Behaviour modification techniques: their use in individual and community programmes

New Perspectives on the Health of Canadians described the self-inflicted nature of many of the major medical problems facing Canada. Given this understanding it might have been anticipated that a carefully mounted large scale health education programme would lead to a reversal of behaviour-related complaints. However, such programmes have not had a strong record of success, with the possible exception of the recently reported Stanford Three Communities study, which is concerned with decreasing cardiac risk factors by a process of mass persuasion, aimed at teaching specific behavioural skills. In the past, living conditions have changed slowly and appropriate lifestyles have evolved along with changing conditions. Only recently has environmental change occurred so dramatically that liviing patterns could no longer mutate and develop gradually to keep pace. Hence the demand for behavioural science to assist people to develop new lifestyles which are in synchrony with a rapidly changing world. Examination of the literature concerning the application of behaviour modification techniques to specific problems clearly demonstrates the difficulties involved in changing behaviours such as smoking and overeating. Behaviour change related to increasing physical activity shows more promise in that it can be presented positively as a pleasant addition to people's lives. If lifestyle modification and environmental control are going to assume a larger part of the health care system, methods have to be devised to translate the experimental successes with relatively small numbers into powerful programmes for press action.