APPENDIX 3: CALLS FOR EVIDENCE
The House of Lords Science and Technology Select
Committee has appointed a sub-committee, chaired by Baroness Neuberger,
to investigate the use of behaviour change interventions to achieve
policy goals.
Introduction
To meet many of the societal challenges we are currently
facing—such as achieving an 80% reduction in carbon emissions
by 2050 or reducing the burden on the health service as a result
of smoking, drinking or the rise in obesity—individual and
collective behaviour will need to change significantly. Governments,
therefore, are becoming increasingly interested in understanding
how they can influence the way we behave using a range of different
types of behaviour change policy interventions that rely on measures
other than prohibition or the elimination of choice. Recent reports,
such as the Cabinet Office issue paper Personal Responsibility
and Behaviour Change (2003), the Government Social Research
Unit's Behaviour Change Knowledge Review (2008) and the
Cabinet Office and Institute for Government report MINDSPACE:
Influencing behaviour through public policy (2010), are indicative
of this growing interest.
The subject is complex. Choosing a behaviour change
intervention or a mix of interventions to achieve particular policy
goals in particular contexts draws on understanding developed
in a large variety of research disciplines, including health psychology,
social psychology, behavioural economics, neuroscience and sociology.
The insights provided by the development and application of social
marketing techniques also make a valuable contribution.
Some behaviour change interventions are recognised
as having been very successful. A recent review of more than 1,000
evaluations of health behaviour change interventions has shown
that theory- and evidence-based behaviour change interventions
can be effective across a range of behaviour change domains. In
relation to smoking, for example, the simultaneous application
of a number of different types of interventions, including a ban
on smoking in public, marketing campaigns to highlight the dangers
of smoking and improved and better advertised smoking cessation
services within the National health Service is said to have led
to a significant reduction in the number of smokers over the last
few years. Other interventions, such as efforts to reduce alcohol
misuse, have been less successful. We shall be examining, amongst
other things, what appears to make one intervention more effective
than another.
Scope of the inquiry
The inquiry will examine our current state of knowledge
about what interventions can effectively influence behaviour,
how behaviour change interventions which have been designed on
the basis of that knowledge can be used to achieve policy goals,
and what factors should be taken into account by government in
determining whether a particular behaviour change intervention
is appropriate. It will look at the evidence-base that supports
current behaviour change interventions and at the effectiveness
of those interventions.
In particular, the inquiry seeks to examine:
- the policy implications of recent
developments in research on behaviour change;
- whether current government behaviour change interventions
are evidence-based, whether such interventions are appropriately
evaluated, and if lessons have been learnt from the process and
then applied to further interventions;
- whether there is sufficient expertise within
public services (for example, local authorities and the NHS) to
ensure that interventions are evidence-based, and implemented
and evaluated effectively;
- the extent to which behaviour change interventions
require a mixture of different tools to succeed;
- how behaviour change interventions and activities
are coordinated across government and beyond;
- the extent to which, and ways in which, government
should be accountable to, or engage with, the wider public about
the use of behaviour change policy interventions;
- the role of industry and the voluntary sector
in shaping behaviour patterns;
- the relationship between government, industry
and the voluntary sector in promoting behaviour change to achieve
policy goals; finally,
- the social and ethical issues surrounding the
use of behaviour change interventions by government.
Case study 1: Tackling obesity
The Committee will conduct two case studies as part
of the wider inquiry. The first case study will look at the use
of behaviour change policy interventions to tackle obesity. Obesity
remains a major challenge for society. In 2008, almost a quarter
of adults in England were classified as obese; and 16.8% of boys
aged 2 to 15 and 15.2% of girls were also classified as obese,
an increase from 11.1% and 12.2% respectively in 1995.[343]
A 2007 Foresight report on obesity, Tackling Obesities:
Future Choices, called for a systems approach to behaviour
change interventions to tackle obesity and, in 2008, the Government
launched Healthy weight: healthy lives, a cross-government
strategy for England which introduced a number of interventions.
Nonetheless, prevalence rates amongst some childhood and adolescent
groups and adults continue to rise. These trends predict worsening
public health, increased pressure on the health service and a
very large cost to the national economy.
Questions
Research and Development
1. What is known about how behaviour can be influenced?
What special considerations apply to addictive behaviour?
2. What are the policy implications of recent developments
in research on behaviour change?
3. Is there adequate research capability within the
United Kingdom to support the current pace of developments in
behaviour change policy interventions? Is there sufficient funding
for the evaluation of behaviour change interventions?
Translation
4. Are there adequate structures and expertise across
government and the public services more generally to support the
translation of research developments in behaviour change into
policy interventions?
Policy design and evaluation
General
5. What should be classified as a behaviour change
intervention?
