UNLEASHING POTENTIAL THROUGH PARTICIPATIVE DECISION-MAKING
According to Sachs (2005), participation is defined as the active involvement of affected populations in decision-making, implementation, management and evaluation of policies, programmes and services. This necessity for participation, with actions carried out ‘by and with people, not on or to people’, was reaffirmed in the Jakarta Declaration (WHO, 1997) and remains a fundamental principle of health promotion. A participative decision-making style involves engaging team members in the decision-making process. This approach seeks their opinions, suggestions, and preferences, and these inputs are considered when making the final decision (Rolková, M., & Farkašová, V., 2015).
Here in the Behavioural Insights (BI) Unit at IHBR, we strive to incorporate a participative decision-making style by actively involving our colleagues in decision-making, strategy development, and related matters. For instance, in our collective effort to develop a terms of reference for the Behavioural Insights Focal Person, we organized sessions with all Heads of Health Promotion Units from all states in Malaysia. During these sessions, we sought their feedback and comments to ensure that the terms of reference were feasible, realistic, achievable, and within their capabilities. This collaborative approach not only enhances the quality of our initiatives but also fosters a sense of ownership and commitment among our team members.
Another example is our ongoing effort to design the strategy for the upcoming townhall session and workshop focused on prioritizing key strategies for behavioural insights in health in Malaysia. Recognizing the complexity of these events, which involve various stakeholders from across the country, we are committed to developing a realistic and refined strategy to ensure we achieve our objectives. This involves careful planning and active consultation with all relevant parties to address their needs and expectations, ensuring the events are productive and successful.
We believe that a participatory approach is beneficial as it encourage shared responsibility, builds a sense of ownership and accountability, promotes transparency, and enhances decision quality.
The BI Unit IHBR
WEBINAR EXPLORING NUDGES FOR PROMOTING HEALTHY LIFESTYLE
Following Dr. Saiful Adli's webinar on Behavioural Insights for Better Health conducted on April 2, 2024, a follow-up webinar focusing on nudges for promoting a healthy lifestyle was held on July 4, 2024. Pn Norbaidurah Ithnain shared her knowledge in using nudges to encourage healthy behaviours in this webinar. The webinar featured various health professionals from the Ministry of Health and covered the theory behind nudges, offering practical examples like healthy eating, handwashing and others.
Ethics and considerations of implementing nudge interventions were also highlighted. Our aim was to help participants recognize opportunities to use nudges as strategic interventions to influence decision-making and potentially improve public health outcomes.
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KEY INFORMANT IN WHO-EU PANDEMIC RESPONSE AND PREPAREDNESS PROJECT EVALUATION
On June 25, 2024, the BI Unit participated as key informants in the WHO-EU Pandemic Response and Preparedness Project Evaluation. This important virtual session was moderated by Mr. Jeffrey Dotingco from the World Health Organization Western Pacific Regional Office. Representing the WHO-EU was Dr. Maurice Coenegrachts, who provided valuable insights into the project's objectives and its impact on pandemic response strategies across the region. Also in attendance was Ms. Liyann Ooi, a behavioural insights consultant from the World Health Organization Malaysia Country Office.
During the session, we highlighted the importance of incorporating behavioural science into public health strategies, especially in the context of pandemic response and preparedness. Our discussion focused on how behavioural insights can enhance the effectiveness of health communications, improve public adherence to preventive measures, and ultimately contribute to better health outcomes during a pandemic. We discussed specific case studies and examples from our work, demonstrating how behavioural insights have been successfully integrated into health campaigns and policy-making processes. We are honored to have been part of this evaluation and look forward to continued collaboration with WHO, the EU, and other global partners in strengthening pandemic preparedness and response efforts.
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USING BEHAVIOURAL INSIGHTS TO UNDERSTAND PUBLIC PERCEPTION OF EMERGENCY SERVICES
On June 13, 2024, a Continuing Medical Education (CME) session was held to offer healthcare professionals a platform for deepening their understanding of how behavioural insights can enhance public perception regarding emergency services.
During the session, Pn. Norbaidurah Ithnain presented research findings on the pivotal factors influencing public perceptions of emergency department usage. Additionally, she underscored key recommendations utilizing behavioural insights.
