Buckinghamshire Behavioural Insight Guide
This guide has been put together to assist Buckinghamshire organisations and policy
makers to understand the science behind how we think and make decisions. The
aim of this guide is to help shape policy formulation and the development and
delivery of projects and programmes that aim to encourage positive behaviours. The
guide can also be used to aid in the communication of clear messages with the
purpose of improving outcomes for the public
0
CONTENTS
An Introduction to the Guide
Some Key Facts About Behaviour and Choice
How Behaviour and Choice Fits with Local Priorities
2
3
5
Supporting the aims of promoting personal, social, corporate and family
responsibility
Tips for Good Communication
Tailoring your message for Specific Sub-Groups and Segments
6
A Planning Cycle for Influencing Behaviour and Choices
9
The Planning Cycle Checklist for Influencing Behaviour and Choice
10
7
8
-----------------------------------------------------------------------------------------------------Appendices:
Worksheet 1 – Defining Target Behaviour and Goals
Deciding on Targets
Worksheet 2 – Identifying and Segmenting the Target Audience
13
14
Segmentation case study – Reactivate Bucks
16
17
Segmenting by Geography and Demographics – ACORN
The Values Mode Tool – Pioneers, Prospectors and Settlers
Healthy Foundations Life Segmentation Tool
Alcohol
17
18
19
20
Worksheet 3 – Identify and Apply Relevant Behaviour Models to
interventions
21
Individual level behaviour change models
Community level behaviour change models
Behaviour change techniques
22
24
30
Worksheet 4 – Engaging the Target Audience
34
Marginalised groups
34
Worksheet 5 – Evaluation of interventions/campaigns
36
1
AN INTRODUCTION TO THE GUIDE
Many organisations in Buckinghamshire are working on projects and programmes that
include encouraging individuals and communities to look at their current actions and
consider behaving differently. This could be in relation to a wide range of issues, from
encouraging people to use services differently, to making changes to their daily habits, or
giving more support in their local community.
Knowledge of behavioural science and the science of choice is increasing, but there is no
one solution. However, using a more systematic approach to planning work on behaviour
change can encourage more desirable behaviours. For larger projects, making use of some
of the more detailed theory and frameworks that have been developed can be beneficial.
This guide is aimed at users who are developing projects, programmes or policies at a
community or population level. It is not a resource for people delivering face to face and one
to one behaviour change support. The guide provides:
Some Key Facts about Behaviour and Choice
This section provides a brief overview to behaviour and choice and will be helpful to anyone
undertaking work in this area.
How Behaviour and Choice Fits with Local Priorities
It may be helpful for groups considering work on behaviour and choice to know how their
work links with local priorities and who may be able to help or support their work.
Tips for Good Communication
Sometimes getting basic communications right can make a difference in how written and
verbal communications influence target groups. For example, changing the wording of tax
letters to explain that the majority of people in the local area had paid their taxes (comparing
to a positive norm rather than focusing on the number of people who hadn’t paid) boosted
repayment rates by 15%. Some tips for good communication are included in the guide.
A Planning Checklist for Influencing Behaviour and Choices
This checklist takes users through a planning cycle for developing projects* that seek to
influence behaviour or choices. The checklist guides the development process through a
range of self assessment questions. For many projects the use of the planning checklist will
be sufficient to maximise the potential of the work.
Supplementary Worksheets
Some areas of work will be more significant in terms of the importance of changing
behaviour and the amount of resources required. Some areas of work may be particularly
complex and require some aspects of the planning to be considered in more detail.
For projects that need more detailed planning this guide contains additional worksheets to
provide users with further tools and information on different stages of the planning cycle.
*
Throughout the guide the term ‘project’ will be used to incorporate programmes and policies.
2
SOME KEY FACTS ABOUT BEHAVIOUR AND CHOICE

Below is a short summary outlining how people behave and make choices:
o People are likely to do what they have always done and act out of habit, often
going with the flow of ‘pre-set’ options
o They are likely to do what impulse tells them (often based on habit) or what their
neighbours or friends do
o They are unlikely to change their behaviour if this means negotiating unclear or
difficult choices, or if the change is complex. Simplifying the choices we want
people to make is key
o People are inconsistent and may make different choices in different
circumstances
o People have a preference for short term benefits over long term gains and like to
avoid losses
o People are heavily influenced by who communicates with them
o Emotional associations can be powerful in shaping actions
o People seek to be consistent with public promises and act in ways that make
them feel better about themselves

An individual’s attitudes may contradict their behaviour. For example, higher levels of
education are related to higher concerns about climate change, but also with longer car
commutes and owning larger vehicles. By contrast, people with lower levels of education
may not be as concerned about the environment, but may have a lower carbon footprint
and make more use of public transport.

In order for people to choose a new behaviour it needs to seem†:
o More advantageous – this is influenced by an individual’s perception of costs and
benefits
o More ‘me’ – it must fit with perceptions of self and / or aspirations
o More prevalent – increased awareness of who else is doing it
o More do-able – limited barriers and increased confidence in ability to change
o Or the old behaviour needs to seem less than any of the above

Influencing behaviours and choices effectively needs a combination of:
o Understanding specific behaviours and the factors that influence these
And
o
Understanding theories of change and how to change behaviours and choices
over time

There are equity issues – might we be encouraging people with the capacity and
resources to make changes and leaving other groups behind?

When seeking to influence one behaviour or choice there may be other consequences
that weren’t considered or expected. For example, if someone gives up smoking they
may eat more as an alternative. It is important to consider what the wider impacts of a
project may be to avoid unintended consequences. Defining a target behaviour and
goals is covered in worksheet 1.
†
Government for Social Research (2011) Behavioural Insights Toolkit: Social Research and Evaluation Division,
Department for Transport
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Further information later in this guide focuses on looking at impacts that are related to
the behaviour or choice being considered. For some projects it may also be relevant to
consider a much wider set of impacts such as does the project have an effect on
equalities, sustainability, or the economy, etc. Where appropriate, a web based
Integrated Impact Assessment Tool is available on the Knowing Bucks website at
www.buckspartnership.co.uk/partnership/BSP/partners/single_impact_assessment.page
A user name and password is required to access this tool.

