Knowledge is NOT the same as Behaviour Change
The BBC recently published the results of a survey into knowledge of how people can reduce their risk of developing cancer and to what extent this knowledge then translates into actual behaviour change. The answer is a rather disappointing it doesn’t – and two thirds of the people surveyed had not changed their diet or lifestyle in response to the information they have. In an interesting comment about the findings, Karol Sikora from the University of Buckinghamshire says the findings show how people contradict themselves, i.e. people know what to do, but don’t do it. Of course I’m not trying to criticise the excellent work Prof Sikora is doing, but to me it would seem rather a question of missing a few variables that make human decisions much more complex than purely equating knowledge equal behaviour. We know that most smokers know about the dangers of smoking, most people know about the advantages of eating sufficient fruit and vegetables etc. etc. – there really is no need to rehash this.
The problem is that knowledge is actually a very minor factor in behaviour change, a sort of starting block, but no more or less – as can be seen in many of the theories used to inform Social Marketing interventions. For example a look at the Theory of Planned Behaviour shows that knowledge is assumed but not explicitly featured at all. Why? Because personal attitudes towards a behaviour (rather than knowledge), combined with subjective “societal” norms and perceived behavioural controls are the prime influencers for the intention to perform a specific behaviour – and that in turn may actually lead to a specific behaviour being performed. So yes, knowledge plays a significant role to get people started on behaviour change, but it is far from all that it takes. Therefore, it may be time that some in the medical community stop focusing on educating people what to do, safe in the knowledge that most people do actually understand the basic public health message of no smoking, a lot of fruit and veg and exercise – and start to focus on the other factors that stop people from actually performing these simple steps.