9. Changing our future

‘Changing our future’ argues that the challenge of climate change must be seen within the current dominant political and economic landscape. Future policies and international agreements need to provide win-win solutions that deal with the biggest challenges facing humanity in the 21st century, which include climate change, environmental degradation, global inequality, and global security. What we need is a new era of planetary stewardship led by governments and underpinned by new economic theories. Effective carbon emission reductions require a partnership between government, both local and national, corporations, and civil society that is supported and encouraged by individual behaviour change. In addition, we need international organizations fit for the challenges of the 21st century.

Beyond nudge: advancing the state-of-the-art of behavioural public policy and administration

This Special Issue features theoretical, methodological, and empirical advancements of the state-of-the-art in behavioural public policy and administration. In this introduction, we develop a behaviourally-informed, integrated conceptual model of the policy process that embeds individual attitudes and behaviour into context at the meso and macro level. We argue that behavioural approaches can be situated within a broader tradition of methodological individualism. Despite focusing on the micro level of policy processes, the contributions in this issue demonstrate that the behavioural study of public policy and administration can go beyond the individual level and give important insights into policy and societal outcomes. Our model enables us to draw more substantial lessons from behavioural research by moving beyond the verification of individual behaviour change. If based on a broad conceptual design and methodological pluralism, behavioural policies bear the potential to better understand, investigate and shape social outcomes.

Advancing behavioural public policies: in pursuit of a more comprehensive concept

Behavioural public policy is predominantly based on insights from behavioural economics and psychology in order to ‘nudge’ people to act in line with specific aims and to overcome the dilemma of behaviour that contradicts economic rationality. In contrast, we define behavioural public policy as a multi-disciplinary and multi-methodological concept that utilises insights from the whole range of behavioural research. Based on a scoping review and peer survey we see merit in behavioural insights from disciplines such as anthropology, geography and sociology as well as the application of qualitative methods. Our findings identify the need to advance behavioural public policy conceptually and methodologically. This article challenges our current understanding of behavioural policymaking by integrating ‘foreign’ views and approaches that do not (yet) belong to the core discipline. We argue that behavioural public policy should not be a synonym for a limited number of policy approaches (for example, nudges) based on specific research methods (for example, randomised control trials) to reach individual behaviour change. Instead, our findings suggest a redefinition of the scientific footing of behavioural public policy.

Is social-ecological risk associated with individual HIV risk beliefs and behaviours?: An analysis of Kenyan adolescents' local communities and activity spaces

The places where adolescents live, learn, and play are thought to influence behaviours and health, but we have limited tools for measuring environmental risk on a hyperlocal level. Working with 218 adolescents and their parents/guardians in rural western Kenya, we combined participatory mapping activities with satellite imagery to identify adolescent activity spaces and create a novel measure of social-ecological dangers. We then examined the associations between community risk and individual HIV risk beliefs and behaviours. We found support for the conjecture, derived from social-ecological models of HIV transmission, that community-level risks may be associated with individual beliefs and behaviours. As community risk increased for a sample of Kenyan adolescents, so did their reports of riskier sex beliefs and behaviours, as well as unsupervised outings at night. This study reinforces calls for disease prevention approaches that go beyond emphasizing individual behaviour change.

Visualizing and gamifying consumption data for resource saving: challenges, lessons learnt and a research agenda for the future

In this paper we present insights drawn from recent research projects aimed at developing visualization and gamification tools to stimulate individual behaviour change and promote energy and water saving. We address both the design of resource-saving programmes and the methodologies to assess their effectiveness. We conclude by presenting a vision for the future and discussing open issues that could lead future research directions in the field of behavioural change approaches to resource sustainability.

Public health approaches to tackling obesity in the UK

Being obese and overweight affects an increasing number of adults and children in the UK. Hilda Mulrooney presents an overview of the population-based approaches to improving public health and enabling more people to lose weight Obesity is a serious condition that is highly prevalent in UK adults and children. A number of population-based approaches to improve the ‘obesogenic’ environment have been put into place while more are being proposed. Many of these approaches have the advantage of potentially altering dietary intakes without individual behaviour change, and they are taking place in a wider context that encourages physical activity and partnership working. Approaches to obesity and progress made towards targets will be discussed.

Making a “Pledge”: Moral Suasion and Health Promotion Practice

Moral suasion offers a versatile and low-cost approach to influence social norms and risky health behaviours, but is often neglected in health promotion in favour of using educational approaches. The purpose of this paper is to discuss the challenges and the benefits of using moral suasion in health promotion. Past and present experiences of using moral suasion to promote health are discussed in conjunction with other approaches, such as harm reduction. The challenge of using moral suasion as an approach is that it focuses on individual behaviour change, rather than addressing the broader structural causes of poor health. However, the paper concludes that the versatility of the moral suasion approach and the success of using “pledges” means that it can be an important intervention, alongside other educational and motivational techniques, to help to change behaviours at the individual and collective levels.

A systematic review and meta-analysis of trials of social network interventions in type 2 diabetes

ObjectivesIn the care of patients with type 2 diabetes, self-management is emphasised and studied while theory and observations suggest that patients also benefit from social support. We sought to assess the effect of social network interventions on social support, glycaemic control and quality of life in patients with type 2 diabetes.Research design and methodsWe searched Ovid MEDLINE, Ovid EBM Reviews, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO and CINAHL through April 2017 for randomised clinical trials (RCTs) of social network interventions in patients with type 2 diabetes. Reviewers working independently and in duplicate assessed eligibility and risk of bias, and extracted data from eligible RCTs. We pooled estimates using inverse variance random effects meta-analysis.ResultsWe found 19 eligible RCTs enrolling 2319 participants. Social network interventions were commonly based on individual behaviour change rather than social or interpersonal theories of self-management, were educational, and sought to engage social network members for their knowledge and experience. Interventions improved social support (0.74 SD (95% CI 0.32 to 1.15), I2=89%, 8 RCTs) and haemoglobin A1c at 3 months (−0.25 percentage points (95% CI −0.40 to -0.11), I2=12%, 9 RCTs), but not quality of life.ConclusionsDespite a compelling theoretical base, researchers have only minimally studied the value of interventions targeting patients’ social networks on diabetes care. Although the body of evidence to date is limited, and based on individual behaviour change theories, the results are promising. This review challenges the scientific community to design and test theory-based interventions that go beyond self-management approaches to focus on the largely untapped potential of social networks to improve diabetes care.PROSPERO registrationCRD42016036117.

Social change design: disrupting the benchmark template

Purpose This paper aims to propose a new ecological systems-driven framework, underpinned by a relational marketplace lens, for social marketing practitioners to consider when planning and designing programs. The authors contend that behavioural change does not occur in a vacuum and, as such, point to an ecology in which the individual is but one participant in a broader scope of social change activities. Design/methodology/approach The paper is conceptual and presents the Indicators for Social Change Framework. Findings The Indicators for Social Change Framework puts forward a series of “must-have” indicators to consider when designing and planning social marketing programmes. Across identified indicators, the Framework delineates types of marketing actions to consider when planning for individual-oriented change and those required for wider systems-oriented change. Originality/value This paper contributes to the broadening and deepening of the social marketing argument that reliance on individual behaviour change perspectives is not sufficient to resolve complex social problems that are inherently influenced by wider social forces. In transforming social change design, this paper transitions towards a logic view of social marketing that encourages and supports social change planners to be inclusive of interactions, processes and outcomes of value creation across the wider social marketing system.