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BUILDING BETTER HEALTH: A UNIFIED EFFORT
Last June 4 – 6, 2024, the Health Education Division, Ministry of Health Malaysia conducted a meeting at Mardhiyyah Hotel & Suites in Shah Alam to talk about rolling out the Behavioural Assessment and Healthy Lifestyle Prescription at Wellness Hubs.
The Institute of Health Behavioural Research (IHBR) had the opportunity to join this meeting and conduct a SWOT analysis of the existing health behaviour assessment tool and to brainstorm on upgrading the tool into a new health behavioural assessment tool (HEBAT) using behavioural insights. A big thank you to the 50 participants, including Wellness Hub coordinators from all states and hubs as well as the national coordination team, for sharing such valuable and pertinent input. We’re hopeful that we’ll create a practical assessment tool that works well in the field for the benefit of our Malaysians.
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CONTINUOUS CONNECTIONS: THE GROWTH OF COLLABORATION
Our enduring partnership persists as we strive to strengthen collaboration particularly within the behavioural insights initiatives. We are pleased to share several proposals for BI projects to UNICEF Malaysia on May 8th, 2024. The discussion was further enriched by the presence of Ms. Liyann Ooi, a behavioural insights consultant from the WHO Country Office for Malaysia, Singapore, and Brunei Darussalam. Ms. Ooi's expertise and insights provided a rich layer of perspective, further enriching our collaborative efforts and fuelling our collective drive towards meaningful impact in the behavioural insights. Thanks Ms. Elizabeth Wong and Ms. Hayon Nam from UNICEF Malaysia for hosting us.
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LEVERAGING BEHAVIORAL INSIGHTS IN DENGUE CONTROL
The increase in dengue cases in certain areas of Selangor has raised significant concern for the Selangor State Health Department. Recognizing the potential of behavioural insights to shape more effective intervention strategies, IPTK and the Selangor Health Promotion Unit have established a collaborative effort to develop a project aimed at enhancing community preventive measures for dengue prevention. The proposed initiative involves conducting a randomized control trial project to create messages using both loss frame and gain frame methods.
On May 8th, 2024 a discussion took place between both parties regarding the development of the project proposal and operational workflow. The BI Unit offered technical consultancy using the D.D.D.I.E framework for project development. We extend our gratitude to Mr. Safruddin Sahalan, Head of the Selangor Health Promotion Unit for visiting our office.
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SOCIAL AND BEHAVIOURAL CHANGE COMMUNICATION POCKET TALK: WHERE GREAT MINDS UNITE
We were delighted to participate in the SBCC Pocket Event, which took place on May 7, 2024, in Kuala Lumpur. This one day event hosted by the UPM-UNICEF C4D Program, brought together numerous enthusiasts of behavioural change communication and behavioural insights from various entities. Among the attendees were representatives from University Malaysia Sabah, Universiti Kebangsaan Malaysia, INTI University, several NGOs, and a handful of government agencies. Dr. Saiful from the Behavioural Insights Unit represented the Ministry of Health.
Participants were introduced to fresh insights into uncovering the fundamental factors that shape human decision-making. The session started with a presentation by Ms. Karen Ong, the Executive Creative Director at Marketing for Change, followed by Ms. Sara Isaac, Chief Strategist at the same agency based in the United States. One of the important takeaways was the recognition that instead of attempting to persuade audiences to alter their beliefs (given our inherent resistance to change), the behavioural determinants framework, which includes elements such as enjoyment, popularity, and simplicity, redefines issues to align with the audience's desires and requirements. This approach often boils down to making behaviours enjoyable, accessible, and socially accepted, as these are the primary drivers behind the adoption of new behaviours for most individuals. Subsequently Dr. Syazana Ali, the founder of the NGO known as Noble Dr., shared her insights into the challenges encountered in delivering high-quality healthcare with a focus on mental health for marginalized communities especially children. As the evening progressed, attendees were treated to an illuminating session on behavioural insights led by Dr. Diyana Kasimon, the acting Director of the UPM-UNICEF-C4D Program. Her expertise shed light on the dynamics that shape decision-making processes, providing attendees with a deeper understanding of how behavioural insights can inform and enhance various aspects of program design and implementation.
