Behavioural Sciences and Public Health

www.hertfordshire.gov.uk
Building capability and capacity to deploy
behavioural science
BSPHN Wales Hub Launch
19th May 2022
Jim McManus,
Director of Public Health, Hertfordshire County Council
President, Association of Directors of Public Health
Hon Visiting Professor, University of Hertfordshire

• You folks are amazing
• Others hubs have found real benefits. You get what you put in
– A space for conversation
– A place for co-ordination
– Sharing ideas
– Growing a system
– Building on what you did with Covid
– Supporting Trainees (Midlands & East)
– Masterclasses (North West)
– People who know on tap
Launching the Hub!!!

Waves of Public Health – the time is ripe for behavioural
and social sciences
Waves of scientific models (Biomedical to Sociological)?
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62341-
7/fulltext
www.hertfordshire.gov.uk/behaviouralscienceresources

1. We cannot understand complex public health
problems without multi-lens
2. Some leadership tasks we cannot achieve
without social sciences and behavioural
sciences
3. Systems approach – systems change needs
all talents and skills. Social and behavioural
sciences here
4. From “inter-disciplinary” to “trans-disciplinary”
Rationale

1. Public Health Policy in Wales is better set up to
embrace all the sciences including social science than
England may be
2. Transdisciplinary knowledge – complex reality
requires the mutually appreciative encounter of all the
disciplines
Some starting points

• A place for dialogue
• A place for developing capacity for people in a
discipline they might find hard to get into
otherwise
• Inclusion of all the sciences, all the talents
Why did we set up BSPHN?

Behavioural Science Background
• Scientific evidence on behavioural and social
science contributions to public health
• English National Strategy 2018
https://tinyurl.com/s4uermdt
• Read strategy on www.bsphn.org.uk
• NICE guidance PH6, PH49
https://www.nice.org.uk/guidance
• Public Health problems are complex problems
from social and structural to biological. Most
PH problems require action at multiple levels
• Covid demonstrated need for behavioural
science in disease management and prevention

“Covid was the 1990s all over again”
• The lessons from HIV
for today’s pandemic
– International HIV
Social Science
Convention, Berlin
1994?
– Resilience
• Social science impact
crucial
Epidemiology
Environmental
planning
Systems
Science
Education
Law Epidemiology
Communication
Psychology

Coronavirus is not a Pandemic it is a Syndemic. That requires
multiple fields of knowledge to elucidate
• Singer, 2009
• 1st Wave: Immediate mortality
and morbidity of COVID-19.
• 1st Wave Tail: Post-ICU and
admission recovery for many
patients.
• 2nd Wave: Impact of resource
restrictions on non-COVID
conditions – all the usual urgent
things that people need
immediate treatment for – acute.
• 3rd Wave: The impact of
interrupted care of chronic
conditions (people stayed home).
• 4th Wave: Psychic trauma,
mental illness, PTSD, economic
injury, burnout, and more.
• LONG COVID

• HIV Risk – enabling people to live with Covid
• Resilience – from individual coping to positive
psychosocial workplaces
• Social Psychology – meanings, norms,
identification
• Crowd Behaviour – design control systems to
understand human behaviour in crowds
• Ergonomics – design of NPI systems
Examples

The English
Strategy

ADPH Guidance

Local covid work to date from
behavioural and social sciences
• Public Mental Health - Created and supported a public mental health cell and
national MH collaborative with LGA on Knowledge Hub
• Lockown – health, coping and compliance
• Behavioural sciences for NPIs - design of communications to design of social
distancing measures in town centres. Evaluated impact of social distancing measures
in town centres to support ongoing suppression strategies
• Vaccine Confidence - behavioural skills and components of “being vaccine confident”
in staff and volunteers promoting vaccine uptake. Research on vaccine hesitancy and
strategies. Engagement tools for populations with low uptake
• Exit the Pandemic - “skills for living and working in a covid endemic environment” to
inform interventions as part of the Roadmap to re-opening
– Undertook research on vaccine hesitancy identifying strategies to improve
vaccine uptake. Particular focus research on gypsy and traveller communities

Combination Prevention as example:
Some Interventions are Behavioural. Some structural. Some one
influences the other.

UK work
The good
1. Crowd behaviour
2. Risk understanding and
management
3. Compliance with safety
instructions
The not so good
1. vaccine communications
2. Ideology outstripped science in
some places
3. Social norms on non
pharmaceutical interventions
4. Allowing pseudoscience a
foothold
5. Instruction not transparent debate
and persuasion
6. Scientists fighting with each other
on social media

Key Leadership Tasks and Context for
Organisations…lessons from HIV
Make your community, organisation and events covid
safe
Learn to
Live Safely
Help people build confidence in managing risk
Confidence
Your organization’s capabilities and role in recovery
across multiple impacts
Articulate
Help people grieve, make sense of what happened
and be alert to mental health issues. Social Identity
importance in “social cure”
Care and
Connect
Help people vision the next two years – i.e. life a
year after the pandemic hopefully.
Hope

1. Be clear - why behavioural sciences?
2. Business case – funding, outcomes.
3. Get buy in across your organisation –
workshops, meetings
4. Involve people early on – HR and academics
5. Get someone qualified to lead this work
6. Job design needs careful attention
7. Have a logic model
8. Harness the breadth of behavioural sciences
9. Get expert advice (supervision / University)
10. Brand it, report it, disseminate it.
11. Get ideas from others – join LGA/BSPHN
Behaviour Change Leads Group
The Golden Rules for employing folk
Guidance document available here:
https://www.bsphn.org.uk/784/Tools-
Resources-for-Professionals

1. “We just need Behavioural Insights”
2. “Any public health person can do it”
3. “6 months ought to do it”
4. Not thinking through recruitment strategy
 Skill Mix
 Not employing skilled/qualified staff with right competencies
 Advertising
 Looking at person-role fit as well as person-organisation fit
5. Underestimating the interest/need
6. The input required for sustainable culture change to make this BAU
7. Do NOT take a deficit approach to the knowledge and skills of others
because solutions come from all skills combining together
Pitfalls to avoid

1. Be clear on what model you are offering- internal consultants or delivering
projects for others?
2. Have a clear method for selecting projects
 Make sure you avoid scope creep – what is the difference between
Behaviour Science and Transformation/Quality or HR
3. Have a corporate and departmental stakeholders advisory group
4. Pick definable projects where you can be very clear whether you succeed
or fail – don’t choose the hardest nut to crack!
5. Plan evaluation from the start and measure the impact of your work
6. Work with contacts across the system
7. Seek to embed behaviour change approaches as BAU to ensure
sustainability
8. Get your ethical framework clear. Clear short principles not reams of
paper
Helpers to avoid the Pitfalls

1. Upskill your workforce – competency frameworks and CPD
2. Bring in academic partners to deliver key pieces of work –
joint funding applications
3. Opportunities for student placements
4. MSc dissertations and Doctoral competencies – no cost!
5. Share best practice with other behaviour change leads
6. Work with key organisations e.g. PHE, LGA, ADPH, BSPHN
7. Build behavioural science into commissioning processes,
training and evaluation – in line with NICE Guidance
8. Deliver innovative solutions to improve your outcomes!
Other benefits and opportunities

thank you
Jim.mcmanus@hertfordshire.gov.uk
www.bsphn.org.uk

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