Saturated fat pledge – a cause for celebration?

October 31, 2013

The pledge by a number of large food producers and retailers to reduce the levels of saturated fat in the food that they sell, has been met with a foray of criticism by food policy experts.  The argument goes that it is such a small step that the impact on the health of the nation will be minute, if that. What followed were calls for tighter regulation and binding laws on the make-up of food.

It comes down to the age old argument on how far should the state intervene? Is a pledge enough? Should it come down to regulation from the top down or should it be about changing people’s behaviour from the bottom up? Should it be a mix of both?

These core arguments (the Libertarian Paternalist Vs. Hard Paternalist) underpin the obesity debate and the recent furore around the saturated fat pledge has opened the old war wounds many of us in The Campaign Company’s office bear from our own internal debate on the matter.

The Libertarian Paternalist believes in the role of ‘nudging’ in order to make it easier for people to make healthier choices, whilst the Hard Paternalist believes citizens have the right to regulate and remove the choices available to limit that behaviour for the greater good.

We managed a childhood obesity project in Camden which looked at these very arguments. Camden tested a number of childhood obesity initiatives; on one hand we had the Hard Paternalist policy of banning every drink apart from water on school premises, and on the other hand we had the Libertarian Paternalist in the context of the Healthy Food Commitment by businesses electing to make manageable changes in the make-up of their food (such as reducing salt, reducing oil, changing oils and single frying chips).

Our research for the childhood obesity project revealed that businesses were instinctively suspicious of state intrusion but were receptive to a policy like the Healthy Catering Commitment which allowed them to make manageable but meaningful changes. Moreover a core recommendation that came from our research with businesses was the need for a conciliatory two way dialogue with business owners to involve them in the change process.

For me, the hard paternalists have crowded the media ground around the saturated fat pledge, and that this attitude, to criticise and impose instead of involving is dangerous. For Nestle – a food giant that has built itself on high saturated fat products like chocolate – to actually commit to changing the make-up of one of their most loved products, KitKats, cannot be underestimated.

In the same way that people need to change their behaviour, nudged here and there, we should of course have the same expectation of businesses – but it is unrealistic to expect sudden and dramatic changes, an expectation that we do not have on the public.

Prochaska and Di Clemente wrote a Transtheoretical model of change which has been used for developing effective interventions to promote health behaviour change. In their work they identify 5 stages of change that people move through in trying to change their behaviour. “Stages and processes of self-change of smoking: Toward an integrative model of change.” The stages describe a person’s motivational readiness or progress towards modifying the problem behavior. The stages are as follows:

1/ Pre contemplation (aware of need to change but not interested)

2/ Contemplation (considering change but undecided)

3/ Preparation (ready to start taking action, taking small steps towards changing behaviour)

4/ Action (behaviour has changed and action is taken to strengthen their commitment to change)

5/ Maintenance (change is now integrated into their being)

Can’t the same stages of change be applied to businesses? Don’t businesses need to go through similar stages in order to change their own behaviour? I would argue that at this point, businesses are in the ‘preparation’ stage – trying to put in place measures to change behaviour. We as behaviour change professionals, have a responsibility to put the same emphasis on engaging with businesses just as we put emphasis on engaging with the public as being key to any behaviour change model for obesity and heart disease. By involving them in the process we can hopefully support businesses through the remaining stages of change.

So why not celebrate the saturated fat pledge for what it signifies in the cycle of behaviour change for businesses?

Rosanna Post is a Project Officer for The Campaign Company.

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Young women and cigarettes – will a targeted product ban work?

October 24, 2013

Every year in the UK, an estimated 205,000 children start smoking. In light of the European MPs plan to tighten tobacco regulations, it is clear that the changes in selling laws has been created with young people in mind. Mary Honeyball MEP comments that the increase of childhood smoking is “an area where Europe lags behind other parts of the world, and one where clear action is required”.

The Labour MEPs celebrate that “perfume” and “lipstick” cigarette packaging, which was originally aimed at girls and young women, are to be banned. Glamourising smoking by the packaging shows how industry has targeted young women making them almost 2.1 times more likely than men to take up the habit.

However, should it be an element of education of young people to stop smoking as well as the added publicity of the health risk that goes along with lighting up?

