North West Behavioural Science Symposium Wednesday May 22 nd 2019 - - PowerPoint PPT Presentation

north west behavioural science symposium wednesday may 22
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North West Behavioural Science Symposium Wednesday May 22 nd 2019 - - PowerPoint PPT Presentation

North West Behavioural Science Symposium Wednesday May 22 nd 2019 Halliwell Jones Stadium Warrington WA2 7NE 09.30 15.45 Tweet us on @nwphpn using #BhSci2019 10:00 10:15: Welcome (5 mins) Dr Sakthi Karunanithi , Director of Public


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North West Behavioural Science Symposium Wednesday May 22nd 2019 Halliwell Jones Stadium Warrington WA2 7NE 09.30 – 15.45 Tweet us on @nwphpn using #BhSci2019

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10:00 – 10:15: Welcome (5 mins)

Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council

& Opening Remarks

Dave Sweeney, Executive Implementation Lead, C&M Health & Care Partnership

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10:15 – 10:20 Facilitator for the day: Mari Davis ➢Housekeeping ➢Flow of the day

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Housekeeping

➢ Tweet us on @nwphpn using #BhSci2019 ➢ Please inform Mari Davis if you have any issues with promotional pictures being taken during the day ➢ Fire exits ➢ Wifi code ➢ Toilets ➢ How the room works! Table faciltators; ideas and suggestions board

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Aims for the day

➢ To learn about the new Behavioural Science strategy to improve health & wellbeing ➢ To learn from existing work and interventions utilizing behavioural science approaches ➢ To consider the opportunities for a consistent and scaled approach to integrating behavioural sciences into health and care commissioning and service delivery across the NW geography – what might that look like? ➢ To network with colleagues leading on behavioural science and population health

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Agenda for the day

10:00 Welcome and opening remarks 10:15 Pre-conference questionnaire – Behavioural Sciences in your sphere of work – Lucie Byrne Davis 10:35 Improving People’s Health: Applying Behavioural and Social Sciences to improve population health and wellbeing in England Strategy Launch – Dr Rory McGill and Michelle Constable 11:05 Refreshment Break 11:20 Case studies – Behavioural Sciences in Action – Part 1 12:00 Workshop 1 12:45 Social Marketing Campaigns in the North West 12:50 Lunch & Networking - 13:15 MEC launch Cheshire & Merseyside pop up presentation 13:30 Case Studies – Behavioural Sciences in Action – Part 2 14:10 Comfort Break 14:25 Workshop 2 15:15 Commitments to action; Summary and closing 15:45 Close

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Agenda

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10:20 – 10:35 Pre-conference questionnaire: Behavioural Sciences in your sphere of work Mari Davis

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Pre-conference questionnaire

Please complete your pre-conference questionnaire as found on your table and give to Lucie, answering the following: ➢ Which County or Borough do you represent? ➢ What type of organisation are you from? ➢ How do you rank your level of understanding of behavioural science approaches on a scale of 1-10? ➢ On a scale of 1-10, how much importance is placed on embedding Behavioural Science into practice within your organisation? ➢ In your opinion, is enough being done within your organisation to embed behavioural science into practice? ➢ Do you know where to access appropriate Behavioural Science Expertise? ➢ Does your Department have a budget set aside for commissioning or directly providing behavioural science expertise? ➢ Please tell us about any specific projects or areas of practice in your organisation where they have applied behavioural science evidence or methods?

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10:35 – 11.05 Improving People’s Health: Applying Behavioural and Social Sciences to improve population health and wellbeing in England Strategy Launch Dr Rory McGill, Public Health Specialty Registrar, Behavioural Insights and Evaluation Team, PHE & Michelle Constable, Chair Elect, Behavioural Science and Public Health Network

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Improving People’s Health: Ap Appl plying ng beh behav aviou

  • ural

ral and and soc

  • cial

al scien ences es to

  • impr

prove ve po popu pulat ation n hea health an and d wel wellbei being ng in n Eng nglan and

Michelle Constable and Rory McGill For the Writing Group

(on behalf of Dr Tim Chadborn)

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Why a Strategy? Why bother? Why should I care?

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Why?

  • Our population faces complex health and wellbeing

challenges that stem from biological, psychological, economic, environmental, and social causes

  • To effectively prevent poor health, we need an approach that

takes account of the whole person, social context, and wider aspects such as education, employment, social norms, and the built and online environment

  • Using our expertise, we can help design and evaluate

policies, services (including digital), and communications that are centred around the people that use them

  • Duncan Selbie, PHE CEO “The behavioural and social sciences

are the future of public health” & “We must reach and be meaningful to people in the lives that they are leading.”

