Final Mile Consulting, New York, NY, United States.
Front Public Health. 2024 Aug 7;12:1355539. doi: 10.3389/fpubh.2024.1355539. eCollection 2024.
Applied behaviour science's focus on individual-level behaviours has led to overestimation of and reliance on biases and heuristics in understanding behaviour and behaviour change. Behaviour-change interventions experience difficulties such as effect sizes, validity, scale-up, and long-term sustainability. One such area where we need to re-examine underlying assumptions for behavioural interventions in Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) prevention, which seek population-level benefits and sustained, measurable impact. This requires taking a "Big Leap." In our view, taking the big leap refers to using a behavioural science-informed approach to overcome the chasms due to misaligned assumptions, tunnel focus, and overweighting immediate benefits, which can limit the effectiveness and efficiency of public health programmes and interventions. Crossing these chasms means that decision-makers should develop a system of interventions, promote end-user agency, build choice infrastructure, embrace heterogeneity, recognise social and temporal dynamics, and champion sustainability. Taking the big leap toward a more holistic approach means that policymakers, programme planners, and funding bodies should "Ask" pertinent questions to evaluate interventions to ensure they are well informed and designed.
应用行为科学侧重于个体层面的行为，这导致在理解行为和行为改变时高估了偏见和启发式的作用，并过度依赖它们。行为改变干预措施在效果大小、有效性、推广和长期可持续性方面遇到了困难。在人类免疫缺陷病毒 (HIV) 和结核病 (TB) 预防等领域，我们需要重新审视行为干预的基本假设，这些干预措施旨在实现人群层面的效益和持续、可衡量的影响。这需要“大飞跃”。在我们看来，所谓的“大飞跃”是指采用行为科学的方法来克服由于假设不一致、隧道式思维和过度重视眼前利益而导致的鸿沟，这些因素可能会限制公共卫生规划和干预措施的有效性和效率。跨越这些鸿沟意味着决策者应该开发一套干预措施，促进最终用户的自主性，建立选择基础设施，接受异质性，认识到社会和时间动态，并支持可持续性。采取更全面的方法的“大飞跃”意味着政策制定者、规划者和资金提供者应该“提出”相关问题来评估干预措施，以确保它们有充分的信息和良好的设计。