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IT'S GOOD TO RECONNECT
It's wonderful to reconnect with Dr. Trevor Webb, who previously served as our BI consultant and is now attached to the World Health Organization Western Pacific Regional Office in Manila in the same capacity. We virtually convened once more to seek his initial feedback on the newly developed draft of the National Behavioural Insights Blueprint. Also present at this meeting was Ms. Liyann Ooi, a Behavioural Insights Consultant from the WHO Office for Malaysia, Singapore, and Brunei Darussalam. The National Blueprint for Behavioural Insights serves as a comprehensive framework aimed at harnessing the power of behavioural science to enhance health outcomes.
This blueprint outlines strategies and pathways for accelerating the adoption of behavioural insights within the Ministry of Health Malaysia. The proposed key strategic thrust in this blueprint is based on the foundation from both Ministry of Health Malaysia's Health White Paper and the WHO Resolution on Behavioural Sciences for Better Health. Also present in this meeting, alongside the usual members from the BI Unit, are Ms. Ermiyati and Ms. Haryati, who are currently being mobilized and temporarily assigned to the BI Unit until the end of July 2024. We at BI Unit believe the technical expertise brings invaluable insights and guidance, helping to refine strategies and ensure alignment with best practices locally and globally.
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ENGAGING COLLABORATION VIA PARTICIPATORY APPROACH TO DEFINING THE ROLE OF A BI FOCAL PERSON
An online meeting was held between BI Unit, Health Education Division, and the heads of the Health Promotion Units from every state on April 30, 2024. The meeting followed a previous session on Health Promotion Management Meeting on March 20204 in Terengganu and aimed to discuss the details of the terms of reference for the BI focal person. This reference was initially established and presented during a workshop on Embedding Behavioural Insights for Better Health in October 2023. Subsequent consultations with several Health Education Officers helped identify job scopes within BI relevant to them.
The latest terms of reference have been divided into three main levels, comprising the BI Unit as the national secretariat, the Health Education Division, and State Health Departments. Ms. Suraya, the Director of the Health Education Division, and Dr. Manimaran, the Director of the Institute for Health Behavioural Research, were present at the meeting. The development of the terms of reference employed a participatory approach. This method encouraged collaboration and engagement, allowing diverse perspectives to be considered in drafting a comprehensive and well-rounded terms of reference. The process fostered ownership and buy-in, enhancing the relevance and effectiveness of the job scope. The meeting led to minor alterations in the utilization of specific terminologies, necessitating a more detailed specification and clear justification of the work within BI initiative. The meeting concluded with a fitting finale—a group photograph taken in front of the WHO logo, symbolizing unity, collaboration, and shared commitment towards a common cause.
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MAPPING OUT PRIORITIES IN A JOINT WORKPLAN MEETING
On April 24th, 2024, a joint plan meeting convened between the BI Unit and the World Health Organization Malaysia Country Office Cyberjaya, following the initial meeting at the Institute for Health Behavioural Research in March. BI Unit was presented by Dr. Saiful, Ms. Guna and Ms. Durra. Discussion primarily focused on operationalizing the BI Unit plan of action and refining strategies to streamline capacity-building efforts within the MOH BI framework and priority areas.
Later in the evening, the discussions were joined by the presence of Dr. Deepa Gamage, a public health specialist in disease control, Dr. Natalia Wroblewska, a public health Specialist specializing in health promotion & determinants, and Muhammad Aizat Mohammad Nazli, a Mental Health Consultant, all from the WHO Malaysia Country Office. The meeting was very smooth where the fertile ground of collaboration yielded a bountiful harvest of ideas and strategies.
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INTEGRATING BEHAVIOURAL INSIGHTS INTO NATIONAL HEALTH LITERACY
The townhall session held from 22nd to 24th April 2024 at Hotel Lexis Port Dickson, Negeri Sembilan, aimed to integrate behavioural insights into the draft of National Health Literacy Policy, specifically targeting Strategic Thrust Number 3, which focuses on strengthening health literacy governance. This initiative is in alignment with the WHO Resolution on Behavioural Sciences for Better Health, emphasizing the importance of utilizing behavioural science to develop effective, equitable, and human-centered health policies across sectors.