It is impossible to influence everyone. Projects should develop a realistic understanding
of how much change can be expected. However, it is important to remember that if a
project is undertaken at a community or population level, it can result in a large number
of people changing. For example if only 5% of the people who smoke in
Buckinghamshire are encouraged to attempt to quit this is 3,500 individuals.
4
HOW BEHAVIOUR AND CHOICE FITS WITH LOCAL PRIORITIES
There are a number of existing strategies and reports that help to identify local priorities.
Some of the main ones are listed below:
Joint Strategic Needs Assessment (JSNA)
On an annual basis, NHS Buckinghamshire and Oxfordshire Cluster and Buckinghamshire
County Council research the current and future health, care and well-being needs of the
people of Buckinghamshire. The findings of this are described in the JSNA:
http://www.buckinghamshire.nhs.uk/service-improvements/joint-strategic-needs-assessment/
Children and Young People’s Plan
The Children and Young People’s Plan is the single, strategic plan for all services affecting
children and young people:
http://www.buckinghamshirepartnership.gov.uk/partnership/CYPT/Children_and_Young_Peo
ples_Plan.page?collection=bcc
Buckinghamshire County Council Corporate Plan 2011-13
The Plan describes Buckinghamshire County Council’s main priorities for the next 2 years
and how the council intend to achieve them:
http://www.buckscc.gov.uk/bcc/corporate_plan/our_vision.page
Safer Bucks Plan 2011-12
http://www.buckinghamshirepartnership.gov.uk/assets/content/Partnerships/BSP/docs/BSPI
G/Safer%20Bucks%20Plan%2011-12%20for%20Cabinet%20_2_.pdf
5
Supporting the Aims of Promoting Personal, Social, Corporate and Family
Responsibility
In order to understand how behaviour change theories can help us to achieve the desired
outcomes of our work programme, we have detailed what we mean by personal, social,
corporate and family responsibility. The definitions are:
Corporate responsibility
The goal of corporate responsibility is to embrace responsibility for the company's actions
and encourage a positive impact through its activities on the environment, consumers,
employees, communities, stakeholders and all other members of the public sphere‡.
Family responsibility
Family responsibility is a sense of shared responsibility across several family members. A
sub set of family responsibility is filial responsibility, which is the sense of personal obligation
or duty that adult children feel for protecting, caring for, and supporting their aging parents.§
Social responsibility
Social responsibility is an obligation to act to benefit society at large. This responsibility can
be passive by avoiding engaging in socially harmful acts; or active by performing activities
that directly advance social goals.**
Personal responsibility
Personal Responsibility is taking responsibility for your actions, accepting the consequences
that come from those actions and understanding that what you do impacts upon those
around you.
‡
http://en.wikipedia.org/wiki/Corporate_social_responsibility
http://www.encyclopedia.com/doc/1G2-3406900175.html
3
http://en.wikipedia.org/wiki/Social_responsibility
2
6
TIPS FOR GOOD COMMUNICATION
This short guide will help you to write easy to read information. It covers:
1. Key questions to help you plan your written information
2. Making your writing easy to read and understand
3. Tailoring your message to be specific to particular target groups or segments
1. Key questions to help you plan your written information
Before you start writing, use these questions to help you plan what you want to say.
•
•
•
•
•
Who is the audience for your information (age, sex, disability, ethnic and cultural
background etc)?
What information are you trying to give?
How will your audience perceive the content, style and presentation of your
information?
How will the communication link in with other information you are providing, for
example verbal information given in a consultation?
How will the information be distributed?
2. Making your writing easy to read and understand
Whenever, whatever and whoever you are writing for always consider these points:
•
Keep sentences short. There are no absolute rules on sentence length. However,
clear writing usually has an average sentence length of 15 to 20 words. Most long
sentences can be shortened–this is useful when trying to explain complicated things.
•
Use active verbs. Write as you would speak, rather than in an academic style –
active verbs make information easier to understand. For example:
• “This leaflet explains the process to you”
•
Use 'you' and 'we'. Use personal pronouns (I, you, we) to help the reader identify
with the material. For example:
• “We will tell you before we ...”
•
Use words that are appropriate for the reader. When you are talking to your
reader, say exactly what you mean, using the simplest words that fit. This does not
necessarily mean only using simple words − just words that the reader will
understand.
Avoid jargon and technical descriptions. If you must include them, make sure you
give a clear explanation of what they mean. The same applies to acronyms.
Use lists where appropriate. Use a bullet point list when you are making several points
under one heading. Bullet points are better than numbers or letters as they draw your
attention to each point without giving you extra information to take in.
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3. Tailoring your message to be specific to particular target groups or
segments
Worksheet 2 provides further information on how to divide the general population into
smaller sub groups with similar characteristics (segmentation). Below is an example of how
better knowledge of the segments/target groups can be used to tailor communication.
EXAMPLE
Communicating with the Values Mode Segments
When writing a communication to residents to inform them of a change to a service/process,
it is important that the message appeals to all types of people – a one size fits all approach
will inevitably miss the mark in some cases. If you want to gain maximum benefit from a
communication, the message will need to appeal to a variety of people and show a better
understanding of their values and motivations.
A simple method that could be used when framing messages is the Value Modes Model
(copyright Cultural Dynamics). This divides people into 3 types – Settlers, Prospectors and
Pioneers. Each of these three types will be attracted and motivated by different aspects, and
any communication needs to reflect this:
Settlers are wary of change and generally pessimistic about the future. Their driving needs
are safety, security, identity, and belonging. They like to follow the rules and follow the
crowd. To appeal to settlers, the communication should say that “everyone else is doing it”.
When the HMRC changed the wording on their tax demands to say that 99% of people in
their area had already paid their tax, the increase of payment amongst the recipients of this
letter increased substantially.
Prospectors are status orientated and are concerned with how something will affect them.
Their driving needs are success, esteem of others, and self esteem. They will do something
because there is something in it for them. For Prospectors, the communication should
outline how they will benefit from this change, whether it is in terms of money, or their time
etc. A number of authorities have successfully encouraged residents to start driving their
own children with special needs to school rather than relying on the local authority to do it by
offering them money.
Pioneers are guided by their own sense of right and wrong with a strong sense of selfefficacy. Their driving needs are acting on ethics, making connections, exploration,
innovation, and being all you can be. They will do something because they think it is the right
thing to do. For Pioneers, the message in the communication should appeal to their sense of
right and wrong and how innovative they are being. Barnet Council appealed to Pioneers to
become “Green Champions” in an attempt to change the habits of residents in the borough.
Their communication stressed innovation in the form of smart meters and that this was the
“right thing to do”.
If you are trying to appeal to all 3 types of people in one communication then a section
aimed at each type would work well. See worksheet 2 for more details on the Values Mode
Tool.
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PLANNING CYCLE FOR INFLUENCING BEHAVIOUR AND CHOICES
For Buckinghamshire, a behaviour planning cycle has been developed that covers the key
steps for developing a behaviour change programme (Figure 1). This is not a linear cycle
and a number of the steps may need to be considered simultaneously. Previous steps may
also need to be revisited in light of new information.
Figure 1
Feedback /
Mainstreaming
Define target
behaviour and
behavioural goals
See
Worksheet 1
Identify and
segment the
target audience
See
Worksheet 2
Identify relevant
behaviour models
Evaluate
See
Worksheet 3
See
Worksheet 5
Select Influencing
factors to design
interventions
Pilot /
Implementation
Develop a
Prototype
intervention
Engage the target
Audience in the
interventions
Identify effective
intervention
techniques
See
Worksheet 4
There are a number of different planning cycles and checklists that are available around
planning and evaluation for behaviour change.
Some incorporate wider elements like getting political buy in e.g. Checklist in the Capital
Ambition
http://www.youngfoundation.org/files/images/Behaviour_Guide_130510_HighRes.pdf
Some focus on effectiveness e.g. NICE guidance on behaviour change
http://www.nice.org.uk/nicemedia/live/11868/37987/37987.pdf
9
Some focus on key principles e.g. 9 principles in Government Social Research Unit
Behaviour Change Knowledge Guide http://www.civilservice.gov.uk/wpcontent/uploads/2011/09/Behaviour-change_practical_guide_tcm6-9696.pdf
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The Planning Checklist for Influencing Behaviour and Choice
Planning Stage
Define target behaviour and behavioural
goals
Identify and segment the target audience
Key Questions
 If the issue to be addressed is complex do
we need to map the system to identify if a
behaviour change intervention is the
appropriate response?
 What are we trying to influence and what
are our reasons for doing this?
 How much change do we want to
achieve?
 Do we want to change the behaviour of
everyone or some target groups
Additional Tools

