3 frameworks and models to help drive behaviour change – part 1

Changing other people’s behaviour is not always straightforward. For example, providing people with what is believed to be the most relevant or persuasive information often does not generate change. However, behaviour change theories, frameworks, and models can help greatly. These allow us to approach behaviour change challenges in a rigorous, evidence-based way.

This article is the first in a 3-part series which will explore key applications of three well-known behaviour change frameworks and models. The evidence presented will be especially relevant to those working in qualitative and/or quantitative market research and will be drawn from a wide variety of scenarios. However, this first article begins with two health-related examples to illustrate the types of challenges often faced when trying to change others’ behaviour.

Why behaviour change?

In 2014/15, the NHS spent £6.1 billion on treating obesity-related ill health, with this figure forecast to rise to £9.7 billion per year by 2050. Almost two-thirds (63%) of adults in England are overweight or living with obesity, and obesity is the second biggest cause of cancer in the UK. In response, in April 2022, the UK government introduced legislation. It is now a legal requirement for large businesses with more than 250 employees, including cafes, restaurants, and takeaways, to display calorie information of non-prepacked food and soft drinks.

However, does this approach help to reduce calorie consumption and, therefore, obesity levels? Broadly speaking, the scientific evidence suggests otherwise. Or, if it does appear to help at first, any effects typically disappear within a few weeks as people begin to ignore the information. As one largescale meta-review put it: “while there are some positive results reported from studies examining the effects of calorie labelling, overall, the best-designed studies show that calorie labels do not have the desired effect in reducing total calories at the population level”.

In another example, the UK Government Department of Health wanted GPs to provide smoking cessation advice to patients. Their means of encouraging this was to financially incentivise GPs to the tune of £80m in total. However, time series analysis showed no detectable effects on behaviours that would be expected to arise from such advice, e.g. increase in the provision of prescriptions for stop-smoking medicines. Subsequent research found that regardless of financial incentives, some GPs found it difficult to raise the topic of smoking in a comfortable and challenging way. Others found it difficult to fit the advice into a very narrow time window.

Providing information or incentives (as in the first and second examples above respectively) will by no means always fail. However, the examples above suggest that changing others’ behaviour is often more challenging than expected. They illustrate that people do not always do what common sense suggests they “should”. Often there are multiple, sometimes less obvious barriers which need to be overcome. Further, short-term changes don’t always translate into long-term changes.

Behaviour change interventions can be effective

However, other evidence suggests that behaviour change interventions can be effective. For example, one study to confirm this was a NICE-commissioned review which included data from 103 systematic reviews of interventions. These targeted one of six behaviour patterns: smoking, alcohol consumption, physical activity, healthy eating, drug use, and sexual risk-taking.

Nevertheless, the study found that the degree of effectiveness varied significantly – both across different types of intervention and across different populations. This suggests that while behaviour change interventions have the potential to be successful, a rigorous and evidence-based approach can be important in increasing the odds of success.

Theories, frameworks, and models

Behaviour change theories represent one potential way to increase the chances of intervention success. In the context of behaviour change, theories seek to explain why, when, and how a behaviour occurs (or does not occur). Theories also explain the important sources of influence to be targeted to alter behaviour.

Unfortunately, evidence suggests that only around 20% of implementation studies have employed theory. Much, if not most, intervention design instead uses the ‘ISLAGIATT’ approach (‘It seemed like a good idea at the time’). This relies on personal experience, a favoured theory, or cursory analysis.

However, behaviour change frameworks and models can help us to apply the theory. Their application across a wide variety of scenarios will be the focus of the second and third articles in this series. First, frameworks help by providing an overall picture of possible courses of action that may be taken. Models do the same but also provide greater depth by representing or explaining the operation or mechanism of something. This allows us to develop hypotheses about why people are behaving as they are currently.

Conclusion

This article has illustrated some typical challenges associated with changing others’ behaviour. However, it has also pointed towards opportunities to tackle these challenges through behaviour change interventions which draw on theories, frameworks, and models.

The next article in this series will focus specifically on behaviour change frameworks. It will describe two well-known frameworks and will draw on a wide variety of real-life illustrations of their effective application. 

This article series contains selected highlights from “Four frameworks and models to help drive behaviour change” – a new, introductory guide written by Activate Research which will be released on 7th February 2023. To pre-order a free copy go to https://www.activate-research.com/behavioural-models-guide