This document was produced for a Webinar for the Association of Directors of Public Health (ADHP www.adph.org.uk ) on 27th April 2017 in partnership with Public Health England (PHE www.gov.uk/phe) Hertfordshire County Council (www.hertfordshire.gov.uk) and the Health Psychology in Public Health Network (HPPHN www.hppn.org.uk ).

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The Role of Behavioural Sciences in
Public Health: A Quick Guide
1. Introduction
This document is intended to complement the Webinar for the Association of Directors of Public
Health (ADHP) taking place on 27th April 2017 at 11am-12pm hosted by Public Health England
(PHE) in partnership with Hertfordshire County Council, the ADHP and the Health Psychology in
Public Health Network (HPPHN).
It aims to provide a brief overview of behavioural sciences and their potential relevance to Public
Health, to act as a reference guide for the webinar and beyond.
It comprises of three sections;
1. An introductory section on behavioural science
2. What is in a Science? An overview of two main sciences often used in Public Health;
Health Psychology and Behavioural Economics
3. Application: How behavioural science can be applied to public health
What is behavioural science?
Behavioural Science is:
 ‘The science of human behaviour’
 Based on insights from psychological research, including the fields of Health
Psychology and Behavioural Economics
Where is behavioural science applied?
 Can be applied at the individual, community or population level
 Central to both upstream (population) and downstream (individual) approaches
What are the strengths of behavioural science?
 Strengths lie in theory and evidence-driven understanding and design
 Translation of evidence into practice

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 Uses robust evaluation to demonstrate effectiveness
 Can be low delivery intensity, i.e. adding value to existing processes
 Small changes can have widespread impact
 Highlights the challenge of translating intention to behaviour, identifying barriers and
facilitators to change
 Acknowledges that previous behaviour is best predictor of future behaviour.
Why is Behavioural Science important for Directors of Public Health and Public Health
Consultants?
Behavioural Science can support:
 Understanding the problem:
 Lifestyle choices are now the biggest contributing factors to preventable disease and
death.
 There is overwhelming evidence that changing people's health-related behaviour can
have a major impact on some of the largest causes of mortality and morbidity
 Behaviours contribute to health across the life-course and are key to the prevention
agenda and are expected to contribute to Sustainability and Transformation Plans
(STPs)
 Behavioural Science can identify the determinants of behaviour and highlight what
needs to change, and for whom.
 Co-creating the solutions:
 Theoretically-driven, evidence-based programmes are more likely to achieve health
behaviour change than ‘common sense’ approaches
 Helps to achieve local and national public health outcomes and local government
aspirations
 Provides low cost ways of enhancing existing systems or processes to increase the
impact of work streams
 Can improve the effectiveness of delivery and outcomes of training
 Can provide rigorous, scientifically led evaluations.

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2. What is in a Science?
Health Psychology
What is Health Psychology?
A discipline of psychology that aims to apply psychological science to:
 Promote and maintain health;
 Enhance the well-being of those affected by illness and disease;
 Improve the health care system and support health policy formation.
It draws on a Bio-Psycho-Social model of behaviour, acknowledging the biological, psychological
and sociological determinants of behaviour, health and illness.
Behaviour is complex and often people are unaware that they are engaging in detrimental
behaviours, or feel unmotivated or unable to make a change. 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. Health Psychology
can be used to focus on behavioural processes involved in enabling the maintenance of health,
management of illness and improvement of health care systems.
What can Health Psychology offer Public Health?
Health Psychologists can:
 identify key target behaviours, which if changed, could impact upon public health
outcomes
 develop and evaluate local services using evidence-based research methods
 select context relevant, evidence-based behaviour change techniques, which can be
applied to developing new public health interventions or increasing the uptake of existing
ones
 identify low cost ways of tweaking existing processes or interventions to ensure they go
with the grain of human behaviour
 embed behaviour change in all programme and service commissioning
 train health care professionals and other partners and staff to deliver behaviour change
interventions
 work with patients, service users and members of the public to encourage behaviour
change, and to ensure their voices are heard in service development.

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Behavioural Economics
What is Behavioural Economics?
Traditional economic theory conceptualises a world populated by perfectly rational beings, who
use all the information at their disposal to make decisions for optimal outcomes. Behavioural
economics, on the other hand, acknowledges that people are not perfectly rational, and instead:
 Are subject to biases,
 Are subject to ‘irrationalities’ (e.g. caring about what others think of one’s decision),
 Use heuristics (or shortcuts) to make decisions (i.e. decisions are not made based on the
cost-benefits analyses),
 Make inconsistent decisions (i.e. make different choices based on context),
 Are emotional.
Through investigating the human and social factors which influence decisions, behavioural
economics is better able to model human behaviour by accounting for the departures from
rationality which emerge in judgements (beliefs) and choices.
Behavioural economics takes into account theories from both economics and psychology and
allows for the modelling of behaviours on a population level.
What can Behavioural Economics offer Public Health?
Behavioural economists can:
 identify evidence based interventions to change behaviours at a population level
 map and evaluate how economic considerations, cognitive limitations and psychology
(including emotions and social influences) jointly shape human decision making
 identify theoretical frameworks and empirical predictions for environments where
traditional economic theory fails to provide guidance
 offer low cost, unobtrusive solutions to policies and programmes to improve outcomes
 run trials to identify the optimal interventions to achieve a desired health behaviour.

