The Challenge of Behaviour Change and Health Promotion

Abstract

Abstract:The evidence about the effectiveness of behaviour change approaches-what works and what does not work-is unclear. What we do know is that single interventions that target a specific behavioural risk have little impact on the determinants that actually cause poor health, especially for vulnerable people. This has not prevented health promoters from continuing to invest in behaviour change interventions which are widely used in a range of programs. The future of behaviour change and health promotion is through the application of a comprehensive strategy with three core components: (1) a behaviour change approach; (2) a strong policy framework that creates a supportive environment and (3) the empowerment of people to gain more control over making healthy lifestyle decisions. This will require the better planning of policy interventions and the coordination of agencies involved in behaviour change and empowerment activities at the community level, with government to help develop policy at the national level.Keywords: behaviour change; empowerment; health promotion; inequity; policy framework Behaviour Change and Health PromotionThe behaviour change approach promotes health through individual changes in lifestyle that are appropriate to people's settings [1]. The assumption is that, before people can change their lifestyle, they must first understand basic facts about a particular health issue, adopt key attitudes, learn a set of skills and be given access to appropriate services. The simple logic is that some behaviour leads to ill-health, and so persuading people directly to change their behaviour must be the most efficient and effective way to reduce illness. This reasoning is attractive to decision-makers because it promises quantifiable results within a short time frame, can deal with high prevalence health problems, is relatively simple and offers savings in health care services, especially for people suffering from chronic diseases [2].The evidence about the effectiveness of behaviour change approaches is unclear, for example, about handwashing among children [3] and cooking and food skills among adults [4]. However, this has not prevented health promoters from continuing to extensively invest in this approach. Behaviour change communication is a widely-used intervention manifested through approaches such as communication for development (C4D), water, sanitation and hygiene (WASH) and social behaviour change communication. These approaches attempt to provide new knowledge and skills that people need to adopt a healthier lifestyle. They use a range of techniques including interactive communication technologies, motivation, counselling, persuasion, influencing social norms and coercion. Health promotion has also relied on pre-packaged, top-down programs especially for health education and multi-risk factor reduction interventions. These have not guaranteed a change in behaviour and has led to a "blaming of the victim", for example, for drinking too much alcohol or continuing to smoke even though people ...

Behavioural and social sciences to enhance the efficacy of health promotion interventions: redesigning the role of professionals and people

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“…Evidence on the effectiveness of the existing interventions aimed at changing individual behaviour is mixed (Davis et al, 2015;Matjasko et al, 2016;Laverack, 2017). There are concerns over the magnitude of the impact on populations as a whole and individual adherence to programmes, especially following the termination of interventions (Middleton et al, 2013;De Poli et al, 2018).…”

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“…Interventions rely on active participation and participants that have a shared interest in the topic and cause are generally more active and engaged (Laverack, 2017). Adolescents can be seen as empowered rather than exploited when one listens to what they have to say, and whether they want to be included at all, by feeling that the issue is important and significant for them (Allard, 1996).…”

“…The added benefit of empowerment is that it provides the individuals with greater control in attaining healthy lifestyles that are sustainable (Laverack, 2017). According to Shier (2001), participation includes such aspects as listening to the adolescents, supporting them in expressing their views, taking the adolescents’ views into consideration, including them in decision-making processes, and sharing responsibility for decision-making with the adolescents.…”

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