Barriers and facilitators to the adoption of behavioural science in a local authority

M. Watkins, E. Vangeli, K. Ahmed, S.Sykes, and J. Wills

PHIRST South Bank, London South Bank University, London, UK

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Abstract

Background

The contribution of behavioural science to the development of public health policy and practice is being increasingly recognised but application across local government has so far been limited. The current study is an evaluation of a dedicated behaviour change unit within a local authority. The study aim was to identify factors that facilitate or impede adoption of behavioural science in local government.

Methods

A sequential mixed methods design was employed that comprised a documentary analysis for which a framework for extraction and interpretation was developed. Data from ten interviews with senior managers across six council directorates and two focus groups with eight staff from two directorates were analysed thematically. A questionnaire based on the Theoretical Domains Framework was conducted with 12 staff identified as champions of behavioural science.

Results

Analyses of data identified four key themes key to the engagement with behavioural science: organisational and cultural buy-in; understanding and application of the principles; acceptability and practicability of the service; perceived value for the organisation.

Conclusions

Behavioural science can help in the design and development of municipal services. This study highlights that for behavioural thinking to be more widely rolled out across local government a dedicated resource to support staff is desirable. As with the adoption of any new service, there needs to be a widespread organisational awareness of what the service can offer and how it can help the framing of public messaging and communications, campaigns and service or programme design.

Keywords: Behaviour Change; Behavioural Science; Local Government

Introduction

Behavioural science (BS) is the study of human behaviour. Covering a range of academic disciplines that include economics and social psychology, BS helps to define problems or issues in behavioural terms and identify target behaviours and populations (Knowles & Cline, 2023; OECD, 2017; McManus, Constable & Bunton et.al., 2021; Sanders, Snijders, & Hallsworth, 2018).

The Local Government Association (LGA) in England claims that behavioural insights should be applied to social marketing and communications, campaign development and delivery (LGA, 2022). Its case studies include an “insight-led” approach to tackling waste management and funded projects include energy efficiency and access by children and young people to mental health services. Behaviour change draws upon the discipline of BS to understand how people think and feel and the sources of their motivations when making decisions. An increasing number of local authorities and national public health agencies have Behavioural Science or Behaviour Change Units providing specialist expertise and encouraging the application and integration of behaviour change across directorates.

This paper arises from an evaluation of a dedicated behaviour change unit (BCU) within a local authority (LA). This unit sits within the Public Health directorate but has a Council-wide remit and works with external partners who commission their services, such as the NHS. It aims to embed BS across the council, encourage the adoption of “behavioural thinking” and support the use of BS evidence and tools across all directorates through training, advice, and project support. The evaluation aimed to identify the barriers and facilitators to engagement with BS.

Methods

Three coproduction workshops with BCU staff took place to identify the scope of the intervention and its desired outcomes. A logic model (see Figure 1) was developed by the evaluation team to identify anticipated outcomes and mechanisms for change that a dedicated BCU might contribute to, leading to improved outcomes for residents and services. The evaluation assessed the achievement of these identified short-term outcomes.

The evaluation followed a mixed methods design (Cresswell & Plano Clark, 2011) in which its elements were conducted sequentially to enable findings from earlier elements to inform the development of subsequent ones. This included documentary analysis, interviews with ten senior managers across the six directorates of the council, two focus groups with five staff from two different directorates from which qualitative data were analysed thematically. A questionnaire was distributed to 42 staff identified as champions of BS with 12 responses which were analysed descriptively.

Documents were supplied by the BCU and taken together provide a picture of how the BCU sees its implementation. They are useful to triangulate the findings from interviews at the early stage of introducing an innovation. They provide historical and contextual insight, the aspirations for the BCU and the initial decision-making processes. Items supplied by the BCU (n=30) document the setting up and activities of the unit in its first three years (2019-2022). The documents included a Light Touch Business Case (29th April 2019), a blog from a local councillor, the briefing for an elected member, good practice guidelines written by BCU staff, relevant webpages (internal facing), meeting minutes regarding the setting up of the BCU (2019), skills manuals, workshop feedback/questionnaires, Advisory Group (AG) presentations and briefings including ones titled ‘What can it do for you?’ and ‘Where could behavioural science be applied in my service?’. Most of the documents were either outlines or written in ‘note’ form, thus it was not possible to achieve an in-depth analysis. The approach to analysis of these texts thus involved skim reading the documents to get an overview and then reviewing the manifest content. A framework for extraction and interpretation was developed based on the categories of context, the nature of the BCU, its desired outcomes and the processes pursued in creating the BCU.

