Why nudge the public when it’s the sector that needs a shove?

How to persuade people to change their behaviour for the benefit of their health is an ongoing problem that has taxed governments, organisations and health professionals for generations. The Leisure Review’s health correspondent wonders whether the gentle approach now needs to be revised in favour of rather more pointed measures.

Sign of the times: should the instructions now be more forceful?

Last month the Local Government Association published another informative briefing paper which they have conveniently deposited in their vast and wide-ranging library of the written word (see the link below). The briefing paper, titled Changing Behaviour in Public Health – To Nudge or Shove?, is worth the 15 minutes it will take to read. It really is worth it but I can’t help thinking that the nudge theory was always flawed from the day it was conceived. ‘Nudge’ is a book that went on to sell millions of copies and its pages went on to inform UK government strategy to the point that a ‘nudge unit’ was developed at the Department of Health. Populated by many from the private advertising sector, this unit became a key influencer of the Responsibility Deal and Andrew Lansley, the then secretary of state for health. It is interesting to note that the nudge department was recently hived off to the highest bidder...
To nudge is easy when you are asking a person to increase their alcohol intake or eat more chocolate-infested breakfast cereal, down even more soft drinks or eat increased amounts of fast food. After all, that’s what Big Food have been doing very successfully for years. “Would you like to go large with that meal?” is an nudge phrase that is omnipresent at many of the fast food counters and drive-throughs the world over.
But it’s a little more difficult to nudge a person to change their negative, or what some would consider to be harmful, lifestyle habits. Nudging these into positive habits probably requires more than a nudge. The word ‘positive’ means different things in different contexts or situations so moving from the negative into the positive will be interpreted differently depending on the environment, mood and social influences. An example I draw is the sensation you get when you eat chocolate. You know it’s naughty but you will eat that ‘family’ or ‘treat’ size bag because it makes you feel good. You know you will pay for it on the hips but to hell with it, I’ll deal with that consequence later; right now I’m enjoying this time with my chocolate bar.

As an example of nudge I offer the Responsibility Deal and the response by Mars. When the Responsibility Deal came into play Mars produced a smaller Mars bar. Cited by the company as a means of tackling the obesity issue, it was perceived as good news by those in the nudge unit and at the centre of the Responsibility Deal. Andrew Lansley did many a TV interview on the back of that move alone but what Mars went on to do was to sell two smaller bars in a double packet, the Mars Duo. Smaller so you could eat it as a ‘snack’ or ‘treat’, this provided the opportunity to sell two bars instead of one and therefore nearly double the price. There is little doubt that this also led to people eating both bars. That is nudge. The drinks industry also played its part: two-for-1 deals, reduced-price alcohol in supermarkets and sweeter, more ‘fun’-orientated drinks such as WKD which targeted specific consumer groups. That is how nudge works. It is easy to make people eat or drink more.

Nudge is based on two key systems that characterise human thought. First, the reflective system, which is deliberate and self-conscious in nature,  and the system we use when we make an informed decision. Second, the automatic system, which is more rapid, is mainly based on instinct and does not involve what we would normally term ‘thinking’. The flaw I identify with nudge theory is its reliance on the individual to make a decision based on many of the social cues they will experience. After all, if social cues are provided and there is no way to action the nudge, and thus change a behaviour, then there is little point. This brings me to my own theory: shove.

Sometimes we simply need to shove people or organisations into doing what we expect of them. Often the preferred language is along the lines of ‘gentle coercion’ or ‘encouragement’, which often comes from strategies or policies, but for some of us who have been around a while we simply know that a cleverly positioned shove often gets a response. I am beginning to think the time has come to shove the leisure, sport and recreation sectors into providing appropriate, proportional and effective interventions so that when those that are nudged into a behaviour change there is actually something for them to access that is fit for purpose. After all, how many people have thought of getting off their backside and starting off with a high-intensity training workout, a boxercise session or one of those sessions where you join some mass Lycra fest. For those new to activity such activities simply turn them off and place them further back in their behaviour-change endeavours.

But don’t get me started on the gym issue. Overly loud music. Poor user etiquette and behaviour which is not challenged by staff or other customers. Instructors paid by commission. An obvious lack of personal interest. Get ’em on a direct debit and move on to another one… 

This last point brings me to the theory of behaviour change. To understand behaviour change is to understand the evidence and what it is people need to help them make the transition from, in this case, inactivity to being regularly active. It is clear to me that what we require is a sector that thinks about the programmes they have to offer and develop them to reflect the evidence to the point that there are progressional offers available that match customer needs. These needs include availability. It always interests me to find many low-intensity types of activity, often referred to as starter sessions, available during the day and then in the early evening the more intensive activities come alive all at once. It’s not as if the inactive are only available during the day time, is it? Is this where the shove is needed?

Something the sector must consider is this: many people start from a very different starting point and it is difficult to match these starting points with programmed offers at centrally located, four-walled facilities. One person’s willingness to access a centrally located megaleisure centre will be another person’s nightmare. One person’s willingness to access the local community facility centre will not match another person’s need to access a local walking group. And so on. People start from different points and have different levels of understanding and different expectations of what their journey might involve.

Understanding these objectives and behaviour-change journeys will be a great starting point for any provider. Simply trying to prise these newbies into an already busy and cramped programme will not work. I think that is simple to understand. What is not so simple to understand is what the inactive require. These are the populations that the sector has failed to engage effectively for a generation. The facts are the facts.

Here’s a good question and an obvious one depending on your viewpoint: have you thought of asking ‘non-users’ what their behaviour-change objectives are?

The sector prides itself on understanding current customers and developing retention-based offers focused on pricing and offer strategies that keep the same people coming to centres, year in, year out. What do you think happens if all you do is engage the same people year after year? Things get stale. People get blinkered. Programming becomes full of cash-cow activities based on income-generation rather than activities based on addressing need.

When you go into a leisure centre these days it often feels like a sales convention. There are pricing schemes for this, bonus schemes for that, special offers for this and invite a guest for that. There are complex sales strategies in play that simply turn the non user off. It’s all a bit over-powering, even for someone like me who has been there and done it all before.

Consider this a gentle shove. If you don’t ask, if you don’t respond, bend, flex or change, you will be on the potential customer blocked list before you have chance to prove yourself.           


Healthy Comment is a highly experienced sector professional who is always willing to press on the issues that many others choose to dance round.



Read thebriefing paper from the Local Government Association Changing Behaviour in Public Health – To Nudge or Shove? at www.local.gov.uk

The Leisure Review, November 2013

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“I am beginning to think the time has come to shove the leisure, sport and recreation sectors into providing appropriate, proportional and effective interventions”
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