The recent HPPHN Behaviour change in practice Conference that was held at the British Psychological Society offices in London on the 20th February 2017 brought a range of speakers with thought provoking and exciting content. We also had the opportunity during the AGM to hear about the journey of the network thus far under the leadership of Professor Jim McManus and cheer for the new Chair, Dr Angel Chater. Congratulations to Angel! Their partnership, and collaboration from a dedicated committee was evident.
Behaviour change theories and techniques are increasingly recognized as an effective asset to interventions targeting current public health issues such as diet, smoking, medication adherence, doctor-patient communication and physical activity. However behaviour change is not confined to health related issues alone; “behaviour change is in everything” – using Professor Marie Johnston’s words, the keynote speaker of the event from the University of Aberdeen. Professor Johnston addressed many current short comings of Health Psychology including problems with intervention design, methodology and reporting, problems with theoretical constructs and the language of behaviour change science.
She then went on to highlight solutions to these. Professor Johnston emphasised the importance of targeting behaviours that are in more direct relation with the desired health outcome as closely as possible. A large number of health behaviour change interventions are more successful in modifying some elements of behaviour or cognitions, without significantly affecting the desired health behavioural outcome. However research methodology also requires some revision; between persons design is often used in health behaviour interventions, which is effective in revealing the differences between groups of people (who to change), this design is, however, limited in detecting the variance within persons (how to change).
Health Psychological research has generated a large volume of research evidence and developed a number of Behaviour Change Techniques (BCTs) and other theoretical constructs. However, these constructs are significantly overlapping and often indistinguishable; for example, self-efficacy and perceived behavioural control. Moreover BCTs are still lacking common sense elements, such as “telling the person to do it”. These issues imply the need for an ontology in behaviour change science; an organized system of the volume of evidence and taxonomies with and agreed consensus on labels and terminologies – essentially personalised language for Health Psychology and behaviour change science.
The second presentation introduced us to behavioural insights, highlighting behavioural economics theory and practice within Public Health England by Amanda Bunten, Sarah Golding, and Harriet Rowthron. Humans do not consistently make logical decisions, we are all emotional and time dependent, therefore, we tend apply mental shortcuts (heuristics). Therefore, creating a built-in environment to influence health behaviours is of crucial importance; in which framing of health messages play a fundamental role. Thus behaviour change interventions in public health need to take these characteristics into account, by making interventions Easy, Attractive, Social, and Timely (EAST), to facilitate the appropriate physical and social opportunity, and automatic motivation.
As part of the conference lunch, all attendees were invited for a group walk from Old Street, the conference venue, to Finsbury Square gardens. This was a simple approach to practicing what we promote to the public to improve their health via purposefully designed health messages and interventions. The majority of delegates joined the walk; the cool February air and mild physical activity revived us before the closing activity of the event.
Finally, a communication skills training workshop was delivered by Dr Wendy Lawrence, a Health Psychologist from the University of Southampton. The workshop included role-play based exercises and demonstration of a variety of consultation styles that clearly illustrated the importance of how health professionals communicate with patients. These workshop exercises may have also had some team building effect on the audience.
The recent HPPHN conference cited many current issues within the discipline, moreover discussed promising current research activity that may solve those issues, for example the required ontology which is being currently developed by the Human Behaviour-Change project led by Dr Susan Michie at UCL. It has been very refreshing and reassuring for a trainee Health Psychologist like myself to see such professional honesty and such healthy criticism and direction of the discipline. I believe Health Psychology being a young discipline may be an advantage after all; its advocates still feel the need to “clean up their act”- using Professor Johnston’s words. After this event, I believe Health Psychology is on the right track to influence and collaborate more frequently with public health.
Dora Kukucska, Trainee Health Psychologist and Research Assistant in Active Herts Project