Over the last decade, we have seen a rise in the prevalence of long-term conditions and the modifiable risk factors that contribute to them, alongside an expansion of services and nationwide initiatives designed to support change. These behaviour change interventions have seen many successes, and have also provided valuable learning on what works, and where adaptation is needed.
Behaviour change interventions are a vital part of improving population health, but to be successful we need to be realistic about human behaviour. The contexts in which people are trying to make changes, and the skills they hold to do so, continue to evolve. Ensuring programmes evolve alongside this is key to supporting behaviour changes that are sustained over time.
Behaviour change is not just about educating people
Many public health campaigns in previous years have focused on education and raising awareness in a bid to improve health outcomes. Whilst educating individuals on recommended guidelines and what they need to do to improve their health is important, without taking a holistic view of the person and the context around them, these changes are often not sustainable.
Over the last 10 years, behavioural science frameworks such as the COM-B model and the Behaviour Change Wheel have demonstrated that outcomes improve when we consider context and motivation alongside knowledge and understanding. The COM-B model highlights that behaviour change depends on:
Capability (psychological and physical)
Opportunity (physical and social environment)
Motivation (automatic and reflective)
Our delivery of Healthier You blends knowledge building with an understanding of the barriers people face in their daily lives, alongside recognition that motivation can fluctuate. To support effective delivery, we have embedded Clinical and Professional Supervision (CaPS) sessions for our Health Coaches. These sessions allow reflection on practice, skill development and exploration of alternative approaches when participants are struggling. They also support shared learning and help coaches apply behaviour change frameworks more effectively, strengthening the overall quality and consistency of the programme.
Personal context counts for a lot
One of the clearest lessons over the last 10 years is that there is no one-size-fits-all approach to weight management. Factors such as time constraints, caring responsibilities, physical limitations and wider structural barriers all influence someone’s ability to engage with behaviour change. People also differ in how they learn and apply new knowledge and skills, meaning programmes that utilise a range of tools, techniques and learning approaches are more likely to succeed.
As Healthier You is rooted in evidence-based practice and aligned with the latest research and NICE guidance, it has continued to evolve. The weight management landscape has changed significantly in recent years, particularly with the wider availability of weight management injections for people with obesity and long-term health conditions. For many, personal circumstances make weight management complex, and access to medication alongside behavioural support has become an important option.
This is one of several tailored routes available to participants, alongside total diet replacement products and diabetes prevention support. To aid effective conversations, we have developed guidance for coaches on discussing injections, navigating weight conversations sensitively and recognising signs of disordered eating. We have also introduced tailored programmes for people with long-term health conditions, and expanded our resources to better reflect cultural diversity, including culturally inclusive nutrition guidance and resources to support weight management during religious celebrations such as Ramadan.
Self-regulation is a skill
Individual differences also shape how people respond to life’s challenges and setbacks. Recognition of self-regulation as a predictor of success has grown over the last decade. Self-regulation refers to the ability to manage thoughts, feelings, physiological responses and behaviour.
When life becomes stressful or unpredictable, effective self-regulation can be the difference between maintaining progress or reverting to old habits. Techniques such as self-monitoring, problem-solving, feedback and action planning support individuals to better understand their patterns and make more conscious choices about change.
Participants are encouraged to reflect on their confidence week to week and consider how their progress aligns with their longer-term values and goals. This allows coaches to offer additional support where needed. We also regularly evaluate programme outcomes through clinical audits and production evaluations, helping us identify areas where participants may need further input or alternative techniques to support success.
Digital can boost our offering, but does not replace it
The digital landscape has evolved dramatically over the last 10 years, particularly during the COVID-19 pandemic when service delivery had to adapt rapidly. Digital delivery has demonstrated significant benefits, including improved access for people in remote locations, those with physical barriers to attendance, and the ability to deliver support at scale.
More recently, the incorporation of AI has enabled greater personalisation and responsiveness within digital services. While this offers clear potential, we have learned that human support remains essential, particularly during periods of maintenance and setback. For this reason, participants accessing our Healthier You programme digitally are still offered human support to explore successes, concerns and challenges at the moments that matter most.
There is significant promise for the future of the Healthier You programme as we continue to combine evidence-based, behaviour change-driven approaches with the evolving benefits of digital delivery.