The session saw participation from various stakeholders representing ministries such as the Ministry of Human Resource, Ministry of Finance, Ministry of Youth and Sports, Ministry of Science, Technology and Innovation, Ministry of Education, Ministry of Transport, and few more. Dr. Saiful, representing the Behavioural Insights Unit of the Ministry of Health, played a significant role in facilitating the discussions and fostering collaboration among stakeholders towards in one of the group work session during the townhall session. We extend our gratitude to the Health Education Division for extending this invitation.
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INNOVATIVE MINDS GATHER: WORKSHOP EXPERIENCES FROM MANILA
In public health, understanding social and behavioural factors is crucial for effective risk communication and community engagement. Strengthening skills in this area aligns with the resolution on behavioural sciences for better health adopted at the Seventy-sixth World Health Assembly. Additionally, Member States endorsed two related frameworks – the Asia Pacific Health Security Action Framework (APHSAF) and the Regional Action Framework on Communication for Health – during the seventy-fourth session of the Regional Committee for the Western Pacific in October 2023.
On April 11th to 12th, 2024, the World Health Organization Western Pacific Regional Office in Manila held a workshop on using social and behavioural insights to support risk communications in the context of emergencies in the Western Pacific region.The objectives of the workshop are:
- To strengthen the use of social and behavioural insights by Member States by presenting and discussing the results of the COVID-19 Perceptions and Behavioural Insights Survey and In-depth Interviews.
- To map challenges and opportunities related to the use of social and behavioural insights to inform risk communication activities and operationalization of Communication for Health (C4H) in the context of emergencies.
- To determine a draft list of priority actions for Member States to promote the collection and application of social and behavioural insights in the context of emergency preparedness and response.
Malaysia was represented by Ms. Gunasundari Marimuthu, Health Education Officer from the Behavioural Insights Unit, Institute for Health Behavioural Research, Ministry of Health Malaysia. She had the chance to discuss Malaysia's experience in applying behavioural insights during the COVID-19 pandemic and in preparing for the endemic phase. Also presenting at the workshop was Ms. Elena Altieri, Head of the Behavioural Insights Unit at the World Health Organization Headquarters. We had the opportunity to deliver a brief update on the progress of the behavioural Insights Unit in IHBR and discuss our future directions.
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CME ON BEHAVIOURAL INSIGHTS TO ALLIED HEALTH PROFESSIONALS
In an effort to advocate the use of behavioural insights approach within the Ministry of Health Malaysia workforce, a continuous medical education session was organized on April 2nd, 2024. Dr. Saiful shared his views on the concept of behavioural insights and why it is useful to utilize this approach in the development of policy or intervention strategies that are not only more effective but also more conducive to long-term behavioural change.
One important aspect that we emphasize to participants is the concept of the behaviour intention gap, which refers to the disparity between what individuals intend to do and what they actually do when it comes to adopting healthy lifestyles. This gap often arises due to various factors such as conflicting priorities, environmental influences, habitual patterns, and emotional responses.
The one-hour online session was evidenced by a remarkable turnout of over 1,300 participants from various departments and division within Ministry of Health participants. This overwhelming participation underscored the keen interest and enthusiasm among the ministry's workforce in embracing innovative approaches to enhance public health outcomes.
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WELCOME ON BOARD!
We are delighted to announce and extend a warm welcome to our newest team member, Ms. Gunasundari Marimuthu, who has officially joined the Behavioural Insights Unit at IHBR since March 18th, 2024. Previously, she worked in the Health Education Division at the Ministry of Health Malaysia Headquarters.
With extensive experience in drafting health promotion policies at the national level, she brings invaluable expertise and benefits to our team. Currently pursuing her doctorate in health communication, we eagerly anticipate her completion of the program. (Here's hoping her viva date arrives soon!) We aspire to undertake more exciting projects and enhance the strength and pace of our efforts in behavioural insights.
