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Dr David French Synergy: 7 Sept 2008

Changing health-related behaviours using risk communication interventions or Why giving people numerical risk information is not likely to result in much behaviour change. Dr David French Synergy: 7 Sept 2008.

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Dr David French Synergy: 7 Sept 2008

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  1. Changing health-related behaviours using risk communication interventions orWhy giving people numerical risk information is not likely to result in much behaviour change Dr David French Synergy: 7 Sept 2008

  2. Background: reviewing the literature on risk communication for NHS (mid-life) LifeCheck

  3. Risk communication in LifeCheck • “clear and personalised results about health risks that the person can change by modifying their day-to-day behaviour, including how these risks affect health and longevity, like smoking or lack of exercise.” • Aims of risk communication can be thought of as three overlapping categories: • Supporting behaviour change • Facilitating informing choices • Reducing distress

  4. January 2006 Joint British Societies’ Guidelines on the Prevention of Cardiovascular Disease in Clinical Practice: Risk Assessment

  5. Model underlying this… • Give people risk information/ “scary” information, then they will change their behaviour • Plenty of examples of this • New technologies “rediscover” this model, e.g. genetic testing • So why is it not as simple as this?

  6. Communicating risk info • Epidemiological studies yield information like: • “you have an absolute risk of a cardiovascular disease event of 10% over the next 10 years” • Is 10% good or bad? • Comparative info may be more useful? • Also understanding of “cardiovascular disease event” • And why 10 years?

  7. Providing probabilistic info • (Many) people are poor at: • understanding probabilities • Handling probabilities • Recalling probabilites • They “extract the gist”

  8. Getting more psychological • So far, only talking about (absolute numerical) likelihood • Many psych models include other constructs: • Severity • Response efficacy • Self efficacy • “fear control” versus “danger control” • Only small part of other models, e.g. TPB

  9. Theory of Planned Behaviour Behavioural Beliefs Attitude Toward the Behaviour Normative Beliefs Subjective Norm Intention Behaviour Control Beliefs Perceived Behavioural Control

  10. Assuming we stick with risk info… • Probabilities are also: • Abstract • “cold” not “hot” (emotional) • Leventhal model/ research proposes the following may be important: • Signs and symptoms are CONCRETE indicators of risk • Should link signs and symptoms to risk? • Agenda of person, not epidemiological agenda

  11. Risk communications… • (one type of) motivational interventions • May help engage, but ignores: • volitional interventions • Goals and action plans of individual • Barriers • Relapses • Maintenance • May be useful – may not be • But is often on others’ agendas (such as DH)

  12. From Risk to Behaviour • self-efficacy • self-management skills e.g. • set concrete, short-term goals • action plans: what, when, how • Other information, e.g. • concrete signs/symptoms • emotion-laden thoughts • Change in behaviour • - people must: • see the need for change • feel that they can change • experience benefits of change • maintain that change in the face of barriers & setbacks • Perceived risk • people tend not to think in terms of probabilities, but in terms of beliefs about • severity • vulnerability • control over the risk Actual risk - as estimated from demographic and biomarkers information

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