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Feedback from local public health (n=50)

79% - NOT enough being done to embed BS in practice 53% do NOT know where to access support 82% - no budget for BS expertise

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Vision and aims

  • Framework for the broad PH system to increase

impact through greater and integrated use of behavioural and social sciences

  • improve health and wellbeing outcomes
  • reduce health inequalities
  • improve value to the public purse
  • To help coalesce and coordinate efforts of national
  • rganisations to support professionals at local level
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Key messages

  • High-level guide with suite of evidence and theory-

informed resources and more to come

  • Scope: systems and organisations acting on the social and

structural environment that affects the population and not only interventions focused on individuals

  • Strong and vibrant behavioural and social science

community

  • Foster further growth in transdisciplinary approaches
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System map of key stakeholders

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Key Content

  • Why do we need this strategy?
  • National and local context
  • What can behavioural and social sciences

contribute to public health?

  • What are behavioural and social sciences? What

key theories and frameworks do they offer public health practitioners?

  • The first steps to implementation and a road map
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Conceptualising the contributions of behavioural and social science disciplines

  • Anthropology
  • Economics
  • Behavioural
  • perational

research

  • Psychology
  • Sociology
  • Other useful public

health tools

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Whole systems approach: Eg Smoking

Environmental and social systems Policy Communities and neighbours Family and Friends Person / Individual Biological Legislation (smoking age, smoking bans in public places, workplaces and cars, ban on

point-of-sale tobacco product displays, prohibition of names such as ‘light’ or ‘mild’, pictorial warnings on cigarette packets), Fiscal measures, Guidelines

Changes in cultures and social norms Social support, exposure to tobacco smoke, number of people to smoke with Service Provision (commissioning of evidence based stop smoking services,

MECC, digital stop smoking interventions), Training of Health Care Professionals,

Incentivisation of patients, organisations and healthcare professionals Development of improved pharmacological treatments Environmental/ Social Planning (Smoke free places, Designated smoking areas,

Tobacco products not on display, Ban on advertising), Communications/ Marketing

(Stoptober, January Health Harms, No Smoking Day, and World No Tobacco Day)

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Implementation Plans

Community of Practice

Resources

  • Signposting
  • Access to experts
  • Frameworks & approaches
  • Training curricula

Evidence

  • Evidence reviews

and position papers

Practice

  • Case Studies
  • Templates

Strategy Document

Strengthen the workforce

Implementation of the Strategy

Public Heath England - Behavioural Insights Masterclass

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Highlights of the Road Map

Priority Theme Examples of Actions

Evidence and theory Call for case studies and share on knowledge hubs Support applications for funding such as the LGA behavioural insights programme Wider system leadership Continue work to embed behavioural science into MECC Access to expertise Contact directory of behavioural science experts and public health professionals Tools and resources Develop guidance for local publichealth commissioners Capacity building

  • Brief guide to employing behavioural and social scientists

in publichealth with a template job description

  • Publish BehaviourChange Framework and toolkit
  • Review training and whether competencies and standards

can be implementedand assessed more effectively Research and translation Continueto embed in various research funding streams Communities of practice Create online forum with resources and tools

  • Survey across local government to assess needs and monitor progress
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Provision of tools to help with…

  • Needs assessment
  • Applied Behavioural

Analysis

  • Effective change

methods

  • Co-creation methods
  • Efficient evaluation

methods

  • Transparent sharing of

results

  • System improvement
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Communities of practice…

North West…

(bsphn.org.uk) (uksbm.org.uk)

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Behavioural science in public health

  • Transdisciplinary
  • Cross-sectorial
  • Transparent
  • Collaboratively with communities and

stakeholder The new strategy has the potential to coordinate developments and to create synergy

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Than hank k you

  • u to
  • every

ryone who ho work

  • rked
  • n
  • n thi

his....

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11:05 – 11:20 Comfort Break

Tweet us on @nwphpn using #BhSci2019

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11:20 – 11:40

Case Studies – Behavioural Sciences in Action (Part 1) - CVD Prevention Digital Exemplar, Eleanor Wilkinson & Chryssa Stefanidou, PHE National CVD Prevention Team Q&A (5 mins)

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Incorporating behavioural science into an agile digital service design in public health PHE Digital: NHS Health Check

Dr Chryssa Stefanidou - Principal Behavioural Insights Advisor, PHE Eleanor Wilkinson - NHS Health Check Digital Exemplar Lead, CVD Prevention Team

May 2019

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Scale of the problem

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NHS Health Check

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A national risk reduction programme that aims to improve the health and wellbeing of adults aged 40-74.

It is key to preventing Cardiovascular Disease, which is the leading cause of death worldwide.

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Behavioural insights and NHS Health Check

Historically, the two teams in Public Health England have worked closely together to explore different elements of the NHS Health Check programme, for example looking at:

  • Invitation letters
  • Risk messaging
  • Branding
  • Telephone invitations
  • Marketing campaigns

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Digital Exemplar

➔ To Understand the NHS Health Check service from an end user, provider and commissioner viewpoint blending service design and behavioural insights research principles. ➔The project vision is to understand what service changes both digital and non-digital could improve the health check service focusing but not limited to ○ Increasing uptake of the service ○ Increasing the impact of the service ➔Conceptualise and prioritise possible service improvements as candidates for an Alpha.

