Integrity is one of the core values of the Healthcare Communications Association and, I believe, a guiding principle for the whole healthcare communications sector. Integrity means communicating honestly and with strong moral principles. However worthy the goal, and in the case of improving health and well-being that certainly ticks the ‘worthy’ box, we should not try to achieve this with tricks or forcing strategies. Although perhaps tempting, the danger is that when people realise their choice is being influenced unconsciously, they feel tricked, and not in the way we do by the magician, but in a more manipulative and uncomfortable way.

The article specifically highlighted political propaganda as one of those unwanted influences we can potentially protect ourselves from by understanding these techniques. The magician’s trick of misdirection is one example of how politicians deflect attention away from less positive news.

No doubt this type of trickery is part of the reason we have seen a recent erosion of trust in governments worldwide.

To consider using such techniques in healthcare communications at any time does not feel right. And especially now, when health is in the spotlight and with fake news and conspiracy theories abundant, the risk of such approaches to fuel these is much too great.

So, how do we achieve the sustainable behavioural changes we are aiming for in health campaigns without these ‘forcing’ techniques. The answer is not to throw all the learnings from cognitive science away, just consider carefully which to choose and how we use them. Over the years mantras like ‘informed choice’ and ‘no decision about me without me’ have been coined to communicate the importance of ensuring the individual whose behaviours we are trying to influence is party to the plan and wants to make the change. The willing participant. Opting-in, just like my desire to be tricked by the magician for my entertainment, but in the case of health for the much more important outcome of improved health. Once that permission is there, exerting what then becomes appropriate influence, using the whole portfolio of cognitive techniques alongside the evidence base, is not just legitimate, it is essential to achieve the best results.

The real ‘trick’ for the success of communications is true insights into the audience, its unmet needs and the barriers and drivers for change. Once again, it brings us back to the need to recognise our social, cultural and environmental differences and tailor our communications to the individuals, not rely on a one-size-fits-all mentality. It needs us to think beyond the instantaneous success that a magician achieves and instead look at how we can not just create the belief in the need for the change required, but also how we can achieve and sustain that change over the longer term.

There are many different behaviour change models, but generically they all identify that once we understand these insights we then need to use them to:

• Identify the individuals who will help drive the change (this may not just be the patient, but also others, for example, carers, family or healthcare professionals)
• Establish the need and desire for change
• Support the understanding and provide the tools to help to achieve the change
• Ensure the change is sustainable.
  
  

We all like magic tricks, but we are not so keen on being treated as an April fool. Successful healthcare communications need to bring their audience on the journey as a willing and cognisant partner. Get this right and we can achieve the real magic of healthcare communications.