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Strategies designed to change behaviour that can affect health should be developed in association with the target groups and should take their circumstances into account, advises guidance from the National Institute for Health and Clinical Excellence (NICE).
Although social circumstances might be difficult to change, individual and collective behaviour may be easier to modify and offer enormous potential to alter current patterns of disease, it says.
But the many attempts to do this have failed or only partially succeeded. And the guidance argues that this is often because they fail to take account of the theories and principles of successful planning, delivery, and evaluation. “At present there is no strategic approach to behaviour change across government, the NHS or other sectors, and many different methods are being used in an uncoordinated way,” it warns.
The guidance recommends developing strategies in partnership with individuals, communities, organisations, and populations. “Plans should be based on the needs of the audience, and take into account the circumstances in which they live. They should aim to develop, and build on, people's strengths,” it says.
“Public health is ultimately about changing behaviour at all levels, from governments to individuals,” said Martin White, professor of public health at the University of Newcastle and a member of the guidance development group. “However,” he added, “there is still much that we simply do not know about these complex processes, so having such detailed guidance will help a wide range of professionals to tackle some of the major problems of our time, such as the obesity epidemic.”
The guidance argues that the NHS should prioritise behaviour change programmes that are based on the best available evidence and that offer value for money; it says the NHS should stop investing in programmes with no good evidence of effectiveness. Interventions should focus on key life stages or periods when people are open to change, such as pregnancy and when they start or leave school or enter or leave the workforce.
Interventions should also help people to understand the short, medium, and long term consequences of their health related behaviour, as well as helping them to feel positive about the benefits of behaviour change and enabling them to plan changes in easy steps, recommends the guidance.
Programmes need to help people identify and plan for situations that might undermine the changes they are trying to make and offer coping strategies to prevent them relapsing. Social policies and legislation should support people in making healthy behaviour changes.
Behaviour Change at Population, Community and Individual Levels (NICE public health guidance 6) is at http://guidance.nice.org.uk/PH006.