Take the next step with a small change.

Design for Health Behaviour Change is not new nor is it always a billion dollar industry associated with smart apps, hospitals with pretty gardens or seductive web sites with luscious photos and texts.

Often it’s everyday people using what they have to make objects, spaces and messages that help them stick with a set of actions to get through a really bad health patch. And they do this because things will get worse, even fatal, if they don’t.

Just think about your big toe for example. If you damage a big toe, what seems like a small injury makes a huge impact on your life. Athletes, policewomen, postmen, homemakers and schoolchildren know this well. But with a damaged big toe you still have to get around, albeit, more slowly and more infrequently.

Even some injured animals like those brave, hobbling main-road dogs, redesign how they move. They make themselves efficient in spite of their disability. These dogs, unfortunately, live in a very unkind world so they just have to make do by any means necessary. To eat from the garbage, hobbling is the only thing that works.

People aren’t main-road dogs.

A busted toe is a small, but still big problem. Many of us can solve some of our accidents or bad health behaviour on our own, but plenty of us need help with the big wicked problems like drinking too much; eating badly; sleeping too few hours; having unprotected sex; smoking too much; texting while driving; not getting enough physical activity; getting badly stressed at work or at home and so on.

Taken together, bad health behaviour adds up to crippling expenses on national health budgets the world over. Government policy-makers would love to find sustainable solutions to these wicked problems, and so would ministers, but worldwide the problem is that high-level policy makers think all people need is the right information and they will change their habits.

Of course this is not so. And everybody knows this is not so. And we all know this will never be so. If it were that simple to change behaviour by providing information, then those trillion-dollar information campaigns surrounding us, on the benefits of healthy eating; protected sex; saving the environment; physical exercise; and being kind to people with disabilities would work like a dream. We would all meticulously record the right things to do, and whenever there is a health threat we would immediately replay the right actions stored in our brains to effortlessly avoid the threat. With the right information programmed in our brains we’ll never have that ‘one for the road’ or that extra doughnut. We’ll always ward off any sexual temptations and we’ll never answer a text while driving. We’ll all be perfect and live to be over one hundred years.

This will never happen. We will always make bad health choices. To change health behaviour we need to design interventions based on the science of how humans behave in real-world health situations rather than how policy makers imagine they should behave. Such interventions can be small changes that are incredibly creative.

I’ll say that throwing your entire budget behind ‘information’ and ‘awareness’ campaigns is a very bad choice. Probably it’s one of the top wicked problems in population health.

Steve.