The Public Health White Paper and NICE Health Incentives?

With the Public Health White Paper due to be published on Tuesday, it seems appropriate to comment on the use of incentives to encourage positive Heath outcomes. Reporting over the weekend indicated that a range of Nudges, including incentives might be part of the White paper agenda.  TCC itself also recently submitted a paper to the National Institute for Health and Clinical Excellence (NICE) consultation on health incentives.

Thanks to the research of Bandura, Sampson, Cialdini and others, we now know a lot about different approaches to behaviour change. However, we also know that even acclaimed behaviour change campaigns don’t necessarily translate from one group of citizens to another. `Don’t Mess with Texas’ may have worked wonders for litter reduction in Austin, but how does `Don’t Mess with Tunbridge Wells’ sound? The same applies to the issue of health incentives. People will respond to health professional’s requests to take more care of themselves in different ways, depending on their needs, emotions, values and motivations.

To run effective behaviour change campaigns, which might include the use of incentives, requires accurate targeting and segmentation with the key aim to understand the different motivational triggers for different groups.  Healthy Foundations was the Department of Health’s, recent attempt to segment the population according to health attitudes. Whilst being a step forward it falls short of its goal to become a useful tool for segmenting the population in a subject area as complex as incentives.

In the paper TCC submitted, we argued that Values Modes takes us much closer to understanding the underlying drivers that make people behave the way they do even when provided objective and factual health information.

The paper also sought to move the incentives debate on from simply whether one is in favour of it or against it, to how one might develop the scoping and insight phases to deliver a pilot with different targeted interventions according to the values of the participants. The NICE Citizen’s Council set out the pros and cons. Assuming the consultation endorses the majority decision of the Citizen’s Council, the TCC paper set out the way to deliver a more effective intervention.

Values Modes gives us a broader, more accessible and useable approach to segmentation, and therefore a much clearer understanding of the relationship between needs, values and behaviour, which could thus enable incentives to be used in the most effective way, but also communicated more effectively to those who would not be in receipt of them, thus securing wider buy-in for any pilot project.

Charlie Mansell is Research and Development Officer for The Campaign Company.He would also like to thank Nick Pecorelli for his helpful comments and contributions to the NICE paper.

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