Health promotion has an ambivalent relationship with behaviour and behaviour change. While the emergence of health promotion and its place within public health is rooted in the recognition of lifestyle factors as leading causes of chronic illnesses and injuries, health promotion has distanced itself from a narrow focus on individual behaviour change, by empowering people and communities to address the environmental, social and political factors that determine health. This 'paradigm shift' laid a basis for the criticism that actions aimed at changing individual health lifestyles are ineffective, as they do not sufficiently account for the interdependencies of behaviours, and unethical, as they blame individuals for being unsuccessful in adopting healthy lifestyles largely shaped by the social and physical context.
However, health promotion should not abandon the concept of behaviour change. While health and illness are indeed linked to broader social and environmental determinants such as education, SES, gender or ethnic background, these moderate the exposure to conditions with immediate effects, including behaviour. Abandoning behaviour would also mean a loss of the potential to apply new developments and insights from behavioural research, such as compensatory beliefs, goal achievement or nudging into public health practice. Applying behaviour change theory allows investigating the interactions between structural and policy changes, community empowerment, behaviour, and health. Although behaviour change principles are mostly used in 'downstream' interventions aimed at influencing the behaviour of the population, they can also be used to achieve structural change through 'midstream' or 'upstream' interventions.
In this presentation, we will argue why behaviour remains an important concept for health promotion, and how health psychology and 'behavioural insight' can help to further develop the theory and practice of health promotion by exploring new theoretical developments, applying and testing state-of-the art knowledge, and integrating these to address the complexity of health and behaviour change.