Behaviour change: the principles for effective interventions

1. Behaviour change: the principles for effective interventions Implementing NICE guidance October 2007 NICE public health guidance 6

2. Benefits of implementing NICE guidance • Helps NHS organisations meet DH ‘Standards for better health’ • Helps local authorities fulfil remit to promote economic, social and environmental wellbeing of communities • Helps organisations improve health and meet government indicators and targets to reduce health inequalities • Can help save money by identifying opportunities for disinvestment or re-directing resources • Provides a focus for local partnerships

3. What this presentation covers • Background • Recommended principles • Costs and savings • Resources from NICE

4. Background:why this guidance matters • Major conditions such as cardiovascular disease, chronic lung disease, some cancers and type 2 diabetes are linked to people’s lifestyles and behaviours • Practitioners and others working in the area need clear, evidence- based guidance on what works in different settings and for different population groups

5. Recommended principles • Principle 1: planning • Principle 2: social context • Principle 3: education and training • Principle 4: individuals • Principle 5: communities • Principle 6: populations • Principle 7: effectiveness • Principle 8: cost effectiveness

6. Planning • Work in partnership with individuals, communities, organisations and populations to develop plans for the target audience based on their needs and the challenges facing them • Take people’s circumstances into account (especially the socioeconomic and cultural context) • Prioritise evidence-based approaches that can be tailored and used at key times when people are likely to be open to change

7. Social context • Identify and try to remove social, financial and environmental barriers to change • Take into account the social and environmental context • Support changes to the physical environment or the way services are delivered to help those who find it difficult (or who are not motivated) to change

8. Education and training • Review current education and training practice in this area, and disinvest in approaches that lack supporting evidence • Ensure practitioners and volunteers have fair and equal access to training and support • Relevant national organisations should consider developing standards for these skills

9. Individuals • Select interventions that help people to: • understand the consequences of their behaviour and feel positive about changing it to benefit their health • make a personal commitment to health-enhancing behaviours by setting goals and sharing these goals with others • plan change in easy steps and develop coping strategies to take account of social situations that may lead to relapse

10. Communities • Invest in approaches that: • develop and maintain supportive social networks and relationships and build people’s resilience and skills • promote and support positive relationships between children and their parents or carers • help organisations and institutions to promote local participation in planning and delivering services and to participate in voluntary activities • promote access to the financial and material resources needed to help people make changes to improve their health

11. Populations • Use the needs and behaviours of the target population as the basis for all interventions and programmes • Ensure population-based activities complement those delivered to individuals and communities • Ensure population-based activities are assessed in terms of the risks, costs and benefits for all target groups

12. Effectiveness • Ensure funding applications and project plans include specific provision for evaluation and monitoring • Ensure appropriate process and outcome measures are used

13. Cost effectiveness • Collect data for cost-effectiveness analysis, including quality of life measures • When researching or evaluating interventions and programmes estimate the cost savings involved (for instance, the cost of primary prevention versus clinical treatment)

14. Costs and savings • Some aspects, such as training and evaluation, will involve extra cost • However, effective interventions should lead to cost savings within the NHS and other public sector organisations in the longer term

15. Access NICE guidance and other support tools online • Quick reference guide – a summary • NICE guidance – all of the recommendations • Costing statement • www.nice.org.uk/PH006