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Multidisciplinary team

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Dr Chryssa Stefanidou- Behavioural Scientist Eleanor Wilkinson- CVD Subject Matter Expert Andrea Hewins- Product Manager Manisha Mistry- Delivery Manager Dellis Roberts- User Researcher

  • Prof. Jamie

Waterall- Service Owner Megan Roger Senior Interaction Designer Callum Bates User Researcher Vicki Litherland Content Designer Iain Cooper Senior Content Designer Kate Burn Senior Service Designer

CVD prevention Behavioural insights Digital

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Behaviour change in a digital service

⮚ Currently Behavioural Insights are not embedded in the agile service design process as a mandatory step ⮚ Public Health England are commissioning the development and implementation of a digital service with a Behavioural Insights Advisor as part of the multidisciplinary team

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8

Intro to digital

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Behaviour change in discovery

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Identify target behaviours associated with the uptake and follow up of the NHS Health Check from an end user, provider and commissioner viewpoint Identify evidence base for the research questions from high-quality systematic reviews Consult with experts to identify needs of the target population Recruitment of participants according to socio-economic, behavioural and cognitive characteristics in order to reflect a diverse range of participants COM-B model of behaviour change for designing and analysing the interviews Comprehensive analysis for all identified user needs using COM-B and TDF (explore barriers and need for a digital intervention)

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Develop recruitment screeners using psychological models and theories

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Recruitment of participants according to socio-economic, behavioural and cognitive characteristics in order to reflect a diverse range of participants Diary study to monitor people’s lifestyle behaviours (smoking, exercising, drinking etc.) Assessing people’s readiness to change their unhealthy behaviours Health Confidence Scale to monitor people’s confidence in their ability to manage their own health Digital Inclusion Scale to consider the different levels

  • f digital

literacy for individuals

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Identify user needs through qualitative semi-structured interviews

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The COM-B model informed the development of discussion guides to identify the barriers and facilitators of behaviours relevant to NHS Health Check

Behaviour: Start Action Plan (end users) Capability Do you think you have the skills to start the action plan? Capability Do you understand the next steps? Opportunity Do you have the support of your friends and family? Opportunity Do you have the time required to do it? Is there something to follow your progress (tools)? Motivation Do you believe that it would be a good thing to do? Motivation How important is it for you to be able to develop a better and clearer plan for doing it?

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Understanding user needs through Behavioural analysis

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Target Behaviour: Start action plan Attend referral (end users)

COM-B Theoretical Domains Framework Facilitators Barriers

Psychological Capability Knowledge

A lack of knowledge about next steps/action plan both in terms of what could do and how to do it

Social Opportunity Social Influences

Encouragement from people around them (partner, family, friends)

Physical Opportunity Environmental, Context and Resources

Access to technology; Significant life changes like moving home; Monetary incentive (ex. not wanting to waste a paid gym membership) Perception that time and location can be a barrier - finding the correct time; Perception that lifestyle services are not easy to access; Time limit on lifestyle service provision; Data privacy

Reflective Motivation Beliefs about consequences

Identification of risk and early detection of disease (ex. “prediabetes”) Potential challenges of changing lifestyles if visible symptoms don't exist

Automatic Motivation Reinforcement

Digital reminders/prompts; Seeing

  • ther people's progress and

achievements

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NHS Health Check User Journey

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Target Behaviours

  • End User
  • Provider
  • Commissioner

Facilitators + Highlights Barriers + Pain points

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Moving on to the alpha phase

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Identify intervention content which targets the influences on behaviours Provide a preliminary list of intervention functions and Behaviour Change Techniques Work closely with the service design team to translate this knowledge into engaging digital content and designs Test prototypes with embedded behaviour change techniques

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Key learnings

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⮚ We need to collaborate in multidisciplinary approaches to develop a service that is viable, desirable and feasible. ⮚ Behavioural science provides robust, validated frameworks that increase the likelihood for intervention effectiveness and can enhance the governmental digital service process. ⮚ Embedding behavioural science into the service design process can help

  • vercome subjective bias (e.g. small sample sizes).

⮚ Cross-government stakeholders should increasingly interact with and draw upon behavioural insights expertise to optimise public health services.

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Questions?

