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Encouraging behavioural change during the COVID pandemic

During the pandemic, the World Health Organisation (WHO) and UK Government adopted UCL behavioural research and methods to encourage people to adhere to restrictions and address vaccine hesitancy.

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28 April 2022

Large scale health and social interventions rely on people changing their behaviour. But achieving lasting behaviour change is a challenge as our behaviours often have complex drivers. Behaviour change frameworks have been used to guide health, environment, legal and government interventions, but most are limited in cover, coherence and links to behavioural models.  

A systematic framework for behavioural change  

In 2011, Professors Susan Michie (UCL Division of Psychology and Language Sciences) and Robert West (UCL's Institute of Epidemiology and Health Care) published the results of a review of 19 behaviour change frameworks and with Dr Lou Atkins synthesised them into one comprehensive, non-sector-specific framework – the Behaviour Change Wheel (BCW).  

The BCW’s central hub comprises the Capability, Opportunity, Motivation & Behaviour Model (COM-B) summarising the states and conditions needed to perform a Behaviour. The COM-B hub is surrounded by two rings, one comprising nine types of intervention and the other comprising seven policy options to support interventions delivery. The BCW provides a systematic framework for selecting or designing new intervention types and policy options based on the changes needed in capability, opportunity and/or motivation to change the behaviour. This method is also used for evaluation and evidence synthesis and has been used in fields as diverse as health, transport, social justice, water conservation, recycling and animal welfare. 

The BCW forms the intellectual backbone of UCL’s Centre for Behaviour Change, a multi-disciplinary centre for research, teaching, training and consultancy in behaviour change. The UCL team’s work has advanced behavioural science and its applications globally. 

Behavioural change in an international context 

In response to the COVID-19 pandemic, the World Health Organization (WHO), adopted the BCW to produce guidance and a toolkit to enable country organisations to translate survey evidence into actionable recommendations in their own contexts. This included finding ways to improve adherence to public health measures.  

This tool, Behavioural Insights on COVID-19, been downloaded 3,200 times and translated into several languages and implemented in 17 countries. The BCW is also being used by the WHO’s Behavioural Insights and Sciences team in several projects. 

Working with government in the UK and Ireland  

In the UK, the cross-Government Covid-19 Scientific Advisory Group for Emergencies (SAGE) drew upon the BCW framework and COM-B model of behaviour. This was used to organise evidence, provide theoretical underpinning and develop new policies in identifying options for increasing adherence to social distancing and shielding vulnerable people and to understand adherence to NHS Test and Trace. 

Public Health England commissioned the UCL team to produce practical guides on applying the BCW, aimed at national and local government and their partners.  

In the Republic of Ireland, the Department of Health have used the BCW to ensure clinical guidelines translate effectively into practice. Action Aid Ireland, an international charity working to reduce poverty with a particular focus on women’s rights, used the BCW to develop interventions aimed at reducing gender-based violence in the context of the charity’s 2017-2022 Women’s Rights Programme in Nepal, Kenya and Ethiopia. 

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Research synopsis

The Behaviour Change Wheel: a method for developing effective interventions in national and international health policy 

A method developed at UCL to design and evaluate interventions and  policy changes – the Behaviour Change Wheel – has been used during the COVID19 pandemic by UK government, the World Health Organization and non-governmental organisations (NGOs) such as Action Aid to encourage people to adhere to restrictions and to overcome vaccine hesitancy. 

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