Public Health White Paper: Applying behavioural insight to health

A new Government paper on Behavioural insight was published just at the tail end of last year. It may well have been missed by many working in this field because of the Christmas and New Year holidays. It builds on David Halpern’s previous Mindspace behaviour change work for the Cabinet Office.

It is quite an important paper as it will influence Government attitudes regarding priorities within public health following the publication of the White Paper on the subject. Government policy  towards the use of behaviour change within public policy was recently summed up by this recent Frances Maude article in the Guardian. The concluding sentence to the article is important:

“one thing we can be certain about: between banning and doing nothing there are many choices.”

The Government’s aim seems to be to act as a bully pulpit, suggesting rather than instructing. On page 7 of the paper it says:

“In a world where general practitioners, public health professionals and local communities increasingly hold the budgets and power, we hope that some of the ideas contained here will spark interest well beyond Whitehall”.

Cynics might also add that they will no doubt also be claiming the credit when something local goes right! In terms of methodology, there seems to be a strong focus on Salience from the Mindspace report – making sure people are aware of their choices.

The paper sets out the following case studies:

  • Smoking: drawing on commitment and incentive devices, we are launching a new smoking cessation trial with Boots.
  • Organ donation: we are introducing a trial of ‘prompted choice’ for organ donation, which we believe will significantly increase the number of donor registrations.
  • Teenage pregnancy: how teenagers who mentor toddlers are significantly less likely to become teen parents themselves.
  • Alcohol: Welsh universities will be trialling new methods to encourage students to drink less alcohol using social norm techniques.
  • Diet and weight: we will be establishing a partnership with LazyTown, the popular children’s TV show, which will encourage healthier behaviour in children.
  • Diabetes: new devices are helping children to manage their conditions in ways that are practical and fun.
  • Food hygiene: how the new National Food Hygiene Rating Scheme will empower people to make better choices when it comes to the hygiene standards of food.
  • Physical activity: numerous innovative schemes have been set up, including the ‘Step2Get’ initiative in London, which incentivises pupils to walk to school.
  • Social care: we have established a partnership to develop a reciprocal time credit scheme to help catalyse peer-to-peer provision of social care.

An interesting new example they refer to on pages 23 and 24 of the report is the “reciprocal” and “making a commitment” ‘Fureai Kippu’ social care credits for helping the elderly that has been pioneered in Japan. This has a unit of account of one hour’s help and has similarities to Local Exchange Trading Systems (LETS). TCC is currently working on projects in the North of England in this area of health and social care, so will be exploring how approaches like this might connect behaviour change with Big Society activity in an effective way – perhaps through the use of Time Banks?

Most of the above areas – apart from perhaps Organ Donation in the short-term – will be local issues for each new Heath and Well-being Board that will be established as a result of the forthcoming Health Bill. Many of them are the sort of issue where there will often be differing outlooks about them due to people’s differing values.

The conclusion to the paper on Page 25 is promising. It refers to experimentation. Expect to see groups of Health and Well-being Boards band together to test slight variations in approaches. This should lead to lots more useful insight coming out of the field of health behaviour change.

Charlie Mansell is the Research and Development Officer at The Campaign Company.

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