Changing Health Behaviour Challenging the ‘Messaging’ Addiction

1. Changing Health BehaviourChallenging the ‘Messaging’ Addiction Paul Ballard Deputy Director of Public Health NHS Tayside Honorary Senior Lecturer Dundee University Medical School

2. Overview • Describe the research re the use of awareness/information campaign models • Describe the key challenges re health inequalities • Describe the key principles of social marketing • Describe Tayside examples of social marketing

3. Awareness/Information Campaigns and Behaviour Change • “Campaigns which rely solely on providing information often have no effect on behaviour” • “Numerous studies document that education alone has little or no effect upon sustainable behaviour” • “Information campaigns are frequently based on an assumption that individuals systematically evaluate choices – this is a mistaken belief” (McKenzie-Mohr/William Smith – Fostering Sustainable Behaviour)

4. Awareness/Information Campaigns and Behaviour Change • Awareness raising/information campaigns may have some benefit if they are carefully co-ordinated and integrated with local programmes. However there remains a cost effectiveness question.

5. Health Inequalities • Where awareness raising/information campaigns do impact on behaviour it tends to be with advantaged groups and therefore this increases the inequalities gap (Sally McIntyre, Ministerial Task Force 2008)

6. Poverty and Health Stress Lack of Direction Loss of Hope Learned Helplessness

7. Health Inequalities Interventions which are less effective in reducing health inequalities or maybe increase them: • Information based campaigns • Written materials • Complex systems • Whole population approaches • Campaigns reliant on people taking the initiative Sally McIntyre 2008

8. Salutogenesis – Sense of Coherence(Antonovsky 1967) A greater emphasis should be placed on the resources individuals require to create health for themselves. These resources would allow them to make sense of the stresses they encounter in daily life. In essence, a person with a well developed sense of coherence will: • Wish to or be motivated to cope (meaningfulness) • Believe that he has the capacity to understand the challenge (comprehensibility) • Believe that resources to cope are available Dr Harry BurnsCMO 2010

9. Tackling Health Inequalities and Achieving Behavioural Change • People are the start of the solution, not the start of the problem • Co-production and community ownership • Income support • Reducing price barriers • Improve accessibility of services and facilities • Measure behavioural change

10. Key Principles of Social Marketing • Seeing and understanding the world from the perspective of those we wish to support • Set shared behavioural goals and measure them • Explore what moves and motivates • Overcome barriers, look at what has to be exchanged • Develop incentives which are valued by the target group to motivate behaviour change

11. Social Marketing – Project Planning(which can include awareness-raising/information provision) Scope  Plan  Research  Develop  Implement  Evaluate

12. Give it up for Baby(this included an awareness-raising element)

13. Give it up for Baby Results April 2007 – September 2009 • 318 had set a quit date • 59% maintained full quit attempt at 4 weeks (38% comparative Scottish figure) • 41% maintained full quit attempt at 12 weeks (17% comparative Scottish figure)

14. Quit4U

15. Quit4U Results • 701 set a quit date • 48% quit rate at 4 weeks • 3 month rates to follow

16. Partnership processes

17. Toolkit