A behavioural science Large Hadron Collider?

The Centre for Behaviour Change at University College London has launched a new venture with global health provider Bupa, to develop applied digital behavioural change initiatives in key health issues. Named the Global Institute for Digital Health Excellence (GLIDHE), the initiative is a bridge between academic and private company worlds that will combine expertise and resources to test behaviour change theories at scale, and help solve major health and wellbeing issues.

Professor Susan Michie, Director of the UCL Centre of Behaviour Change, says, 'The goal is to support people to change behaviour in their everyday lives. This means that partnerships between academia and organisations that can provide field testing at scale is imperative. The concept is not specific to health – it applies to all areas of life where behaviour is key – for example, environmental sustainability, organisational functioning, international conflict, an equitable and just society.'

GLIDHE was developed following research collaborations between Bupa's Group Digital Director Alan Payne, UCL Professor of Health Psychology and Associate of the Centre of Behaviour Change Robert West, and UCL Professor of Computing Science Philip Treleaven. Bupa's grand vision to work as a global healthcare provider with behavioural and computing science at its core led to a neat partnership fit with UCL's Centre for Behaviour Change, who have been brought in to provide the behavioural science input.

This academic rigour is an important element in a time of rapid growth in digital healthcare technologies. Mobile health applications is one of the fastest growing categories on app stores, but this boom in popularity comes with its problems of validity and reliability. 'It's showing up the weaknesses of traditional research methods and we are having to create new, much more agile, methods of evaluating interventions, while still having confidence in the robustness of the findings,' explains Professor Michie. Alan Payne adds, 'Bupa's priority is prevention and reducing the demand on health eco systems. Our scope includes the use of smartphones and devices to telephone interventions, allowing us to cross the digital divide and allow us to service all demographics at all times.'

For UCL, this ambition, as well as Bupa's scale (with over 22 million 'customers' in 190 countries), allows researchers to test and study behavioural theories more quickly. In particular it allows UCL to advance discoveries in its 'Grand Challenges' program, which aims to bring disciplines together to address wider societal problems and input to practitioners, policy makers, and the public.

'The initiative allows behavioural science and computer science to work closely together to create what we hope will be the behavioural science version of the large hadron collider!,' Professor Michie says. 'The data sets will be huge and complex and the challenges will be methodological, practical and theoretical. From the point of view of psychological science, this gives us the potential to test theories, to evaluate components within complex interventions and to build cumulative evidence in new ways and on a vast scale.'

Some of the areas GLIDHE are looking to test initially will involve smoking cessation, following positive trials with Robert West, whose work in developing SmokeFree 28 (SF28) formed the basis for the first GLIDHE project, BupaQuit. GLIDHE will also look at areas of cravings management and alcohol intake reduction apps, in collaboration with national health institutions.

The process for GLIDHE will involve two advisory boards, one scientific and one of global organisations, to advise on maximising engagement and reach. They will systematically identify and prioritise research topics; develop, test and evaluate interventions; and deliver the products with a view to maximum take-up. Professor Michie says, 'We will test those models that combine empirical support with practical utility for our purpose. A recent review identified 83 behaviour change theories (see www.behaviourchangetheories.com). Very few set out to be comprehensive, that is, they were partial representations of the behaviour change process. We focus on two that between them represent a comprehensive model of behaviour change – the Capability-Opportunity-Motivation model (COM-B; see www.behaviourchangewheel.com) and PRIME theory of motivation (see www.primetheory.com). We envisage that an important part of this work will be to test and refine theories, so we see this as an evolutionary process.'

I ask Professor Michie if she has any concerns about such a partnership, given that we know that the funding provider can influence all stages of the research process? She agrees the question 'is an important one for all academics working with non-academic partners, especially those organisations who are incentivised to make profits for shareholders (Bupa is a mutual organisation without shareholders). Even if good formal agreements have been made, it is important to ensure that researchers show complete scientific integrity at all times. As Universities are forging more partnerships with commercial organisations and as the public sector is becoming more entwined with other sectors, this issue is becoming more acute and deserves greater consideration by the academic community.' 

Michie says that 'the questions of responsibility for scientific direction and intellectual property were addressed early on in our discussions. Our collaborators at Bupa are very supportive of the idea that we would lead the scientific work and that the scientific output can be used any way we wish to, completely unencumbered, and this research and academic independence was key factor in the partnership. They are committed to building an evidence base to guide their future work and quite understand that this may mean publishing "null" findings. Our agreement has been formalised in a Memorandum of Understanding.'

Michie clearly has big ambitions for the GLIDHE's work. 'I foresee two major impacts. From the perspective of a scientific partner, it is to see significant advances in our understanding of behaviour change and in the synergistic advances in scientific thinking and practice of working closely with computer scientists. The second impact is social and health: to engage millions, especially those in low and middle income countries, to use products that will improve their health. But we're even going beyond narrow definitions of health to encompass well-being, addressing topics such as stress and sleep.'

- Written for The Psychologist by Eloise Smart, graduate member of the Society and blogger.