Being overweight or obese in childhood has profound impacts on the health and life chances of our children.

Yet we live in a democracy where free choice is a democratic right and the consequences of those choices seems to be everyone responsibility!  In my view, Professor Dame Sally Davies makes the right point, we live in a society where we are (as a population) addicted to sugar, high carbohydrate diet. 

Seven months ago, I swapped to a very low sugar and carb lifestyle, (sometimes called KETO, it is similar to the 800 diet from Michael Mosley).  For the first 4-5 days I had the sweats as my body moved off the carbs and started to burn fat instead.  I have to say the change in both my weight, my mental health and general feeling of energy has remained high, I don’t even feel hungry…

I share this personal story as an empathy view. I was addicted to sugar and carbs and I wasn’t eating that much processed food.  

The facts

Consequences of childhood obesity on health

Many children who are obese or overweight suffer physical health issues, including type 2 diabetes, asthma and musculoskeletal pain, and experience mental health problems, such as depression. These affect the quality of our children’s lives, their education and their life chances. In later life, these can reduce their productivity, earnings and shorten their lives. 

The Agenda

The Government is setting out an approach to public service delivery that emphasises the power of civic society to tackle the big social challenges that we face. This approach is placing more emphasis on the need to:

1.           Realign many of the current social programmes so that they reflect the power of a ‘Society’ response to social challenges rather than a State dominated solution.

2.          Develop supportive, not coercive, approaches to better health and well-being and the appropriate use of public services.

3.          Develop approaches that maximise both choices and responsibility.

4.          Develop targeted and segmented interventions aimed at specific groups with a special focus on assisting the poor and young, and in so doing, reduce inequality.

5.          Develop approaches that demonstrate savings and value for money. They should be co-created - designed by and with the involvement of the target audiences.

It seems Dame Sally is offering a different interpretation in public space a little like the smoking ban, using what we would term a “SMACK” ( I explain this below) If you try to eat or drink unhealthy snacks on public transport you will faced some type of yet to be explained punishment,  a fine or something similar …

The Cost/Value Matrix©

The Cost/Value Matrix© is a conceptual device used by ICECreates.com to represent four different forms of interventions that can be employed to promote change in individuals and groups:

‘Nudge’, ‘Shove’, ‘Hug’ and ‘Smack’.

Most successful social interventions use a mix of these four. It should also be noted that the four forms of intervention are not absolutely distinct.

The matrix is constructed using two axes, active and passive choosing and positive and negative enforcement. In most circumstances what is required is a mix of interventions that work on both the active system two and passive system one mindsets and encompasses both rewards and penalties. 

For more information. On the cost value matrix please get in touch with paula.stewart@icecretaes.com and Paula will share our full white paper.

So, what next…

I stand firmly with Dame Sally, we must take positive action in education and behaviour change for ourselves and the future generations, the human body is not designed to consume the level of sugar and carbohydrates that we as a nation consume today. The data is staring us in our faces.

What we have understood in terms of designing for behaviour change is you CANNOT fix people, it doesn’t work, we must ENABLE people, and this needs us to truly understand what is important the people who as a society we need to support to change for not only for their health but for our ability to afford to care for each other.

SO, here is my question for us all...

In terms of your weight and eating, what’s important to you?

I would love to find out

 Stuart.jackson@icecreates.com

Great teams need great group chemistry, and that’s a fact. We know that certain groups have it, and others don’t – that’s another fact. Most importantly, chemistry needn’t be elusive or mysterious. It’s an art that can be built, refined and practised.

When you’re around great team chemistry, it’s palpable. So, what’s behind the success of these teams? Whether the DNA of a winning culture has been inherited or is newly established, it requires careful nurturing to sustain. Over the years at ICE, we have been closely observing the commonalities recognised in successful teams.

What we’ve noticed is that well and happy cultures are curious by nature. All sorts of things trigger this curiosity – it can be as simple as “Oh, I wonder what that’s all about? Why is that working?’