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3. Applications: How can Behavioural Science be applied to Public Health?
Below are three case studies of health psychologists working with Local Authorities to improve
public health:
CASE STUDY 1 - Coventry University & Public Health Warwickshire
Dr Emmie Fulton and Dr Katherine Brown are based jointly in the Centre for Technology
Enabled Health Research (CTEHR) at Coventry University, and Public Health Warwickshire.
Since 2011 they have both held part-time roles embedded in public health. Emmie and
Katherine’s work includes developing and delivering interventions for early stage dementia,
veterans’ mental health, sexual health services, falls prevention and developing methods to
more effectively evaluate public health campaigns. The work is stimulating and varied, and
facilitates strong links with Public Health England, community services, the council, the local
Health and Wellbeing board and CCG’s. As a result of the partnership, they have facilitated
further academic partnerships and collaborations between the University and the council,
and have recently developed opportunities for PhD’s funded by Public Health. They are now
planning upcoming events and workshops to further foster these growing links.
CASE STUDY 2 - Hertfordshire County Council
Michelle Constable is a Health Psychologist in Training based in the Public Health Service at
Hertfordshire County Council also undertaking the Professional Doctorate in Health
Psychology at the University of West England. This is the first health psychology post within
the Public Health team. The aim of the role is to embed health psychology and behavioural
science across public health, primary and social care; and support a strategic shift to
primary, secondary and tertiary
prevention. Michelle works on a wide range of projects with partner organisations
developing services with an embedded behaviour change approach. Examples of current
projects include: self-management of long-term conditions, motorcycle road safety,
smoking cessation, and conducting evidence reviews for commissioners. Michelle also
provides behaviour change training to a wide range of stakeholders. Michelle works at the
interface of commissioning and delivery. Check out the Health Psychology in Public Health
Network: www.hpphn.org.uk

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CASE STUDY 3 - Collaboration between the University of Bedfordshire (UoB), University of
Hertfordshire (UH), University of East Anglia (UEA), Hertfordshire Sports Partnership
(HSP), Hertfordshire County Council (HCC), Herts CCG, MIND, Leisure Trusts and Sport
England
Dr Angel Chater is a Health Psychologist and lead for the Centre for Health, Wellbeing and
Behaviour Change at the University of Bedfordshire. Neil Howlett is a Doctorate student
and research fellow, based at the University of Hertfordshire. In a large collaborative
project the above stakeholders have united to develop, deliver and evaluate a community-
based physical activity programme entitled Active Herts. Angel and Neil have provided
health psychology and behaviour change expertise to HSP and HCC to support the
development of Active Herts, which included: the development of programme material
(booklet/leaflets/website); identifying measurements that will highlight determinants of
behaviour change; and Capacity building of the Get Active Specialists, trained by Angel and
Neil in behaviour change theory and motivational interviewing, with the aim of supporting
behaviour change one-to-one consultations. The Active Herts programme is currently being
run in four areas of Hertfordshire for inactive adults at risk of cardiovascular disease and/or
poor mental health. Over one thousand people have already engaged in the project and it is
due to be evaluated by the external partners based at UEA in the near future.

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How can you use Behavioural Science in your role?
You can use Behavioural Science to support your role in a number of ways:
 Increased commissioning power: By using theoretically-driven, evidence-based
approaches, you can spend your money more wisely on programmes with a greater
likelihood of success
 Capacity building: By upskilling your workforce in behavioural science, future
programmes will be developed based on a scientific and rigorous framework
 Collaborate with academic institutions: Universities often host academics that have
expertise in behavioural science who are able to provide input to the development or
refinement of health-related programmes. You can offer to host an MSc or doctoral
student placement at no financial cost.
 Invest in a Behavioural Scientist: Core training in behavioural science often falls in to the
remit of Health Psychology. By employing a health psychologist or trainee health
psychologist, you can facilitate the integration of behavioural science within your remit.
This could be in terms of needs assessment (such as epidemiological data analysis/
systematic reviews), programme development (creating theoretically-driven
programmes), capacity building (upskilling of staff to develop/deliver services) and
evaluation (to analyse service outcomes and future directions).