A study conducted by Ash (Action on Smoking and Health) shows that 2012, 31% of young people wish to kick the addiction and 74% of children have tried one or more ways to stop . This then supports the findings that drug education, when interactive and directed at youths, decreases levels of smoking. This then draws up the question: if more compulsory health education surrounded smoking would it stamp out the habit for good?

The ban of flavoured cigarettes is also thought to target the younger spectrum of smokers. This is due to the view that the flavours such as chocolate, vanilla and clove are a “gateway” into an addiction. It is also thought that the flavoured – specifically menthol- are harder to give up therefore creating a more harmful situation.  The NHS and NICE (National Institute for Health and Care Excellence) conducted a study that proved if a young person is exposed to increased levels education on the topic that is supported by a form of mass media; they are less likely to start smoking. That being said, creates a question of whether different varieties of cigarettes need to be banned to prevent young people from smoking? By using an element of Social Learning Theory – where the person learns in a social context – children are then more socially influenced not to smoke creating a view that certain types of cigarettes don’t necessarily need to be banned.

The ban that will be in action as of 2016 plans to see fewer children starting smoking however, despite the health benefits of the ban, many MEPs were concerned about job losses in the industry or whether it would actually decrease the number of children and teens picking up a packet. Phillip Morris Tobacco Company suggests that with the tighter regulations, up to 175,000 people in Europe will be made unemployed and will cause 5 billion Euros in lost tax revenues, going against European Parliaments plans of tackling unemployment.

The soon-to-be ban on menthol cigarettes also disproportionately affects ethnic minority smokers. Just across the pond, the mint flavoured cigarettes are favoured by 80% of the smoking African-American population. Many black advocacy groups have voiced complaints that the European Parliament has not taken the preferences of minority communities into account when writing the legislation.

The legislation that has scrutinized the amount of advertising a company can have on their box to the amount of cigarettes we receive in a pack has created mixed reactions and opinions from many members of the public (and the TCC office!) who may be affected by the tightening of the regulations. However, will we actually see a decrease in youth smoking by taking away the chocolate flavoured cigarette or will the sales of regular cigarette’s increase?

Paige Salvage currently work shadows at TCC. Find more about what we do at the  The Campaign Company here. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

The New Electorate: Why understanding values is the key to electoral success

October 14, 2013

There is no better way to understand the power of the values prism than by exploring the alignment of voting behaviour and values. If the values theory holds water, there should be a clear relationship between core beliefs and voting behaviour. There is.

The New Electorate published by IPPR today, sets out the values electoral map and the challenges each main party faces in building a coalition of support.

Many commentators portray politics as a left right continuum with a centre point. But this cannot explain why, for example, some voters who believe in a more equal distribution of wealth shift from Labour to Ukip.

Using the values prism helps us understand the complete picture. One of the main findings from the analysis is that since 2008 the centre ground has not shifted significantly there are just fewer people on it. More people believe passionately in fairness, more are anxious about social change and crave security and stability and more people think there are too many welfare scroungers. It is therefore harder for any major political party to build a broad-based coalition.

All three main political parties have become astute at chasing Prospectors (the aspirant and pragmatic voter). They all get more support from this values group than you would expect if their support were spread evenly across all values groups. However, in different ways they find it harder to speak to the other two main values groups – Pioneers (focused on society and generally more post materialistic) and Settlers (focused on security, identity and belonging).

The Conservatives have always struggled to reach the Pioneers with the loudest values (those who care most about fairness). After wooing them before the 2010 election with compassionate Conservatism they are now pursuing a strategy based on a tough stance on immigration, welfare and the economy, which is designed to build support among Settlers and Prospectors, but is also pushing many Pioneers away.

During its time in office, Labour lost support among all values groups but they lost most support among Settlers. Today Labour has garnered the support of many former Liberal Democrat Pioneers but still struggles to speak to the Settler.

Who will win the next general election? Quite simply the party that successfully builds a values bridge to the values group where it currently underperform. For Labour this means talking convincingly to the Settler, who have becomes increasingly detached from their old tribal loyalties. Above all Settlers need to be convinced that Labour understands their concerns about immigration and to do this Labour must talk about immigration not just as an economic phenomenon but also as a social and cultural one.

Nick Pecorelli is an Associate Director of The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here

Seaside Towns: can Think Tanks…and Morrissey…be wrong?

August 8, 2013

After a lovely sunny July, many people will have headed to the coast and perhaps even visit a few seaside towns.