Worksheet 2 Segmentation Tools





How prevalent are the behaviours that
contribute to the problem I want to
resolve?
Who does and does not behave in this
way?
Are there any national segmentation tools
for this behaviour?
What do we know about our target group?
What are the key differences in the
population in relation to motivation and
barriers to change?
How might we tailor our approach to the
different segments in our community?
Worksheet 1
SMART Objectives
ACORN
Values Mode
Healthy Foundations Life Segmentation Tool
Obesity and Physical Activity Segments
Alcohol Segments
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Planning Stage
Identify and apply relevant behaviour models
to identify and shortlist influencing factors
Select key influencing factors to design
interventions
Identify effective intervention techniques and
the best intervention mix
Key Questions
 What do we understand about the
lifestyles and experiences of our
communities in relation to this change?
 What would motivate people to change
 What problems do people face making
this change?
 What would they be giving up in order to
adopt this change?
 What are the competing influences we are
up against?
 What is the interplay between the different
influences on behaviour?
 What contextual and wider factors need to
be taken onto account?
 Have the circumstances in which the
target group live been taken into account?
Additional Tools
Worksheet 3

Worksheet 3




Which are the strongest influencing
factors and which of these are feasible to
influence?
Are any proposed interventions based on
evidence of effectiveness or best
practice?
What mix of methods has been
considered to address the differing
motivations of different target groups
Has a mix of methods been considered to
address wider barriers and motivations?
Has account been taken of any other
existing interventions that are relevant to
Using Theoretical Models
Choosing A Model
Commonly Used Models
Identifying and prioritising key influencing
factors
Worksheet 3
Considering the Mix of Interventions
Determinants of health model
Needs, opportunities and abilities Framework
MINDSPACE 6E’s (Explore, Encourage,
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
the programme?
What is the theoretical link between the
intervention programme and its intended
outcome?
Engage, Exemplify, Enable, Evaluate)
Social Marketing Foundation
System Mapping
Theories of Change
Engage the target audience in the
interventions





Develop a prototype intervention





Do we understand the target behaviour
and influencing factors from the target
audience’s perspective?
If we can’t resource specific engagement
work locally is there any information from
elsewhere that will inform this?
Are the proposed interventions acceptable
and accessible to the target audience?
Do the proposed interventions take
account of lay wisdom about barriers and
change
How can the target audience play an
active role in the delivery of the
interventions and the promotion of the
behaviour change?
Worksheet 4
Does the final intervention address the
issues raised by the engagement exercise
as far as possible?
Does the final intervention reflect known
best practice if available?
Is the intervention accessible and tailored
to the target groups?
Is there access to the resources needed?
Has an impact assessment been
Worksheet 4
Good Practice on Public Engagement
Methods
13

Pilot / Implementation



Evaluation


undertaken to identify and address any
unexpected consequences of the
intervention?
How will we know if the intervention is a
success? Are there clear objectives and
measures for the intervention?
Have evaluation indicators / measures
been developed to demonstrate if all the
key objectives / outcomes have been
achieved?
Have mechanisms for capturing data to
measure success been established?
Has the intervention been successfully
communicated to key stakeholders who
can support the intervention?
Does the evaluation take into account
short, medium and long term impacts?
Can indirect impacts be identified and
assessed?
Worksheet 5
Worksheet 5
Scottish Community Development Centre
Planning and Evaluation Cycle
Charities Evaluation Services Monitoring and
Evaluation Template
Feedback / Mainstreaming



If the project is a success, how can it be
sustained /made sustainable?
If areas for change have been identified
how will the changes be addressed?
If the project is not delivering the expected
outcomes, should the project be
discontinued and what are the exit issues
that need to be managed?
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WORKSHEET 1 – DEFINING TARGET BEHAVIOUR AND GOALS
For an effective project, it is important to be clear on what it is trying to deliver in terms of
both the behavioural choice/goal we want to achieve and who we want to achieve it.
Deciding on targets
The target should be related to a desired behaviour or choice. For example, more people
recycling, more people becoming physically active, or more people volunteering
Once the target(s) have been decided, SMART objectives (Specific, Measurable,
Achievable, Realistic, and Time Bound) need to be agreed. These should include factors
such as who will benefit from the intervention, what will they receive, how much benefit, and
by when?
Specific
What is the specific task? This can address a number of factors including:



