Determinants of behaviour and their efficacy as targets of behavioural change interventions

Abstract

Unprecedented social, environmental, political and economic challenges - such as pandemics and epidemics, environmental degradation and community violence - require taking stock of how to promote behaviours that benefit individuals and society at large. In this Review, we synthesize multidisciplinary meta-analyses of the individual and social-structural determinants of behaviour (for example, beliefs and norms, respectively) and the efficacy of behavioural change interventions that target them. We find that, across domains, interventions designed to change individual determinants can be ordered by increasing impact as those targeting knowledge, general skills, general attitudes, beliefs, emotions, behavioural skills, behavioural attitudes and habits. Interventions designed to change social-structural determinants can be ordered by increasing impact as legal and administrative sanctions; programmes that increase institutional trustworthiness; interventions to change injunctive norms; monitors and reminders; descriptive norm interventions; material incentives; social support provision; and policies that increase access to a particular behaviour. We find similar patterns for health and environmental behavioural change specifically. Thus, policymakers should focus on interventions that enable individuals to circumvent obstacles to enacting desirable behaviours rather than targeting salient but ineffective determinants of behaviour such as knowledge and beliefs.

Fig. 1 ∣. Effect size range in meta-analyses of behaviour change.

a,b, Range (minimum, red; maximum, yellow) and mean (line) of effect sizes (odds ratios) for meta-analyses of individual (Supplementary Table 1) and social-structural (Supplementary Table 3) determinants of change (panel a) and for meta-analyses of intervention studies that targeted individual (Supplementary Table 2) and social-structural (Supplementary Table 4) determinants (panel b). Only meta-analyses that excluded extreme publication bias are included (Supplementary Note 1). Mean odds ratio values are presented above the mean line. Odds ratios <1.44 are negligible, those ≥1.44 but <2.48 are small, those ≥2.48 but <4.27 are medium and those ≥4.27 are considered large.

Fig. 2 ∣. Models of behavioural change intervention efficacy.

a–c, Conclusions of our synthesis of meta-analyses of behaviour change interventions for all behaviours (panel a), health behaviours (panel b) and environmental behaviours (panel c). In all panels, individual targets of change are presented on the left and social-structural targets of change are presented on the right. Vertically, targets of change are organized from least to most effective based on the average effect sizes for each behavioural target (Fig. 1b; Supplementary Figs. 1 and 2), and grouped based on whether effects are negligible, small, medium or large (Table 1). Only meta-analyses that excluded extreme publication bias are included (Supplementary Note 1).