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Behaviour change interventions: getting in touch with individual differences, values and emotions

Published online by Cambridge University Press:  28 July 2020

Sofia Strömmer*
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Wendy Lawrence
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sarah Shaw
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sara Correia Simao
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sarah Jenner
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
Millie Barrett
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Christina Vogel
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Polly Hardy-Johnson
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
David Farrell
Affiliation:
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Glasgow, UK
Kathryn Woods-Townsend
Affiliation:
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
Janis Baird
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Leanne Morrison
Affiliation:
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Centre for Clinical and Community Applications of Health Psychology, Southampton, UK School of Primary Care, Population Health and Medical Education, Southampton, UK
Deborah M. Sloboda
Affiliation:
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada L8S 4K1
Hazel Inskip
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Mary Barker
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
*
Address for correspondence: Sofia Strömmer, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, SouthamptonSO16 6YD, UK. Email: ss3@mrc.soton.ac.uk

Abstract

Systematic reviews and meta-analyses suggest that behaviour change interventions have modest effect sizes, struggle to demonstrate effect in the long term and that there is high heterogeneity between studies. Such interventions take huge effort to design and run for relatively small returns in terms of changes to behaviour.

So why do behaviour change interventions not work and how can we make them more effective? This article offers some ideas about what may underpin the failure of behaviour change interventions. We propose three main reasons that may explain why our current methods of conducting behaviour change interventions struggle to achieve the changes we expect: 1) our current model for testing the efficacy or effectiveness of interventions tends to a mean effect size. This ignores individual differences in response to interventions; 2) our interventions tend to assume that everyone values health in the way we do as health professionals; and 3) the great majority of our interventions focus on addressing cognitions as mechanisms of change. We appeal to people’s logic and rationality rather than recognising that much of what we do and how we behave, including our health behaviours, is governed as much by how we feel and how engaged we are emotionally as it is with what we plan and intend to do.

Drawing on our team’s experience of developing multiple interventions to promote and support health behaviour change with a variety of populations in different global contexts, this article explores strategies with potential to address these issues.

Type
Review
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with the International Society for Developmental Origins of Health and Disease

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