About this guidance

What does this guidance cover?

In 2007, the Department of Health (DH) asked the National Institute for Health and Clinical Excellence, now known as the National Institute for Health and Care Excellence (NICE) to produce guidance on the principles for effective behaviour change.

Following a review of the guidance in 2010, NICE decided to wait for the conclusions of the House of Lords Science and Technology Select Committee's inquiry on a range of factors that impact on behaviour change, before making a decision to update the guidance. Following publication of the report (House of Lords 2011), NICE decided to extend the original guidance to cover recommendations about individual interventions for behaviour change.

This guidance does not cover:

The absence of any recommendations on interventions that fall within the scope of this guidance is a result of a lack of evidence. It should not be taken as a judgement on whether these interventions are effective or cost effective.

How was this guidance developed?

The recommendations are based on the best available evidence. They were developed by the Programme Development Group (PDG).

Members of the PDG are listed in Membership of the Programme Development Group and the NICE project team.

For information on how NICE public health guidance is developed, see the NICE public health guidance process and methods guides.

What evidence is the guidance based on?

The evidence that the PDG considered included:

  • Evidence reviews:

    • Review 1: 'Individual-level behaviour change: review of current NICE guidance and recommendations' was carried out by Bazian Ltd and University College London. The principal authors were: Rob Davies, Joelle Kirby, Alan Lovell, Alicia White, Rob Cook and Benjamin Gardner.

    • Review 2: 'Individual-level behaviour change: review of evidence of effectiveness of interventions and behaviour change techniques in individual level interventions' was carried out by Bazian Ltd and University College London. The principal authors were: Sarah Caton, Alicia White, Craig Whittington, Alan Lovell, Joelle Kirby, Elly O'Brien, Anelia Boshnakova, Alex McAleenan, Alex Lipman, Benjamin Gardner and Rob Cook.

    • Review 3: 'Individual-level behaviour change: A qualitative review of studies describing the skills base needed to deliver behaviour change interventions or techniques' was carried out by Bazian Ltd, University of Southampton and University College London. The principal authors were: Kath Barnard, Rob Cook, Alan Lovell, Joelle Kirby, Alicia White and Benjamin Gardner.

  • Reviews of economic evaluations:

    • Review 1: 'Behaviour change update: stage 1. Behaviour change technique (BCT) analysis of existing, cost-effective interventions' was carried out by University College, London. The principal authors were: Lion Shahab, Emma Beard and Benjamin Gardner.

    • Review 2: 'Behaviour change update: stage 3. BCT analysis of behaviour change interventions reported in studies of cost effectiveness' was carried out by University College, London. The principal authors were: Lion Shahab, Fabi Lorencatto and Emma Beard.

  • Expert papers:

    • Expert paper 1 'Behaviour change – identifying effective elements of behaviour change interventions' by Charles Abraham, University of Exeter.

    • Expert paper 2 'Mechanisms and processes of behaviour change' by Ray Pawson, University of Leeds.

    • Expert paper 3 'Behaviour change and addiction' by Robert West, University College, London.

    • Expert paper 4 'Behaviour change – policy and context' by Laura Haynes, Cabinet Office.

    • Expert paper 5 'Behaviour change – implementation and maintenance' by Colin Greaves, University of Exeter.

    • Expert paper 6 'Behaviour change – complex and multiple health-related behaviours' by David Buck, The King's Fund.

    • Expert paper 7 'Behaviour change – local authorities and public health' by Alan Higgins, Oldham Council and Rachel Flowers, Newham Council.

    • Expert paper 8 'Behaviour change: choice architecture, economic environment and the ethics/acceptability of such techniques' by Theresa Marteau, Behaviour and Health Research Unit.

    • Expert paper 9 'Behaviour change – Complex and multiple interventions' by Rona Campbell, University of Bristol.

    • Expert paper 10 'Behaviour change – evidence into practice' by Deryn Bishop, The Training Tree.

    • Expert paper 11 'Behaviour change qualifications' by Diana Moss, Royal Society of Public Health.

    • Expert paper 12 'Behaviour change competencies' by Diane Dixon, University of Strathclyde.

    • Expert paper 13 'Behaviour change – policy and context' by Jessica Allen, University College, London.

    • Expert paper 14 'Evidence of effectiveness of specific behaviour change techniques' by Susan Michie, University College, London.

In some cases the evidence was insufficient and the PDG has made recommendations for future research. For the research recommendations and gaps in research, see Recommendations for research and Gaps in the evidence respectively.

Status of this guidance

The draft guidance, including the recommendations, was released for consultation in July 2013. At its meeting in September 2013, the PDG amended the guidance in light of comments from stakeholders and experts and the fieldwork. The guidance was signed off by the NICE Guidance Executive in December 2013.

The guidance complements but does not replace NICE guidance on behaviour change, alcohol use, eating patterns, physical activity, sexual behaviour, smoking and other guidance concerned with changing people's knowledge, attitudes and behaviours to prevent and tackle disease and illness. (For further details, see section 7).

The recommendations should be read in conjunction with these existing topic-specific NICE guidance unless explicitly stated otherwise.

The guidance is available on NICE's website. The recommendations are also available in a pathway for professionals whose remit includes public health and for interested members of the public.

NICE produces guidance, standards and information on commissioning and providing high-quality healthcare, social care, and public health services. We have agreements to provide certain NICE services to Wales, Scotland and Northern Ireland. Decisions on how NICE guidance and other products apply in those countries are made by ministers in the Welsh government, Scottish government, and Northern Ireland Executive. NICE guidance or other products may include references to organisations or people responsible for commissioning or providing care that may be relevant only to England.

Implementation

NICE guidance can help:

NICE has developed tools to help organisations put this guidance into practice.

Updating the recommendations

This guidance will be reviewed 3 years after publication to determine whether all or part of it should be updated. Information on the progress of any update will be posted at the NICE website.

Your responsibility

This guidance represents the views of the Institute and was arrived at after careful consideration of the evidence available. Those working in the NHS, local authorities, the wider public, voluntary and community sectors and the private sector should take it into account when carrying out their professional, managerial or voluntary duties.

Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties.

Changes after publication

January 2015: minor maintenance.

Copyright

© National Institute for Health and Care Excellence 2014. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE.

ISBN 978-1-4731-0374-0

  • National Institute for Health and Care Excellence (NICE)