. (2011). Thinking, fast and slow. Macmillan. 10
  • 12. Health Psychology and Behaviour Change • The science of human behaviour and experience • Aims to: • Promote and maintain health • Enhance the well-being of those affected by illness • Improve the health care system and support health policy formation • Understanding how people think, feel and learn can help us understand and predict how they will act If we can UNDERSTAND human behaviour, it gives us insight into how to CHANGE human behaviour At the heart of behaviour [change] is the person… Bio-Psycho-Social Model (Engel,1977,1980) Strength of Health Psychology lies in the application of theoretically- driven, evidence-based science Behavioural Science 12
  • 13. Importance of Theory • Key questions to ask when developing interventions (individual, community or population based levels): 1. What things should be considered when trying to understand and change behaviour? • What bio-psycho-social factors might be important? 2. What factors might influence uptake/engagement? • What barriers/ facilitators might influence behaviour? • Must move away from ‘common sense’ models of behaviour change and draw on theory Imagine you wanted to change physical activity behaviour in an obese population to reduce diabetes and CVD risk… What would you need to consider?? Hold that thought… 13
  • 14. Now imagine a population of Homer Simpsons! Theory: COM-B Capability Motivation Opportunity Behaviour Problem = Obesity Target behaviour = Physical Activity (Michie et al., 2011) 14
  • 15. Behaviour Capability Psychological capability Physical capability Motivation Reflective motivation Automatic motivation Opportunity Social opportunity Physical opportunity Amore holistic model of behaviour change – COM-B  Capability, motivation and opportunity all need to be present for a behaviour to occur  They all interact as part of a system  Motivation must be stronger towards the target behaviour than competing behaviours (Michie et al., 2011) 15
  • 16. COM-B model components Definition Psychological capability Knowledge, psychological skills (such as planning, attention, strength and stamina) to engage in the necessary mental processes (interpersonal skills, memory, attention, decision processes). Physical capability Physical skills, strength or stamina Reflective motivation Active thought processes – attitudes and beliefs about what is good or bad, the costs and benefits of doing something, beliefs about consequences, goals, plans, and intentions. Automatic motivation Less conscious thoughts processes that drive behaviour - emotional reactions, desires (wants and needs), impulses, drive states, habits, reinforcement, associative learning and reflex responses. Social opportunity Opportunity afforded by the social environment, social cues and cultural norms, social acceptability and expectations. Physical opportunity Opportunity afforded by the environment involving time, resources, locations, cues. 16 (Michie et al., 2011)
  • 18. Standard Economic Theory • Consistently rational (not emotional) • Self-interested (not altruistic) • Utility maximisers (the greatest amount of value possible for the budget) • Takes the optimal route to achieve goals • Subject to biases • Subject to irrationalities • Use heuristics (shortcuts) to make decisions • Context and time dependent (inconsistent) • Emotional ‘Homo-economicus’ In reality Behavioural Economics 18
  • 19. 19 Heuristics Mental shortcuts or rules of thumb to aid in problem solving Cognitive Biases Systematic thinking errors that affect decisions and judgement Anchoring Availability Loss Aversion Status Quo
  • 20. How can Behavioural Science be Utilised?
  • 21. 21 Defaults We tend to ‘go with the flow’ of a pre-set option Salience Our attention is draw to what is novel and appears relevant to us Substitution Easier to substitute a behaviour than eliminate an entrenched one We are expecting you at St Barts Hospital on Sep 26 at 2.30. Not attending costs NHS £160 approx. Call 02077673200 if you need to cancel or rearrange.
  • 22. What can it do for you?  Help to achieve local and national public health outcomes  Provide theoretically-driven, evidence-based programmes  Provide low cost ways of enhancing existing systems or processes  Improve the effectiveness of delivery and outcomes of training  Provide rigorous, scientifically led evaluations 22
  • 23. Analyse Advise Design Trial Train  Behavioural Analysis  Policy  Interventions  RCTs  Masterclasses  Literature review  Systematic review  Programmes  Communication  Mode of delivery  Programmes  Quasi- experimental studies  Evaluation  Qualitative research  Workshops  Seminars How can Behavioural Experts help? Translation of evidence into practice
  • 25. Health Checks Increasing uptake of NHS Health Checks Health issue: Diabetes, CVD (heart attack and stroke), Kidney Disease and Dementia Behavioural target: Increasing uptake of NHS Health Checks Method: Altering the standard invitation letter and sending SMS messages 25
  • 26. Control Treatment DH led trial NHS Health Check You will receive a letter about your NHS Health Check. Your NHS Health Check is due tomorrow at 13.30. vs. + Primer Reminder 26
  • 27. NHS Health Check: Results 18% 30% 0% 5% 10% 15% 20% 25% 30% 35% 40% Standard letter and no texts Revised letter and primer and prompt messages Percentage uptake of NHS Health Checks All reported results are statistically significant at p< 0.05 level.27
  • 28. Antimicrobial Resistance Reducing inappropriate antibiotic prescribing Health issue: Antimicrobial resistance Behavioural target: Reducing inappropriate prescription of antibiotics in primary care Method: Letter sent to the top 20% GP prescribers 28
  • 29. AMR 29 “The great majority (80%) of practices in INSERT NHS AREA prescribe fewer antibiotics per head than yours.”