Chryssa.Stefanidou@phe.gov.uk Eleanor.Wilkinson@phe.gov.uk

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Appendix

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A Behavioural Approach

1.Define the problem in behavioural terms 2.Select the target behaviour 3.Specify the target behaviour 4.Identify what needs to change Stage 1: Understand the behaviour

Behaviour Capability Motivation Opportunity

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A Behavioural Approach

  • 5. Intervention functions
  • 6. Policy categories

Stage 2: Identify Intervention Options

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A Behavioural Approach

  • 7. Behaviour change techniques
  • 8. Mechanisms of action
  • 9. Modes of delivery

Stage 3: Identify content & implementation options

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11:40 – 12:00

Cheshire & Merseyside MECC approach, Dave Sweeney, Executive Implementation Lead, C&M Health & Care Partnership & Louise Vernon, C&M MECC Implementation Lead Q&A (5 mins)

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Population Behaviour Change in Cheshire & Merseyside

Louise Vernon Cheshire & Merseyside MECC Programme Lead Champs Public Health Collaborative Dave Sweeney Executive Implementation Lead Cheshire & Merseyside Health & Care Partnership

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Vision in C&M for Making Every Contact Count (MECC) at scale

  • MECC is a behaviour change approach that supports positive health and well

being choices, signposting the public to further information and support

  • We want to see MECC flourish in every place, building on great existing local and

sub-regional work and creating innovative approaches

  • The aim is to create a culture shift and focus on prevention
  • Every front line contact can add up to a huge impact on population health and

wellbeing in C&M

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Our approach in Cheshire & Merseyside

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  • 1. Systems Leadership
  • C&M has 2.5 million people, nine local authorities, 12 CCGs, nine trusts, one STP

and two fire and police authorities

  • In Aug 17 C&M DsPH Board agreed to help drive the delivery of MECC at scale using

a systems leadership approach with partners

  • The Champs Public Health Collaborative are working with those key partners (PHE,

HEE, NHSE, LA’s, STP and voluntary sector) to create a new innovative and large scale approach

  • Jan 2018 Scoping exercise report – assets and variation in practice
  • NICE Behaviour Change Guidelines PH6 and

principles underpin the programme - including planning, assessment, training, programme delivery and evaluation

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  • 2. Co-production of the vision/strategic framework

In April 2018 partners from across C&M met to establish a shared vision/ strategic

  • framework. Key recommendations included:
  • 1. Create a consistent and standardised approach to MECC, with an online portal

to share resources

  • 2. Establish a culture focused on prevention, this was seen as critical to enable

staff to fully utilise MECC training

  • 3. Produce an effective Communication and Engagement Strategy and ensure

senior leadership ownership

  • 4. Establish a Partnership Board to oversee the work on behalf of the broader

MECC network.

  • 5. Develop robust and standardised evaluation methods
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  • 3. Distributed Leadership – Partnership Board
  • Established Partnership Board co-chaired by Dave Sweeney, Executive

Implementation Lead, C&M Health & Care Partnership and Dr Charlotte Simpson, Healthcare Public Health Consultant , PHE NW and NHSE.

  • Essential representation from groups across the sub region
  • 3 active partnership working groups supporting the board in;

a) Training and Education b) Communications and engagement c) Evaluation

  • DsPH and the SCN co-fund a programme lead post
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  • 4. Workforce Development
  • C&M ambition to create a focus on prevention and embed a

sustainable model

  • An accredited face to face training programme is one of a suite
  • f learning opportunities available to everyone
  • Development of a train the trainer model by September to

strengthen the approach at scale

  • Suite of resources co-created and available to increase

awareness and knowledge

  • Creation of a network of MECC leads and champions
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  • 5. Communications & Engagement
  • www.mecc-moments.co.uklaunched today for colleagues to view

containing tools and support for local implementation

  • Communications and engagement strategy developed from insight

through 1:1 interviews with senior leaders, MECC leads and frontline staff in all public and voluntary sector organisations

  • Raising awareness and build understanding of behaviour change and

a shift in culture to focus on prevention, stimulating action

  • Co-produced with focus and test groups across C&M MECC

campaign, tools and resources to support behaviour change, including an on-line services signposting portal

  • Implementation leads and a new network of

colleagues will be supported to become MECC ambassadors

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  • 6. Evaluating impact
  • Guide - C&M How to Evaluate for MECC guide developed
  • Training evaluation process including impact on practice/confidence
  • Communications framework - Pre, mid and post developed to evaluate activity

using a set of key indicators

  • Leadership Insight project by PHE on how to support system wide

implementation of MECC

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Lessons Learnt – Perceived barriers from insight work

Early indications from PHE led organisational/system insight highlights;

  • Pressure/capacity
  • Commissioners need to be engaged; commissioning for full impact
  • Low priority in comparison to other challenges
  • Benefits realisation not understood
  • Simple and clear definitions needed
  • Public ask and vice versa
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Innovative opportunities in C&M

