\n
The COM B model can be applied to influence behaviours in several ways including starting a novel behaviour, stopping a behaviour, and increasing or decreasing a behaviour.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow do we give public heath staff COM-B to use COM-B in work? (Getting service leaders\/teams to invest in BeSci when they\u2019re so busy firefighting)<\/strong><\/summary>\n
The COM B model can help in considering what staff might need to apply behavioural science in practice:<\/em><\/p>\n\n\n\n<\/p>\n\n\n\nThe Behavioural Science Unit, in collaboration with experts at the University of Bangor, have recently undertaken some work to explore the factors influencing the application of behavioural science across Wales using the COM B model as a framework. A report summarising the methods, key findings and recommendations will be published in June 2023.<\/em><\/figcaption><\/figure>\n<\/div><\/details><\/div>\n\n\n\nAt what stage do you conduct a systematic review of effective interventions to guide the intervention development?<\/strong><\/summary>\n
Systematic reviews of the literature can be completed at anytime throughout the process. For example, you may want to carry out a review to identify specific factors potentially influencing the behaviour(s) of interest when you\u2019re completing your behavioural diagnosis. If you\u2019re specifically looking at effective interventions during your review, it\u2019s a good idea to have your behaviour defined, and your behavioural diagnosis complete first so that you\u2019re able to search for the correct type of interventions. Your behavioural diagnosis may reveal that there are barriers relating to psychological capability, and that may guide you to review only interventions that are focused on education, training and enablement.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow important is evidence in developing behaviour insight interventions and how will this be embedded into your team\u2019s work?<\/strong><\/summary>\n
We encourage others to review the evidence when developing their behaviour change interventions, and so we try to keep evidence at the centre of all that we do too. Behavioural science is a quickly growing discipline and the scientific literature to support out work is growing too. As a team, we regularly review the evidence to help inform work. This could be when we\u2019re completing a behavioural diagnosis, or when we\u2019re searching for interventions that have targeted similar behaviour change techniques to the ones we\u2019d like to us. We also draw on the literature when we\u2019re looking for frameworks and models, such as the COM-B model and Behaviour Change Wheel.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nTop tips for embedding behavioural science in practice<\/strong><\/summary>\n
Start small! Do a little bit of what you know first. That could be defining a behaviour or reviewing the literature to see if there is any insight into a behaviour you\u2019re already working on. The more you practice, the more skilled you\u2019ll become at regularly applying behavioural science\u2026 and don\u2019t do it alone! Share your work with colleagues, or us if you\u2019d like to. Sharing your thinking with others or discussing next steps as a team can help to clarify your thinking. Reach out to others who you know may be doing something similar, perhaps someone you connected with at the network \u2013 If you don\u2019t know who that might be, we\u2019re more than happy to connect the dots if we can!<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nCan this approach be used at an organisational level?<\/strong><\/summary>\n
Yes. In a sentence – structures, strategy, systems, skills, styles, (motivated) staff and shared values (adapted from Mckinsey\u2019s 7S) would need to be in place to underpin the approach. Ultimately, it would be great to have behaviourally enabled\/informed organizations where knowledge and skills around behavioural science are diffuse, where processes reflect these knowledge\/skills and support their deployment, and the workforce believes behavioural science adds to their efforts.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nThe guide is excellent. Any tips on how to embed within an organisation?<\/strong><\/summary>\n
The routine application of behavioural science relies on sufficient levels of capability (people with knowledge and skills); opportunity (systems, processes and norms); and motivation (belief that this adds to our efforts) \u2013 these are extremely brief \u2018foundations\u2019 to build from. <\/em><\/p>\n\n\n\nProportionality (doablity) is important \u2013 the guide describes (on page 11) a sliding scale of use \u2013 from using a personal understanding of behavioural science \u2013 which could happen (and probably does already in some places) on a daily basis; through to commissioning stand-alone behavioural science advice, reports or research \u2013 which might need a budget (and a good specification!). Developing capability, opportunity and motivation to use behavioural science to maximum effect along that sliding scale is key.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nShould there be: links to public health frameworks tidier framework, updated MRC frameworks on evaluation. E.g., on Evaluation of complex interventions, natural experiments, see Peter Craig etc removing focus on RCTs?<\/strong><\/summary>\n
Thanks for reinforcing the links, and yes, there should be a range of ways of measuring impact of behaviourally-informed interventions \u2013 the guide advocates for \u201cusing the best methods that are practicable and affordable, and with a clear focus on measuring the target behaviour in the target population\u201d \u2013 that\u2019s not always an RCT, page 35 has a starter list of options. <\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow will the BeSci team develop their thinking and work in evaluation of behavioural science developed interventions?<\/strong><\/summary>\n
In collaboration, with similar units, academics, policy makers and practitioners; with a clear recognition of ethics; and in an open and transparent way.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow can one scale interventions for system-wide change?<\/strong><\/summary>\n
The BCW shows that \u2018interventions\u2019 include policies that can be implemented by national, regional or local governments, as well as by organisations such as the NHS. Some BCW policy options naturally operate at a system-wide level, such as fiscal policies, comms and marketing campaigns, regulation, etc. When it comes to others such as provision of services or products, it is a matter of ensuring that the resources and infrastructure are present or can be developed. A very successful example of this is the stop-smoking services, but there are plenty of other examples and it\u2019s important to remember that educational<\/em> provision and the criminal justice system are essentially behaviour change interventions.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow can we demonstrate to funders the value of BS? Are there standard evaluations we can build in when we kick off?<\/strong><\/summary>\n
