The authors conducted a literature review and provided a discussion about the reasons why people often have difficulty changing patterns of behaviour they are aware are unhealthy. Subsequent recommendations were provided for potentially improving the effectiveness of policies and campaigns designed to improve public health.
According to the authors, people often have an inflated sense of personal immunity to adverse health consequences, but can more accurately recognise the potential risks to others. Therefore, the authors recommended that campaigns aimed at increasing people’s motivation to change unhealthy behaviour should highlight the potential impact of their behaviour on other people. To illustrate this, the authors referred to an infection-control campaign that informed clinicians that hand-washing would reduce their risk of catching a disease. When the wording was changed to highlight the risk to patients, not themselves, clinicians’ soap use increased by 45%.
Another challenge discussed in the article was that people often have difficulty translating healthy intentions into action. To address this, the authors suggested that campaigns could be designed to encourage people to form implementation intentions. In support of this, the authors cited a study in which 79% of patients who created an implementation intention (that specified when and where to take their medication) adhered to their medication regimen (whereas adherence was only 55% in the control group).
The authors cautioned that even people with good intentions are at risk from falling back into old habits. One approach they recommended to address this was implementing policies that minimise the contextual cues that people associate with unhealthy behaviours (e.g. banning retail displays of cigarettes). Another recommendation was to develop campaigns that encourage people to perform new healthy behaviours repeatedly and consistently so that they become habitual (e.g. exercising at the same time every day). Similarly, the authors described how behavioural change can be facilitated by creating associations between desired behaviours and those which are already routinely performed. One example the authors gave about how this could be applied in practice was a campaign that advised people to replace the batteries in their smoke detector every time they adjusted their clock for daylight saving.