  • Fire and Rescue safe and well checks
  • PHE Insight work shared with key senior leaders (DoN’s, HRD’s)
  • STP NHS Prevention Pledge to include MECC
  • Pharmacy Network and Healthy Living Pharmacies
  • Primary Care Network pilots development with NHSE (2019)
  • PHE Dental Programme – Mouth Care Matters programme (2019-20)
  • DWP potential collaboration
  • Cancer Alliance collaboration on early detection
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Thank you

www.mecc-moments.co.uk #meccmoments Louisevernon@wirral.gov.uk

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12:00 – 12:30

Workshop One - Exploring the 8 key themes in the behavioural science strategy Mari Davis

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8 key themes in the behavioural science strategy

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Workshop One Questions on your tables – please use the booklet

  • 1. Why is this theme a priority?
  • 2. Where and in what way are we already doing this?
  • 3. What are we not doing?
  • 4. What further actions might we take?
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Tables 1 and 9 ……….. start with priority theme 1.. then 2 etc Tables 2 and 10 ………..start with priority theme 2.. then 3 etc Tables 3 and 11 ………..start with priority theme 3..then 4 etc Tables 4 and 12 ……….. start with priority theme 4..then 5 etc Table 5 ……….. start with priority theme 5.. then 6 etc Table 6 ……….. start with priority theme 6..then 7 etc Table 7 ……….. start with priority theme 7..then 8 etc Table 8 ……….. start with priority theme 8..then 9 etc

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12.30 – 12.45

Workshop One plenary session Mari Davis & Chairs

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12.45 – 12.50

Social Marketing Campaigns in the North West Paula Hawley Evans, Health and Well Being Programme Lead/Public Health Specialist, (PHE North West) introducing a Showcase film on behalf of Claire Troughton, Regional Marketing Manager (PHE North West) https://campaignresources.phe.gov.uk/resources/

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12:50 – 13:30 Lunch & Networking:

13:15 – 13:30 - Optional pop-up presentation - MECC launch Cheshire & Merseyside Tweet us on @nwphpn using #BhSci2019

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13.30 Introduction to the afternoon session:

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13:30 – 13:50 Case Studies – Behavioural Sciences in Action The power of combining behavioural science and social marketing, Sue Cumming, Liverpool City Council, Head of Behavioural Insight & Change Q&A (5 mins)

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Public Health Liverpool

The power of combining Behavioural Science and Social Marketing

Sue Cumming, Head of Behavioural Insight & Change, Public Health Liverpool, Liverpool City Council

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This Session…

Much of the global burden of disease arises from unhealthy behaviours BUT….. We still struggle to change behaviours Our behaviour is often not deliberate and considered

By understanding drivers of behaviour including attitudes, motivations, barriers and psychology we can create shortcuts in the brain to change behaviour

BUT….. Habitual and unconscious AND ….. In line with how we perceive other people to behave

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BEH EHAVIOUR

MOTIVATION AUTOMATIC REFLECTIVE

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REFLECTIVE AUTOMATIC

Problem Solving Effortful Logical Planning Slow Habit Impulses Emotional Automatic Fast

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Behaviour occurs as an interaction between three necessary conditions

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AUTOMATIC REFLECTIVE

Behavioural Insights Nudge Theory Insight and Social Marketing

BI preference for Randomised Controlled Trials SM uses marketing channels at scale BI uses routine data, literature, psychology and qualitative research, then tests SM uses market research and commissions interventions

AUTOMATIC

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Behavioural Insights Nudge Theory Insight and Social Marketing

AUTOMATIC REFLECTIVE

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Tools for Nudge

MINDSPACE

Messenger

Incentives Norms Defaults Salience Priming Affect Commitments Ego

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Reducing Obesity in Children Campaign to reduce sugar consumption in 4 – 11 year olds

AUTOMATIC REFLECTIVE

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38.8% of 11 year olds are obese or

  • verweight

34.6% of 5 year olds have decayed teeth 2 children a day (on average) under age 10 have to be admitted to hospital to have teeth removed

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INSIGHTS

Parents simply don’t know how much sugar their children are consuming. Food labels are bewildering and parents find it hard to understand how much sugar is in their children’s food Single items e.g. breakfast cereals don't appear to be high in sugar Parents of under 18s are more likely to believe that if a sugary cereal has other nutritional benefits, its ok to have for breakfast Parents are not aware of the Maximum Daily Amount of sugar

REFLECTIVE

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Much of sugar consumption is through ‘mindless consumption’ – dependent on the environment

AUTOMATIC

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The Liverpool sugar reduction journey

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EVAL ALUATION - Obese or ove verweight ht prevalence – year 6 childr dren

Source: PHE, NCMP profile

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EV EVALUATION

  • Over 85,000 visits to our website www.savekidsfromsugar.co.uk since launch 19/6/17
  • 16,500 completion of our online sugar checker that shows the total amount of sugar a

child has each day from a cereal, snack and drink.

  • In November 2017 a representative population survey was conducted with parents of

children aged 4 -11 to evaluate the campaign. Total number of interviews 310:

  • 65% of parents recalled seeing the campaign
  • 67% of parents who recognised the campaign said they did make a change as a

result of the campaign

  • 9 in 10 parents say the campaign will have an impact on them.