Senior managers across the six directorates of the council accepted the invitation to interview resulting in a sample that comprised ten stakeholders. In depth phone or video call interviews took place, employing a semi-structured topic guide. The interviews explored factors contributing to the establishment of the BCU, integration of BS into policy, service design and the added value of having a BCU and its function in local government. The topic guide was piloted within the internal evaluation team prior to commencement of the study to improve and refine the open-ended interview questions. Interviews lasted up to an hour, were audio recorded and transcribed verbatim by a university approved transcription service.

Qualitative interviews were analysed using the Framework Analysis approach (Gale et al. 2013). The researchers sought to achieve familiarisation with the data for the identification of key ideas and produced a working analytical structure which was built on an amalgamation of the evaluation questions and a priori concepts. The framework was systematically applied to all data and the boundaries and sub-components were refined before ordering and interpreting the data. A subset of transcripts (one third) was coded by two researchers independently and discrepancies were discussed to reach coding consistency and agreement. The qualitative software, NVivo 12, was used for coding.

To assess whether behavioural thinking is embedded across the council and how it is being used, a questionnaire was distributed to 42 ‘champions’ who had received training by the BCU and whose role was to cascade the principles and approach of BC. The survey was based on the Theoretical Domains Framework (Cane et al. 2012) that is used to identify and describe the factors that drive behaviour. The Determinants of Implementation Behavior Questionnaire (Huijg et al. 2014) is a tool to assess implementation of behaviour according to TDF domains. Items from several domains were adapted for the implementation of BC approaches and refined following a pilot study and discussion with BCU staff to more closely align with BC implementation across the council. Items included assessed the domains of knowledge, skills, beliefs about capabilities and consequences, professional role identity, social influence (i.e. approval of others), intention and environmental context and resources. Participants rated extent of agreement with each item (e.g., ‘in my profession, it is my job to apply behaviour change approaches to inform local authority projects’) on a seven-point scale from strongly disagree to strongly agree. Questions regarding level of engagement with the BCU, and incorporation of BC approaches in their work were also asked. Twelve champions completed the questionnaire across five directorates.

To understand why and how areas of the Council engaged with the BCU and embraced behavioural science and ‘behavioural thinking’, the managers in two directorates were invited to take part in focus groups. The first focus group comprised three managers from the Children’s Services directorate that had been identified in the interviews as having limited work with the BCU and who were less certain about the role and application of BS. The second focus group comprised five managers from a directorate that worked on environment, transport and sustainability that had been identified in the interviews as enthusiastic and knowledgeable about BS and cited several examples of working with the BCU to improve service delivery. The focus group guide included questions to identify if, and in what ways, the areas of work were perceived to be informed by or shaped by behaviours; the context of the local authority and what were perceived to be enablers and barriers to the adoption of organisational or cultural change; and questions pertaining to their experience of working with the BCU. The data from the focus group were analysed using the framework developed from the interviews.

Findings

Four themes were identified in the analysis of all data: organisational and cultural buy-in; understanding and application of the principles; acceptability and practicability of the service; perceived value for the organisation.

