About the upstream boat’s public health journey

Theupstreamboat sails upstream in public health via the imaginary upstream-midstream-downstream metaphor.

Dark blue tortuous lines tapering upward with a blue boar with its upper part
Upstream-midstream-downstream metaphor

Evidence-informed public health-focused behavioural theories, intervening models, frameworks, and tools power this imaginary boat.

The boat mission:

To promote awareness and practical applications of the upstream-midstream-downstream approach to address social, economic, and political determinants of health and inequities.

The roles of the Behaviour Change Wheel in this upstream journey

Theupstreamboat favours the “behaviour change wheel” because it makes the boat’s journeys easy to navigate.

About the wheel

The wheel creators – Prof. Susan Michie, Lou Atkins, and Robert West – have constructed the wheel by stirring 19 behaviour change frameworks through a systematic review.

The wheel consists of a hub and three layers: The innermost layer(green), the middle layer(red), and the outermost layer(ash).

The Behavior Change Wheel

(Source: Michie S, Atkins L, West R. (2014) The Behaviour Change Wheel: A Guide to Designing Interventions. London: Silverback Publishing; www.behaviourchangewheel.com

The COM-B analyses the behaviour; based on its findings, one has to choose one or more interventions from the middle layer. The outer rim of the wheel contains seven policy categories, again we have to choose, that create favourable environments for implementing the selected interventions, and more importantly to maintain the new behaviours.

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