How behaviour change can help with our ‘wicked problems’ - Dr Fiona Spotswood

Marketing academic, Fiona Spotswood’s interdisciplinary view on behaviour change is explored in her book Beyond Behaviour Change which publishes this month. Spotswood argues that understanding the complexity of behaviour change, including the diversity of approach and its history, will be key to tackling issues such as climate change and obesity.

Sadly, wicked problems like obesity and climate change aren’t going anywhere fast. As such,‘behaviour change’ has become a buzzword in academia and amongst policy makers. Research councils fund it, academics research it and policy makers do it.

But like all topics of social scrutiny, behaviour change is evolving. A mind map of key issues would include things like ‘interdisicplinarity’, ‘nudge’, ‘systems thinking’, ‘individual responsibility’ and ‘rigorous evaluation’.

Topics like these are the subject of discourse within centres which study behaviour change across the UK. There is no cohesive ‘field’ of behaviour change, but a disparate range of experts who continue to build a portfolio of evidence from their particular set of ideological, methodological and ontological perspectives.

No silver bullet

What fascinates me is bringing together the range of these perspectives from established experts across the spectrum of behaviour change approaches and considering the historical roots of political, legal and persuasive intervention, along with the ‘nudge’ craze and softer marketing based measures.

This inspired me to write Beyond behaviour change, as did the House of Lord’s Science and Technology Committee’s findings from their review of behaviour change; there is no silver bullet and approaches to behaviour change will be most effective if they are combined.

Unravelling problems

This has become the mantra of good practice now and is not news, but what is interesting for me is the way theory can help reconceptualise a wicked problem and unravel it to a point where interdisciplinary interventions can be implemented.

Untitled The Foresight Obesity Map Systems thinking is a good example; providing a way of illustrating the complexity and interrelationships between factors at varying ecological levels.

The Foresight Obesity map (shown right) is the most famous example: a simple glance demonstrates the sheer overwhelming magnitude of the problem of obesity. Surely interdiscipinarity has to be the answer.

Theoretically, however, I find social practice theory makes an even stronger contribution to reframing behaviour change and I am certain it will be (or at least I hope it will be) a backbone of work in the future.

Going back to the Foresight Obesity map, a clear fallout is that focusing behaviour change approaches on the individual will fail to make the impact that is required.

“practice theory does not seek to analyse the individual but rather the practice itself”

That is not to denigrate the fantastically rigorous evidence base unpicking the most effective combinations of individually-focused interventions, it is simply to argue that the need for a more systemic, holistic approach to complex wicked problems is a given. I think theories of practice have a lot to offer here.

In a nutshell, practice theory does not seek to analyse the individual but rather the practice itself, made up of elements in the form of competences, materials and meanings. Practices are treated as an ‘entity’ which are carried and performed by individuals.

Constituent practices

To understand a wicked problem, researchers disaggregate it into constituent practices – like that of snackfood eating, driving or watching television. We study the way the elements within the practice are linked, break, performed and reformed and how the practice has evolved and might be encouraged to evolve in a socially beneficial way.

The implications of practice theory are far reaching. For example, the approach stops the prevailing emphasis that the individual is always the ‘thing that has to change first’ to solve society’s problems.

It opens up a need for new ways of doing research and for policy makers to accept methodological and ontological variety. It implies interdisciplinarity because a multitude of solutions will naturally be required to tackle the links between elements.

“Regulation does not fit within the current neoliberal political climate, whereas interventions which require individual responsibility and self-management do”

With these implications come challenges, such as the emphasis in policy circles on positivist, traditional forms of research evidence – those that tend to consider the impact of various effects on an individual’s decision making. Also there is the problem of regulating business – surely a necessity if a practice theoretical analysis of practices involved in obesity, for example, is to be followed to its natural conclusion.

Regulation does not fit within the current neoliberal political climate, whereas interventions which require individual responsibility and self-management do. The abstract nature of SPT can be a challenge, too, and the lack of associated ‘toolkit’ for policy use. Undoubtedly academics and policy makers – in their two culturally alien worlds – need to work on how to improve communication of evidence and the applied usefulness of theory.

It is clear to me that the future cannot contain a continued focus on downstream interventions based solely on individualism, and that we must embrace a new paradigm which incorporates interdisciplinary, holistic thinking and methodological flexibility.

However, this call for paradigm shift and holistic thinking by no means represents a conclusion reached by all Beyond behaviour change’s contributors, and in fact the tensions between some of the chapters are an intriguing part of the story. The intention is not to force cohesion but to facilitate progress by providing a space for the consideration of diverse ideas, and most of all to encourage movement within the discourse. I invite readers to become part of this discourse around ‘behaviour change’ at this pivotal point in its history.