  • 30. 30 Reduction of 3·3% in top 20% - equates to 0.83% across all GPs Estimated 73,406 fewer antibiotic items dispensed Cost of £4,335 - saving £92,356 in just prescription costs Quality Premium allocated up to £23m to reduce prescriptions by 1% 2014 2015 Letter reduced prescriptions Letter Letter reduced prescriptions in control group Rateofantibioticsdispensedper1,000weightedpopulationforstudyperiod,with95%CI AMR: Results Hallsworth, M., Chadborn, T., Sallis, A., Sanders, M., Berry, D., Greaves, F., Clements, L. and Davies, S.C., 2016. Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial. The Lancet, 387(10029), pp.1743-1752
  • 31. Food Environment Encouraging Healthy Food and Drink Purchasing Health issue: High rates of obesity Behavioural target: Make the Healthy choice the Easy Choice Method: Product placement and pricing promotions on sales of food and drink within 3 NHS food environments 31
  • 32. Three studies of choice architecture 32 Sales of water by 22 bottles a day Proportion of total water sales by 12% 23% in confectionary sales 63% in water and 67% in fruit sales No effect on crisps 12% Approx reduction of 14 kcals per drink
  • 34. NICE Guidance Public Health commissioning - lifestyle factors NICE Guidance PH6, PH49 and LGB7 o Develop a local behaviour change policy and strategy o Commission interventions at population, community, and individual levels o Embed behaviour change all programmes from initial planning to evaluation 34
  • 35. National Developments Health Psychology in Public Health Network o Network launched in 2014 to build on the synergy between health psychology and public health agendas.  Behavioural Sciences Strategy for Public Health o Strategy for all public health organisations being developed by a range of partners: ADPH, PHE, HPPHN, FPH, LGA, BPS  Campaign for Social Sciences – The Health of People o Launched in 2017 - How the social sciences can improve population health 35
  • 36. Local Opportunities Explore shared agendas Different approaches to embedding behaviour change in England oJointly funded posts – Warwickshire oEmploy a behaviour change specialist – Herts, Solihull oFund a PhD oInterns, MSc & PhD training placements, secondments oDiscrete pieces of research for MSc or Doctoral students oCommission research, consultancy, training oJoint funding bids oAcademic evaluations 36
  • 37. Interventions and Collaborations 37 Hertfordshire – Active Herts  Joint Sport England funding bid – PH, CCGs, Herts Sports Partnership  Systematic review (Howlett et al. 2016)  Evidence based intervention developed  Behaviour Change training for those delivering interventions  Academic evaluation of behaviour change constructs, level of activity, wellbeing and fidelity
  • 38. Interventions and Collaborations cont. 38 Hertfordshire Health Improvement Service  Stop Smoking Service delivering weight management intervention  Health Psychologist input: o Development of service spec. and evaluation of bids ensure behaviour change embedded in intervention o Developing training plan including behaviour change (Dixon & Johnston 2011) o Comprehensive evaluation framework
  • 40. 40 Proposal • develop a framework strategy for maximising the contribution of behavioural science to the protection and improvement of the public’s health and wellbeing in England; • with a particular focus on enhancing the effectiveness of public health interventions and reducing health inequalities through better application of behavioural science.
  • 41. 41 Toward a behavioural sciences strategy for public health and wellbeing in England A prospectus for conversation and development February 2017 Conversation Event – Fri 17th March 2017
  • 42. 42 Potential objectives 1. Enhanced pre-service curricula 2. Strengthened in-service training 3. Guidance on approaches and frameworks 4. Inclusion in governance processes 5. Improving access to evidence 6. Capacity through networks and procurement 7. Community of evidence and practice 8. Advise on research priorities
  • 44. Further learning opportunities Health Psychology in Public Health Network: http://www.hpphn.org.uk Online training http://www.bct-taxonomy.com/ Teaching, training & events http://www.ucl.ac.uk/behaviour-change Public Health England’s Behavioural Insights Masterclasses: Tim.Chadborn@phe.gov.uk Behavioural Economics Seminars at the London School of Economics http://www.lse.ac.uk/LSEHealthAndSocialCare/events/BehavioralEconomicsSeminars.aspx Behavioural Economics Events http://be-events.org/ Campaign for Social Sciences: YouTube: The Health of People: Part 2 Recommended Reading Chater, A. & Cook, E. (2014). Health Psychology. London: Pearson. (Chapter 3, Intervention Design: Changing Health Behaviour.) Kahneman, D. (2011). Thinking, fast and slow. Macmillan.