Achieving organisational and cultural buy in to behavioural science

The documentary analysis showed that the local authority had a system-wide prevention strategy approved in 2018 whose aim was to keep its residents well, thriving, and resilient. Prevention is seen as not only related to health and social care but also to communities, social cohesion, crime, built and natural environments and the local economy. The establishment of the BCU was a recognition that behaviours underpin many of the ways in which the public can improve their wellbeing and the council improve its service delivery. The aim of the BCU is to incorporate BS across council services through analysing the issues concerning directorates and the behavioural issue at hand, and designing, testing and evaluating tailored behaviour change solutions. It is described on the council intranet as:

A specialist team of behavioural scientists working across directorates to embed behavioural science solutions within key projects, such as: improving the environment by having residents recycle more, increasing foster carer enquiries, reducing vaccine hesitancy and more! We support teams with the planning, development, implementation, and evaluation of a range of evidence-based behavioural science interventions, with the ultimate mission to provide better outcomes for the residents.

The BCU is funded from the public health budget. The initial business case was for a head of service and staffing comprising three Behavioural Scientists, a project manager, an evaluation officer, and academic consultancy. A series of workshops was delivered during 2019 to present its vision and processes to other directorates and business transformation leads. The BCU offered an advisory and project support service for directorates who would pitch a request which would then be reviewed by the BCU and if appropriate would be approved by the Advisory Group of directors if it accorded with priorities. Less than a year after its inception however, the context for the BCU changed dramatically with the COVID-19 pandemic. This significant event changed how the BCU worked, confining its activities from 2020-mid 2022 to public health messaging.

Directors in the interviews, senior managers in the focus groups and the BC champions were asked about the local authority system and what enabled or inhibited the adoption of this organisational and cultural change. A key predictor of engagement with BS was the priorities of the directorate. For example, issues such as the environment, sustainability and climate change have a narrative in which there is a need to change both public, and their own workforce’s, behaviours through, for example, active travel or careful use of energy. The directorate of Children’s Services saw less accord with BS and BC and saw their statutory responsibilities as constraining the ways in which they could change their approach. Although there was little reference to structural and cultural features of the organisation that enabled the BCU in the documents, there was reference in interviews with directors to the Director of Public Health (DPH) and their influence both internally and externally in driving forward this innovation. Notwithstanding the intention to have a system-wide approach reflected in the Corporate Prevention Strategy and the BCU working across the council, the focus group participants described the council as working in silos. Participants in focus group 2 thus described their directorate as more easily able to incorporate behavioural thinking and BS because theirs by contrast, was an “enabling service” that worked across the council.

I would say that all the services that we’re talking about here are partly about putting stuff down – infrastructure or whatever it is – to enable people to do things. But, more and more, over my years in this business, it’s about getting people to think about how they do something differently. (Focus group 2).

Understanding and application of the principles of behavioural science

The adoption of behavioural thinking is a conceptual change for an organisation and the nature of that change needs to be understood. Senior managers identified three main benefits of behavioural science: understanding the drivers of public behaviours such as recycling which would then improve the outcomes of council work; being better able to craft communications both within and outside the council; changing the ways that staff approach projects, ‘directing it towards more realistic activity’ (Interview P9) through using evidence and behavioural insights before actions or projects were decided upon. Senior managers were easily able to give examples of issues addressed by the Council which are underpinned by public or employee behaviours and where support from the BCU would be helpful. These included recycling, food use advice for residents, decision making by frontline staff, the uptake of services as well as addressing public health issues relating to healthy eating behaviours or smoking.

All champions offered an example of where their role is, or could be, informed by BS. Most examples related to understanding and changing service user behaviours and include:

• ‍Thinking about consumer education and response to recalls etc.
• ‍Getting businesses to make changes in the workplace.
• ‍Changing the behaviour of road users to reduce the number of killed and seriously injured on roads.
• ‍Encouraging householders to waste less food.
• ‍To encourage our residents to walk and cycle for short journeys or to walk and cycle as part of longer journeys involving public transport.

Examples from BC champions of how an understanding of BS had informed an intervention or way of working included: ‘meeting business objectives (e.g. providing info) via understanding where people naturally look’; communications with the public, how frontline workers talk with the public and public information campaigns. An example was offered in focus group 2 of how a project to reduce pollution from idling traffic was changed from ‘anti-idling’ to ‘idling action’ to focus on a more positive and action-oriented approach. Another detailed example was offered in focus group 1 of how the BCU had advised how to improve the ways in which foster carers are recruited by better understanding their motivations and thereby more positively framing communications.:

Adopting a behavioural point of view means we focus our recruitment towards what makes someone think they can do it (Focus Group 1).

