Introduction to Behavioural Change Lynn Stockley Lynn Stockley & Associates Summary • Why you don’t need to be worried......... • 2 main categories of behaviour change theories/models – Descriptive – To bring about change • Within those, some are intended for using with individuals, and other with groups or populations • Using broad principles identified by NICE and GSR is good practice • Take control and combine and adapt these theories/models to suit your purpose. Lynn Stockley & Associates PRECEED-PROCEED Lynn Stockley & Associates • Darnton A (2008) Behaviour Change: Government Social Research Knowledge Review. Government Social Research Advisory Group, London. http://www.civilservice.gov.uk/Assets/Behaviour%20change _practical_guide_tcm6-9696.pdf • National Institute for Health and Clinical Excellence (2007) Behaviour change at population, community and individual levels, London. http://www.nice.org.uk/nicemedia/pdf/PH006quickrefguide. pdf Lynn Stockley & Associates “ tools to be used in the design of interventions” “should use models as an aid to thinking” Lynn Stockley & Associates Exercise:- In pairs Each of you – share one of your last New Year’s resolutions (or make one up). With the help of the other person, try and list all of the things that influence that behaviour. Not how to change it – but what influences it. Lynn Stockley & Associates Frameworks, theories and models • Those that are intended to be descriptive of influences on behaviour • Those that identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation Darnton 2008 Lynn Stockley & Associates Frameworks, theories and models • Those that are intended to be descriptive of influences on behaviour • Those that identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation Darnton 2008 Lynn Stockley & Associates ‘Psychological’ models Describe influences within and as perceived by the individual e.g. • Attitudes e.g. preferences, perceptions of costs, balance of risks and benefits • Concepts like self efficacy • Norms • Agency • Habit • Emotion • Contextual factors Lynn Stockley & Associates Ajzen’s Theory of Planned Behaviour (1986) Beliefs about outcomes Attitude towards the behaviour Evaluation of outcomes Relative importance of attitude and norm Beliefs about what others think Intention Subjective norm Perceived Behavioural Control Reproduced from Conner 2007 Behaviour ‘Societal’ models • Show behaviour of individuals interacting with other influences e.g. • community • living/working/conditions • environmental • cultural • political Lynn Stockley & Associates Dahlgren and Whitehead’s Model of the Main Determinants of Behaviour Lynn Stockley & Associates Reproduced from Watt, R. UCL Lynn Stockley & Associates Structuration Theory adapted from Giddens 1984. Reproduced from Delormier 2009. Lynn Stockley & Associates Foresight Obesity Map Exercise:- In small groups Identify a population sub group one of you is familiar with:Draw the Dahlgren and Whitehead diagram Fill in the respective elements as far as possible Lynn Stockley & Associates Dahlgren and Whitehead’s Model of the Main Determinants of Behaviour Lynn Stockley & Associates Frameworks, theories and models • Those that are intended to be descriptive of influences on behaviour • Those that identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation Darnton 2008 Lynn Stockley & Associates MODEL OF HEALTH PROMOTION 2: HEALTH PROMOTION METHODS USING BEATTIE’S TYPOLOGY (BEATTIE – 1991) MODE OF INTERVENTION Advice Education Legislation Authoritarian Behaviour change Policy making and implementation Health surveillance Mass media campaign Individual Group/Popn Lobbying Counselling Action research Education Skills sharing and training Group work Group work Negotiated Community development .........identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation ........................in individuals Lynn Stockley & Associates Stages of Change Reproduced from Watt, R. UCL. Lynn Stockley & Associates ..........identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation ........................in groups or populations Lynn Stockley & Associates Is social marketing a behavioural framework/model/theory......... .......and does it matter? • NICE: a mechanism that is successful in some circumstances: • GSR: provides step-by-step guidance for developing interventions. This guidance is consistent with more specific frameworks e.g. Intervention Mapping (IM) (for health programmes Lynn Stockley & Associates “Social marketing is an adaptable approach, increasingly being used to achieve and sustain behaviour goals on a range of social issues. While formal definitions vary, three key elements commonly appear: Its primary aim is to achieve a particular 'social good' (rather than commercial benefit), with clearly defined behavioural goals. It is a systematic process phased to address short, medium and long-term issues. It uses a range of marketing techniques and approaches (a marketing mix......” http://www.nsmcentre.org.uk/what-is-social-marketing.html Lynn Stockley & Associates Social marketing - components Lynn Stockley & Associates Social marketing - stages Lynn Stockley & Associates “...identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation...” • Darnton 2008 GSR Behaviour Change review identified 9 principles • NICE identified 7 principles Lynn Stockley & Associates NICE 1. How to plan interventions 2. Assessing the social context 3. Education and Training 4. For individual level interventions 5. For Community level interventions GSR 1. Identify the audience and the target behaviour 2. Identify relev behav (descriptive) models 3. Identify key influences 4. Identify effective intervention techniques 5. Engage audience 6. Develop prototype 6. For population level interventions 7. Pilot – with monitoring 7. How to evaluate 9. Feedback 8. Evaluate What does this mean for me? • Good practice to use either of the set of principles • Behavioural models and theories are tools not recipes:– get to know your tools. Case studies; metaanalyses interventions and models e.g. Abrahams and Mitchie – You control your tools – not the other way around. Mix, match and adapt. Lynn Stockley & Associates Summary • Why you don’t need to be worried......... • 2 main categories of behaviour change theories/models – Descriptive – To bring about change • Within those, some are intended for using with individuals, and other with groups or populations • Using broad principles identified by NICE and other is good practice • Now you’re not worried you can take control and combine and adapt these theories/models to suit your purpose. Lynn Stockley & Associates