500 1000 1500 2000 2500 Jan-19 Feb-19 Mar-19 April

Save Kids from Sugar web hits 2019

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USING NUDGE, INSIGHTS AND SOCIAL MARKETING Campaign to motivate higher risk drinkers to drink less

AUTOMATIC REFLECTIVE

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  • 1 in 3 people in Liverpool are drinking above the national alcohol guidelines of 14

units per week. This is above the national average for England of 1 in 4

  • For those aged 40 – 64 Liverpool has higher than

national figures for the number of hospital admissions related to alcohol - 1945 people per 100k people compared to 877 for England

Liverpool data

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INSIGHTS

Limits often see as ‘scaremongering’. Some feel that they are set artificially low “14 really means 28” People disengage with info on ‘Units’ Most people don’t realise how much they are drinking People disassociate with the long term health risks

  • f drinking

People are motivated with the short term effects such as effects on appearance REFLECTIVE

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Normalised own behaviour – perceive other people drink more than them

People strongly believe they are in control of their drinking and that they drink less than ‘heavy drinkers’ or ‘alcoholics’. This results in them lacking any sense of risk or urgency to drink less

AUTOMATIC Much of Alcohol consumption has become habitual and automatic

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People sensitive to being identified as someone who needs to cut back on alcohol

❑ Potential red line to be introduced on weight gain ❑ Realisation that heavy drinking reflects own behaviour ❑ Challenge habitual drinking as lacking control

People want validation that their drinking is within a healthy level, but find units confusing and off-putting Triggers

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What’s been achieved one year later

  • 25,500 drinks checker completions. 2,000 completions per month.
  • 91,100 website users, 14,500 of these are returning users
  • GP referral pilot – 330 Patients
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Barriers and Enablers in the application of behavioural science to tackle Public Health.

Enablers

  • ‘Nudge’ topical
  • Behavioual Insight Team
  • LGA Grant Funding to run trials
  • Evidence creates acceptance

Barriers

  • Takes more effort
  • Budgets
  • Expertise
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THAN ANK YOU

Questions?

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13:50 – 14:10 Taking A Whole System Approach to Obesity, Julie Holt, Public Health Specialist, Oldham Council Q&A (5 mins)

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Oldham’s journey towards a whole system approach for obesity

Utilising behavioural sciences to improve health and wellbeing event 22nd May 2019, Warrington

Julie Holt,

Public Health Specialist, Oldham Council

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Overview

  • Scale of overweight and obesity issue in Oldham –

adults and children

  • Start of the journey – previous strategy
  • Whole system activity – stakeholder event
  • Pioneer site for PHE Whole System Approach to Obesity

(WSO) supported by Leeds Beckett University

  • Next steps - planned activities in Oldham
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All age overweight and

  • besity
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Excess weight in adults in Oldham 2016/17

Overweight and obesity (Excess weight) Adults (18+) England average 61.3% Oldham average 66.4% almost 7 in 10 Oldham’s population of 18 – 64 years is 137,000 Over 91,000 are overweight or obese

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NCMP results for children in Oldham 2017/18

Definition Reception year Year 6 Oldha m England Oldham England Healthy weight 75.2 76.6 62.3 64.3 Overweight 12.3 12.8 12.9 14.2 Obesity* 10.9 9.5 23.4 20.1 *Of which is severe

  • besity

3.0 2.4 4.7 4.2 ‘Excess weight’ Overweight and

  • besity combined

23.2 22.3 36.3 34.3

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Energy imbalance between calories in and calories out

Cause of obesity – simple view

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How active are adults in Oldham?

Adults (16+) 2016-17

Oldham England

  • No. of respondents

1010 198,911 Active 55.9% 62.6% Fairly active 12.5% 12.3% Inactive 31.6% 25.1% Oldham England

  • No. of respondents

1007 196,675 Participating at least 2 x per week 71.8% 77.2%

Adults (16+) 2017-18

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How active are children and young people in Oldham?

Sport and physical activity levels Activities taken part in over the last week Academic Year 2017-18

Activity levels Oldham C&YP in School years 1-11 England C&YP in School years 1-11 Active every day 60mins and over 9.1% 17.5% Active across the week 60 mins/day but not every day 20.9% 25.7% Fairly active 30-59 mins /day 24.9% 23.9% Less active less than 30mins /day 45.3% 32.9%

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Causes of obesity – a complex system

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Previous activity in Oldham

  • ‘Healthy Weight, Healthy Lives for Children in

Oldham 2010-2015’ Strategy

  • Based on Foresight report
  • Some activity undertaken
  • Scale and capacity challenges
  • Obesity rates have continued to rise
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Obesity prevention

‘The aim of obesity prevention is:

‘to stabilize the level of obesity in the population, to reduce the incidence of new cases and, eventually, to reduce the prevalence of obesity.’

