Approach
Government health policy in England is now heavily geared towards helping people assume greater responsibility for their health. The idea is that by choosing healthier lifestyles, people can play their own part in avoiding illness.
As commissioners of health services, primary care trusts (PCTs) have been tasked with taking the lead on encouraging people to change their behaviour and adopt healthier lifestyles. But how do they best go about this ambitious goal?
In 2007 The King’s Fund set up the Kicking Bad Habits programme to find out how. It focused on the four behaviours that are most costly to the NHS:
- smoking
- alcohol misuse
- poor diet
- lack of exercise.
The programme involved a series of discussion papers and expert seminars held between February and July 2008. Our aim was to bring together a wide range of individuals and organisations already working on innovative approaches to changing people’s behaviour. Leading public health practitioners and academic researchers, government officials, and representatives from the private and voluntary sectors attended the seminars and gave input to the working papers. We also put the discussion papers on our website, and asked people to email us their views.
Our research showed that there is a limit to the effectiveness of traditional public health campaigns that simply give people information or tell them not to do something because it’s bad for them.
We wanted to find out whether some approaches work better with certain target groups, such as people on low incomes. And we wanted to look at newer, more innovative ideas, such as financial incentives. Lastly, we were interested in whether providing intensive support, aimed at building people’s self-confidence, is an effective strategy, in both the short and the long term.
We decided to look at five key questions:
- Do incentives help people change their behaviour?
- What works best to change the behaviour of people in low-income groups?
- How effective are strategies that are centred around giving out information?
- Does increasing a person’s motivation and self-confidence help them change their behaviour?
- How can behaviour change interventions best be targeted and tailored to bring about results?
During the programme, and in the seminars, we looked at case studies of innovative schemes that are already bringing impressive results across the country. These include:
- reducing drinking among young people
- providing tailored advice and support to people at high risk of heart attack or cancer
- reducing smoking in pregnant women
- encouraging primary school children to eat more fruit and vegetables
- helping people with long-term conditions to manage their illness.
