Awareness Does Not Work, Behaviour Change Does.

Thursday, May 23, 2019 - 14:00

By Leah Lewis, MPH


Tom Ato is 47 years old and his favourite snack is salted prunes. He is invited to a community health fair and obligingly, he goes to the nicely decorated venue with his wife and two children, where music is pumping and smiling faces are all around. While there, he sees the ‘Healthy Heart’ booth, and so out of sheer curiosity, he gets his blood pressure checked by the volunteer nurse. Tom’s reading that day indicates that his blood pressure is a bit elevated and the nurse advises him that he should certainly try to bring it down to the normal range. He then receives a pamphlet of helpful information and after he and his family had their full of wellness fun for the day, they go home. Does Tom then make the effort to consume less salt? Does he even know why his blood pressure was a bit elevated that day? He has been having a rough time at work and has been a bit stressed lately. Could this be the cause, or was it just because he was nervous while being screened on the day due to his secret fear of nurses, and he’s actually not hypertensive at all?


What is awareness?

This is one example of an awareness strategy used in the field of health promotion. Awareness strategies do just that - provide information for the purpose of enhancing knowledge and understanding in the minds of a captive audience. These strategies are extremely useful for disseminating important information related to the risks of infectious and non-infectious diseases within a population, the accessibility of healthcare services, the importance of healthy lifestyle practices, and much more. However, if persons are required to act based on the information that is given to them, that they have become more aware of, then an awareness strategy by itself is not enough. For example, the health fair that I described above was a lovely event where very good information was given, but because there was no follow up with Tom Ato by any healthcare professionals, and he was not compelled to change his actions by adopting new behaviours, he most likely wasted his time in going. He became aware of his blood pressure that day. Then what?

This is the pitfall of an awareness programme – if improved health is the desired outcome, then it cannot stand alone. Posters, billboards and advertisements are not enough. Lectures, seminars and symposia make little difference. One-off events and short term initiatives without long term support, only give short term results. For there to be lasting and effective change within a group of persons of any number, then the other health promotion arms of behaviour change and supportive environments must be used in combination with awareness.

The power of behaviour change strategies.

What about behaviour change, and what does this arm of health promotion have to do with persons consciously choosing to live a healthier lifestyle? Indeed, it is paramount. You see, the best designed wellness programme would amount to nothing if its target group of persons are unwilling to modify their everyday habits. To achieve improved health, behaviour change strategies that motivate persons to begin and maintain healthy behaviours (which fit their everyday lives in accessible and convenient ways) should be implemented. For example, if Tom Ato’s contact information was taken at the health fair and he was called the following day by a healthcare professional, he could have begun the process of improving his health for the long term through the use of accessible support.


Consider the human mind and its willingness to believe.

We must consider the human element of thought and personal will in relation to the acceptance and adoption of different behaviours through belief. Belief in essence, is the confident surety within one’s self that something is real, true, possible and/or achievable.  People’s thoughts (for example, their beliefs, attitudes, values and expectancies) have a strong effect upon their behaviour. This is true for both young and old. This tender area of mindset is paramount and can determine the success or failure of any behaviour change programme, be it wellness or otherwise. People must want to change, and they must know why they have chosen to do so. There must be benefits to adopting this new pattern of living which supersede the barriers that keep such persons in their original state.


The roles of awareness and behaviour change strategies both work hand in hand. Once used in harmony, they can and will bring about the improved health of a population.


Best wishes on your journey to better health.