“Why is changing health-related behaviour so difficult?”

Michael Kelly and Mary Barker from the University of Cambridge and the University of Southampton have just published a fantastic article in the Journal of Public Health – “Why is changing health-related behaviour so difficult?” – that conceptualizes in a very accessible way why changing health-related behaviour is so difficult and what we do wrong in no acknowledging it.

This article – is compulsory reading for all those who for years have been researching effective health strategies to prevent the rise in obesity, tobacco o alcohol consumption or promote physical exercise. It is worth reading for all those outside the public health field who are trying to design new change strategies for instance against climate change or for the introduction of new technologies in the classroom.

We are all convinced that changing behaviours is essential to respond to the health epidemics (type 2 diabetes, cardiovascular disease…) affecting hundreds of millions and also puzzled by the fact that we are having a hard way achieving it (and bringing evidence)

The authors draw attention to six errors policy makers (and often we as education specialists) apply to health-related behaviour change in non-communicable disease prevention;

error 1. It is just common sense

“It is obvious what needs to be done, so let us just get on and do it”.

If changing behaviour was simply about making common sense simple changes and good choices then we would all be able to make whatever changes we wanted to whenever we wanted, but we do not.

Just because something appears to be obvious and simple does not mean that we should not bother to study it

error 2. It is about getting the message across

“If we could only get the message out there in some form which people could understand and identify with, then they would change in response”.

The investment in social marketing campaigns which borrow heavily from the commercial analogy and their lack of tangible success suggests that the commercial analogy is flawed if applied simplistically to public health matters. Campaigns can have an important role and can be effective, but they are but one part of a total strategy and behaviour change is not just about simple messaging.

error 3. Knowledge and information drive behaviour

“If we tell people the negative consequences of eating too much or exercising too little, they will change their behaviour accordingly.”

This is clearly not true and every front-line clinician and practitioner knows it is not true.

error 4. People act rationally

“If you tell people what is good for them and what they need to do to protect their health, they will do it”.

Most diets fail, not because people do not know what is supposedly good for them, but because knowledge and its rational assessment alone do not drive behaviour.

error 5. People act irrationally

“People have their own reasons for doing things”.

When someone with asthma refuses to stop smoking, we might regard them as very foolish or addicted or both. But what we tend not to see is that this may not be so irrational a decision after all given their lives and experiences.

error 6. It is possible to predict accurately

“We can say with certainty how individual people will behave in any given situation”.

While we can patterns of health inequalities, tobacco and alcohol consumption and trends in these over time and place in great detail, however, none of this has provided sharp-edged tools with which to tackle health inequalities, the obesity epidemic or the rising tide of alcohol consumption.

blog health

As a conclusion, the authors advocate to rethink the way health professionals work with the public. They insist on the need to steer away from information giving and towards empowering and motivating individuals to generate their own solutions to their problems.

At P.A.U. Education with the Avall project, jointly with Bjarne Bruun Jensen from the Steno Health Promotion Research (Denmark) and Esteve Llargues – the project’s designer and coordinator – from the Granollers General Hospital (Spain), we designed an educational intervention during childhood viewing children and schools as catalysts for health-promotion actions at community level and that could provide a key prevention strategy, with education on dietary habits and physical activity for children and their families being considered the foundation for healthy lifestyles in adulthood. Two years after the study completed, the intervention group showed a lower increase in BMI and the trend consolidated after 6 years.

Mark Hanson’s recent research from the University of Southampton has revealed the importance of healthy lifestyle in parents in the period before they conceive a child. This time in the life course offers a window of opportunity to reduce the risk of later NCDs as well as childhood obesity in two or more generations simultaneously – in parents and in their future children and possibly their grandchildren.

These examples help envision new effective intervention strategies that can only work with the active support and conviction of policymakers…


Schools: they are a changin’


Back to school! A full school year is ahead of us and many countries experienced “innovative” school reforms. Does it make sense to change again and again our school programs, school standards…?

