Many health interventions encourage people to adopt healthier behaviours, but intention alone is often insufficient to achieve sustained change. Cancer Research UK’s nurse-led outreach activity supports cancer prevention, early diagnosis and screening in deprived community settings.
This project sought to redevelop an existing behaviour change tool using behavioural science principles to better support individuals these settings in moving from thinking about change to taking action and maintaining new behaviours. It used a process evaluation of the current tool and a behavioural diagnosis of behaviour change attempts in outreach activity visitors to inform the redevelopment.
The redevelopment focused on creating a practical, user-friendly resource that helps people assess their readiness to change, identify barriers and facilitators, set goals, make plans, and track progress.
Two key themes were identified in a nurse focus group: the value of habit theory and limitations in lack of time or difficulty applying habit theory.
In observation of outreach activity visitors, two types of visitor were identified. People either had high or low readiness to change. This groups require different interventions to target different aspects of the COM-B behaviour change model.
In redevelopment, three types of intervention were incorporated: enablement, persuasion and incentivisation. For visitors with low readiness to change, the new tools need to enable positivity towards making changes. For visitors with high readiness to change, the new tools need to enable identification of behavioural goals, persuade people they are capable and incentivise changes.
Other types of intervention to not meet the criteria for incorporate into the tool, including education, training, environmental restricting, coercion or restriction.
The redeveloped tool was structured around key stages of behaviour change, including assessing readiness, exploring advantages and disadvantages, planning behaviour change, overcoming barriers, and monitoring progress.
The "Getting Ready to Change" section was created to encourage users to reflect on their motivation and readiness to change, helping them weigh perceived benefits and costs before committing to action. The tool incorporated techniques commonly used in behaviour change interventions, including self-reflection, problem solving, goal setting, action planning and self-monitoring.
The redevelopment also created a structured action plan and progress-tracking component, recognising that behaviour change is an ongoing process and encouraging people to learn from setbacks rather than viewing them as failures.
This work demonstrates how behavioural science principles can be translated into practical resources that support people to make health-related behaviour changes. By breaking behaviour change into manageable stages, the tool helps individuals move from motivation to action while addressing common barriers that can prevent change from being sustained.
The redevelopment emphasises evidence-informed techniques such as goal setting, action planning, problem solving and self-monitoring, all of which are associated with successful behaviour change interventions. Embedding these techniques within an accessible resource may help improve engagement and support people to make meaningful lifestyle changes.
The findings also highlight the importance of supporting both motivation and confidence. Helping people identify why they want to change, while providing structured tools to plan and review progress, may increase the likelihood that intentions translate into real-world behaviour change.
Future research should explore how the redeveloped tool performs in practice, including its acceptability to users, its impact on behaviour change outcomes, and how it can be adapted for different populations, settings and health behaviours.
Read the report in fullVictora Whitelock, Ceri Eames, Lesley Green, Megan Cook, Sophie Tring, Kirstie Osborne.
If you have any comments, questions or feedback, please reach out to our team.
