An integrated approach to behavior change
For policy makers seeking to understand and influence citizen behavior, a traditional, siloed approach—economic levers, the psychology of an individual's motivation, or behavioral insights like "nudging"—can fail to generate a comprehensive understanding of the drivers of behavior, leaving gaps in policies and interventions.
ICF’s Integrated Model of Behavior seeks to bridge these gaps. It offers a framework that considers the interconnectedness of traditional methodologies. The Integrated Model stems from the realization that people seeking solutions to problems are generally not concerned with the tools being used but rather with finding effective interventions.
The new model developed organically out of extensive research on the effectiveness of behavior change in the real world and a comprehensive review of a wide range of traditional models. We integrated the traditional approaches, examined their commonalities and contradictions, and ultimately created a holistic framework.
The Integrated Model in practice
In terms of improving health and wellbeing, ICF—in partnership with The Behaviouralist—was commissioned by the Welsh Government to explore the barriers to the uptake of its 56-day pharmacy prescribing policy.
Our team undertook quantitative and qualitative research to map the decision-making pathway, identify barriers and facilitators to implementation, and formulate a range of recommended interventions. One key finding was the importance of differentiating the behavior (more individualized prescribing) and the impact (increased average repeat prescription intervals)—crucial to avoiding potential negative effects of implementing the policy.
As part of the study, we identified behaviors along the whole of the behavioral pathway. These included ones related to the practitioner’s choices and resource constraints, issues that were much less likely to be identified using traditional health-focused behavior change models.
We also used the Integrated Model to support a project under the umbrella of U.K.'s Department for Environment Food and Rural Affairs (DEFRA) Zero Growth and Environmental Improvement plans. The project encourages more stakeholders to attend engagement events in order to support a cross-industry approach to environmental protection.
We used the Integrated Model to map barriers to this engagement across the behavioral pathway. By identifying issues related to motivation, choice, implementation, and negative feedback loops, the model informed potential interventions. For example, altering the email invitation using insights gained into the wide range of barriers to the engagement events was a simple, immediate intervention to test.
We also recommended more long-term actions, like launching an ambassadorial program or integrating an engagement element into existing events. Other suggestions, such as compensation, addressed issues around the cost-benefit of attending engagement events for stakeholders who may be concerned about any loss of income during their time away from work.
In a very different sector, our Integrated Model has also helped the efforts of the Youth Endowment Foundation (YEF) to reduce violent offending and victimization among young people.
While evaluating one of their sports-based programs, we mapped potential causes of violence to elements on the Integrated Model pathway, such as “motivation” and “choice.” From there, we could create precise theories of change that now inform the intervention trials, helping both us and the YEF to understand what works.
A unified future for behavior change
We believe the Integrated Model improves upon traditional frameworks by bridging the gaps between traditional approaches, unifying the best of these models, combining their commonalities, ironing out their contradictions, and extending them where they have not captured the whole range of relevant issues.
The new model encourages practitioners to focus on solving the problem itself and to consider the entire behavioral pathway, offering a broader perspective than a siloed approach. It therefore reduces the likelihood of an intervention failing, due to overlooking any critical contributing factors to certain behaviors. By addressing all relevant areas simultaneously, the Integrated Model means subsequent behavior change interventions can have much more impact.