Beyond behaviour change: Key issues, interdisciplinary approaches and future directions is available to order here from the Policy Press website for £26.99.  
 

We are the rats - blog post by Dr Fiona Spotswood

“As we set off for our run, a swarm of hi-viz sweeping down the pavement, most of the group were attempting to avoid tripping over the feet in front whilst peering and tapping at their wrists to start a heart rate watch or Garmin tracker. All you can hear is ‘beep beep beep’ and the panting of runners whose minds are not focused on avoiding the puddles but rather on their cosy post-run analysis of each kilometre; armchair, recovery drink and commentary on which bit was hard, where they improved and who they beat up which hill. It’s a new kind of running” (research field notes by the author).

Google Image

Self-tracking devices are popular for amateur ‘leisure time’ runners, and underpin a set of activities which include data analysis, social media sharing, comparison and goal-setting for improvement. ‘Wearable technology’ is a growing area of technological development, offers market potential and is ripe for research interest.

Working with Lukasz Piwek from Bath University, I am conducting a piece of research which examines wearable technology from an innovative perspective. Most research in this area – from a ‘behaviour change’ perspective - is about whether or not self-tracking devices ‘work’ as a mechanism for improving the self-regulation of physical activity or calorie intake. This fits the bio-medical paradigm and also the ‘New Public Health’ emphasis on individuals’ capacity to mitigate risk and take responsibility for their own health. Within a neo-liberal political environment which fiercely protects the market and supports individual responsibility above all else, this ‘healthist’ paradigm has supported a related burgeoning of consumerism, wherein the market is continuously producing new ‘solutions’ to consumers’ ‘problems’ in the form of wearable devices, technological platforms, social media, fitness apparel and so on.

There is considerable literature critiquing the current focus on self-responsibility in the public health and behaviour change arenas. One theoretical platform for criticism is Foucault’s notion of governmentality. Governmentality emphasises that striving for ‘perfect’ health involves intensive ‘work on the self’ or self-governance, and despite the language of empowerment and freedom, this striving actually entails compulsion, added responsibilities to others, and often punishment and social exclusion in the case of those who fail to conform. The ‘panopticon’, wherein prisoners are controlled both by the prison guards and the other prisoners, is a useful metaphor.

The Panopticon

Within the healthist paradigm, individuals are both self-governing but also controlled by greater forces; health has taken on a moral element, where those who fall short are in society’s spotlight. Individuals are ‘governed’ through the emphasis on self-responsibility, although not through coercion but through subtler measures. Through the repeated emphasis from political and corporate agendas, individual ‘desires’ are aligned with those of the powerful. The market and government collude to provide the structures to ‘help’ people maintain their health through self-discipline and responsible citizenship.

What I’m getting at is that we are the rats and the policymakers and corporations are the pied piper.

Taking responsibility for your own health is not a bad thing, per se. But an emphasis on responsibility means we assume a lack of criticality about the broader, bigger, bolder forces which shape society in which our apparent ‘decision making’ takes place.

Researching ‘behaviour’ in a different way is a starting point for sharing in a fairer way the focus of responsibility for ‘wicked problems’ between individuals and the corporate giants. Theories of Social Practice can help us do this. Social theory has been introduced as a potential way of avoiding the focus on individuals which is a characteristic of the predominant paradigm of behaviour change policy and research. Individualistic focus is unrealistic (how can an individual possibly seek to make decisions that are not influenced by Coca Cola’s multi-billion dollar marketing budget), can lead to victim blaming and leads to an avoidance of meaningful change (including regulation) on largescale societal forces.

Rather than focusing on the individual, the unit of analysis in theories of practice is the practice itself, often usefully conceptualised as comprising three elements – materials, meanings and competences. Practices are treated and research as ‘entities’ in which individuals act as carriers and crossing points of bundles of practices. Through their regular, routinized performance, practices are sustained and evolve.

By using social practice theory to explore empirical findings about how and why runners self-track using wearable technology, it is our intention to unpick the whole entity of self-tracking practice and its bundle of interrelating practices. Rather than thinking about self-tracking as a ‘health behaviour’, which is a limiting concept because it presumes all ‘health outcome’ variables lead to and come from individual responsibility and action, our research will consider the meanings, materials and competences involved in self-tracking, plus those of neighbouring practices such as club running, sharing, comparing and analysing run data, setting goals for future training and so on. We will attempt to conceptualise the practice as a whole, and use our findings to critique existing portrayals of self-tracking as a way of ‘taking responsibility for health’, a conceptualisation we suspect is too simplistic to do justice to the complexity of practitioners’ performances, which might not fit quite so neatly into traditional thinking about ‘health behaviours’ as the pied pipers would have us believe.