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Comprehensive approach to prevention

  • Should address both dietary habits and physical activity patterns of the

population;

  • address both societal and individual level factors;
  • address both immediate and distant causes;
  • have multiple focal points and levels of intervention (i.e. at national,

regional, community and individual levels);

  • include both policies and programmes;
  • build links between sectors that may be otherwise viewed as

independent.

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Stakeholder Event, Chadderton Town Hall 19th November 2015

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Oldham Priorities

Physical Childhood excess Adult excess Diabetes inactivity weight weight Heart disease Poor eating / Poor oral health Strokes drinking habits Cancers

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Asset based approach

  • Asset v deficit approaches
  • What are assets?
  • What are assets for health?
  • Asset based tools and techniques
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Roundtable discussion 1 Opportunities for action to address overweight / obesity and enable healthy weight

Enabling and supporting behaviour change:

  • around physical activity and play
  • around eating and drinking behaviours:

Supportive environments:

  • around physical activity and play
  • around healthy eating and drinking
  • wider aspects including built environment /

green space / housing and active travel

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Roundtable discussion 2

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Barriers

Several themes were identified:

  • accessibility
  • communication,
  • education,
  • funding,
  • regulation
  • services.
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Priorities identified

  • 1. A multi-agency strategy
  • 2. Communication, education and

health promotion.

  • 3. Information on services and

activities

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Whole System Approach to Obesity

Oldham was a ‘pioneer site’ in the Public Health England funded programme supported by Leeds Beckett University. The aim of the programme was ‘to explore how a local area could use all its levers, resources, leadership and relationships to create a more effective, sustainable, system- wide approach to tackling obesity’.

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WSO activity

  • Attended trainings
  • Used and reviewed manual
  • Held 2 multi-agency workshops in November 2017
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Mapping the causal system – topics explored

Table number Facilitator/s 1 2 3 4 5

1 Anna Tebay Convenience foods Lack of physical activity Lack of awareness: healthy choices portion sizes Lack of skills to prepare healthy foods Low income 2 Oliver Barnes Joint Parenting skills/ knowledge/ understanding of healthy diets Access and availability of unhealthy fast food Perceptions of what a healthy diet is Physical activity – emergence of technology Low income 3 Gloria Beckett Cultural values and beliefs Social norms Reduced skills and education East access to take away/ convenience foods Poor mental health 4 Lianne Davies Learnt behaviours passed down for generation to generation Availability of fast foods Conflicting policies - not being consistent Technology Advertising 5 Dominic Coleman Cultural influences Joint Large numbers of takeaways and unhealthy food Low incomes Infant feeding / breast feeding / antenatal care Physical activity – access for all

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The food environment – hot food takeaways

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Behaviour change through the life course - Pre-conceptual, maternity and early years

  • Pregnancy advice
  • Breastfeeding
  • Healthy Start
  • Early Years
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Food and drink choices

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School aged children

  • ‘Whole school approach’
  • School Governors’ training
  • Foster carer’s training session
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Play and Physical activity

  • Promote play
  • GM Moving
  • Schools - sports

development, daily mile, ‘Health champions’

  • Park runs
  • Walking – ‘Walking for

health’

  • Cycle – Infrastructure

development

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Adults

  • NHS Health Checks
  • National Diabetes Prevention

Programme

  • Get Oldham Growing
  • Weight Loss Voucher Scheme
  • Prediabetes cooking programme
  • Community activities:

– Slimmin’ without women – Man V Fat

  • MECC
  • Health literacy
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Opportunities for prevention

  • Planning
  • Licensing
  • Environmental Services
  • Children’s services
  • Adult Social Care
  • People Services- Fit for Oldham
  • Thriving Communities – Place Based Initiatives / social prescribing
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The proposed 5 waves of public health

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Support and treatment - care pathways

  • Training of staff to raise the issue with individuals, families and carers
  • Embedding play, physical activity and healthier eating in care pathways
  • Need to agree clear weight management care pathways for pregnant

women, children and families and adults with access to commissioned services and alternatives to meet needs

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Senior leadership support Data and intelligence Partnership and collaboration Dedicated time and commitment from the team implementing the approach and the w ider system netw ork Dedicated time and resource to support development of w orkforce capacity Accountability and governance structures

Outputs Activities and Participants Short term

  • utcomes

(1-2 yrs.) Medium term

  • utcomes

(2-4 yrs.) Long term

  • utcomes

(5yrs+ yrs.) Inputs

Collate and use data and intelligence to develop a narrative that makes the case for change and demonstrates how health inequalities w ill be addressed Health in all Policies Approach being implemented across the Council Provide leadership to persuade stakeholders to take action Community engagement in the approach Collaboration w orking across departments and w ith other

