4 minute read
Changing behaviour the healthcare way
Deep down, we’re creatures of habit. But the kinds of messaging we use can help shape these habits – and create more useful ones.
BY ANNIQUE SIMPSON
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Few public incidents have united PR professionals in amusement and bemusement more than the UK government’s messaging on COVID-19.
Conflicting instructions; counterintuitive colour choices; confusing phrases and categories – the list of comms faux pas from No. 10 are enough to have even the hardiest industry expert running for the hills.
But PR folk aren’t alone in their frustrations. Social psychologist Stephen Reicher went viral on Twitter last May after accusing the government of ignoring the advice of its own behavioural science advisory group, SPI-B.
If No. 10 is indeed refusing to listen to Professor Reicher and his SPI-B peers, it’s missing a trick. When it comes to changing behaviour, the predictive power of behavioural sciences like health psychology are arguably unmatched.
But what do the scientists recommend?
A LITTLE NUDGE GOES A LONG WAY
According to nudge theorists Richard Thaler and Cass Sunstein, humans sometimes need protecting from our propensity to make poor, self-harming decisions. By subtly manipulating our decision-making environment, governments and organisations can ‘nudge’ us towards the most personally beneficial option without blocking the other choices.
Message framing nudges have long captured the attention of health psychologists, with messages focusing on the positive features (or gains) of a target health behaviour being shown to be highly persuasive.
For example, a 2018 study found that more people used a hospital hand sanitiser dispenser when it was next to a poster with the gain-framed message “40 per cent more hand hygiene, 40 per cent less hospital infections”.
According to theorists, gain-framed appeals are most effective for encouraging behaviours which lower our risk of ill health, like condom use and cleaning our hands. As humans tend to be risk-averse, especially when thinking about gains, we’re more likely to adopt these low-risk health behaviours after reading positivelyframed messages.
Our desire to seek risks is thought to increase when we think about potential losses. Loss-framed messages have been shown to be more effective than gainframed messages for promoting health behaviours which come with a high risk of revealing health problems, like breast self-examinations.
HELP CREATE SELF-HYPE
When Dorothy Gale urged Scarecrow, Tin Man and Cowardly Lion to “believe in yourself” in the 1978 film The Wiz, she probably wasn’t thinking about health psychology. But the power of self-efficacy, defined as a strong belief in one’s ability to perform well in difficult circumstances, is as true for changing health behaviours as it is for locating a brain, a heart and the nerve.
According to social cognitive theory, self-efficacy drives behavioural change in several ways. It motivates people to solve their problems; to feel more committed to their decisions; to expect positive outcomes from their actions and to spot supporting opportunities in their environment.
Four factors are thought to boost selfefficacy, including verbal persuasion, which involves listening to stories of how others like you have successfully met similar challenges and being reminded of your own skills and past successes.
Sport England’s This Girl Can campaign is a great example of self-efficacy in action. The initiative harnesses the power of verbal persuasion – from its videos showcasing everyday women beating their exercise demons to its poster app which allows women to star in their own This Girl Can campaign.
Since launching in 2015, the multiaward-winning initiative has convinced over 2 million women to get more active. A 2018 study found a positive link between the campaign’s content and participants’ intention to exercise. The researchers attributed their findings to the campaign’s use of “non-idealised depictions of women exercising”, hinting at the importance of self-efficacy principles in the campaign’s success.
HARNESS THE POWER OF INFLUENCE
As social creatures, our behaviour is largely influenced by our interactions with others. So it’s no surprise that psychologists have spent the past 70 years trying to understand how and why social influence happens.
Conformity, one of the more common forms of social influence, occurs when a person changes their behaviour to fit in with the majority group because of real or imagined pressure from others.
This can happen in one of two ways. With normative social influence, conformity is driven by a desire to be liked and accepted. We go along with informal or formal social rules to avoid being rejected by the majority.
Informational social influence is our tendency to look to others who we believe to be better informed about a present situation for guidance on what to do. We tend to default to experts during times of uncertainty or during a crisis. However, their influence diminishes if we deem them to be untrustworthy or incompetent — something that Prime Minister Boris Johnson knows all too well. After the story of his former advisor Dominic Cummings’ alleged lockdown breach broke in May, public confidence in the government’s handling of the pandemic dropped by 0.5 points. There was also a similar decline in reported compliance with government guidelines.
The legacy of Cummings-gate appears to live on, with 47 per cent of people citing the lack of government officials following the rules as a reason to personally ignore them, in an Ipsos MORI poll published last October.
But all may not be lost. According to scientific advisory group Independent SAGE, which counts Professor Stephen Reicher as a member, the government can boost public compliance and confidence by switching to precise, evidence-based messaging.
And with such sound advice, it’s not only No. 10 who could stand to benefit from listening to what behavioural scientists have to say.
