Behaviour change in public health

Led by Neil Howlett, Dr Nick Troop and Dr Daksha Trivedi, behaviour change research at Herts has focused on using behavioural science, particularly in the field of physical activity, to produce translational research knowledge with local and national partners in public health promotion.

Neil Howlett is on the core committee of the Behaviour Science and Public Health Network. This network were lead contributors to Public Health England’s national strategy: Improving People's Health: Applying behavioural and social sciences to improve population health and wellbeing in England.

Our research aims to produce trans-disciplinary collaborations to embed behavioural science into public health efforts to reduce the burden of unhealthy behaviours in the most disadvantaged communities.

Systematic reviews

We conducted a systematic review and meta-analysis of randomised controlled trials of physical activity and sedentary behaviour interventions for inactive adults. The findings showed that changes in physical activity can be achieved through intervention up to a year after completion and highlighted a number of behaviour change techniques (BCT) that were associated with effectiveness (e.g. action planning, instruction on how to perform the behaviour, prompts/cues, self-reward).

Additional reviews have looked at the most effective BCTs in physical activity interventions for people with dementia and for adolescent and young adult cancer survivors. Reviews in progress are focused on physical activity to help with bereavement and assessing the effectiveness of Motivational Interviewing for physical activity.

Behaviour change theory

Previous research has suggested that theory has been used inconsistently, and has rarely been applied to the design, implementation, and evaluation of physical activity interventions. The COM-B model of behaviour suggests that behaviour results from an individual having sufficient capability, opportunity, and motivation. Our research analysed the content and predictive validity of the COM-B for moderate-to-vigorous physical activity (MVPA). The findings suggested that capability (habits, action planning, and self-monitoring) and motivation (intention, self-efficacy, and exercise self-identity) are key in performing regular MVPA. A parallel analysis was completed for sitting behaviour showing capability (habits and self-monitoring) and opportunity (subjective norms) to be key.

Public health interventions

The Active Herts programme is a community physical activity programme for inactive adults, with additional cardiovascular disease risk factors and/or mental health issues. Active Herts implements the best BCTs in the intervention materials/delivery and evaluates key drivers of MVPA from the COM-B as secondary outcomes. In two areas programme users are receiving a BCT booklet, regular consultations, a booster phone call, motivational text messages, and signposting for 12 weeks of exercise classes.

In another two areas programme users are also receiving 12 weeks of free tailored exercise classes, with optional exercise ‘buddies’ available. An outcome evaluation is assessing changes in physical activity as the primary outcome, and sporting participation, sitting, wellbeing, psychological capability, and reflective motivation as secondary outcomes. A process evaluation is exploring the views of programme users, programme providers, and commissioners about what has worked best and why.

Evaluation projects

We provide robust evaluation for key partners such as the charity HENRY, who are testing a novel volunteer-led delivery of a programme to improve the behaviour and knowledge of parents and young children around nutrition and physical activity. Our evaluation of these projects comes from funders such as the Big Lottery and the Health and Social Care Volunteering Fund.