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FORGE AHEAD: UPM AND COLLABORATIVE EXPANSION IN FOCUS
We first learned about UPM UNICEF C4D during our attendance at the Asia Pacific Social and Behaviour Change Communication Regional Symposium in October 2023. It was there that we discovered they were also engaged in work related to behaviour insights. This realization sparked our interest in connecting with them to explore potential areas of collaboration.
UPM UNICEF C4D Programme is a partnership between UPM & UNICEF, particularly with the communication department in the Faculty of Communication and Modern Languages. The partnership is an initiative by both parties to provide trainings and consultation services, modules development as well as action research and interventions within the scope of mental health in communication. We were glad to have hosted the meeting on March 7th, 2024, during which we discussed further potential collaborations, particularly in conducting behaviour insights projects, capacity building, and developing behaviour insights learning materials. Dr. Diyana Kasimon, Deputy Director of UPM UNICEF C4D, led the team along with her delegation. Their presence marked a significant step forward in fostering long term collaboration between BI Unit and UPM UNICEF C4D.
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GUIDING TOWARDS WELLNESS HUB SERVICES
The Wellness Hub is one of the initiatives under the Ministry of Health Malaysia aimed at enhancing community health quality by promoting healthy lifestyles, health promotion services, self-care, and environmental cleanliness. The BI Unit is pleased to shed light on effective methods for encouraging community engagement with services at all 33 Wellness Hubs currently established across the country. Dr. Saiful, Head of the BI Unit, emphasized the significance of conducting a thorough behavioural diagnosis and understanding the community profile.
He highlighted that this data serves as a crucial baseline for crafting targeted intervention strategies with the potential to make an impact, effectively addressing specific needs and preferences. This ensures that the Wellness Hub's services are accessible and appealing to all. The session was held in conjunction with the Wellness Hub Management and Technical Meeting on 7th March 2024, with the attendance of Wellness Hub coordinators from across the nation.
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THANK YOU JOHOR!
On March 5th, 2024, the BI Unit received an invitation from the Health Promotion Unit of the Johor State Health Department to discuss a proposed behaviour insights project. The meeting primarily aimed to explore potential strategies to promote healthier behaviours, especially among school children.
A comprehensive proposal was presented, targeting the promotion of healthy lifestyle among school-aged children. Dr. Saiful, the Head of BI Unit, critically reviewed the technical aspects of the proposed project and provided valuable feedback to enhance its effectiveness. Entry Additionally the Johor Health Department sought advice and clarification regarding the classification of previous health promotion projects within the community as behaviour insights initiatives specifically about projects related to waste management and community participation in weekly mass cleaning activities.
The collaboration between BI Unit and the Johor Health Department underline the importance of expanding behavioural insights to design and implement impactful health promotion strategies. Through such partnerships and initiatives, efforts to foster healthier lifestyles and communities can be significantly enhanced.
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INTEGRATING BEHAVIOURAL INSIGHTS INTO COMPETENCY-BASED TRAINING AT THE MINISTRY OF HEALTH
Our ongoing commitment to enhancing the utilization of behavioural insights within the Ministry of Health (MOH) remains steadfast, as we actively seek opportunities to incorporate behaviour insights into competency-based training programs. In line with this objective, we organized a three-day workshop at the Scholars Suite in Tanjung Malim Perak from February 27th to 29th. The workshop aimed to introduce behavioural insights to several representatives responsible for organizing competency-based training within MOH.
During the workshop, Ms. Durra delivered a comprehensive presentation highlighting the significance of applying behavioural insights in policy formulation. She emphasized the relevance of behavioural insights in addressing various challenges faced by the healthcare sector. This discussion is particularly significant, as it aligns with the WHO Resolution on behavioural Sciences for Better Health, demonstrating Malaysia's commitment to prioritizing behavioural insights as a crucial agenda item. By sharing insights and knowledge on the integration of behavioural insights into competency-based training, we aim to equip MOH representatives with the tools and understanding necessary to effectively incorporate behavioural science principles into their training programs
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LEVERAGING BEHAVIOURAL INSIGHTS: WORLD BANK GROUP SEMINAR ON POLICY IMPACT
The BI Unit was delighted to receive an invitation from the World Bank Group Malaysia to attend the Seminar on behavioural Insights for Policy Impact scheduled for February 27th, 2024. This invitation signifies recognition of the unit's expertise and contribution in utilizing behavioural insights to inform policy decisions and drive positive societal impact. The seminar aimed to provide participants with a global overview of country experiences and best practices regarding the utilization of behavioural and social insights from economics, psychology, and related fields to address policy challenges.
