Nakkeeran N, Sacks Emma, N Srinivas Prashanth, Juneja Anika, Gaitonde Rakhal, Garimella Surekha, Topp Stephanie M
School of Global Affairs, Dr. BR Ambedkar University, Delhi, 110006, India.
Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, 21218, USA.
Wellcome Open Res. 2021 Aug 23;6:212. doi: 10.12688/wellcomeopenres.17149.1. eCollection 2021.
The focus of behavioural sciences in shaping behaviour of individuals and populations is well documented. Research and practice insights from behavioural sciences improve our understanding of how people make choices that in turn determine their health, and in turn the health of the population. However, we argue that an isolated focus on behaviour - which is one link in a chain from macro to the micro interventions - is not in sync with the public health approach which per force includes a multi-level interest. The exclusive focus on behaviour manipulation then becomes a temporary solution at best and facilitator of reproduction of harmful structures at worst. Several researchers and policymakers have begun integrating insights from behavioural economics and related disciplines that explain individual choice, for example, by the establishment of Behavioural Insight Teams, or nudge units to inform the design and implementation of public health programs. In order to comprehensively improve public health, we discuss the limitations of an exclusive focus on behaviour change for public health advancement and call for an explicit integration of broader structural and population-level contexts, processes and factors that shape the lives of individuals and groups, health systems and differential health outcomes.
行为科学在塑造个人和人群行为方面的重点已有充分记录。行为科学的研究和实践见解增进了我们对人们如何做出选择的理解，而这些选择反过来又决定了他们的健康，进而决定了人群的健康。然而，我们认为，孤立地关注行为——这只是从宏观到微观干预链条中的一个环节——与公共卫生方法不一致，公共卫生方法必然包含多层次的关注点。那么，单纯关注行为操纵充其量只是一个临时解决方案，最坏的情况是它会助长有害结构的复制。一些研究人员和政策制定者已经开始整合行为经济学及相关学科的见解来解释个人选择，例如，通过设立行为洞察团队或助推单位来为公共卫生项目的设计和实施提供信息。为了全面改善公共卫生，我们讨论了单纯关注行为改变以促进公共卫生的局限性，并呼吁明确整合更广泛的结构和人群层面的背景、过程和因素，这些因素塑造了个人和群体的生活、卫生系统以及不同的健康结果。