  • rganisations

Development and implementation of a localised obesity action plan that identifies, prioritises and aligns actions(including policies and programmes) across stakeholders Engage stakeholders to support a w hole systems approach to tackling

  • besity

Actions in place to target health inequalities Develop collective stakeholder

  • w nership of the issue through

development of systems map that depicts obesity causes in the local area Prioritised and aligned set of actions being delivered to tackle obesity across the local system, that address health inequalities Feedback loops betw een activities and

  • utcomes

Systems thinking practice being integrated across the Council Assumptions Central Government action will enable/ amplify local action on tackling obesity. Systems change will impact on

  • besity related outcomes

Local delivery & implementation will vary to ensure suitability and relevance to local circumstances Activities are cyclical – not linear

  • and feedback loops will

be key Systems behaviours embodied by the local authority and local stakeholders Collaborative w orking across departments and w ith other organisations Improvement in intermediate markers of health and inequalities (healthier eating and physical activity) Transferable w orkforce skills and capacity related to systems w orking developed Community and other assets being used effectively Reduction in child and adult obesity in the local areas Reduction in health inequalities Improvement in w orkforce productivity Savings

  • health and

social care

Systems change Health outcomes

Whole Systems Obesity Logic Model

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Strategic approach

  • Oldham Council (Health and Wellbeing) Directorate Senior Management

Team – Briefings and detailed papers/ presentation

  • Scrutiny Committee – Presentation/ workshop
  • Elected Members development session planned
  • Portfolio Lead Health and Wellbeing – meetings/ briefing papers
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Strategic activity – Next steps

  • Multi-agency steering group
  • Strategy and action plan
  • Focus on opportunities:

– Council responsibilities and functions – Training – Communicating consistent messages – Public sector workforce - Council and NHS – Community and Voluntary Sector – Place-based resources including greenspace

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Aim

‘A local whole systems approach responds to complexity through an

  • ngoing, dynamic and flexible way of working that enables local

stakeholders to come together, share an understanding of the reality of the challenge, consider how the local system is operating and where there are the greatest opportunities for change. Stakeholders agree actions and decide as a network how to work together in an integrated way to bring about sustainable, long term change’.

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Contact details

Julie Holt Public Health Specialist Oldham Council Email: julie.holt1@oldham.gov.uk

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14:10 – 14:25 Comfort Break

Tweet us on @nwphpn using #BhSci2019

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14:25 – 15:00

Workshop Two - Mari Davis How do we take a shared and scaled approach to integrating behavioural sciences into health, care and public health commissioning? Service delivery across the NW geography – what might that look like?

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Questions on your tables

Action 1: Identify the barriers and enablers

  • Barriers – what will hold us back?
  • Enablers – what will propel us forward?

Action 2: Identify the opportunities and how we might make this work Opportunities:

  • In our organizations
  • With partners in our local area
  • With partners in the NW region
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➢ 15.15 – 15.35

  • 1. Identifying our personal, organizational & regional commitments to

actions in the strategy

  • 2. . Post-conference questionnaire & evaluation form
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Identifying our personal and organisational commitments to action

  • What can we each commit as first steps to taking action
  • Write on your post it and put your name on the post it
  • Share with a partner for 2 mins each
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Post-conference questionnaire & Evaluation form

Please complete your pre-conference questionnaire as found on your table and return to Marie, answering the following: ➢ Which County or Borough do you represent? ➢ What type of organisation are you from? ➢ How do you rank your level of understanding of behavioural science approaches on a scale of 1-10? ➢ On a scale of 1-10, how valuable was the symposium in enhancing your knowledge of how behavioural science can be embedded within your

  • rganisation? In your opinion, is enough being done within your organisation to embed behavioural science into practice?

➢ On a scale of 1-10, how valuable was “Improving People’s Health: Applying Behavioural and Social Sciences to improve population health and wellbeing in England Strategy Launch” in enhancing your knowledge of how behavioural science can be embedded within your organisation? Does your Department have a budget set aside for commissioning or directly providing behavioural science expertise? ➢ On a scale of 1-10, how valuable was “Case Studies – Behavioural Sciences in Action (Part 1)” in enhancing your knowledge of how behavioural science can be embedded within your organisation? ➢ On a scale of 1-10, how valuable was “Workshop One” in enhancing your knowledge of how behavioural science can be embedded within your

  • rganisation?

➢ On a scale of 1-10, how valuable was “Social Marketing Campaigns in the North West” in enhancing your knowledge of how behavioural science can be embedded within your organisation? ➢ On a scale of 1-10, how valuable was “Case Studies – Behavioural Sciences in Action” in enhancing your knowledge of how behavioural science can be embedded within your organisation? ➢ On a scale of 1-10, how valuable was “Workshop Two” in enhancing your knowledge of how behavioural science can be embedded within your

  • rganisation?
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15:35 – 15:45

Chairs Summaries and closing remarks Safe journey home