Educative systems are accustomed to change. Some would say that they are in a state of constant change. Over the past 30 years, all European countries for instance have been continuously engaged in a deep reflection regarding the future of their educative systems. The rhythm of these organizational and curricular reforms during this period more than doubles that experienced since the turn of the 20th century. Are we simply facing yet another cycle of change that will yield to a set of new reforms? Will it constitute a “controlled” change to adapt schools to new technological, social and economic conditions? Or are we on the edge of a true revolution?

Over 20 years ago, Seymour Papert argued that: “children will (no longer) sit quietly in school and listen to a teacher give them predigested knowledge. They will revolt.” The revolt didn’t take place at the time and our schools didn’t change (much).


times changin

There are several good reasons to think that times are now riper for a “revolt” of great magnitude. In countries like Spain or Portugal, more than 30% of early school leavers and more than 40% of unemployed youth aged over 18 throw the very meaning of school education into question. In the USA, we have just witnessed the first cases of higher education students filing a lawsuit against their law school for creating false expectations with regards to their future employability.

In this context, does it make sense to make school reforms as if we were trying to make up for some problems without changing the whole picture? Have we still time to adapt our school education systems in order to prevent resounding failure? Or should we totally rethink school education in a much deeper way?

The failure of our societies to provide work to youth and to fully integrate them into society may mark the end of school education as we know it until now: a continued process that should lead children and youth to progressively gear up for their futures as successful professionals and responsible citizens.

Policymakers that keep changing the schools without changing the life perspectives for young people may listen again to Bob Dylan:

“There’s a battle outside
And it is ragin’
It’ll soon shake your windows”



How can we reinvent education? Better said, how could we reinvent the world with education? A tremendous question raised by the best selling documentary “Demain” and a disappointing solution: Finland. Not that Finland is disappointing (see one of my past blog entry) but after nearly two hours of film talking about innovative solutions for the energy, the economy, the agriculture, the democracy, you could have expected something more than the so famous Finnish case. Being a reference for the OECD is not necessarily a guarantee of deep transformation. Democratic schools, escuelas nuevas, green schools… and hundreds of teachers that reinvent education every day out of passion and commitment could have been featured in the documentary. Tomorrow’s education is much more than giving more autonomy to principals and teachers. Education is a promise for tomorrow.


a documentary by Cyrille Dion and Mélanie Laurent

a documentary by Cyrille Dion and Mélanie Laurent

Years ago, I was asked by UNESCO to prepare a street chidren educator’s handbook. I asked whether UNESCO and the educators really needed one more manual that was likely to end up unused in the basement of ministries. What could it mean to educate street children? How come could street children engage into education when their lives were about daily survival.? If your main concern is what you will eat and where you will sleep the same evening, how can you prioritize education?

Learners require a vision of the future, not the immediate future but a long term perspective. The objective was then changed. We launched a project to give street children an understanding of the future so that they could understand what education could do for them and their future.

P.A.U. Education started working with street children educators designing a project entitled: the white book of our future. The idea was simple: enable street children to write and publish a book about their future. After 9 months of participatory work with street children in Mali, Honduras or Egypt, books were published. Children “with no name” were credited as “authors”. Invisible children gained recognition and a presence they never had until then. In Mali a law acknowledging their rights was passed.

Education is a promise of a better tomorrow but children needs to be guided to understand what tomorrow could mean for them. This is what innovation in education is about.

Tomorrow… Demain… Now!

A conversation on education

There are many websites, newsletters and journals on innovation and education. I had the chance, for the last 15 years at P.A.U. Education, to be part of some of them.  For all of them, we pretended to be the “single gateway”, the “community meeting point”, the “platform for exchange”, the “reference”. Retrospectively, reading these sentences make me feel overpromising (to say the least). How could we pretend “centralizing” a global movement leading to digital education when innovation in education is mostly ruled by a decentralized agenda: anywhere, anyone, anytime.

How can we support this “decentralized” movement? How can we join the many practitioners and educators that passionately work for a change in education?

Creating a conversation on education! No more and no less.

The need for conversation is growing and we all need a place to share our visions, practices and perspectives on the way education is changing.

This is why I have decided to launch the Open Education Studio. It’s a space to spread out innovation in education.