For us at ICE, curiosity is synonymous with a hunger for knowledge and understanding. When teams share a genuine interest in each other, their world and ‘why’ and ‘how’ things work, this cultivates a culture whereby knowledge sharing, understanding and thought exploration are the norm. This extends to an inherent desire to experiment and evolve, always learning from what has gone before to inform what best impacts upon projects.

Another observation we’ve made is that micro-interactions are embedded within successful teams. Things like holding doors open, taking time to ask about family and getting everyone a cuppa before meetings can seem like pleasantries, but they are supported by behaviours that are essential in high performing teams – empathy, care and trust. When these behaviours are being lived out, they offer the opportunity for personal vulnerability across teams.

You see, these actions aren’t about ‘just being nice’. The behaviours around these micro-interactions are aligned with a basic human evolutionary need. Think Maslow – these actions move past the first 3 levels of psychological needs: safety, belonging and love. These micro-interactions demonstrate levels of respect, esteem and self-actualisation. When it comes to belonging, our emotional brains are either all in, or all out. Great teams are all in.

In the spirit of shared learning, here are a few easy to replicate observations that we’ve identified during our work with high performing groups.

Typing less, talking more

High performing teams build trust by being attentive and vulnerable together. When it comes to the important stuff, these teams aren’t relying on an audit trail of emails to ‘protect’ themselves. This protective behaviour is common in organisations that lack trust, and it really does impact negatively upon performance. Instead, they make the time to have face-to-face interactions, commit to action and deliver on promises. They are not afraid of challenge or entering into honest and open conflict that helps to achieve their mission. They know that communication goes far beyond what is said. To fully understand each other, they remove ‘screen time’ and replace it with ‘physical time’. This extends to meeting etiquette. Often, we notice high performing teams will remove distractions such as phones before going into a meeting. It’s not easy, and that’s why it builds relationships.

Setting the scene

The first few minutes of any interaction are critical. During this time, our brains are deciding whether they’re in or out. Encounters such as meetings and events require careful crafting to set the scene for open and honest dialogue. Successful teams create a safe and supportive environment where vulnerability is actively encouraged. It’s so important to remember that 75-80% of our communication is through body language and tonal expression. Face-to-face discussions aren’t a ‘nice to have’; they’re essential.

Disagreeing, yet committing to action

All too often, disagreements can zap energy and become all-consuming, leaving teams feeling exhausted and trying desperately to locate their nearest escape route. Fear not – it doesn’t have to be this way! In fact, we actively encourage disagreements. High performing teams are not made up of ‘yes people’. The most successful teams have great debates - they’re lively, engaging and challenging, and egos are left at the door. Most importantly, they don’t leave the room until they’ve committed to an action, and that’s a really powerful habit.

The buck stops here

Committing to action and accountability go hand-in-hand. How many times have you left a meeting, only to find yourself wondering weeks/months down the line why nothing has happened? Great teams have fanatical discipline, and each task has a designated accountable person, with responsibility delegated across the team. This allocation typically takes place when teams are committing to action and the accountable person owns the outcome of the task or project. Underpinning all of this is a foundation of positivity. ‘Thank you’ is never in short supply. Whilst this may seem like a basic interaction (after all, teams are supposed to help each other), successful teams make a point of taking the time to share their strong sense of gratitude.

Successful teams are to be admired, but they certainly aren’t the result of magic or an accident. There are many variants, but successful teams share the same core behaviours and attitudes. There is a respect that is lived out in their every interaction – no matter how big or small. It’s an ongoing exchange that can be practised and strengthened, just like the muscles in our minds and bodies. In short, it’s a functional emotional connection and wow, it really is powerful to witness and be a part of.

-      Stuart

Key facts

According to a recent government report, suicide is the biggest killer in men under 50 years old. Promoting mental wellbeing and preventing mental ill health in this population is, therefore, vital.