However, this week the influential Centre for Social Justice (CSJ) think-tank has punctured that hazy seaside idyll with its report ‘Turning the Tide‘ with case studies of 5 seaside towns and warned that they and other similar places are stuck in a cycle of poverty, ‘suffer severe social breakdown’ and are becoming ‘dumping grounds’ for vulnerable people, which is ‘perpetuating the cycle’ of decline.

Is this inevitable and can the cycle be changed by a greater understanding of behavioural interventions?

It is first of all important to recognise this is not a new thing. I recall talking to Councillors in towns like this in the early 1990’s recession, and this was a well-known problem, with some London Council’s already sending homeless vulnerable people to empty properties in seaside resorts. Even during the boom years I recall a project in a seaside town primary school where 50% of the children had never been to the beach with their parents! It did not take a late 1980’s Morrissey song to tell me that ‘This is the coastal town, that they forgot to close down’ nor this current report either.

What behavioural actions could be taken to tackle repeating cycle of  concentrated low aspiration described by the report?

The report itself makes some big suggestions around school improvement and skills and attracting jobs but these sound very top-down and could take years. The price of housing in the rest of the South East and benefit changes in London could make the ‘dumping ground’ issue even worse in the short-term.

A more localised and rapid approach could perhaps involve the following :

  • Understanding the motivations of people in these areas. Motivations come fromvalues the target groups values tend to bevery different to those of both central and local government officers. This has consequences such as how people connect with others, particular values groups may not connect into the social networks that link to job opportunities or positive life choices (Newham used these techniques to understand resilience)
  • Working on resilience as an asset based approach is a way of providing the support and networks to enhance family and community level willpower to help break the cycle of low aspiration. A strategy such as Newham’s could include:
    • Early intervention
    • Free school meal in primary schools subject to budget availability
    • More intense literacy and reading schemes
    • Musical instrument learning to create an early sense of achievement
    • Greater reciprocity policies that tap into local people’s values and motivations around fairness – for example in the area of currently rationed social housing
  • Develop Co-operative schemes that back a resilience approach such as Oldham Council’s imaginative ‘giving people the tools for the job.’ This is different to Big Society approaches that tend to be characterised as reducing services and then expecting demotivated and demoralised local people to take up the slack for the lost service.  Instead an insight driven, asset based, co-operative and resilience approach provides new ways to deliver targeted and more personalised services to the people who most need it.

This agenda is also a lot less expensive than that suggested in the CSJ report, which might raise expectations, but then fail to deliver on them. At the same time it is also complementary to such a scheme too. Some Council’s are already taking this forward. Perhaps in the Autumn, as the sunshine fades, we may see more adopt this approach?

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

 

Dangerous Dogs: will stronger sanctions work?

August 7, 2013

BBC News yesterday reported that the government has proposed a number of sentencing options for a fatal dog attack – from five years to life. The consultation for those options is here and runs until 1 September 2013.

However the RSPCA – the people who do know something about the subject – said more needed to be done to stop attacks happening in the first place. Their head of public affairs, David Bowles was quoted as saying:

“Unless you solve this problem of people not being able to control their dogs properly then I still think you’re going to see a rise in dog attacks and dog biting,”

TCC has done some pioneering research in the field of dangerous dogs which is summarised here. As the report shows, ‘control of dogs’ may have different meaning to public bodies and to their owners due to differing values. The report also sets out an approach to behaviour change in this area.

The current consultation process will be used to inform recommendations put forward in the Anti-Social Behaviour, Crime and Policing Bill. However there is a danger that legislation will be based on little prior research and the debate will focus just on sanctions and not cover preventative behavioural measures that could also be adopted.

We will be sending the research to the consultation to flag up some of the preventative concerns raised by the RSPCA and hope other organisations also submit similar further insight.

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

111 – what message is it sending?

July 31, 2013

I recently wrote about the challenges faced by the NHS over increasing use of A&E services. The recent controversy over NHS Direct withdrawing from 111 telephone services is likely to send a further message that people are ‘better off heading to A&E.’

We need the insight to understand the values that may motivate people to use these services in the way they do.

When NHS Direct was launched in 1998 it was marketed like a 24 hour consumer based service like a bank. This would have appealed to those with outer directed values.

The 111 service had the potential to appeal to those who hold security and safety values. However all the news coverage will have worried them about the actual ‘safety’ of the service. This will make it harder to persuade people to avoid using A&E when they might not need to.

