Public acceptability of government intervention to change health-related behaviours: a systematic review and narrative synthesis

Abstract

BackgroundGovernments can intervene to change health-related behaviours using various measures but are sensitive to public attitudes towards such interventions. This review describes public attitudes towards a range of policy interventions aimed at changing tobacco and alcohol use, diet, and physical activity, and the extent to which these attitudes vary with characteristics of (a) the targeted behaviour (b) the intervention and (c) the respondents.MethodsWe searched electronic databases and conducted a narrative synthesis of empirical studies that reported public attitudes in Europe, North America, Australia and New Zealand towards interventions relating to tobacco, alcohol, diet and physical activity. Two hundred studies met the inclusion criteria.ResultsOver half the studies (105/200, 53%) were conducted in North America, with the most common interventions relating to tobacco control (110/200, 55%), followed by alcohol (42/200, 21%), diet-related interventions (18/200, 9%), interventions targeting both diet and physical activity (18/200, 9%), and physical activity alone (3/200, 2%). Most studies used survey-based methods (160/200, 80%), and only ten used experimental designs.Acceptability varied as a function of: (a) the targeted behaviour, with more support observed for smoking-related interventions; (b) the type of intervention, with less intrusive interventions, those already implemented, and those targeting children and young people attracting most support; and (c) the characteristics of respondents, with support being highest in those not engaging in the targeted behaviour, and with women and older respondents being more likely to endorse more restrictive measures.ConclusionsPublic acceptability of government interventions to change behaviour is greatest for the least intrusive interventions, which are often the least effective, and for interventions targeting the behaviour of others, rather than the respondent him or herself. Experimental studies are needed to assess how the presentation of the problem and the benefits of intervention might increase acceptability for those interventions which are more effective but currently less acceptable.

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“…Public opinion on, and acceptance of, existing and future public policies matter because levels of acceptability and support can critically affect policy effectiveness 12. Reviewing the opinion of target populations increases the chances of success of public health policy 13, and high levels of public support can enhance compliance 14.…”

“…Reviewing the opinion of target populations increases the chances of success of public health policy 13, and high levels of public support can enhance compliance 14. US research suggests that political decision makers are disposed to act in accordance with public opinion 15, possibly with a view to increasing their chances of re‐election 12. Therefore, public opinion can be a proximate and crucial factor of government action 12, 15, 16.…”

“…US research suggests that political decision makers are disposed to act in accordance with public opinion 15, possibly with a view to increasing their chances of re‐election 12. Therefore, public opinion can be a proximate and crucial factor of government action 12, 15, 16.…”

“…There is growing support in Europe, Australia, New Zealand, Canada and the United States for restricting smoking‐related behaviours, particularly when framed as interventions to protect children and adolescents 12. A better understanding of public opinion on e‐cigarette policies is crucial, as it can inform framing of, and communication about, existing and prospective policy initiatives, thereby increasing the acceptability of effective regulation 12, 13.…”

“…A better understanding of public opinion on e‐cigarette policies is crucial, as it can inform framing of, and communication about, existing and prospective policy initiatives, thereby increasing the acceptability of effective regulation 12, 13. Following good practice, the Scottish Government, the UK Department of Health, the Welsh Government and the European Commission held consultations aimed at gathering public opinion on e‐cigarette regulation.…”