A public health team in the North of England recently asked ICE to create an insight-led campaign that encourages men aged 30-49 years old to engage in behaviours that are known to have positive impacts on wellbeing and mental health, such as those recommended by the New Economic Foundation’s Five Ways to Wellbeing. This includes: connect, be active, take notice, keep learning and give (see here).

Research techniques

ICE conducted insight groups (experientials) and one-to-one vox pop interviews, using techniques like ‘in their shoes’, journey mapping, and ICE clean language to bypass rational thought processes and get to the root causes of behaviour. The insights we gathered not only gave us the ‘what’ and the ‘how’, but also the ‘why’ that helps us to design an experience that truly engages with what is important to the men who will be targeted by this campaign.

Key behavioural insights

• The word ‘mental’ had negative connotations for men and was associated with illness rather than health. To men, being asked to do something to improve mental health indicated there was a problem that needed to be fixed in the first place.
• Men who took part in our research believed that being a man means being strong. Admitting to having problems can be like admitting there is a ‘chink in the armour’, which can be seen as being weak. As a result, needing to improve mental health is an idea that not all men will want to engage with, because it goes against what they think it means to be a man.
• Men were already engaging in many of the activities associated with the Five Ways to Wellbeing and did not respond well to being told to ‘do more’, because it made them feel like there was a perception they were not already doing enough.
• Men liked imagery that clearly showed that they were the intended target audience of a campaign, but could not always relate to photos of men-like-them because, ultimately, they were not them.

Behaviour change

The insight revealed that focusing a campaign on improving mental health, particularly one that is in a preventative space, risks men not wanting to self-identify that the message is aimed at them - ‘well I don’t have a problem with my mental health, so why would I want to improve it?’. Improving mental health is our desired outcome, but communicating this to men may actually put them off.

To change someone’s behaviour we need to focus on what matters to them, not to us.

Framing activities around valued aspects of the male identity that came out during the groups, such as wanting to protect and look after others, and men’s desire to achieve (the ‘why’) is more likely to drive behaviour than raising awareness that they are important for mental health.

Furthermore, to overcome the dislike of being told to do more of an activity, ICE will frame messages as questions, which encourages men to consider how the campaign message applies to their lives and experiences - without making them feel judged. Using questions is especially effective because they work with our brain’s natural use of attentional functions and can be used to subconsciously prime behaviours.

Neuroscience fact– The power of the unconscious mind: Many of the decisions we make are not rational and are made without us consciously thinking about them. The unconscious mind can be primed to nudge individuals to engage in desired behaviours – with the individual themselves making the choice to change behaviour.

Solution

Based on the findings of this study, our in-house creative team at ICE is currently developing a campaign that will use the ‘why’ that drives behaviour to help our client improve mental health outcomes in their area. The concepts being tested also use themes that are generationally relevant to men aged 30-49 years old to help them to identify as the target audience and to start conversations.

These are only a few of our findings from this study. To find out how ICE can help you find out the ‘why’ that drives your citizens’ behaviours and how to encourage citizens to engage in the Five Ways to Wellbeing, please contact Dr Emma Mackley on 0151 647 4700 or at emma.mackley@icecreates.com.

At 2016's CIPR PRide Awards, Advice ASAP - co-created with NHS Gloucestershire CCG - was presented with the Gold Award in the Public Sector Campaign category. The PRide Awards recognise deliverable results for clients and employers.

"With clear objectives and a well thought out strategy, this campaign delivered tangible results and significantly changed behaviour amongst its target audience. The judges were highly impressed by this outstanding entry. A clear winner." - CIPR PRide Awards Judges

Do our citizens know where to turn?

5 January 2015 saw both Gloucestershire Royal and Cheltenham General Hospitals declare ‘major incidents’ due to high demand in their emergency departments, with 30% of people attending with non-urgent ailments. Advice ASAP was co-created with Gloucestershire CCG to combat the number of inappropriate attendances at emergency departments.