The A&E Crisis and the recent controversy over 111 telephone services, means the recently launched engagement programme ‘The NHS belongs to the people: a call to action’ should be seeking communicate across values sets to:

  • engage people over their views so those who are keen to be involved;
  • gather real insight into what will motivate people to use a different mix of services;
  • reassure people who will be worried over any changes however non-controversial they might be

Only through a multi-segmented approach to communications, insight and engagement will everyone’s views and motivations be taken into account.

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

The London Olympics – what legacy?

July 31, 2013

Last weekend saw celebrations of the first anniversary of the start of the London Olympics and the question often asked is what impact has this had on better health?

At the time the Olympics were used to encourage take up of healthy physical activity. Figures currently show there has been some decline since last year, though still an improvement from 2005 when London won the bid.

Perhaps the problem has been  defining the improvement? There was a strong perception of some improvement in national well-being and community spirit during the Olympics itself, which has been confirmed by the latest ONS well-being results. There has also been an increase in some forms of activity such as cycling with in London easier access to cycles through the Cycle Hire Scheme which celebrated its third anniversary this week. Should we instead measure from 2005 to 2017 as a recent Lloyd’s Bank report has done?
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Perhaps the most powerful legacy is still in the balance? Everyone at the time commented on the impact of the Gamesmaker volunteers. The post Olympics research showed they illustrated how organisations could make make volunteering work well through:
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A specific, time-limited challenge: Games Makers weren’t asked to sign up as volunteers for ever, just to do their bit to help make this historic event happen and run smoothly..

Playing to strengths: Games Makers were carefully screened and matched to the roles that suited them best and made the most of their skills and personalities…

Something in return: The Games Makers were well briefed, properly trained and kitted out with high-quality tools for the job…Most of all, they were made to feel a vital part of something important, and got the satisfaction of knowing they’d done a job well.

Thus in order to see the whole potential legacy, one needs to be clear about:

  • the time-span one is measuring;
  • measuring the impact on well-being as well as sport participation;
  • and recognise that increasing social capital through connecting people together by volunteering can be as important as the specific sporting participation.

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

A&E Crisis – can we change behaviour?

July 24, 2013

News reports over the last few days have talked of an ‘A&E crisis’  with MPs saying staffing issues and rising attendances were among the main causes of the problems. They state that just 17% of hospitals had the recommended level of consultant cover, while difficulties with discharging patients and a lack of beds at times meant the flow of patients through the system has been disrupted.

Addressing staff issues in acute hospitals or creating more out of hours services to provide more local care at home would be powerful solutions but the costs and arguments over GP contracts could mean either approach might take a long time to resolve before ‘winter pressures’ happen in a few months.

Perhaps a behavioural approach to addressing A&E attendances could be less expensive and implemented more quickly. It may not be a full solution to such a big issue on its own, but along with addressing the other issues above, it might add to the tool-kit for acute providers and GPs

Clearly where paramedics, a GP or a nurse makes a referral that is a clinical judgement. That is not the problem; it is exactly what an A&E is there for. However often the decision to take an elderly person to A&E will be taken by able-bodied adults who are low users of health services and have low knowledge of the condition. They may for example not be used to the symptoms of a diabetic episode or another chronic disease that A&E’s were not really designed for. Naturally people are seeking reassurance and a trip to A&E is perfectly rational in those trying circumstances. However often the visit is unnecessary. The NHS needs additional ‘reassurance’ mechanisms and these able-bodied family members are the key target who need to be engaged with on this issue.

What could be done to address behaviour in this area?

  • Close family relatives of regular A&E attendees could be segmented and engaged with after a visit to hospital. These people not the patients are key determinants of such a visit that may not be clinically determined
  • They could be given a number at the hospital on top of the NHS Direct and 111 numbers they will have. This at the very least alerts the hospital to a potential admission. Fundamentally a reassuring conversation may help a person who is contacting the other numbers to get a further opinion.
  • Feedback should be given to the family member immediately after an unnecessary visit in order for them to learn lessons from it. Lack of feedback often means someone might well bring their relative to the hospital again.
  • Online family networks could be developed so family members could learn more from others in similar situations so they gain a greater understanding before taking a decision to go to A&E
  • GP’s could also develop a better relationship with family members on long-term patients who go to A&E’s, so they again feel better informed

