In Figure 5, the innermost circle pertains to factors influencing individual choice, the middle circle covers components that help explain behavioural influences, and the outermost circle refers to enablers, specifically policy instruments, that can give incentives for behavioural change. See chapter 4 for examples of specific policy instruments.
The Nordic Behaviour Change Framework is predicated on the understanding that food policies and interventions aimed at promoting better diets should focus on enhancing the availability, affordability, accessibility, and appeal of healthy dietary options, while simultaneously reducing these factors for unhealthy diets (Hawkes et al. 2013). These ‘4 A’s’ elucidate behavioural influences and are closely associated with the concept of opportunity, as described below. Availability refers to the physical presence of food within the local area. Affordability denotes the ability to purchase food at a reasonable price. Accessibility concerns the ease with which food can be obtained and is impacted by factors such as transportation (Leng et al. 2016). Appeal relates to the qualities of food that make it attractive or desirable to individuals, for example, taste and ease of preparation.
The ‘COM-B’ model, as detailed by Atkins and Michie (2013) provides a framework for understanding and influencing behavioural change. It posits that for a behaviour to occur, individuals must have both the physical and psychological capability (C) to perform it, the right physical and social opportunities (O), and the motivation (M) to engage in this behaviour (B). Therefore, it is essential that individuals understand how to perform the behaviour, comprehend its importance, and possess the necessary skills to facilitate change. According to this model, three core components are essential for any behaviour to occur (Atkins and Michie 2013):
Capability: This involves the individual’s ability to engage in the desired behaviour, encompassing physical skills and abilities as well as psychological aspects like knowledge and understanding of how and why to perform the behaviour. To facilitate change, individuals must be equipped with the necessary skills and clear instructions.
Opportunity: This pertains to the external environment that enables the behaviour, including factors such as the availability of resources, time, and the physical environment, as well as social opportunity like social norms, cultural practices, and the influence of others in an individual’s social circle. The behaviour is more likely to be adopted if it is perceived as normal within their peer group.
Motivation: This involves the drive to engage in the behaviour over other competing actions, influenced by habitual processes, emotional responses, and analytical decision-making. Individuals must believe that the behaviour is worthwhile and important enough to prioritise over other activities.
To facilitate behavioural change towards healthier and sustainable diets, a variety of policy instruments can be employed to enhance the capability, opportunity, and motivation of individuals to choose better diets. These strategies vary, ranging from altering the food environment through instruments like labelling and creating a healthy retail environment, to restricting food advertising and directly targeting individuals (Hawkes et al. 2013). The challenge in altering health-related behaviours lies not only in enhancing people’s motivations to eat healthier through policy instruments and interventions but also in bridging the gap between these intentions and actual behaviour. Effectively addressing this intention-behaviour gap is crucial for successful behaviour change (Broers et al. 2017). Different policy instruments giving the incentive to change behaviour towards healthier and more sustainable diets will be discussed in more detail in the next chapter.