lynn stockley & associates introduction to behavioural change lynn stockley

Lynn Stockley & Associates  

Introduction to Introduction to Behavioural ChangeBehavioural Change

Lynn Stockley

SummarySummary• 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  

Lynn Stockley & Associates  

PRECEED-PROCEEDBandura’s Mastery

Bandura’s Mastery

ModellingModelling Schein’s Organisational

Schein’s Organisational

Culture Culture

DE

FR

A’s

4E

’s M

odel

Prototype/Willingness

Model

Framework

for

Framework

for

Environmen

tal

Environmen

tal

Education Stra

tegies

Education Stra

tegies

Social marketing

Social marketing

• 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

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“ tools to be used in the design of interventions”

“should use models as an aid to thinking”

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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.

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Frameworks, theories and modelsFrameworks, 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 modelsFrameworks, 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’ modelsPsychological’ modelsDescribe 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

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Ajzen’s Theory of Planned Behaviour (1986)Ajzen’s Theory of Planned Behaviour (1986)

BehaviourIntention

Attitude towards the behaviour

Subjective norm

Beliefs about outcomes

Evaluation of outcomes

Beliefs about what others

think

Relative importance of attitude and norm

Perceived Behavioural Control

Reproduced from Conner 2007

‘‘Societal’ modelsSocietal’ models

• Show behaviour of individuals interacting with other influences e.g.

• community

• living/working/conditions

• environmental

• cultural

• political

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Dahlgren and Whitehead’s Model of the Main Determinants of Behaviour

Lynn Stockley & Associates  

Lynn Stockley & Associates  

Reproduced from Watt, R. UCL

Structuration Theory adapted from Giddens 1984. Reproduced from Delormier 2009.

Lynn Stockley & Associates  

Foresight Obesity MapForesight 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

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Dahlgren and Whitehead’s Model of the Main Determinants of Behaviour

Lynn Stockley & Associates  

Frameworks, theories and modelsFrameworks, 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 MODEL OF HEALTH PROMOTION 2: HEALTH PROMOTION METHODS USING BEATTIE’S PROMOTION METHODS USING BEATTIE’S TYPOLOGY (BEATTIE – 1991)TYPOLOGY (BEATTIE – 1991)

Advice

Education

Behaviour change

Mass media campaign

Counselling

Education

Group work

Legislation

Policy making and implementation

Health surveillance

Lobbying

Action research

Skills sharing and training

Group work

Community development

MODE OF INTERVENTION

Individual Group/Popn

Authoritarian

Negotiated

.........identify intervention techniques to bring about change and/or suggest broad approaches to intervention design, implementation and evaluation

........................in individuals

Lynn Stockley & Associates  

Lynn Stockley & Associates  

Stages of ChangeStages of Change

Reproduced from Watt, R. UCL.

..........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 Is social marketing a behavioural framework/model/theory......... .......and framework/model/theory......... .......and does it matter?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  

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

Social marketing - componentsSocial marketing - components Lynn Stockley & Associates

Social marketing - stagesSocial marketing - stages

Lynn Stockley & Associates  

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

NICENICE

1. How to plan interventions

2. Assessing the social context

3. Education and Training

4. For individual level interventions

5. For Community level interventions

6. For population level interventions

7. How to evaluate

GSRGSR

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

7. Pilot – with monitoring

8. Evaluate

9. Feedback

What does this mean for me?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; meta-

analyses interventions and models e.g. Abrahams and Mitchie

– You control your tools – not the other way around. Mix, match and adapt.

Lynn Stockley & Associates  

SummarySummary• 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