Clearly there are some forms of behaviour change, sometimes applied in less sensitive areas, such as incentives or forms of naming and shaming that would go against the ethics of the NHS that could not be applied here. However a behavioural approach is worth looking at with pilots and randomised control trials conducted to see what worked. The point being this is much more likely to be done quickly rather than wait for relatively slow moves on staff reconfiguration or GP contracts to change

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

Power, Organisation and Values

July 5, 2013

Matthew Taylor of the RSA spoke at the Local Government Association (LGA) conference  – which The Campaign Company (TCC) attended this week – on the issue of different types of social power. He said:

Defined simply, power is the capacity to achieve desired objectives. It can be expressed in various ways: through coercion, explicit persuasion or an ability to shape norms and assumptions.

He was reiterating the definitions he came up with at his RSA Annual lecture last year. Taylor defined three sources of social power, hierarchy in authority, individual aspiration and social solidarity. These three types also correspond to the three mains forms of social organisation: Hierarchies, Markets and Networks. Taylor indicated those three forms of power have different directions of engagement too:

First, the downward power of hierarchical authority associated most strongly with the state. Second, the lateral power of solidarity and shared values generally associated with the idea of community. Third, the upward power of individual aspirations, which tends to be associated with markets.

Taylor has also set out the challenges they face:

  • Hierarchy in authority is all those people who think they can tell us what to do and the frameworks that compel people to conform. However levels of Trust are lower. Society is much less deferential than it used to be. Technology has also now strengthened the individual against the hierarchy.
  • Individual Aspiration is a will to achieve and is all about individualism. However the relatively recent rise of this has created a vacuum, and led to society being perceived as more narrow and materialistic. This approach to power nowadays stuggles to justify the myth of ‘homo economicus’ – that we are all maximising utilisers – which has been comprehensively rebutted by behavioural economics.
  • Social solidarity is about our responsibilities to each other. However there is also a decline in ‘congregational institutions’, such as political parties and trade unions. Social diversity has been partly implicated, possibly due to mobility. We have to trust and like people very different to ourselves. We have also seen the fracturing of class  and there is also the rise of the super-rich.

Taylor argues that the way to address complex social problems is to bring all these approaches to power together. He argues we live in a society where we are not producing solutions which mobilise all this power. For example why is social mobility the answer to solving inequality, as it does not address injustice or lack of inclusivity? Taylor says that where we do not use all forms of power, we risk failure:

Wicked problems are, by definition, tough and multifaceted, so we need to draw on all forms of social power to tackle them. When progress seems impossible, we revert to a fourth way of thinking about power and change: fatalism.

Reading this set of definitions I was struck by the similarity with values segmentation:

  • Hierarchy in Authority has similarities with safety and security driven values
  • Individual Aspiration is similar to outer directed values
  • Social solidarity has a lot of similarities with networked inner directed values

As we have argued before on the development of local social capital, and through our recent research for Newham Council, this is no surprise to us as forms of social organisation do seem to impact on values. We already seem to see the interplay between values and social networks and other forms of social organisation. We would expect power relations to do this too and be influenced by values in turn

Perhaps Matthew Taylor’s key insight here is that we need collaboration between:

  • all 3 types of social power;
  • all 3 forms of social organisation;
  • those who hold differing values across the 3 mains values sets;

in order for us to seriously address big societal problems.

However TCC knows from its work that often a Values Gap prevents that from effectively happening. For example the values of a public sector organisation making it difficult to engage with the very different values held by many of its residents.

Perhaps in order to start addressing big societal problems we first need an asset based approach to map communities for their power relations, social organisations/networks and also their values.

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.

Nick Pecorelli presenting on how Values can improve Council communications with residents

February 11, 2013

On Sunday morning TCC’s Nick Pecorelli gave a presentation on how Values can improve local government communications and how they can also be applied at a local level.

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The Conference was organised by the Local Government Association Labour Group and details of the reaction to the presentation can be viewed at the Twitter Hashtag: #LocalLab13

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Speaking after the event, Nick said, “It was a pleasure to be able to contribute to the discussions and judging by the feedback, both at and after the event and online it seemed to be appreciated by attendees”.

We are grateful to Councillor Ian Beckett and Theresa Vaughan for permission to reproduce these photographs in this blog posting

Charlie Mansell is Research and Development Officer for The Campaign Company. If you want to see what your own primary values set is, why not take the simple Values Questionnaire here.