Designing interventions to help people change their behaviour is hard. It is a sea of complexity which only gets more complicated the more you delve into someone’s personal life. Without this complexity though, it is unlikely the intervention will work at all. But how do you drill down to this level of detail, at scale, in a group setting? What evidence is there that the intervention should work and how do you get the evidence that is has worked?
One of the key issues facing intervention designers attempting to change behaviour effectively has been not just knowing what to do, but also knowing how to do it. Many behaviour change programmes do not have the feedback mechanisms built within them to establish whether the behaviour change methodology is; a). effective in the real world (and not just in a controlled trial environment), and b). is being executed properly and in a way that is having the desired effect on the intended audience.
Many interventions have ‘scaled’ in as much as they have managed to write down enough that they can, in theory, tell someone else how to deliver their intervention. They often use sessional staff with minimal training. At BeeZee Bodies we just don’t see this delivering quality in the real world. The amount of investment in training staff and the investment in developing a robust training process itself is immense. In our view, we want our staff to be able to deliver evidence based messages, but only in a way that is applicable to that particular group, at that particular time and in that particular way. By this I mean, ‘in that way that is required and appropriate in each individual group setting’. On top of that, they need to be able to use the benefits of the group alongside understanding how to communicate individual level behavioural changes to ensure that the complexity of peoples’ individual lives is not missed just because it is hard.
Commissioners of behaviour change services have tough job to do. It is tough to see the difference between organisations that deliver ‘evidence-based behaviour change’ in theory and evidence-based behaviour change in practice. There is a subtle distinction. Being able to write a programme that conforms with NICE standards and guidance, Government strategies and the latest evidence base is the easy part. Any university undergraduate can have a really good go at this in an afternoon. The procurement systems rarely provide an opportunity for providers to demonstrate the nuance required to assure commissioners that an organisation understands, and has systems and processes to deliver, genuine individual and group level behaviour change that is sustainable. In a world of public sector cuts, commissioners are also looking for cheaper services that do more. This is wishful thinking, and while innovation can provide significant savings, what is needed in investment in the people delivering these services.
You would not buy in part-time soldiers, equip them with minimal training and then expect the results that a well-trained, professional army is capable of to be delivered. It takes passion, courage and commitment to invest in staff. They do meaningful, important work and they should feel as though we recognise how hard what they are doing is, and that we are behind them, willing to develop them with training and support. Of course we need evidence based services to deliver quality, but there is more evidence about what works out there then what a University student can pick out of some NICE guidance in an afternoon.
This industry is asking for science only. What is missing is the art.