The Open Education Studio is an invitation to change, a place where innovations in education can be shared, and where the dialogue can be enhanced.

The Open Education Studio is driven by thoughts and experiences from inspired practitioners. None can pretend to teach, or preach. All join the studio to share, listen, inspire and be inspired.

The Studio is an open place where teachers, educators, practitioners, entrepreneurs, publishers, industry or policymakers “speak freely and candidly” and tell the truth about their practices, ideas and desires, frustrations, expectations, and more.

Joining the Open Education Studio means directly cutting into old practices and conventions and making innovation available and accessible to all.

See you there!

Reinventing learning spaces

“Anywhere, anytime, anyone”: what type of learning spaces do we need to make the dream of an ubiquitous and accesible education come true?

Technology apparently is the answer. Instead of building schools and universities that will take ages and consume millions, let’s use screens and microchips. Billions will enroll in MOOCs and the future of learning will be written in the endless memory of powerful learning management systems. But the “no more school” temptation won’t solve the problem of learning places. It will only displace it. “Where do we learn” remains as important as “how do we learn” or “what do we learn”. More than ever we need learning spaces where students come together and share.

As education is continuously reinventing itself, we are about to (re)discover the importance of learning in the street. Colin Ward and Roger Hart always believed in the importance of children social capital built outside of school through play, games and sports and activities with peers where children learn to govern their own activities.

A recent educative project – the Beit project – pushes the paradigm of learning spaces to new limits. A mobile installation simply made of a set of wooden desks and chairs covered by a roof is installed temporarily in public places in order to transform them into sites of dialogue and reflection, engaging students and schools of different socio-cultural backgrounds, which together will build a common experience. No wonder maybe that this innovation is due to an architect, David Stoleru.

A learning space in the city: the Beit project

A learning space in the city: the Beit project

Two chairs, one desk, two students, one common vision, a significant place full of contents and you have designed a learning space! No need for fancy colors or furnitures: walls are abolished and learning can take place everywhere at -almost- no cost and with no technology at all.

Let’s now extrapolate this example to other places: a fast food restaurant for instance where young people spend endless hours connected to their smartphones can be transformed into a learning space with a simple interactive wall giving access to a collection of MOOCs, just as in any public library. Any city can nowadays afford a “MOOC academy”, i.e. a civic center connected to the best MOOCs platforms in the world on a 24×7 basis. A coffee machine, a microwave oven, chairs, tables and couches: this is everything we need to build a new learning space.



The year of the learning path

Students are back to school. New MOOCs are about to be launched. Exams are around the corner. All learners have resumed their journey along the learning path.

Learning is a transformation experience, changing oneself for better. Cheryl Strayed once described this experience in her book “Wild” taking us on the Pacific Crest Trail for a 1800 km hike. Not all of us will have the courage, the need, the time to embark on a similar journey. But all of us have the possibility to take the learning path.

2016 may be – at last – the year of “education for all”. It may also be “the year of the learning path”, when everyone will be able to start anew and learn.

Learning is infinite but there is only one learning path with clear marks so that no one can get lost.

It all starts with attention and passion; the attention we need to realize that we need to learn and the passion that will keep us committed during the trail.

Once the decision is taken, once we are on the path and can’t go back, we will then walk through information and knowledge. A textbook, an exam, a video… are only parts of the learning path.

Accumulating “learning miles”, wearing off our “learning boots” will enable us to take actions for change. “Learnin’ is a changin’”. A learner shouldn’t be allowed to exit the path unchanged. Too often, students walk the path without noticing it. They are in the back seats, not paying attention to the teacher. They keep silent and are soon forgotten. They make as if they are on the learning path but they have already left and no one noticed it. These “early path leavers” may have another chance to join the path but they will have to start again from day one.

Those who stay on the path not only take actions but change their habits.

Changing habits is only the penultimate stage on the learning path. The learner will exit the path thinking upon his/her identity, questionning the change that was experienced and already planning the next trail.

The learning path is one and all learners should walk on it again and again, all year round.

(see a short video animation)

the learning path

learning path

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