6. How should different levels of intervention (individual,
organisational, community and national) and different types of
intervention (legislative, fiscal, educative) interact in order
to achieve policy goals more effectively?
7. Should behaviour change interventions be used
in isolation or in combination with other policy interventions?
Practical application
8. Have publicly funded behaviour change interventions
been both evidence-based and subject to effective evaluation?
How successful have such interventions been?
9. Within government, how are the lessons learnt
from the success or lack of success of behaviour change interventions
fed back into the design of future interventions? Are lessons
learned from industry and voluntary sector behaviour change activities
also taken into account?
10. What mechanisms exist, at national and local
government level, to provide advice and support during the design,
piloting, implementation and evaluation of behaviour change interventions
in order to ensure that they achieve intended policy goals and
also cultural changes within government and public services more
generally?
Cross-government coordination
11. What mechanisms exist within government to coordinate
and implement cross-departmental behaviour change policy interventions?
12. What mechanisms exist within government to cascade
learning and best practice on behaviour change policy interventions?
Ethical considerations
13. When is it appropriate for the state to intervene
to influence the behaviour of members of the public and how does
this differ from when it is appropriate for the commercial or
voluntary sector to intervene? In particular, when should this
be done by outright prohibition and when by measures to encourage
behaviour change? Are some methods of producing behaviour change
unacceptable? Which and why?
14. Should the public be involved in the design and
implementation of behaviour change policy interventions and, if
so, how? Should proposed measures for securing behaviour change
be subject to public engagement exercises or consultation? Should
they be piloted? Do considerations differ in the case of interventions
aimed at changing addictive behaviour?
International comparisons
15. What lessons can be learnt from previous successful
or unsuccessful behaviour change interventions in other countries?
Which countries provide the most helpful examples of best practice?
Are behavioural change interventions generally transferable between
different societies?
Tackling Obesity
16. The Committee would particularly welcome submissions
on behaviour change interventions, whether in the public sector,
the private sector or by voluntary organisations, designed to
tackle obesity, in the United Kingdom or internationally, in order
to examine:
(a) the latest developments in the evidence-base
in relation to changing eating and physical activity behaviour;
(b) who are the most effective agents for the
delivery of behaviour interventions to tackle obesity;
(c) how current behaviour change interventions
tackle obesity and what use is made of available scientific evidence;
(d) whether such interventions are appropriately
designed and evaluated; and
(e) what lessons have been learnt and applied
as a result of the evaluation process.
The Committee would also be interested to hear about
any other issues not already covered by this call for evidence
that are relevant to the scope of the inquiry.
Case study 2: Travel-Mode choice interventions to
reduce car use in towns and cities
Greenhouse gas emissions from transport represent
21% of the total United Kingdom domestic emissions. Emissions
from private car use constitute 78% of that figure, representing
17% of total emissions or 91.5 million tonnes of CO2
in 2008. Although technological measures are important in reducing
emissions and may be effective in the long-term they are not sufficient
to achieve the necessary reduction in carbon emissions in the
short-term. Getting individuals to reduce the amount that they
use their cars is necessary if the UK's carbon reduction targets
are to be met successfully.
Behaviour change interventions to encourage people
to travel more sustainably have become an integral part of transport
policies in recent years, featuring in the previous Government's
Low Carbon Transport Strategy of 2009. To date, however,
such interventions do not appear to have led to a major change
in transport mode choice, or a significant reduction in CO2
emissions from transport.
The Committee invites evidence on the following questions
Questions
17. The Committee would welcome submissions on behaviour
change interventions, whether in the public sector, the private
sector or by voluntary organisations, designed to change travel-mode
choice in order to reduce car use in towns and cities, in the
United Kingdom or internationally, in order to examine:
(a) what are the most influential drivers of
behaviour affecting an individual's choice of mode of travel;
(b) what is the role of infrastructure in encouraging
and facilitating changes in travel-mode choice;
(c) what are the latest developments in the evidence-base
in relation to changing travel-mode choice and the implications
of those developments for policy;
(d) what are the most appropriate type and level
of interventions to change travel-mode choice;
(e) who are the most effective agents for the
delivery of behaviour interventions to change travel-mode choice;
(f) how do current behaviour change interventions
seek to change travel-mode choice and what use is made of available
scientific evidence;
(g) are current policy interventions addressing
both psychological and environmental barriers to change;
(h) are policy interventions appropriately designed
and evaluated;
(i) what lessons have been learnt and applied
as a result of the evaluation of policy; and
(j) what lessons can be learnt from interventions
employed in other countries.
The Committee would also be interested to receive
evidence on the broader scope and questions outlined in the first
call for evidence, where it is of relevance to this case study.
343 Statistics on obesity, physical activity and
diet: England 2010, The Information Centre for Health and
Social Care, NHS. Back
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