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Six common mistakes related to health behavior!

It is important to stop the actions that spring out from the negative thoughts during the lockdown and keep ourselves engaged in activities. Do not let the lockdown knock you down. It is for our safety alone and not to take away our freedom of movement.

The six common mistakes made by the policymakers have so far only gone downhill preventing the successful implementation of health-related changes in the country!

 

Highlights:

  • We argue that the extensive body of evidence of how to bring about behaviour change is consistently ignored.
  • The automatic and reflective systems described in psychology and social practice theory described in sociology are particularly important new areas for developing ideas about behaviour change.

 

Common sense is not so common!

By common sense we mean the idea that understanding human behaviour is so obvious that it needs little or no serious thought. The appeal to common sense is, we suggest, deliberately anti-intellectual and anti-scientific. Facts spread by the so-called experts coming from renowned universities and academics.

So, Jane Ellison, Minister for Public Health, explained in parliament that the Change4Life social marketing campaign, run by Public Health England, encourages individuals to make simple changes. ‘The campaign is trying to talk to people in a language that makes it straightforward and easy for them to understand the good choices they can make for the health of both themselves and their family.’

 

Conveying the message as is.

Response to stimulus. This is a common go-to psychological behaviour we humans have and that is fine. So, the notion that response to messages says all there is to say about behaviour change is very wide of the mark. Commercial advertising is one of the common examples to study the change in behaviour here.

Commercial advertising campaigns have a variety of aims and changing immediate purchasing behaviour is only one of them. They are also designed to raise awareness, to keep a company in the consumers’ eye, to highlight new products, and the changes in the amount of market share which follow these campaigns tend to be modest – certainly not of the order of magnitude required to reverse the epidemics of type 2 diabetes, obesity and alcohol misuse.

Moreover, the highly sophisticated ways in which products as different as car insurance and chocolate are advertised belies the notion that it is simply a response to a simple message.

 

The role of information

There is another related common mistake of which the behavioural science literature warns the unwary. This is to privilege the role of information from expert sources as a driver of behaviour change.

It borrows from traditional medical models of the doctor-patient relationship, the basis of which is that patients have an information deficit and come to see medical practitioners to consult them for their expertise to remedy their deficiency in knowledge and understanding.

In return, they get information in the form of a diagnosis from which treatment proceeds. This is a model that works pretty well for patients with acute conditions. It tends to work less well for the chronic conditions that are the great contemporary medical challenge and where patients often have very high degrees of information and expertise and is even less effective in the realm of the prevention by way of changing behaviour.

This fundamental belief about the role of information and knowledge in judging the behaviour is wrong and unscientific. Giving people information does not change them. In the course of the research with services providers, young women and more, as we know that they and their families should be eating a healthy diet with more fruit and vegetables. What they say is that a host of other things in life get in the way of them doing this.

 

People tend to behave rationally

The rational behaviour is a result of perceiving the evidence provided by the health providers, doctors and thus there are changes that are likely co-ordinated with actions.

However, this is not a long-standing agenda as people who think rationally consider economic utility theory.

The idea of economic utility theory is that the driving force of human behaviour is that people seek to maximise their pleasure or their gains and profits and to minimise their pains, losses and costs. The formal theory was called the subjective expected utility model.

The standard way of implementing such models in the case of health-related behaviour change was to emphasise health threats (losses or pains) and ways of protecting oneself from those threats by changing a habit. That can include a 21-day rule and certainly stepping outpost our lockdown in their respective countries can make it essentially difficult tread with work and life balance amidst the pandemic.

Since the first models appeared there have been many others built on the same basic utility maximisation principle including the theory of planned behaviour, protection motivation theory, the health action process approach and stages of change.

Because these theories chime so well with the individualistic conceptions of human behaviour embedded in Western culture in which self-interested actors ‘obviously’ maximise gains and minimise costs, they have enjoyed great popularity in spite of having achieved very limited success.

Even where people are in possession of the information behaviour change can be very difficult. So, we know that most smokers want to quit and that many people are permanently dieting in order to lose weight. But most smokers do not quit at least straight away and successful quitting takes multiple attempts. Most diets fail, not because people do not know what is supposedly good for them, but because knowledge and its rational assessment alone do not drive behaviour.

 

People tend to behave irrationally

However, neither is the converse true. If people do not act rationally all the time, neither are they always irrational. When someone with asthma refuses to stop smoking, we might regard them as very foolish or addicted or both. But what we tend not to see is that this may not be so irrational a decision after all given their lives and experiences. People have their own reasons for doing things. Behaviours that persist tend to be functional for people.

In their context, smoking was therefore not an irrational thing to do. There is a considerable literature which has examined health behaviours from the point of view of the actors involved.

Whether this is about the choice of food, decisions about breastfeeding or walking and cycling it shows that one person’s rationality is another’s irrationality. It is arrogant to assume that people consume alcohol, chocolate, or cream cakes because they are irrational or are simply behaving thoughtlessly or stupidly.

 

Accurate proactiveness and prevention!

And lastly, though we have made great strides in identifying key factors which shape behaviour and in what works in changing behaviour, it is still very difficult to conclude an individual’s behaviour. People will behave differently in any given situation. In even the most careful of our models, a great deal of variance in individual behavioural outcomes remains.

Prediction of an individual’s behaviour and predicting accurately what changes will flow from a specific stimulus are limited to a small number of highly automatic responses and to relatively short time frames. At a population level, patterns of common behaviours may be observed and the outcome of those behaviours can be seen vividly in, for example, patterns of health inequalities, tobacco and alcohol consumption and trends in these over time and place.

Important research is presently underway to elucidate mechanisms much more precisely. It remains to be seen whether, when this becomes available, it will stop policymakers falling back on platitudes about ‘getting people to change their behaviour’.

 

 

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