Insight was used to identify the ‘why’ – why were people who could be treated more appropriately by other health services visiting emergency departments? Parents of children aged 0 to 5, 10 to 18 and adults aged 17 to 39 were identified as the key target audiences.

With these audiences presenting with minor conditions that could be more appropriately treated in the community health access centre and community minor injury and illness units, we needed to produce a solution that would help inform citizens about where best to turn.

Development of ASAP:

The innovative app and website allows citizens to identify the most relevant health services to treat their conditions, locate the services closest to them (using geolocation functionality such as maps), and to view opening and waiting times.

Videos are used as a visual aid to advise on the roles of different services – raising education and awareness of where and when to attend, depending on the condition.

Results:

Within the first week of the campaign, the NHS Gloucestershire health community witnessed an 8% reduction in emergency department attendances and a corresponding 8% increase in attendances at the county’s community minor injury and illness units.

Testimonial:

“Our ASAP partnership project with ICE Creates has been hugely beneficial and has resulted in a striking, sustainable campaign and intuitive campaign tools co-produced with clinicians and local people.

Through genuine and meaningful insight gathered from our population and reflecting changing times and the ‘key message culture,’ ICE identified that highlighting the clear routes into assured advice on what to do if you are ill or injured was the right path to take.

As well as signposting to face-to- face and telephone advice options, ASAP offers a groundbreaking app and website that guides people through health conditions and symptoms, care advice and provides the user with specific (and appropriate) service details.

This was a challenging project, but ICE provided friendly and professional project management support throughout, highly creative campaign concepts and visuals and were patient and understanding in our shared approach to developing wireframes and the wider digital assets.

Early signs from evaluation have shown that where people have seen or have acted on the ASAP messages, there have been clear signs of intended or actual behaviour change that can only benefit the local NHS and individual patients as we look to build on the first phases of the campaign.”

Anthony Dallimore, Associate Director, Communications – NHS Gloucestershire

You can view the Advice ASAP website here: http://www.asapglos.nhs.uk/

To request a full case study or to discuss how we can co-create solutions bespoke to the needs of your citizens, contact Paul Williams on 0845 5193 423 or at paul.williams@icecreates.com

The problem: In the UK each year, 40,000 deaths are attributable to exposure to outdoor air pollution. Local authorities are now expected to encourage active travel (such as walking, cycling and public transport) and a shift away from using cars for short journeys.

ICE recently partnered with a council who wanted to reduce air pollution within their locality by promoting active travel amongst people who use their cars for short journeys, such as for the school run. In particular, the local authority was interested in understanding why people chose to use their cars for short school runs so that they could create a campaign which would encourage them to change.

What did we do? ICE conducted insight groups with parents and grandparents who use their car for the school run, to explore why they use the car currently and to help the local authority to understand what will make 'people like them' change.

Why do people use cars for the school run? Using the car to take kids to school was perceived to be easier and more convenient than other transport options. Getting kids to school on time in the mornings is stressful and driving was seen as a way to maintain control over the situation - with kids happier to take the car, less likely to misbehave and more likely to be on time for school.

“It’s to make sure you get there on time, because 9 times out of 10 you’re either late getting up or the kids won’t eat their breakfast so it’s one mad rush in the morning.”

“I feel good that I’m dropping her off to school…at least I know she gets there.”

Other methods of transport were generally perceived negatively as being not safe, not as convenient and more expensive than driving. Together, this contributed to a perception that driving was the only option that they had.

Yet…

When asked to describe their morning school run, parents were overwhelmingly negative, describing the morning school run as being: “hectic”, a “nightmare”, a “rush”, “chaos”, “crazy” and “stressful”.

For one parent, the school run was only a 5 minute journey, yet it took them 10-15 minutes to park. This inconvenience and wasted time was, however, discounted when compared to the perceived convenience of taking the car.

A clear disconnect emerged between parents’ perception of using the car for the school run and their lived experience of doing so.

