24 Oct 2007

NICE public health guidance aims to help people change their behaviour so that they can enjoy healthier lives

The National Institute for Health and Clinical Excellence’s (NICE) public health guidance, published today, aims to help health professionals bring about changes in people’s behaviour that will enable them to enjoy healthier lives. The recommendations in the guidance form a set of generic principles that can be used as the basis for planning, delivering and evaluating public health activities aimed at changing health-related behaviours at the population, community and individual levels.

It has long been accepted that interventions to change people’s health-related behaviour have enormous potential to alter current patterns of disease. For example, encouraging people to give up smoking reduces rates of lung cancer and other smoking related illness and getting people to eat a healthier diet and increase levels of physical activity can help to reduce levels of obesity. However, because there has been no unified approach to behaviour change across different public sectors, such interventions have to date enjoyed only limited success.

The NICE guidance is based on a comprehensive assessment of the evidence on what approaches and strategies are effective in bringing about health related benefits for the population as a whole. The guidance, which is for NHS and other professionals with responsibility for helping people change their health-related knowledge, attitudes and behaviour, highlights the need to:
• Plan interventions and programmes aimed at changing behaviour carefully, taking into account the local and national context - for example, socioeconomic and cultural factors – and work in partnership with recipients.
• Base interventions and programmes on a sound knowledge of community needs and build them upon the existing skills and resources within the community.
• Equip practitioners with the necessary competencies and skills to support behaviour change.
• Assess potential barriers to change and how these might be overcome (for example, improving access to affordable opportunities for physical activities).
• Evaluate all behaviour change interventions and programmes.

Commenting on the guidance, Andrew Dillon, Chief Executive, said: “While medicine can achieve so much in treating disease and disability, getting people to change their behaviour is the most effective – and certainly the most cost-effective – way that we have for improving the health of adults and children in Britain. Put simply, prevention is better than cure. Small changes in life-style and in the everyday things we do can bring about very significant improvements in life-expectancy and in the quality of our lives. The problem is that it’s hard to make these changes, especially for those who have few choices about how they live, work and look after the people they care about. Our recommendations therefore cover not only how to help people to change, but also, crucially, how we can tackle the barriers to change that so many people face.”

Professor Mildred Blaxter, Hon. Professor of Medical Sociology and Chair of the Programme Development Group, said: “Evidence-based public health is both possible and desirable, but in the area of changing people’s health-related behaviour there are special difficulties. Behaviour is very complex, and no single method of promoting change can be universally applied to all sorts of people and all areas of life. Also, a great variety of health professionals and others can be involved. A feature of this guidance is that many different disciplines have worked together to examine the evidence, and provide a coherent general approach for all those involved in attempting to change the attitudes, habits, and lifestyles that crucially affect people’s health.”

Professor Wendy Stainton Rogers, Professor of Health Psychology at the Open University and a member of the Programme Development Group, said: “Our recommendations stress the importance of building on the strengths of individuals, of families and of communities, consulting them when programmes and services are being planned, and tailoring what we do to the particular customs, values and concerns of the different communities and groups that make up today’s Britain.

She continued: “In particular our recommendations seek to go beyond ‘nice words’ and ‘good intentions’. Actually putting these into practice is far from easy, and we offer specific advice about the planning and delivery of effective interventions and programmes.”

Ann Williams, a community member of the Programme Development Group, said: " I firmly believe that if everyone is to benefit from public health initiatives, it is critical that they are based on solid evidence of what is effective and what works. These guidelines have been established on that basis to enable a coherent approach to public health policy and a framework not just for academics but for everybody involved, aimed at achieving effective progress in improving the health of the whole population."

The guidance should be read in conjunction with other topic-specific public health guidance issued by NICE. Future NICE public health guidance that aims to change people’s behaviour will be based on this guidance.

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