Behaviour change is an increasingly common theme in public policy. Peter John goes as far to claim that ‘many of the greatest challenges in public policy can only be fully addressed by changing the behaviour of citizens’.
Previously, public policy interventions in behaviour change worked from the assumption that behaviours were rational processes, and that merely raising awareness of an issue would change behaviour. This assumption does not adequately account for the habits that make up people’s behaviour, as well as the environment in which they operate. More recently, a range of behavioural science programmes, such as those developed by the Behavioural Insights Team and the Centre for Behaviour Change, have sought to consider much more comprehensively the range of factors that influence behaviour.
The advances in debates around behaviour change mirror those around public policy and policy systems more generally: that they are messy and complex, and we should plan actions and interventions with that in mind. There remains a debate about whether individual behavioural science interventions can still fix policy problems, or whether policymakers need to think instead about how whole systems can be modified to produce more favourable outcomes. A combination of the two is likely to be more successful.
A helpful tool to analyse efforts that promote both individual and systems change is the COM-B model of behaviour, which identifies three drivers of behaviour:
- Capability: the psychological ability to enact behaviour
- Opportunity: the physical and social environment that enables behaviour
- Motivation: the reflective and automatic mechanisms that activate or inhibit behaviour
The Centre for Behaviour Change argue that all three drivers combine to shape behaviours, and so any policy interventions must consider and address them all. In short, having the knowledge of what is a healthy behaviour will be insufficient without the motivation to act and an environment which supports the behaviour in question.
This has practical consequences for public policy. For example, a common behavioural change intervention is an information campaign. Leaflets may be sent to relevant people. Adverts may be posted on billboards. But if they are just seeking to improve somebody’s knowledge without doing anything else, they will struggle to have any impact.
Behaviour change will also struggle if only focusing on one individual at a time. Achieving behaviour change involves recognising that behaviour occurs within a system of other behaviours. Within the world of health and social care for instance, ‘it includes analysing the behaviours of both those who receive and deliver healthcare, and those who produce, deliver and are influenced by public health policies’.
However, this only helps inform policy interventions if we can then think about how interventions can be properly designed and applied. The COM-B model proposes a six-step process for designing interventions to change behaviour:
- Select the target behaviour
- Specify the target behaviour
- Understand the target behaviour
- Build the intervention
- Specify the intervention’s content
- Deliver the intervention
Breaking down an intervention in this way ensures that the correct behaviours are targeted (1), that they are described as clearly as possible to allow measurement (2), and that they are understood in as much detail as possible (3). This allows an intervention to be built (4), in a way appropriate to targeting the behaviour (5), and then delivered in the appropriate context (6), for example through a face-to-face interaction, or a change in public policy.
Within this process, there will still be unintended consequences and/or policy failure. There will always be imperfect knowledge in making any policy decision. Nonetheless, the value of using behavioural perspectives is exactly that. It encourages us to consider as full a range of influential factors as possible.
So far, we have used this work in two separate assignments. In our work on behaviour change in the Welsh NHS, we reviewed some of the efforts in Wales to encourage changes in the way the NHS interacts with patients. They range from changing the nature of conversations between patient and clinician, to encouraging non-medical staff to have conversations with citizens, to encouraging people to adopt healthier behaviours that will help to prevent a need for future treatment.
We have also used behaviour change frameworks to inform might help increase household recycling rates in Wales. A number of themes emerged, including that groups other than government are well placed to identify the barriers to behaviour change and design interventions that fit the local context. It also stressed that behaviour change interventions may be more successful if they can disrupt existing norms and practices.
There is still a long way to go. There is still a greater evidence base required on understanding existing behaviours and as such how to change them. Beyond that, we still need to know more about how to engage citizens in any behaviour change interventions. However, using behaviour change perspectives to address some of the fundamental policy challenges should remain a priority.
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