This disconnect needs to be addressed to help parents to see that other methods of travel are less stressful than the realities of using the car. Routine behaviours, such as mode of daily travel, are deeply embedded in our lives. People will, therefore, tend not to weigh up the positives and negatives before making a journey and so may assume the car is more convenient, when in reality that might not be the case.

What would we recommend based on this insight? From the insight we gained, ICE would recommend a campaign which aims to get parents to ‘leave the car at home’, with a focus on kids getting healthy and physically active. Although the overall aim would be to reduce levels of air pollution, this was not a salient issue with the target audience and so messaging around air pollution may not change their behaviour, whereas parents had been influenced by messaging about health and physical activity of their children in the past.

Any campaign messaging should address the disconnect between perceived and actual experience of taking the car. Importantly, by taking part in the campaign, parents will begin to see the benefits of other modes of transport for themselves.

Our insights told us that kids can influence their parents' behaviour, so a campaign which uses ‘pester power’ (kids pestering their parents) could be effective. Competition, rewards and the idea of a challenge could be a good way to engage both kids and their parents.

The insights told us that schools would be a good messenger for the campaign, because it would make the campaign seem official and schools could communicate both with kids and their parents.

Finally, the insights suggested that a campaign which focuses on people making a small change, such as using the car for the school run in the morning but not the evening, could help to make other transport behaviours normal and routine.

For more information, contact Dr Emma Mackley on 0151 647 4700 or at emma.mackley@icecreates.com

 Are your customers’ behaviours threatening your income?

We know that you feel a great responsibility to your customers, and helping them to manage their finances is one of your priorities. Money management can be particularly challenging for your customers on low-level fixed incomes. If they are struggling to make ends meet, they can be at risk of falling into rental arrears, which has a detrimental effect on your income stream and increases your costs by having to chase payments.

We can help

Our social marketing and behaviour change specialists have worked extensively with housing customers across the country to create a simple programme to improve your customers' financial position.

It is called GET MON£YSMART and it received the top award for Behaviour Change Innovation at the annual Nudge Awards.  

It is a structured, multi-channel social marketing programme designed to engage, educate and empower your customers to take control of their finances by making small, manageable, incremental changes to their lifestyle behaviours.

This effective and engaging programme will protect your income by supporting your customers to reduce their spending on non-essential items and to pay their rent on time.

You can take a look at the case study and find out more about the programme here.

The marketing resources can be easily tailored to fit with your corporate brand and can be supplied alongside a communications and engagement plan that can be shaped to meet your specification and mobilised quickly.

To find out more, contact Paul Williams on 0151 647 4700 or at paul.williams@icecreates.com

Research question: How can local authorities reduce alcohol consumption and increase the number of alcohol free days for 18-25 year old females?

ICE recently partnered with a council that has high chronic liver disease mortality rates for females, as well as an increased proportion of young people who drink alcohol. Continuing this trend will lead to increased mortality for females in the borough. The local authority also wanted to reduce serious alcohol related consequences such as hospitalisations, anti-social behaviour and sexual assault.

Research techniques: ICE conducted insight groups, one-to-one interviews and ethnographic daily diary exercises. The use of clean language and projective techniques allowed our researchers to tap into the attitudes, values, beliefs and emotions that drive young women's drinking behaviours and decision making.

Key behavioural insights: Owing largely to a national public awareness campaign ('Know your limits', Home Office, 2006), 18-25 year old women define responsible drinking as drinking to their own perceived limit. They use this limit as the upper bounds of what is responsible drinking and they define “too much” alcohol as drinking beyond this limit.

“I think responsible drinking is something like knowing your limits.”

Whilst this may sound sensible, when ICE researchers explored this further and asked the young women to describe how they knew they had drunk too much alcohol, they described a physical and emotional state that suggests they were highly intoxicated and vulnerable (unable to speak, falling over and feeling sick/vomiting), which would likely increase the risk of experiencing serious negative consequences such as hospitalisation and sexual assault.