All champions, except one, reported the incorporation of behaviour change approaches to inform their work, with over half (58.3%, n=7) doing so ‘a lot’ or ‘a great deal’. Two thirds (66.67%, n=8) of champions reported using at least one behaviour change framework. Of these, the COM-B was used by most (n=7), followed by Behaviour Change Wheel (Michie, van Stralen and West 2011) and EAST/MINDSPACE (Service et al. 2014; Dolan et al. 2012), each applied by half (n=4). Three participants who reported incorporation of BC approaches to inform their work did not report using any behavioural frameworks to do this, so it is unclear how BC approaches were believed to be applied. All participants reporting incorporation of BC approaches in their work, also reported likelihood to use BC approaches to inform future projects.

The acceptability and practicability of the behavioural science service

The BC champions were expected to be the ‘eyes and ears’ identifying organisational opportunities for BC and to be enthusiastic promoters of BS. The questionnaire respondents (n=12) all agreed that BS informed their individual approach but varied in the extent to which they had felt able to promote BS. The third strategy reported as enabling the establishment of a BCU and its acceptance was its specialised workforce of behavioural scientists who were seen as having discrete skills and professional expertise which could add value to existing project teams.

Make sure you get the right people in post, so they know the job and aren’t just slightly posher project managers…the people I work with…they’re on the top of their game (Interview P7).

Champions also rated themselves as skilful or somewhat skilful in their knowledge and skills for the competent application of BC approaches within the areas that they currently work (i.e., commissioning services, service design, service evaluation).

Some senior managers did report doubts in interviews about the extent to which behavioural thinking is currently embedded within the council, acknowledging that the BCU had not reached everyone. This was attributed to the BCU, as a relatively small team, encountering challenges in achieving change, understanding and buy-in across a large organisation:

I think the team is too small to be a business partner... it hasn’t got the capacity so for me it would sit better in a corporate department (Interview P3).

Interview participants reported that their staff were often not aware of the BCU champions nor had any experience of the champions’ work:

I have still got some work to do to get others thinking about it. I’ve got 600 people in my directorate so there are quite a few people to work through, to be honest (Interview P2).

Directors did suggest that the BCU needed to further promote itself, enabling its role to be better understood:

I would almost like to see them come along to all the service boards, tell us what they can do… then we can probably make better use of them (Interview P7).

Focus group participants also believed that there needed to be much more marketing either informally, ‘working through influencers’ or through more formal and myriad communication routes of ‘practice week’, service roadshows, manager forums, newsletters, and the intranet.

The process of engaging with the BCU service varied. In focus group 1 it was described as ‘random’ and ‘someone becoming aware’ by virtue of having attended a training session. The cascading of information had, in this instance, worked successfully as this champion had then informed other staff of tools such as the COM-B model and EAST framework. The need to triage work was acknowledged due to the small size of the service but the process of seeking support from the BCU was described as cumbersome and lengthy which had, on occasions, limited opportunities when national policy demanded a swift response. All participants commented on the limited capacity of the BCU service. The directorate concerned with environment and transport engaged frequently with the BCU service through informal conversations and were so supportive of BS that they were proposing having an ‘embedded’ behavioural scientist dedicated to that directorate but remaining ‘within the orbit of the BCU’.

Perceived value for the organisation

The BCU was expected to change the ways in which services or programmes were designed as shown in Figure 1. In the short-term, this included awareness of the BCU and adoption of behavioural thinking, as evidenced in the use of BC frameworks and principles and more creative, innovative, and agile ways that directorates would approach and design responses. Over a longer time period, there was the aspiration that using the BCU would be part of “business as usual” and built into the strategic plans with buy-in from the whole organisation. There would be evidence of improved services for residents that are behaviourally informed and organisational outputs and return on cost.

