A qualitative study to understand the barriers and facilitators to embedding behavioural research in health organisations.

Le résumé fourni par la source

Behavioural research primarily aims to understand how and why humans make certain decisions, choices and habits (O'Keefe, 2016). Drawing on many disciplines such as psychology, sociology, neuroscience, and economics, behavioural science is an interdisciplinary approach that studies human behaviour and strategies to change it (Moffat et al., 2022). In recent years, there has been a rapid increase in the use of behavioural science to address many societal issues, such as antimicrobial resistance, educational attainment and climate change (Hallsworth, 2023). This growth has been particularly evident in health contexts, where behavioural science is increasingly used to understand behaviours among patients, healthcare professionals and organisations. While much attention has been given to its contribution towards public health policy and practice (Moffat et al., 2022), behavioural science extends beyond these settings, with an increasing number of health organisations across the public, private and third sectors establishing dedicated behavioural science teams or units. These teams are producing many meaningful outputs, often applying behavioural insights to address real-world problems, for example improving uptake of health services (Alderson et al., 2021), supporting quality improvement in healthcare (Johansen and Tulloch, 2024), and optimising referral pathways and system productivity (Behavioural Insights Team, 2023). Behavioural research is also not always confined to dedicated teams or units. It may also be undertaken by individuals in broader roles, where behavioural research forms only one component of wider responsibilities (Fomina and Webster, 2025). Recent UK evidence highlights that behavioural research is particularly relevant to health, with healthcare identified as the most common sector for behavioural researchers and users, and population and planetary health highlighted as future priority areas (Fomina and Webster, 2025, Coupe et al., 2025). Recent workshop evidence also suggested that behavioural research was perceived as particularly credible in health, due to its growing evidence base (Yang et al., 2025). Despite the growth in applied behavioural science, it is not yet fully integrated into the routines and practices of health settings (Ghebreyesus, 2021). One key issue concerns the quality of behavioural research being conducted. This can be assessed through the hierarchy of evidence, which ranks research methodologies according to their quality and dependability (Vatkar et al., 2025). Within health research, systematic reviews and randomised controlled trials (RCTs) are often positioned at the top of the hierarchy, while qualitative research such as case studies and cohort studies sit at the lower levels (Wallace et al., 2022). Many health organisations conduct behavioural research through qualitative studies that generate behavioural insights, and while these approaches can offer valuable context for understanding behaviours, they provide less evidence about intervention effectiveness or evaluative designs. Progressing towards more robust forms of behavioural research such as RCTs, can be challenging, as these approaches are often resource-intensive and time-consuming (Wallace et al., 2022). Building on our previous study (protocol registered on Open Science Framework, Waghorne et al., 2025), which aimed to understand how high-quality behavioural research becomes embedded, one of the aims of this study is to understand the barriers and facilitators to conducting high-quality behavioural research within health organisations. A second issue concerns how behavioural research becomes embedded within health organisations. This reflects the challenge in healthcare, that to improve outcomes, findings need to be adopted by health services and professionals, yet the uptake of this evidence remains uneven (Eccles et al., 2005). Behavioural science projects can generate useful insights, but their impact can be limited when findings are not translated into action, supported by organisations or sustained over time. Existing literature suggests that several organisational factors may influence whether behavioural research is embedded in practice, such as leadership support, buy-in, access to time and resources, and shared understanding about behavioural research (Fomina et al., 2025). However, there remains limited understanding of how health organisations progress from conducting behavioural research as individual projects, to embedding it as routine practice. The current study also relates to the broader concept of learning health systems (LHS), which is described as a system that uses routinely collected data, evidence and experiences to support continuous learning and improvement (Mcdonnell et al., 2000). LHS are particularly relevant to healthcare, where improvement is driven by a multidisciplinary team, including healthcare professionals, patients and the public, working towards a shared goal of improving patient care (Hardie et al., 2022). However, this concept remains broad and variably defined, with limited consensus on what organisations need to do in practice to become an LHS (Easterling et al., 2021, Hardie et al., 2022). Understanding the factors that facilitate or hinder the embedding of behavioural research may also offer insights into the broader organisational conditions needed to support LHS, including how evidence can be used and sustained within routine practice. In this study, embedded behavioural research refers to behavioural research that becomes a sustained and valued part of how an organisation operates. This goes beyond one-off interventions by focusing on whether behavioural research is routinely used, supported and integrated within the organisational systems and structures. Overall, although health organisations are conducting more behavioural research, this work may often focus on qualitative approaches rather than more robust evaluative designs. Behavioural research is also not always embedded or sustained within organisational routines, which may limit its potential long-term impact. This study therefore seeks to understand how health organisations can progress towards conducting and sustaining high-quality behavioural research as part of routine practice by identifying the barriers and facilitators that influence this process.

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