“So it’s over the edge and you start to lose kind of most senses, and you don’t really know what you’re doing.”

Importantly, the young women did know a number of drink protective behavioural strategies (drink water, space drinks, swap a single for a double, don’t mix drinks). They know the desired behaviour change, however, they apply it reactively and too late.

How is ICE using these behavioural insights to change behaviour? 

A key finding of this study was that the young women used a series of visual cues to self-identify if they had drunk too much.

“You start losing, like, your eyesight and stuff. Stuff goes blurry.”

ICE has designed a series of behavioural nudges (e.g. blurred images in toilet mirrors) that will be employed in situ at pubs and clubs to use young women’s unconscious thoughts and nudge them to self-identify that they may be approaching their limit, thus enabling them to apply drink protective behavioural strategies more proactively.

Because we rarely use rational decision making processes when deciding when and how much to drink (we do it because it’s fun, relaxing and social), strategies that appeal to such rational decision making (including those that focus on the serious negative consequences of drinking) are unlikely to have a significant impact on reducing how much and how frequently young women drink alcohol.

Working with young women’s unconscious thoughts and feelings and nudging them towards self-identifying that they have reached their limit provides a novel way to change this maladaptive behaviour and helps to reduce incidences of serious negative consequences of drinking alcohol.

For more information, contact Dr Adam Moore on 0845 5193 423 or at adam.moore@icecreates.com

How do web-based interventions improve wellbeing, physical health and mental health?

This ICE Yellow Paper focuses on the importance of good physical, mental and emotional health, as well as the evidence and action - the case for creating an online health ecosystem:

Digital Innovation - Online Interventions for Improving Wellbeing, Condition Self-management and Achieving Behaviour Change

Insight Research Case Study 

Read More.... Insight Research Case Study

Help your local health population, workforce and partners understand where you’re going – even better, take them with you!

Vanguard sites have already proven themselves by securing the opportunity to boldly implement new models of healthcare.

As the NHS looks to break the mould and deliver new services that build on the foundations laid down in the 5 Year Forward View, they will all need to connect with their local population, workforce and partners in order to secure buy-in and shape their approach. ICE can work with you to host meaningful, collaborative engagement sessions where everyone has an opportunity to share their ideas and, just as importantly, they see those ideas recorded and transformed right before their eyes.

“…I was really impressed with what he was producing…we are looking to organise a patient feedback event involving children and this type of interactive and fun recording would be perfect for it.” – Dr Avril McCarthy, MedTech Lead NIHR Devices for Dignity HTC 

When engagement techniques and their outputs fail to connect with their audience, we tend to see:

• A lack of opportunity for citizens/staff/partners to have their say or learn from one another’s experiences
• Alienated individuals that don’t see how they fit into the picture or how the vision will work for them
• Wordy documents that don’t capture the buy-in or imagination of the audience

What happens if you provide a level arena for conversation and ideas to form together, along with clean questioning and vibrant visuals?

Our change practitioners will help you to tell your story with everyone in the room included, and all of it is captured onto your very own graphic visualisation by our gifted scribes.

What can our co-creative graphic visualisations give you as the hosting organisation?

• Focused insight to unlock belief systems and create a unified energy amongst individuals

• A visual set of iconic metaphor-centred reminders, owned by everyone who took part

• Incredible visuals - readily available to share, promote and revisit the conversation

• Assurance that the audience understands the purpose of your discussion and that their input feeds it's objectives

What benefits do your audience receive?

• Captivating facilitation that drives productive conversation, whatever their learning preference or confidence.

• They won’t feel that they are being influenced into a certain response thanks to our clean questioning approach and open discussion

• They are more likely to buy into the ideas being discussed as they can see their input is being captured and appreciated/debated by others in the room

For more information see our Graphic Scribes Booklet and call us on 0151 647 4700 or email simon.platt@icecreates.com