3 Recommendations

3 Recommendations

This document is the Institute's formal guidance on generic principles that should be used as the basis of initiatives to support attitude and behaviour change. When developing the principles the Programme Development Group (PDG; see appendix A) considered the evidence of effectiveness (including cost effectiveness), relevant theory, fieldwork data and comments from stakeholders.

The reviews that informed this guidance are listed in appendix B. The evidence reviews, supporting evidence statements and economic appraisal are available.

Key theories, concepts, and other evidence that informed this guidance are listed in appendix C.

On the basis of the evidence considered, the PDG believes that where interventions and programmes are applied appropriately, according to the principles outlined in this guidance and in conjunction with other topic-specific NICE guidance, then they are likely be cost effective. In some circumstances, they will save money.

See also the recommendations for research and other gaps in the evidence.

The guidance highlights the need to:

  • Plan carefully interventions and programmes aimed at changing behaviour, taking into account the local and national context and working in partnership with recipients. Interventions and programmes should be based on a sound knowledge of community needs and should build upon the existing skills and resources within a community.

  • Equip practitioners with the necessary competencies and skills to support behaviour change, using evidence-based tools. (Education providers should ensure courses for practitioners are based on theoretically informed, evidence-based best practice.)

  • Evaluate all behaviour change interventions and programmes, either locally or as part of a larger project. Wherever possible, evaluation should include an economic component.


Principle 1: planning interventions and programmes

See recommendations 1 to 6 in NICE's guideline on behaviour change: individual approaches for guidance on developing local strategies and commissioning and planning behaviour change programmes.

Principle 2: assessing social context

Target audience

NHS and non-NHS policy makers and commissioners planning behaviour change interventions or programmes for communities or populations, especially disadvantaged or excluded groups.

Principle 3: education and training

Target audience

Policy makers, commissioners, trainers, service providers, curriculum developers and practitioners.


Principle 4: individual-level interventions and programmes

Target audience

Commissioners, service providers and practitioners working with individuals.

Principle 5: community-level interventions and programmes

Target audience

NHS and non-NHS policy makers and commissioners planning behaviour change interventions and programmes for communities or subgroups in the population.

Principle 6: population-level interventions and programmes

Target audience

National policy makers, commissioners and others whose work impacts on population-level health-related behaviour.


Principle 7: evaluating effectiveness

Target audience

Researchers, policy makers, commissioners, service providers and practitioners whose work impacts on, or who wish to change, people's health-related behaviour.

Principle 8: assessing cost effectiveness

Target audience

Policy makers, research funders, researchers and health economists.