What: What do we want to accomplish?
Who: Who is involved?
Where: Where do we want to deliver this?
Measurable
If a goal is not measurable you will not know if you are making progress. The measurable
component of the objective can address:



How much?
How many?
How will I know when it’s accomplished?
Achievable
It is important that any objective is achievable so SMART objectives will consider how the
goal will be accomplished and what attitudes, abilities, skills, and financial resources you
need in order to deliver it.
Relevant/Realistic
A relevant and realistic goal will be something that the key stakeholders will see as
worthwhile and be committed to deliver. I.e. does the project seem worthwhile?
Time Bound
It is important to specify a timescale and be clear about what is reasonable within a given
time. Questions to ask about timescale include:




When?
What can I do in the short term (e.g. 6 weeks from now)?
What can I do in the medium term (e.g. 6 months from now)?
What can I do in the long term (e.g. over a year)?
15
Assumptions
One’s own perspective may influence the priority setting stage. Practitioners need
awareness of their professional and social ‘norms’ that may be applied unintentionally. A
more ‘balanced’ or objective perspective will be aided by a comprehensive needs
assessment phase, including public/patient/client/user involvement.
CASE STUDY
Awaiting further details: The
Volunteer Master Composter
Scheme:
This is the main tool with which
to encourage others to
compost and avoid garden
waste going to landfill. For
more information please see:
http://www.bucksinfo.net/recycl
eforbuckinghamshire/homecomposting/mastercomposters/
Measuring behaviour change
is not easy. With WRAP's
guidance / current compost bin
scheme, disposal savings can
be estimated as follows:
Since 2000 - 2011 over 57,000
compost bins have been
distributed in Bucks, resulting
in diverting over 7,300 tonnes
pa of garden waste from landfill
equating to disposal savings of
£440,000 pa.
16
WORKSHEET 2 - IDENTIFYING AND SEGMENTING THE TARGET AUDIENCE
If your target group shares similarities and is therefore likely to respond in the same way to
the same communications and interventions, you will not need to segment the group into
smaller sub-groups. However, this is unlikely. Segmentation divides a broad target
audience into further subgroups that share similar characteristics. The benefits of this are
that it enables interventions to be specifically designed to meet the features of these subgroups. Some segmentation models move beyond basic demographics and factor in wider
influ
ence
s
such
CASE STUDY:
as
Reactivate Bucks – segmenting the audience
over
all
Three months prior to a ‘Give it a go’ week the steering group meets to
appr
oach
review the previous campaign and identify the target audience for the
to
following campaign. A decision regarding the target audience is made
life,
by looking at local and national data on activity levels for Buckinghamshire
pers
from the Active People survey, the DoH Health Profiles and the local
onali
knowledge of partners. Once we have established who the target
ty
group will be, we review the market segmentation profiles to help
traits
us determine the type of activities they are likely to participate in, the
,
valu
marketing mediums and the messages we should use to encourage them
es
to take part. This process provides us with a clear plan and tools to us in
and
order to implement a successful Reactivate Give it a go campaign.
belie
fs.
Prior to the Reactivate project deliverers worked in isolation across the
county trying to both deliver and market activity to everyone rather
than targeting activity at the most inactive groups and using marketing
mediums that were not appropriate for the audience. This resulted in a
sporadic mix of activities with low attendance. I believe and our results can
testify that the use of Market Segmentation information in
this coordinated manner has undoubtedly saved partners time and money,
with a legacy of partnership working and a more active population.
17
There are different ways to segment groups. There are a number of segmentation tools. This
worksheet provides an overview of the following segmentation tools that might be of interest:
1. Segmenting by geography and demographics, such as age, gender, geographical
local (ACORN)
2. Segmenting by values (Pioneers, Prospectors and Settlers)
3. Segmenting by motivations in relation to health (Healthy Foundations tool)
4. Segmenting according to specific behaviours (e.g. Alcohol)
To choose a tool, it will be useful to think about which characteristics they have that may be
most relevant to the project you are working on.
1.Segmenting by geography and demographics - ACORN
What is ACORN?
ACORN is a geo-demographic segmentation of residents which divides postcodes, and
households, into different categories, groups and types.
How can it be used?
ACORN profiles communities and households. This enables the identification of people with
similar interests, commuting habits, communication preferences and many other lifestyle
similarities. By identifying likeminded communities and households across
Buckinghamshire, specific groups of people can be identified and effectively communicated
with.
ACORN can help target communication activity to groups whose behaviour we are looking to
influence. Effectiveness of the campaign can also be measured by understanding the %
behaving in a specific way pre and post campaigns, also helping to understand the best
segments to target for future campaigns.
18
EXAMPLE
Changing Recycling Behaviour
A campaign was run in 2007 to promote doorstep recycling and recycling rates were
measured for each ACORN group pre and post campaign. This showed that although the
more wealthy groups were more likely to recycle (pre-campaign), recycling rates increased
dramatically from the less wealthy groups following the campaign – so future campaigns are
likely to be most effective if targeted at the less wealthy groups.
ACORN can also help target groups who are at most risk of a range of issues, such as
health issues like smoking or a lack of exercise
Bucks ACORN profiles can be found via the following link:
http://www.buckinghamshirepartnership.co.uk/partnership/BSP/partners/acorn.page
The local area profiles also contain some ACORN information:
http://www.buckinghamshirepartnership.co.uk/partnership/BSP/data/local_comm.page
2.The Values Mode Tool – Pioneers, Prospectors and Settlers
What is it?
The Values Mode model has used work with tens of thousands of individuals to segment
individuals based on their values and motivations. The benefit of this approach is based on
the assumption that values influences behaviour and behaviour influences opinion so
segmenting people in this basis can help when undertaking work on behaviour and choice.
The Values Modes has a number of categories that are then grouped into larger segments
and the top line segment is three groups:
1. Settlers (security driven in and represent around 20% of UK national
population),
2. Prospectors (outer directed or esteem driven and represents around 40%)
3. Pioneers (inner directed and represents around 40%)
The model acknowledges that people can move categories as their lives progress.
Further detail around the different group characteristics can be found at the following link:
http://www.campaignstrategy.org/articles/usingvaluemodes.pdf
How can it be used?
Mapping and understanding these segments can be used in a number of ways. Examples
include:

Pioneers lead, prospectors follow and settlers follow prospectors in adopting new
behaviours and this can help with targeting early adopters for new behaviours and
choices
19


Different segments will respond to different rewards and stimuli so projects can
develop approaches and communications that are tailored and have a greater
chance of success
People may agree about a behaviour or choice but have different reasons why
adopting this behaviour or choice is right. Using these segments enables better
targeting and communications
Further information on the Values Mode can be found at:
http://www.nlgn.org.uk/public/wp-content/uploads/Changing-Behaviours.pdf
20
3.Healthy Foundations Life Segmentation Model and Tool
What is it?
The Healthy Foundations Life Segmentation Tool was developed to segment individuals
according to what motivates them around health and to incorporate how these motivations
are affected by their social and material circumstances. It offers insights into the needs,
lifestyles and motivations of different individuals and groups in society.
The model is made up of 5 motivational segments. An overview of each segment is provided
in the table below. The table identifies the motivational differences between the segments.
Health
Conscious
Realists
High
Balanced
Live For
Compensators Todays
Hedonistic
Immortals
Unconfident
Fatalists
High
Med
Low
Med
Control Over Health
Healthy lifestyle is
easy / enjoyable
High
High
High
High
Med
Low
Med
Med
Low
Low
Health Fatalism
Risk Taking
Short Termism
Self Esteem
Low
Low
Low
High
Med
High
Med
High
High
Med
High
Med
Low
High
Low
High
High
Med
High
Low
Value Health
Denotes negative motivation
If it is appropriate to the change under consideration, these segments can then be further
divided according to social and material deprivation and life stage. This generates additional
segments of ‘Fighting’, ‘Thriving’, ‘Surviving’ and ‘Disengaged’.
How can it be used?
The Segmentation Model and Tool can help to build a deeper understanding of local
audiences and thus support the development of tailored interventions aimed at particular
segments to improve the effectiveness and efficiency of behaviour and choice projects.
Pilot projects to assess the use of the tool have included:



Mapping motivational insights against service use to design better services
Using evaluation data from service users (for example diaries, quantitative data
collection and focus groups) and analysing this alongside the healthy foundation
segments to inform the development of a health trainer service
Combining the healthy foundations tool with other information to provide a more
rounded picture of local populations
Further information on the tool and how to use the tool to develop tailored interventions is
available from https://socialmarketingportal.dh.gov.uk/healthyfoundations/
21
4.Alcohol segments
What is it?
There are various health related segmentation tools available. National segments for
alcohol use have been developed based on the characteristics in relation to alcohol use.
13 different segments have been identified, but only 8 of these relate to groups with
increasing or harmful levels of alcohol intake. Information is provided below on the 3
segments that have been identified as at greatest risk and that are therefore the greatest
priority for action.
Segment 10
Segment 10 includes high numbers of pensioners, who are generally in poor health with
conditions that include asthma, angina and heart problems. They have high acute hospital
admissions. They often live alone and in local authority flats. As well as drinking beer and
spirits, they are likely to smoke. They tend to read tabloids.
Segment 12
Segment 12 includes people with a broad range of ages, who are likely to live in terraces,
often in former industrial areas. They generally have the worst levels of overall health, with
asthma, cholesterol and heart conditions as well as high acute hospital admissions. They are
likely to smoke and drink beer and lager, at home and in pubs. They tend to read tabloids.
Segment 13
Segment 13 includes young people in their 20s who have a very high rate of acute
admissions. They are likely to live alone in local authority flats or hostels, be unemployed
and some are single parents. They are likely to drink large amounts of both beer and spirits
and to smoke. They tend to read tabloids.
How Can You Use it?
The alcohol segments provide a useful portrait of the different segments and their drinking
habits. However, they do not provide any suggestions on specific approaches to use with
these groups.
Buckinghamshire does not have significant numbers of the priority segments above, but
does have other groups that are at increasing risk. Anyone doing work on alcohol can get
more information at:
http://www.alcohollearningcentre.org.uk/Topics/Browse/SocialMarketing/
For a useful segmentation tool relating to obesity and physical activity go to
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidan
ce/DH_090118
22
WORKSHEET 3 - IDENTIFYING AND APPLYING RELEVANT BEHAVIOUR
MODELS
In order to develop a better understanding of what influences behaviour and choice it can be
useful to use existing behaviour models that attempt to identify the links between issues
such as internal values and beliefs, external influences and norms.
A lot of the early work on theories of behaviour was undertaken in relation to health
behaviours. However, these models do have wider application.
Using a model offers the opportunity to test out if all key influences have been considered
and how they might relate to the final behaviour / choice.
Models offer a framework for thinking and their application is beneficial, but there are some
constraints with models that should be considered:

Models are concepts, not representations of behaviour. They show the factors
influencing behaviour, but do not explain the processes for changing behaviour.

Behaviour is complex, but models are deliberately simple. They are concepts to
aid understanding – they are deliberately simplistic and do not capture all the factors
that account for behavioural outcomes.

There is a limit to how far models will stretch. They are developed in the context
of a specific behaviour, and tend to work best in that context – although some do
have wider applicability.

Models don’t tend to differentiate between people. They tend to show the
behaviour of a statistical ‘everyman’ and need to be adapted in order to cover
different audience groups (social marketing contains an aspect where population
groups can be ‘segmented’).

Factors don’t always precede behaviour. Most behavioural models present socialpsychological factors as preceding behaviour but there are instances where people
are compelled to change their behaviour first, which then lead to changes in the
social-psychological variables.

