Behaviour Change in Public Health: Evidence and Implications

The evidence on the role of particular lifestyles, smoking, binge drinking, lack of physical activity, and poor health care seeking, in increased risks for mortality and morbidity is compelling [1]. Understanding the pathways through which these various " unhealthy " behaviours affect health is complicated by the broader ecological context in which they occur. The complexity is further enhanced because behaviours do not occur in isolation and there is often a convergence of associations. Interventions to achieve changes in either single or multiple behaviours have therefore often been limited in their effectiveness and longer term sustainability. In order to develop and implement a meaningful behaviour change agenda we need to establish innovative ways of opera-tionalising and understanding the complexity of behavioural factors and their dynamic interrelationships and how these collectively affect health. The Behaviour Change Research Cycle (BCRC) (Figure 1) provides a simple illustration of the life cycle of evidence required. Extant research on behaviour change interventions highlights the importance of structural support and a range of requisites such as capability, motivation, and opportunities [2]. Taking this broader perspective on behaviour change extends the field beyond merely a psychological enquiry aimed at understanding individuals' behaviour to a more pragmatic endeavour that includes research that can actively inform the development and implementation of interventions. Evaluation of the appropriateness, cost effectiveness, affordability, acceptability, and sustainability of the intervention follows thereafter. Generating evidence on behaviour change is therefore as diverse as the academic disciplines supporting wider public health practice [3]. Through this special issue, robust research on behaviour change, as envisaged and implemented across the range of public health disciplines, is presented to enhance our understanding of how behaviour change research could inform public health practice at local, regional, and global levels. The selected papers in this issue provide avant-garde research across the various levels of the behaviour change research cycle. Research on motivators of certain behaviours is presented through three studies included in this special issue. W. Liang and T. Chikritzhs explore survey data and find a significant association between heavy alcohol use and risk of violence. Likewise, pro-and antitobacco imagery as seen in media and other outlets appear to be an important determinant of the attitudes towards and uptake of smoking among adolescents. G. Waqa et al. conclude therefore that public health warnings can work in real life. Most behaviour change (positive or negative) happens when individuals find themselves in a …