Process evaluations were carried out by the BCU with its service monitored through numbers of, and feedback on, the delivery of training, advisory sessions sought, communications volume and type, and website analytics of the staff intranet. It is not yet possible to discriminate an overall impact for a local authority to have a dedicated BS resource although there were several accounts of specific contributions made to service design such as waste recycling. Focus group participants, whatever the extent of their engagement with the BCU service, were clear that the service had added to their work:

I think what BCU did coming in was to turn things on its head and get people thinking about different approaches that they could try, that they might already be doing, but could up a little bit, increase (Focus group 1).

Discussion

This study reveals individual, organisational, and contextual factors that facilitate or impede a new service such as the BCU and the adoption of BS as a new approach for local government. Key to the engagement by local government with BS is to achieve organisational and cultural buy-in by demonstrating a clear value for the organisation; to ensure that senior leaders understand the new service innovation; and that the organisation is aware of, and finds the service acceptable, practicable and easy to use.

Despite increasing interest in the behavioural and social sciences across governments and agencies e.g. by the OECD (2017), BS is still underutilised in practice. A study of the factors influencing the use of BC evidence (Curtis, Fulton & Brown, 2018) which a strategy document for Public Health England (West, Michie & Chadwick, 2020) identified as key to embedding behavioural insights, concluded that a coordinated effort is needed to encourage cultural and attitudinal change together with relevant training and tools to support decision-makers and practitioners throughout the commissioning process. Explanations for underutilisation include a lack of understanding of the mechanisms of BC (Moffat, Cook & Chater, 2022), confusion about psychological theories (Weston, Ip & Amlot, 2020), structural processes that encourage post hoc justifications rather than evidence to inform interventions (Byrne-Davis, Turner, Amatya et. al., 2022) and practical considerations such as lack of capacity, funds, and time (Curtis, Fulton & Brown, 2018). A recent study of a Behavioural Science Unit in Public Health Wales (Knowles & Cline, 2023) identified the importance of understanding the operating context for the service.

Achieving organisational innovation in a LA is challenging when it is likely by virtue of its many technical functions, to work in silos. The evaluation showed that there are various levers within the council system and factors that enable or inhibit illustrated the adoption of the innovation of BS and the use of the BCU service. These barriers and facilitators are shown in Figure 2. The evaluation demonstrated that the most effective way to embed behavioural thinking is to work at all levels across the organisation, in doing so “winning hearts and minds”. This is best achieved through working on the ground formally through existing fora, the intranet and informally through conversations and asking staff to request support. It takes time for a small service to become visible so having specialists who also understand local government (Chadwick, Constable, McManus, 2022) and therefore where in the system they need to make contact, is likely to be more effective than using consultancy or an external service.

Personal relationships were identified as key in the adoption of the innovative service. This was through everyday encouragement in different for a and meetings but also through the opportunities afforded by cross-boundary roles such as the Director of Public Health. For behavioural thinking to become embedded in decision making there needs to be a clear alignment with the issues of concern as shown in the second outer circle in Figure 2. This was recognised by the BCU in their initial communications e.g. ‘What can Behavioural Science do for you?’. Not all behaviours are the same and context, whether it be the location of the local authority or its organisational structure, can affect how easily behavioural thinking is adopted. It was claimed, for example, that rurality meant there was less motivation and opportunity for the public to adopt certain environmental behaviours in this area. More complex issues affecting frontline staff across local government such as resilience in decision making were described as less amenable to behavioural thinking due to the need to fulfil statutory requirements and safeguarding. There is, therefore, an argument for BS to address the ‘low hanging fruit’ issues in local government.

This evaluation identified that the organisational antecedents resulting in the innovation adoption and diffusion (Pollitt 2013 ; de Vries et al. 2016) were an identified budget (from public health), leader support at directorate level and political acceptance at member level, the size of the organisation which allowed for the BCU to be a service partner across the organisation and an extensive training programme with a network of champions to enable the spread of BC learning.

