by Michelle Guillemard
Eat five servings of vegetables and two servings of fruit every day.
If only it were that easy to inspire change.
If I’ve learned anything over the past decade, it’s that facilitating behavioural change isn’t as straightforward as writing about health in an easy-to-understand way.
Ensuring our patients understand a complex medical topic is one thing, yet achieving behaviour change is something else entirely.
Behaviours are difficult to change.
Most people know they need to eat better, move more, drink less alcohol, reduce their stress levels, sleep more, etc.
So why aren’t people making the changes they need to make to be healthier?
Again, behaviours are difficult to change.
If we want our readers to not only understand our content but also act on it, then we need to know more about how behaviour change works.
We can start by looking for strategies to help us get better at utilising behavioural change techniques in our writing.
We need to understand the barriers to change so that we can address them.
General approaches to behaviour change
One of the largest trials on behaviour change ever conducted, known as the Multiple Risk Factor Intervention Trial (MRFIT), aimed to help more than 12,000 men to get healthier.
The men had a high risk for heart disease. The program in the trial was designed to help them stop smoking and lower their blood pressure and cholesterol.
The trial wasn’t as successful as the researchers had hoped – specifically, the impact of the change in risk factors was less than the original hypothesis, and the researchers noted only slightly better improvements in the treatment group.
One of the key outcomes of this trial, since cited in dozens of books and literature on behaviour change, was that behaviour change is difficult to implement in isolation.
Social and environmental factors play a vital role in behavioural change.
“Individuals are products of their environment, the theory went, and thus one cannot change the individual without changing the community in which he or she lives,” wrote author David M Cutler.
Implementing change at different levels
A complex interplay of determinants at various levels shape health behaviours.
These levels are individual, community (including interpersonal, social and environmental) and public policy.
Multiple levels of influence exist across these levels
As a result, this makes our job tricky – yet also important.
As health writers, we might think we only have the power to reach individuals – yet the internet and social media can help us to make a difference at a community level, too.
Whether it’s writing an article that gets widely shared, building or contributing to an online community, or working on a project for a dedicated community sector, our content can help communities as well as individuals.
Plus, we’re not limited by the written word. Podcasting and video are increasing in popularity – giving us more opportunity to diversify our communication strategies and tap into different communities, further extending our reach.
As writers, though, we know a personalised approach works well.
We write to our readers like we’re having a conversation with them. So perhaps the aim of the game is to write for the individual, then share it with the community.
Writing to inspire change
The NICE guidelines on behaviour change are a good place to start when it comes to understanding interventions that motivate and support change.
I’ve summarised their guidelines below and have listed some tips beneath each guideline to help you consider how you can address these changes in your writing.
1. Understand
- Guideline: Understand the short, medium and longer-term consequences of their health-related behaviours, for themselves and others.
- My tip: In practice, this could be explaining and exploring the ‘why’ behind the reasons for change (instead of only listing the reasons).
2. Promote positivity
- Guideline: Encourage readers to feel positive about the benefits of a particular beneficial behaviour – and the positive outcomes that come as a result of changing their behaviour.
- My tip: Use positive language, and promote the benefits of actions as well as outcomes.
3. Plan
- Guideline: Design changes in the form of easy steps to achieve over time – as opposed to quick wins or changes that are too difficult to achieve.
- My tip: Encourage readers to start small rather than being overwhelmed with massive change – list simple strategies they can implement in their daily lives.
4. Recognise
- Guideline: This point is about helping people to consider and recognise how their behaviour may be influenced by their relationships and social lives – as these may undermine the positive changes the person is trying to make.
- My tip: Ask questions to encourage readers to think about these problems, and highlight these issues as potential barriers.
5. Cope
- Guideline: Relapse is normal, and coping strategies to prevent further relapse can help.
- My tip: Use empathy in your writing, and reassure readers that they are not perfect, that relapse is okay and that change takes time.
6. Commit
- Guideline: They say you have to be ready to change to change, and making a personal commitment to change an unhealthy behaviour is key. Actions are instrumental to achieving change.
- My tip: Promote a long-term mindset and focus on the journey as well as the intrinsic motivation, not the destination – advocate change as a way of life, not merely a consequence.
7. Share
- Guideline: Sharing successes and milestones and even setbacks with others can be motivating and empowering (though there’s a school of thought that suggests sharing goals before they’re ‘achieved’ can be detrimental to the success of the goal)
- My tip: Encourage readers to start or join helpful groups (online and offline) to share successes as well as setbacks.
Remember: look for opportunities to promote change. By taking your writing to the next level, you really can make a difference.