Factors are not barriers. Behavioural models can appear to present factors as
buttons to be pressed, in the expectation that the behavioural outcome shown will
result. This is a misleading interpretation, not only because other factors which are
‘off the model’ may also need to be accounted for, but because the mechanistic
assumptions underpinning such a view are inadequate to explain the nature of
change, and to support individuals in that process.
Despite these limitations, theoretical models offer additional insight into behaviour and
choice. Here are some key questions to help you to choose from the range of models
available:



Which behavioural dimensions need to be considered (e.g. attitudes, habits, social
norms)?
What perspective do you want to look from (e.g. from an individual perspective or a
population / community perspective)?
Which interventions may be of interest?
23
Individual level behaviour change models
The table below lists a number of more commonly known behaviour change models and
illustrates which of the above behavioural dimensions they incorporate. For example, we can
see from this table that the Health Belief model looks at attitude and a person’s confidence in
ability to change, in order to predict whether or not that person will change their behaviour.
There is a wealth of literature and research about change theory and it is not possible within
this guide to address all of that. Below is an introduction to some theories that provide an
example of some of the approaches to change.
Model
Attitude
(beliefs,
values,
knowledge,
awareness)
Behavioural dimension
Norms
Confidence Habit Emotion
(societal, in ability to
change
family,
peers)
(agency,
capacity)
Perception
of
contextual
factors
Applied
model /
framework
(availability,
access,
legislation)
From the
perspective of
the individual
1.Health belief
model
2.Health action
process
approach
3.Theory of
planned
behaviour
4.Theory of
interpersonal
behaviour
5.Stages of
change model
Y
-
Y
-
-
-
-
Y
Y
Y
-
-
Y
-
Y
Y
Y
-
-
-
-
Y
Y
Y
Y
Y
Y
-
Y
Y
Y
Y
Y
Y
-
1. Health Belief Model
The health belief model suggests that a person’s health related behaviour depends on their
perception of four areas:




The severity of a potential illness
The person’s susceptibility to that illness
The benefits of taking preventative action
The barriers to taking that action
2. Health Action Process Approach
The Health Action Process Approach (HAPA) suggests that the adoption, initiation, and
maintenance of health behaviours must be seen as a process that consists of at least a
24
motivation phase and a volition phase. The volition phase might be then subdivided into a
planning phase, action phase, and maintenance phase. It is claimed that perceived selfefficacy plays a crucial role at all stages along with other cognitions. Details can be found on
the following website:
http://www.hapa-model.de/
3. Theory of Planned Behaviour
According to this theory, various factors listed in the boxes to the left of the diagram will
interact to predict a person’s intention to adopt a behaviour. This intention along with actual
behavioural control will then predict whether the behaviour is adopted.
Further details can be found on the following website:
http://people.umass.edu/aizen/tpb.diag.html
4. Theory of Interpersonal behaviour
In this theory, intentions (as in many of the other theories) are immediate antecedents of
behaviour, but crucially, habits also mediate behaviour. Further information can be found on
the following website:
http://www.cres.gr/behave/pdf/Triandis_theory.pdf
5. Stages of Change Model
Also known as the Transtheoretical Model of Behaviour Change and developed by
Prochaska and DiClemente, this model assesses an individual's readiness to act.
The benefit of the model is that the chances of achieving change are increased by identifying
what stage of change an individual is at providing an approach that is tailored to this. The
model identifies 6 stages:
25






Pre-contemplation – (Not Ready) "People are not intending to take action in the
foreseeable future, and can be unaware that their behaviour is problematic" These
individuals require information on why their behaviour is a problem
Contemplation – (Getting Ready) "People are beginning to realise that their
behaviour is problematic and thinking about changing. These individuals need
support to looks at the pro’s and con’s of change
Preparation – (Ready) "People are intending to take action in the immediate future.
These people will need support to identify what triggers their behaviours and
strategies to introduce and maintain change
Action – (Making the change) "People have made specific overt modifications
modifying their problem behaviour or acquiring new healthy behaviours. These
people will need support through the change process
Maintenance – (Maintaining the change) "People have been able to sustain action
for awhile and are working to prevent relapse"
Relapse or Termination – (Relapsing or moving into a stable new behaviour). Some
people will relapse, but evidence suggests that each change attempt improves skills
for change. Some people will terminate the undesirable behaviour and have zero
temptation and 100% self-efficacy... they are sure they will not return to their old
unhealthy habit as a way of coping
Community or population level behaviour change models
Model
Attitude
(beliefs,
values,
knowledge,
awareness)
Norms
(societal
, family,
peers)
Behavioural dimension
Confidence Habit Emotion
in ability to
change
(agency,
capacity)
Perception
of
contextual
factors
Applied
model /
framework
(availability,
access,
legislation)
Community or
population
level
1.Social capital
2.Determinants
of health
3.Needs,
opportunities,
abilities
4.Social
marketing
5.DEFRA 4E
6.Systems
thinking
Y
Y
Y
Y
Y
-
-
-
Y
Y
-
Y
Y
Y
-
-
Y
-
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
1. Social Capital
Social capital research informs the extent to which people are civically engaged and their
level of trust. High social capital in the form of social networks is suggested to lead to a
variety of outcomes including economic growth and educational attainment.
26
Further information can be found in the following document:
http://www.esds.ac.uk/government/docs/soccapguide.pdf
2. Determinants of health
EXAMPLE
Obesity and the determinants of health
Using obesity as an example, it is possible to look at the determinants of health in order to
effectively design interventions with the aim of reducing obesity.
There are many factors that can be linked with obesity, but some of the key ones are
included below:




Individual lifestyle factors – e.g. Diet, physical activity
Social and community networks – e.g. Peers, parental control, face to face social
interaction
Living and working conditions – e.g. Access to leisure and health foods, school
proximity to fast food restaurants, education, etc availability of healthcare and
interventions
General socioeconomic, cultural and environmental conditions – e.g. socio-economic
status
A more detailed obesity system influence diagram can be found here:
http://www.shiftn.com/obesity/Full-Map.html
27
3. Needs, opportunities, abilities
This model looks at the different influences that may interact to determine the motivation,
intentions and behaviour of people.
EXAMPLE
Active Travel
The above diagram can be illustrated using the example of Active Travel – building physical
activity into our daily lives through the promotion of cycling and walking etc as alternatives to
driving or other more sedentary forms of transport.
Push factors are those that would encourage people away from car use. Pull factors are
those that encourage people towards active travel:
Needs
Friends, clubs, and support
Confidence with perceived safety issues
Reduced actual safety issues
Quality, connected infrastructure – i.e. crossing points etc
Improved sense of ‘place’ Open green spaces vs. dark and dingy alley ways
28
Opportunities
Cheaper (free) than alternative
Commitment to green agenda
Incentives
Increased independence (i.e. no bus timetables to catch)
Easy ‘detour opportunities’
Improve sense of mental wellbeing – ‘Time to think’
Improve physical wellbeing
Abilities
Time available (can be quicker by active travel)
Equipment (trainees, bike, safety equipment etc)
Route planning
4. Social Marketing
The Social Marketing Foundation reported that policy making in relation to behaviour has not
systematically considered internal factors and social norms that influence the way that
people behave. They looked at evidence of what has worked in relation to influencing
behaviour change and developed the framework below as a tool to prompt thinking about
human behaviour and to consider how initiatives across the three elements of external
factors, internal factors and social factors can be used together.
If a problem is particularly complex, with influences at a range of levels, it may also be
helpful to consider using systems thinking. Systems thinking can best be understood as a
discipline for understanding complex problems; the process of analysing the problem itself
reveals opportunities for interventions.
http://archive.defra.gov.uk/evidence/social/behaviour/documents/behaviours-1206scoping.pdf
5. Mindspace 6E’s (incorporating DEFRA 4E’s)
The 6 E’s identify the range of ways in which behaviour and choice can be influenced. Use
of this framework to map out how various actions fit together can increase the understanding
of a programme and its potential effectiveness
29
30
EXAMPLE
Behavioural Goal = Energy Efficiency in the home
INCENTIVES
Energy efficient products:
Reduced VAT
Warm Front / EEC
Install microgen:
Grants/ low VAT rate
(MicrogenStrategy)
Community Energy Programme
Efficient homes:
Landlord energy saving allowance
Low Carbon Building Programme
DISINCENTIVES
SYSTEMS &
CAPACITYEnergy Efficient
Products, White
Goods Labelling,
Change boiler,
Boiler regulation,
Switch tariff,
Disclosure on
bills, Build / buy
efficient homes,
Home Information
Packs/Energy
Performance
Certificates,
Building
RegulationsInstall microgen–
climate change
and sustainable
energy act
(national targets)
WHO ARE YOU
TARGETING?
Install insulation –
WarmFront
Microgen – pilot
study with energy
companies
Encourage - Give the right
signals
Enable
- Make
it
easier
MIND
SPACE
Engage
-Get
people
involved
HOW WILL YOU
TARGET?
EST publicity,
advice e.g.
Homebuyers
checklist
EEC publicity
(insulation)
Exemplify - Lead by
example
SHARED RESPONSIBILITY?
Gov. C commitment –2012 commitment
6. Systems Thinking
One approach in systems thinking is that of system mapping. Brief steps to undertake this
exercise are as follows:
System mapping - questions


What is the problem?
Consider whether there is sufficient understanding of the
client/user/patient perspective in the group who are undertaking the
mapping.
31




Map out the factors affecting this problem and how they link together.
Think about the factors operating at different levels - individual,
community and population.
On the system map, mark which factors have a positive (enhancing) or
negative (dampening) effect using + or – signs on the pathways.
After completing the map, decide which pathway(s) can be changed or
influenced to address the problem. Divide these areas into quick wins
(inexpensive and simple) and longer term (more resource intensive or
difficult) actions.
Consider how changes will be monitored to review their success.
EXAMPLE
A good example of a systems map is the Foresight obesity map:
http://www.bis.gov.uk/assets/bispartners/foresight/docs/obesity/obesity_final_part5.pdf
Behaviour change techniques
Listed in the table below are a number of specific behaviour change techniques. This is
followed by a brief outline of what each technique involves.
Model
Attitude
(beliefs,
values,
knowledge,
awareness)
Behavioural dimension
Norms
Confidence Habit Emotion
(societal in ability to
change
, family,
peers)
(agency,
capacity)
Perception
of
contextual
factors
Applied
model /
framework
(availability,
access,
legislation)
Specific
behaviour
change
techniques
1.Cost-benefit
analysis
2.Goal setting
3.Motivational
interviewing
4.Self
monitoring
5.Increasing
self efficacy
6.Rewards
7.Building
habits
Y
-
-
-
Y
-
Y
Y
-
Y
Y
-
Y
Y
Y
Y
Y
-
-
Y
-
Y
-
Y
Y
-
Y
-
Y
Y
Y
-
-
Y
Y
Y
Y
Y
Y
-
Y
Y
1. Cost-benefit analysis
Involves outlining the costs and the benefits of a specific change to increase motivation
32
2. Goal setting
Goal setting involves establishing specific, measurable, achievable, realistic and timetargeted (SMART) goals
3. Motivational interviewing
This is a collaborative, person-centred form of guiding to elicit and strengthen motivation for
change
4. Self monitoring
Involves setting mini goals and monitoring their achievement maintains new behaviours
5. Increasing self efficacy
Involves increasing confidence to change by examining levels of self belief
6. Rewards
Involves positive reinforcement following achievement of target behaviour
7. Building habits
Involves developing strategies to make the new behaviour routine
Some other behaviour change theories that may be of interest
Transitions
This recognises that transitions in people’s lives can be a motivator for change. Key
transitions include starting work, getting married, having children, or retirement.
Lewin’s Three Step Change Theory
Kurt Lewin proposed that there are three main stages of change. These are:



Unfreezing – this acknowledges that people become comfortable in their current
state and that even changes that can be beneficial can feel threatening and
uncomfortable. Creating an understanding of a future state may not be enough and
people may need unfreezing from their current position. A ‘push’ and ‘pull’ method
may be needed to achieve this move and make people ready for change
Transition – Lewin considered change as a journey rather than a single step and so
transition acknowledges that a person may have to go through several stages of
change before they can really accept and work with the new position
Refreezing – When the change is achieved it is important to ‘put down roots’ and
establish this as the new place of stability. Lewin calls this refreezing
Further information on Lewin can be found at
http://changingminds.org/disciplines/change_management/lewin_change/lewin_change.htm
33
Lippitt’s Phases of Change Theory
Lippitt’s theory of change extended Lewin’s theory. It is a seven step theory that focuses
more on the role and responsibility of the change agent than on the change itself. The seven
steps include:
1. Diagnose the problem
2. Assess the motivation and capacity for change
3. Assess the resources and motivation of the change agent. This includes the change agent’s
commitment to change, power and stamina.
4. Choose progressive change objects. In this step, action plans are developed and strategies
are established.
5. The role of the change agents should be selected and clearly understood by all parties so
that expectations are clear.
6. Maintain the change. Communication, feedback and group coordination are essential
elements in this step of the change process.
7. Gradually terminate from the helping relationship. The change agent should gradually
withdraw from their role over time. This will occur when the change becomes part of the
organizational culture
Diffusion
Diffusion is a process by which change spreads through a social system. A diffusion of
innovations curve proposes how innovation and change is adopted by consumers.
Individuals progress through 5 stages: knowledge, persuasion, decision, implementation,
and confirmation.
Nudge – Architecture of Choice
Based on behavioural economics, the book, ‘Nudge’ by American writers Thaler and
Sunstein has received attention from the current Government as containing insight into
effective ways to nudge people towards behaviour change. The Government has set up a
behavioural insights team to make a reality of the Coalition Government’s intention to find
34
‘intelligent ways to encourage, support and enable people to make better choices for
themselves’.
Behavioural economics theory claims that people do not behave as easily controllable
beings that are willing to do as they are instructed. Instead people respond as freethinking
individuals to relatively small things, which may encourage them to act for themselves and
do big things differently.
Further information from the Behaviour Insight Team can be found here:
http://www.cabinetoffice.gov.uk/sites/default/files/resources/Behaviour-Change-InsightTeam-Annual-Update_acc.pdf
CASE STUDY:
Working with perpetrators of domestic violence
Domestic Violence Intervention Project (DVIP): East London
A programme for perpetrators of domestic violence is a complex
intervention. It works to change men’s abusive behaviour, making it
possible for them to address deep-rooted attitudes and responses. Our
understanding is that perpetrators are fully responsible for their behaviour,
and they can be helped to stop damaging themselves and their families.
Our service has three core parts: expert risk assessment; a violence
prevention programme (VPP) for men; and an integral women’s support
service (WSS) for their women partners and ex-partners.
The DVIP
Further details can be found on the DVIP website, including details of how
the intervention outcomes are measured:
http://www.dvip.org/about-us.htm
35
WORKSHEET 4 ENGAGING TARGET AUDIENCE
Most organisations will have an engagement strategy of some form, and these are the most
useful starting point.
Some general rules relating to engagement with a target audience could include:






Know the demographics of your target audience
Identify relevant research or case studies that have successfully engaged with you
specific target audience
Use social media where appropriate to elicit views
Identify ‘champions’ or opinion leaders within the community
Learn about target audience’s needs and head off problems
Be aware of other engagement activities targeting the same audience
Marginalised groups6
As part of the process of engagement, you may wish to target a ‘marginalised’ or ‘hard to
reach’ group. Some prompts on the kinds of groups that may be considered as harder to
reach are as follows:











People who are disadvantaged by poverty and associated inequalities;
People who do not speak English as a first language;
People with hearing, speech or visual impairments;
People with learning, communication or cognitive difficulties;
People with physical disabilities
Mental health service users;
Older people;
Young people – i.e. teenagers and children
People who are housebound
Homeless people
People who have previously experienced or continue to experience discrimination
such as racism or homophobia
Marginalised groups often need a longer and more sustained time table of involvement. This
is so that barriers may be broken down and an environment of trust created. It is important to
specifically meet needs of time of the event, crèche facilities, transport, accessible venues,
facilities such as induction loop systems, signers, interpreters, special dietary requirements
and the provision of information in different ways. In addition, events should be aimed at
specific groups and communities and emphasis placed on confidentiality and the value and
benefits of their input.
Target groups and issues to consider
As a general tip, public health teams and community engagement teams often do targeted
work with specific groups that services find ‘hard to reach’ and may be able to recommend
forums or other mechanisms that you can use.
6
Patient and Public Engagement Toolkit for World Class Commissioning South Central WCC Collaborative PPI Programme
36
Minority ethnic communities








Minority ethnic communities are not a homogeneous group, it is important to
understand the specific needs of the different ethnic groups you wish to engage with.
Time and resources are needed to build relationships and trust with communities,
and in particular with people who may be less visible within these communities, such
as women, disabled people or people with mental health problems.
Well established communities often have strong networks, and these social groups
can help to encourage people from BME communities to engage. They offer a sense
of safety which, in turn, offer leads to other involvement activities.
Community leaders can provide useful input. However, this is not a substitute for
engaging with people directly.
There is evidence to suggest that text-based methods of communication, even where
these are translated, will not be accessible to all members of some minority ethnic
communities, as people may speak but not read English, or may not read the
language that they speak. This implies more visual methods of communication and
face-to-face engagement are more likely to be effective.
Gender issues are particularly relevant for some minority ethnic groups.
Some ethnic minority communities conceptualise health and illness differently, so
their understanding of, for example mental health problems, will be different. These
differences need to be understood and addressed through the engagement process.
In some cases cultural and religious belief systems can hide issues of disability,
making it harder for people to engage with services or get involved in engagement
activities.
37
WORKSHEET 5 EVALUATION
Evaluation
We need to understand how effective any intervention to influence behaviour and choice is.
A number of stakeholders will be interested in what is being achieved including:



People delivering the project – is the project achieving the desired outcomes, are we
doing a good job, what do we need to change to make it more effective?
Users – is the project meeting their needs and what do they think about the work?
Funders – Is this money well spent is it achieving its objectives in the most cost
effective way?
The project evaluation should answer these questions.
Evaluation is an important process to assess to what extent a behaviour change programme
delivered the expected benefits and whether this was achieved in a cost efficient way. The
diagram below was produced by the Scottish Community Development Centre and provides
a useful evaluation cycle to apply to any project that addresses the different perspectives of
the key stakeholders.
Identifying key indicators for each part of the evaluation cycle and establishing mechanisms
to measure and assess these indicators is a useful evaluation framework. The Charities
Evaluation Services produced a useful monitoring and evaluation template (provided on
page 36) that includes clarification of how information is going to be collected. This template
only considers outcomes but the approach could also be used for inputs, processes and
outputs.
38
Monitoring and Evaluation Template – From Charities Evaluation Services
Specific Aims
Outcomes
Outcome Indicators
Information
Collection
Methods
When and by Whom
How to Report and
Use
39