Rogers’ theory (1962) about why and how innovations get adopted pointed to specific features of the innovation that would influence its adoption including its relative advantage over existing processes but also its compatibility, the ability to trial its implementation, its observable value and its level of risk, findings that were also found by Greenhalgh et. al (2004) in their systematic review of the adoption of innovations in service organisations. For local government to adopt new ways of thinking, they must have sufficient information about what a resource such as the BCU does, how to use it and be clear about how the innovation would affect them personally, for example, in terms of costs. Four key factors influenced the adoption of a BCU in this LA. Firstly, risk was low - the BCU could be trialled in different settings with little risk to any directorate and budget as it is located within, and funded by, the public health directorate. Second, the catalyst for its introduction or what De Vries et al. (2016) term the antecedents and context for the innovation was its alignment alongside a council wide prevention strategy and thus part of an overall strategic vision. Third, although the BCU was set up before the COVID-19 pandemic, the pandemic provided a unique context for its translation and visibility (Byrne-Davis, Turner, Amatya et al., 2022) but this also limited the ability of the BCU to embed its work as staff of the BCU were directed during the pandemic to support the public health directorate. Fourth, BS could be perceived to be easily aligned to some of the most pressing issues. The directorate concerned with environment and transport described themselves as passionate and wanting to make a difference and with a continuing desire to try out new approaches to, for example, road safety and highways engineering. The Children’s Services directorate were more reluctant to adopt BS and mostly had yet to be convinced about the utility of an innovation for their service and wanted more evidence. Figure 2 shows how the functions of local government directorates can enable or inhibit the adoption of an innovation such as BS.

Other local authorities are embracing BS but vary in their responses. Yorkshire and Humber for example, have a Behavioural Science Hub to provide a digital repository of resources and good practice examples. The service model adopted here, whereby the BCU is available across the whole council, was seen as flexible and responsive by some directors but others questioned its capacity and alignment beyond public health issues. Setting up a BCU as a dedicated resource working across the council creates challenges of scale. The novel service sought to become embedded in the local government system through three main strategies. First, achieving ‘buy-in’ across the directorates by making the service universally available and enabling directors who have not yet worked extensively with the BCU to actively partake in Advisory Group decision making. Secondly, aligning the BCU to corporate strategy so demonstrating political buy-in. The third strategy was the identification of champions who are usually BCU-trained managers based within the directorates who would cascade awareness and understanding of what BS could offer. Although champions are a common method of implementing innovations across organisations, their effectiveness is not known (Santos et al. 2022). The service model also assumes that having the specialists who also understand local government and therefore where in the system they need to make contact, is likely to be more effective than using consultancy or an external service.

Limitations of this study

The BCU is still in the early stage of service establishment despite being in existence for three years. The time frame for the adoption for an innovation in the public sector is always likely to be lengthy. The pandemic as an unexpected event, is of crucial importance in explaining the outcomes from this evaluation as BCU efforts were diverted to communication design and improving vaccination responses.

This was a mixed methods evaluation and the sample size of each element albeit small, was representative of those at director and manager levels and across directorates. It should be acknowledged that due to the nature of the service set-up, the outlined factors limit the extent to which the authors can strongly assert the useful role of a dedicated behavioural change unit for local government, but several features show promise for influencing take up. Further work is recommended to ascertain how impact can be maximised for public services and the cost-effectiveness, efficiency and equity of the service offer.

Conclusions

Behavioural science can help in the design and development of municipal services. This study highlights that for behavioural thinking to be more widely rolled out across local government a dedicated resource to support staff is desirable. As with the adoption of any new service, there needs to be a widespread organisational awareness of what the service can offer and how it can help the framing of public messaging and communications, campaigns and service or programme design.

Conflict of Interest

None to declare

Funding

This evaluation was conducted by PHIRST South Bank and funded by the National Institute for Health and Care Research (NIHR; PHIRST South Bank Award ID NIHR131568 and Research Award ID NIHR134421). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Ethical Approval

Ethical approval was granted by London South Bank University School of Health and Social Care Ethics Panel on 12/10/2021[reference ETH2122-0006] and approved by the local authority on 14/11/2021

Acknowledgement

Many thanks to the study participants and our local authority partner for supporting this evaluation.