The tried and tested way to do this is by calculating the Return on Investment (ROI). This is a well-developed method in policymaking and healthcare. It can get quite technical when one is estimating benefits that accrue many years down the line and depends on what parameters one wants to use to discount benefits that do not occur immediately, but the principles are quite simple, and it is a good way of focusing attention on best value options.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nWe hear a lot about successful behavioural nudges, but do you have any examples where interventions have had negative results, and advice for moving forward when that happens?<\/strong><\/summary>\n
One example was drugs education campaigns in schools which appeared to increase drug use. Human behaviour is more like the weather than an electrical circuit \u2013 not always predictable even with the best science because there are so many moving parts. That is why it is so important always to keep monitoring the impact of interventions and be ready to make changes if things do not seem to be going according to plan. That is one of the big lessons from the application of behavioural science: apply the best available methods to gather data and keep gathering it as required to shape interventions in the light of changing contexts.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nIs COM-B the only model? Or are others more suitable in specific circumstances?<\/strong><\/summary>\n
COM-B appears to be the only one so far that covers literally everything that underpins behaviour. There are lots of more specific models that focus on different aspects of motivation or social influence or cognitive biases and so on. But COM-B is a very general model and will not be enough on its own \u2013 you will need to drill down into the specifics of the behaviour change scenario (using COM-B as a guide) to develop the intervention approach. For example, COM-B doesn\u2019t tell you whether varenicline or NRT are better at aiding smoking cessation \u2013 there is a whole literature on that, but a COM-B analysis can make it clear that tackling craving is the key to successful quitting.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nWhat key messages about the subject and\/or it\u2019s application can I pass on from you to our students of Behaviour Change Science at Aberystwyth University, please?<\/strong><\/summary>\n
Number one: Treat the \u2018science\u2019 in \u2018behavioural science\u2019 seriously. That means always be thinking about how you use the best available models and theories to structure your data collection and use data to update or abandon your generalisations, models and theories. Number two: Do not allow yourself to get attached to generalisations or theories. Treat everything as a hypothesis about which you have a certain degree of confidence and be willing to revise your confidence and your hypotheses as new data emerge.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nAre individual BeSci changes enough to have significant impacts on things like climate change and cost of living challenges? (Vs system\/legislation)<\/strong><\/summary>\n
It\u2019s best to think of behaviour change in terms of multiple levels of actors with individuals at the bottom, then social groups such as families and peer groups, the structural groups such as schools, organisations and so on all the way up to whole populations. These levels interact so that, for example, individual preferences for different types of food influence organisations to cater for those preferences and market their products in such a way as to increase demand among individuals. That is why the starting point for any behaviour change intervention should generally be a behavioural systems map so that you can see where and at what levels to intervene.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nWith challenges over the practicality and reliability of evaluation, how do we effectively show the value of an intervention? What are the other options?<\/strong><\/summary>\n
There is no substitute for evaluation. The question is only what is the most rigorous and useful evaluation that is practicable and affordable and to do that, and then to adjust one\u2019s confidence in the results according to the rigour of the evaluation. For example, if the only thing you can do is a pre-post comparison among a sample of people whose behaviour you wish to change, try and make sure your sample is as representative as possible, keep an eye out for anything that might have happened at the same time as your intervention that might have had an influence, and be appropriately cautious in your conclusions about what kind of effect the intervention may have had. In my experience there is a tendency to overinterpret the findings of evaluations.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow \u2013 if at all \u2013 can this link with other theories. For instance, human factors and good and bad behavioural markers for practitioners?<\/strong><\/summary>\n
COM-B aims to provide a framework in which you can plug and compare other theories and see where there gaps are and how best to fill them.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nWhat\u2019s your greatest failure implementing BI and what did you learn from it?<\/strong><\/summary>\n
As a researcher I develop and evaluate interventions and so the emphasis is on finding out whether or how well they work. One that failed to work was one in which midwives were trained to deliver brief smoking cessation advice to pregnant smokers. What I learned is that it is vital to involve those who would be delivering the intervention in the development process.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow can we encourage sceptical senior management teams to explore the benefits of behavioural science and be open to experimentation?<\/strong><\/summary>\n
Treat it as a behaviour change problem. Think about what needs to change to get them on board in terms of, for example, their understanding of the costs and benefits (capability) and how it can be incorporated into the workflow in a way that would be easy (opportunity) and deliver quick wins for them in their role as managers (motivation). Don\u2019t overpromise but also point out examples close to home where applying behavioural science has delivered improved interventions.<\/em><\/p>\n<\/div><\/details><\/div>\n\n\n\nHow do you develop an evaluation framework that captures the impact taking into consideration the challenges with data?<\/strong><\/summary>\n
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