These encompassed adjusting social incentives around tax payments, enhancing student learning, improving health outcomes, and promoting energy and resource conservation. Through the seminar, the World Bank sought to engage in a strategic dialogue on the opportunities to integrate behavioural insights into policy interventions in Malaysia. A total of three presentation covering diverse topics on behaviour insights were delivered including:
- Michelle Dugas, a behavioural scientist with the World Bank’s Mind, behaviour & Development Unit (eMBeD), within the Poverty and Equity Global Practice on behavioural Science in Policies – Global Review of Country Experiences and Best Practice
- Jonathan George Karver, a behavioural Scientist with the World Bank’s behavioural science unit on behavioural insights for tax compliance.
- Bambang Suharkono Sjahrir, a Senior Economist of the Poverty and Equity Global Practice of the World Bank sharing on Indonesian experience with behavioural science in policies.
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THE SCIENCE OF BEHAVIOUR CHANGE: BEYOND COMMON ASSUMPTIONS
From January 29th to 31st, Dr. Saiful Adli bin Suhaimi, Head of the Behaviour Insights Unit, was invited to participate in the Workshop for the Production of Promotional Materials for the National Health Promotion Campaign 2024/2025, hosted in Port Dickson. The workshop was organized by the Health Education Division and attended by various health professionals, including pharmacists, medical officers, dietitians, and health education officers.
During this workshop, Dr. Saiful delivered a comprehensive two-hour lecture focusing on the content development for the campaign as well as employing nudges as a strategic approach. His presentation emphasized the critical importance of interpreting baseline data to ensure that the campaign strategy is custom-tailored to effectively target specific demographics and induce behaviour change. This insightful discourse aimed to equip attendees with the necessary knowledge and tools to craft impactful promotional materials that resonate with the intended audience and drive tangible health outcomes.
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BEHAVIOUR INSIGHTS REFRESHER: EMPOWERING OUR TEAM FOR SUCCESS
In a significant stride towards fostering a shared understanding of applying behaviour insights for health, our team recently concluded a highly successful CME on 4th January 2024. This initiative aimed at ensuring every team member in IHBR is equipped with the knowledge and understanding the concept and definition of behaviour science and behaviour insights contributing to a unified approach in our pursuit of health-related goals. Through interactive sessions participants gained valuable insights into the dynamics of individual and collective behaviours.
The successful completion of the refresher course signifies a milestone achievement for our team, establishing a consistent level of understanding in the application of behaviour insights for health. This shared knowledge base is expected to enhance our decision-making processes, drive positive health-related behaviours, and ultimately contribute to the overall success of our organization. The commitment of our team to ongoing learning and development reflects our dedication to staying at the forefront of advancements in healthcare and ensuring the highest standard of care for those we serve.
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WELCOMING THE YEAR OF 2024!
Behaviour science are now focusing not only on individual actions but also on the behaviour of entire systems that can adapt and change. This shift recognizes that the outcomes of policies often come from the dynamic and sometimes unpredictable interactions of many individuals, groups, and institutions within a large network. In these complex systems, people interact in ways that aren't coordinated, leading to patterns at the system level that can't be easily predicted by looking at individual behaviours or preferences. The intricate nature of human behaviour, influenced by diverse cultural and societal factors, poses difficulties in crafting interventions that effectively address these complexities. Balancing the need for valuable insights with concerns surrounding data privacy and ethical considerations remains pivotal. The integration of behavioural interventions into existing healthcare systems requires concerted efforts to align with clinical practices and policies. Sustaining positive behaviour change over the long term and ensuring inclusivity in technological advancements are ongoing challenges. Additionally, resource constraints, adaptability to unforeseen health crises, and fostering interdisciplinary collaboration between psychology, medicine, public health, and data science are crucial considerations in navigating the evolving landscape of behavioural insights in health for the year 2024.
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