Advice

Introduction

Introduction

June 2015: This briefing is an update of NICE's local government briefing on behaviour change published in January 2013. It is based on 2 NICE guidelines: Behaviour change: the principles for effective interventions (PH6) and Behaviour change: individual approaches (PH49).

This briefing summarises NICE's recommendations for local authorities and partner organisations on commissioning, planning, delivering and evaluating initiatives to support behaviour change at the individual, community and population level (see table 1). It is particularly aimed at health and wellbeing boards.

Behaviour change interventions are coordinated sets of activities that seek to change specific behaviours.

This briefing focuses on health‑related behaviour change. However, the principles may be useful for other local authority services, not just public health. For example, they may help when planning interventions or services to encourage:

  • students to attend school

  • people not to drop litter

  • recycling.

All the recommendations can be found in the relevant NICE pathways.

Key messages

Chronic diseases such as cardiovascular disease, cancer, respiratory disease and diabetes are a major cause of death and disability. Along with some forms of dementia, they can be closely linked to behaviours and lifestyle factors that can be changed. Examples include: smoking, having an unhealthy diet, doing little physical activity, being overweight, taking part in risky sexual behaviour or alcohol misuse.

People in the poorest communities are more likely than others to live with at least 1 – and often several – of these risk factors and each of these risk factors, in turn, is associated with a number of health conditions. So changing 1 or more of the behaviours involved will help people significantly reduce their risk of illness and help reduce health inequalities. It will also help reduce premature deaths and disability – and the associated costs in terms of healthcare, social care and welfare benefits, so leading to long‑term savings.

Behaviour is influenced by a range of socio‑economic, cultural and environmental conditions, social and community networks and individual factors such as age and sex. So a combination of interventions that tackle population, community and individual‑level factors are needed to help people change their behaviour in the longer term. The following can also help:

  • Using evidence‑based principles and behaviour change techniques (the smallest 'active' component of an intervention designed to change behaviour).

  • Having a theoretical basis for interventions. This also helps in understanding why an intervention is effective or not (see Complex interventions guidance Medical Research Council).

The best quality evidence can be found in well‑conducted evaluation studies and randomised controlled trials with minimal bias. Anecdotal evidence and smaller or poorly conducted studies should not be used as a sole basis for investment decisions. See our local government briefing Using evidence in practice for additional information on assessing evidence.

The National Institute for Health and Care Excellence (NICE) is an independent organisation providing guidance and advice to improve health and social care.

For further information on how to use this briefing and how it was developed, see about this briefing.