References

Byrne-Davis, LMT., Turner RR., Amatya S. et al. (2022). Using behavioural science in public health settings during the COVID-19 pandemic: The experience of public health practitioners and behavioural scientists. Acta Psychol (Amst) 224, 103527.

Cane J, O’Connor D, Michie S (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci, 7, 37

Chadwick P., Constable, M., McManus J. (2022). Employing behaviour change roles in local authorities. Good Practice Guidelines for Employers. Retrieved from BSPHN Good Practice Guidelines for Employers 2022

Creswell, J. W., & Plano Clark, V. L. (2011). Designing and Conducting Mixed Methods Research (2nd ed.). London: Sage.

Curtis K., Fulton, E., & Brow,n K,.(2018) Factors influencing application of behavioural science evidence by public health decision-makers and practitioners, and implications for practice. Preventive Medicine Reports, 12, 106-115.

De Vries, H., Bekkers, V., & Tummers, L. (2016). Innovation in the Public Sector: A Systematic Review and Future Research Agenda. Public Administration, 94 (1), 146–166.

Gale NK, Heath G, Cameron E et al. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol, 13, 117

Greenhalgh, T., Robert G., Macfarlane F. et al. (2004) Diffusion of innovations in service organizations: systematic review and recommendations. The Milbank Quarterly, 82, 581-629.

Huijg, J.M., Gebhardt, W.A., Dusseldorp, E. et al. (2014). Measuring determinants of implementation behavior: psychometric properties of a questionnaire based on the theoretical domains framework. Implementation Sci, 9, 33.

Knowles, N. & Cline, A. (2023) Enhancing Behavioural Science application across public health policy and practice in Wales. Behavioural Science and Public Health Network. Retrieved from Enhancing Behavioural Science Application Across Public Health Policy and Practice in Wales

LGA. (2022). Behaviour change: The appliance of science to public service interventions and communications. Retrieved from Behaviour change: The appliance of science to public service interventions and communications

McManus, J., Constable, M., Bunten, A. et al. (2018) Improving People’s Health: Applying Behavioural and Social Sciences to Improve Population Health and Wellbeing in England. Public Health England. Retrieved from Improving people's health: applying behavioural and social sciences

Michie, S., van Stralen, MM., West R. (2011) The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6, 42.

Moffat, A., Cook, EJ. & Chater, AM. (2022) Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework. Front. Public Health, 10, 1016076

OECD. (2017) Behavioural insights and public policy: Lessons from around the world. OECD Publishing. Retrieved from Behavioural insights and public policy

Pollitt, C. (2013) “Context: what kind of missing link?” In Pollitt, C. (ed.) Context in Public Policy and Management: The Missing Link? Edward Elgar Publishing pp 415–422.

Rogers, EM. (1962). Diffusion of Innovations. New York: The Free Press of Glencoe.

Santos, WJ., Graham, ID., Lalonde, M., et. al. (2022) The effectiveness of champions in implementing innovations in health care: a systematic review. Implement Sci Commun, 3(1), 80.

Sanders, M., Snijders ,V., Hallsworth, M. (2018) Behavioural science and policy: where are we now and where are we going? Behavioural Public Policy, 2(2), 44–167.

Service, O., Hallsworth ,M., Halpern, D., et al. (2014) EAST: four simple ways to apply behavioural insights. The Behavioural Insights Team, London.

Shaw, S., Elston, J. & Abbott, S. (2004). Comparative analysis of health policy implementation:, Policy Studies, 25(4), 259-266, DOI: 10.1080/0144287042000288451

West, R., Michie, S., Chadwick, P. et al. (2020) Achieving behaviour change. A guide for national government. Public Health England. Retrieved from Behaviour change: guides for national and local government and partners

Weston, D., Ip, A., & Amlôt, R. (2020) Examining the application of behaviour change theories in the context of infectious disease outbreaks and emergency response: a review of reviews. BMC Public Health, 20, 1483