Creativity in Behaviour Change

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Creativity in Behaviour Change 

– A day of learning, sharing and creating as part of LSHTM’s annual symposium – 

Just about every public health problem requires a change in behaviour. Designing innovative toilets is no good if people will not use them. Developing new drugs is money wasted if you cannot get people to adhere to their treatment course. However, at the Environmental Health Group (EHG) we realised that often people in the behaviour change sector don’t share ideas frequently enough on what really works in behaviour change. For some time our team at the EHG  have had a lot of questions bubbling up in our minds that we thought could be best addressed by bringing a lot of actors within the sector together. In particular we realised that at the moment a lot of academic effort is being channelled into how to evaluate behavior change interventions while less time, effort and funds are allocated to how to actually create a good behaviour change intervention. And so the idea for a Creativity in Behaviour Change day was born!

On the 23rd of September 185 people gathered in the John Snow Lecture theatre at LSHTM. Two thirds of those attending were LSHTM staff or students. However, the remaining third were representatives from NGOs, donors, Government representatives and academics from other institutions.

Want to know more about who was speaking and what about? You can find the full agenda for the day here.



In the morning Val Curtis and Robert Aunger from the EHG kick started the event with an interactive session that explored what behaviour change is and why creativity is an important ingredient in the process. They outlined the behaviour change approach that they have developed over several decades and gave examples of how it has been applied to a range of behaviours in interventions across the globe. Robert Aunger explained the theory that underpinned the approach and compared this with other models of behaviour change and theories of creativity. He explained that their approach also had 5 stages: Assess, Build, Create, Deliver and Evaluate which guide their process of intervention design. By the end of the session the audience had tried to apply the approach to their own ‘problem behaviours’ that they wanted to change. During the morning tea break the audience participated in a mapping exercise to understand where in teh ABCDE process everyone was currently working.

Watch the video of the morning session by clicking this link

Download Val Curtis and Robert Aunger’s Slides here: Aunger&Curtis.
Read a summary of the Behaviour Centred Design approach (BCD summary) or search other materials about it here.


After the morning tea break we had a session on formative research for behaviour change intervention. In recent years formative research has increasingly been considered as standard practice when designing behaviour change interventions but the speakers in this session highlighted the diverse array of methods that can be employed to do this. At the beginning of the session we heard from Hans Mosler, a professor at the University of Zurich. He explained the RANAS Framework which he uses in conjunction with qualitative work to help quantify the factors that are likely to lead to adoption of the target behaviour. Fern Terris-Prestholt, a Lecturer at LSHTM, then presented her work on discrete choice experiments. She explained how she had used pictorial discrete choice experiment tools to understand user preferences for the services provided by male circumcision clinics. The next presentation was done jointly by Katie Greenland, a Research Fellow at LSHTM and Crispen Sachikonye from the creative agency DDB Zambia. Together they explained how they moved from formative research insights into developing a creative brief and campaign concept for a multiple behaviour change intervention in Zambia (see more about this on our website).  The last presenter was Marc Sands the Communications Director of Voices for Change. He explained how they came to understand their target audience and the design decisions they made as a consequence. At lunch time the audience was treated to the ‘Behaviour Change Cinema’ which showcased short clips of innovative behaviour change interventions from around the world.

Watch the video from the second session by clicking this link
Download the slides from the speakers here: 

After lunch we began a session on the creative design of behaviour change interventions. The aim of this session was to understand whether creativity is something that could be done more systematically. Sian White, a Reserach Assistant at LSHTM, began the session by talking the audience through each step of the creative process which was used to design a nutrition behaviour change intervention in Indonesia. The second presentation was given by John Hackney, the Managing Director at McCann Health who shared his top tips for how to get the best out of a creative agency as well as some of the common pit-falls to be avoided during the creative process. Lastly, Weston Baxter a research degree student at Imperial College explained how the Design Engineering Group is exploring and systematising creativity. He presented diverse case studies, from epi-pen use to recycling, and emphasised the need to prototype product ideas early. Following these three presentations the speakers joined a panel discussion where the audience asked questions.

Watch the video from the third session by clicking this link

Download the slides from the speakers here: 

In the last session of the day we pondered what the future of behaviour change might look like. Ford Hickson, a lecturer at LSHTM, started the session with a theoretical paper explaining why current HIV prevention interventions are inadequate to control HIV and other STIs among men having sex with men (MSM) and went on to suggest that evolutionary psychology might hold the keys to an alternative approach. We then heard from Heidi Hopkins from the ACT Consortium at LSHTM, she described REACT study which tried to change the behaviour of health workers in diagnosing and treating Malaria. She highlighted what can be learned from studies that yield mixed results gave her thoughts on why interventions might and work or not work.
Lastly we heard from Tara Macleod the Deputy Director of Strategy and Planning at Public Health England. She explained PHE’s unique marketing strategy which establishes umbrella brands throughout the life-course and then identifies stakeholders in the private and NGO sectors to align themselves with. Tara concluded that the strategy has enabled their work to become much more effective and recommended that it could be an example for other countries to follow. The day ended on a highlight with the ‘Behaviour Change Soapbox’ where 8 speakers had 3 minutes to share their big ideas for the future of behaviour change.

Watch the video from the last session by clicking this link.
Download the slides from the speakers here: 

Note:  Ford Hickson did not use slides

The following courageous speakers shared these big ideas during our Behaviour Change Soapbox:

Janneke Blomberg from GAIN – Shared lots of small ideas from her recent experiences designing a behaviour change campaign with LSHTM in Indonesia. Her key lessons were to ensure that learning is built into the program throughout, she spoke of the value of buying consumer insights and being agile and flexible throughout so that you can iterate and adopt changes. She said that creative process should also build on positive examples from the private sector and that its important to understand the way your partners work from the outset.

Tony Rawlins from Stepjump Marketing – Reminded us why its important to draw on the expertise of creative agencies. He encouraged academics and practitioners to engage with how creative agencies work and make sure that what we develop is entertaining and that it communicates what we intend it to.

Philly Desai from Voices for Change – Philly explained why behaviour change interventions work best when they draw on a range of behaviour change approaches and disciplines. He explained how social norm theory, social network theory and behaviour economics was used in Voices for Change.

Saud Alrakhayes a private consultant – His big idea was that the behaviour change world needed to stop working in silos and begin to be more multidisciplinary and multifaceted, bringing approaches together, talking to each other more, through events like today, and addressing behaviours across different sectors.

Karen Tan from Public Health England – Her big idea was reminding us to think small. Often behaviour change can utilise the same resources and platforms that are already in plce. What is needed is to adjust and ammend them so that they have more effect but do not add cost. She gave the example of PHE’s letters that go out to women to remind them about cervical cancer screening. The letters have been going out for years but now they are trying to play with the wording to see if they can make them more effective.

Miwako Nagasu a Reserach Student at LSHTM – reminded us that often people doubt their ability to change their behaviour and this obstacle causes them to switch off completely. Her challenge to us was how can we design behaviour change approaches that are supportive and help people think ‘I can do it.’

Om Prasad Gautam from Wateraid UK – As the head of hygiene for Wateraid Om said that a major challenge for the sector was to take behaviour change to scale so that interventions could be done at a global level. His idea was to devlop a behaviour change module for building the capacity of actors around the world.

Susan Wolf from Disability Awareness at St Martin in the Fields – Her big ideas was to support people in becoming self-aware so that they face less fear in adopting new behaviours. Changing behaviours can be scary and exciting for many and only through self awareness can people becomes aware of alternative behaviours and choices.

We asked some attendees to define what behaviour change was – check out their responses below.

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