The Nature of Change Has Changed. Insightful and Timely Understanding of What People Feel, and Think Is More Important than Ever

Abstract

Technology is transforming industry after industry, perhaps none so much as the media landscape which has, since the millennium, seen traditional and hierarchical, mass media upended by flatter, networks, interconnectivity across the globe, spurning social media, and narratives that have now become the mainstay of people’s lives. Tracking such narratives enables one to understand what people themselves feel is important to them. This has never been more important than at the present time. The daily lives of everyone were rapidly transformed by the unprecedented challenges of COVID-19, which for 2 years saw many different approaches by different country leaders. In general, it demonstrated that systems were broken and leadership lacking when most needed. Volatility, uncertainty, and indeed fear were compounded by miscommunications and a lack of clarity. The pandemic, coupled with the unwarranted invasion of Ukraine, has further adversely affected peoples’ outlook with rapidly changing priorities by (new) leaders, who are now seeing further societal turmoil in people’s daily lives as mental health, basic living costs…, add to the already heightened uncertainty. Leaders must accept and embrace that not only is the rate of change accelerating, but the nature of change itself is changing and having a transformational effect on people and institutions. This paper shares the results of tracking key lifestyle narratives, in A Virtual Living Lab, from before COVID-19 to September 2022, when most countries had removed their pandemic restrictions. It shows how investigating “important” narratives, those with utility, can enable people to track and respond to what people think is important by “engaging with engagement” that already exists in current social media environments that describe what people think/feel and can lead to behaviour change. Paradoxically, with media fragmentation, there are many like-minded, micro-communities that have deeper engagement and thus, the potential to create competence with the apparent complexity of modern living.

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Beaumont, C. , Berry, D. and Ricketts, J. (2023) The Nature of Change Has Changed. Insightful and Timely Understanding of What People Feel, and Think Is More Important than Ever. iBusiness, 15, 1-25. doi: 10.4236/ib.2023.151001.

1. Introduction

For a moment in history, everybody, every institution public, private, and family, around the world, shared the same priorities during the outbreak of COVID-19, to protect our people, our family, our colleagues, our friends, and our customers. The uncertainty and fear were compounded by mis-/dis-information as the pandemic became an internet virus as much as a biospheric virus. Leaders and institutions were found to be lacking as uncoordinated responses and changing priorities compounded the fear of the unknown, in a changing, globalised, and interconnected context.

Before COVID-19, in social implementation research, it had been popular to establish a “Living Lab”, a physical environment where controlled ethnographic investigation could be undertaken. They can provide the basis for focused experimentation both in terms of product/service evaluation, likely usage, and behavioural dynamics as well as how “early adopters” might help diffusion. Social distancing became a necessity during the pandemic. This paper shows how one can utilize Big Data and AI technologies to interpret interactions with online content in a coherent and authentic way can create a Virtual Living Lab (VLL) (Beaumont et al., 2021, 2022). This paper began tracking lifestyle narratives before COVID-19, through to September 2022, which saw a period of unprecedented change and uncertainty, and interconnectivity. As personal lifestyle choices become increasingly important, social sharing of new healthy ideas and practices, that go viral, will have the potential to drive major behavioral shifts.

Social media and mobility are now part of every day. Social sharing and social business represent new norms since people trust people (rather than institutions, Edelman, 2021, 2022). Interconnectivity has elevated new connections that are based on cultural truths rather than rational facts. People’s actions are more often based on human interest stories than hard data and rational expectations. Nobel laureate Shiller (2019) has shown how when contagious stories go viral they can drive major economic events. He has coined the phrase “Narrative Economics”.

Interconnectivity is a bigger story than globalisation. The tension between independent cultural identity and the impact of interdependence brought is a defining element of our world going forward. In an interconnected age, there are many narratives, often competing. They are changing the way democracy works and breaking down communications conventions. At the same time, as the pandemic covered by this paper, several topics show the disconnect, and for some distrust, of many people from public and private leaders. These included COP26, the Great Resignation, new (unexpected) political leaders, economic hardship…, Ukraine, as well as increasing concerns of mental health associated with the pandemic, seemingly providing incessant daily, negative news. This provides the context for the period covered by this paper which begins by comparing June 2019 with September 2022.

The pandemic showed us much was broken and there is a need to reset (Beaumont & Ricketts, 2020). The goal should not be simply safe, but to look at ways of regeneration that make society better. The analyses show a need to understand and respond to fundamental human and societal needs, which after COVID have a now greater immediate concern. For example, economic health affects families daily with no apparent let-up; mental health has been hidden and magnified by the pandemic; personal relationships have been stretched while at the same time, many have found much-needed support in their communities. One significant consequence is that both health and well-being have moved up the agenda.

Daily tracking of the emotions associated with the COVID-19 narrative, in the UK (Figure 1), from the start of the national lockdown in March 2020 through to August 2020 shows the roller-coaster of feelings that were experienced while the population confronted the unknown with their daily lifestyles turned upside down. The natural fear and anxiety were only heightened by poor crisis management characterized by miscommunications, conflicting communications between national and local outlets, and almost daily alterations to legal constraints on lockdown behaviour culminating in confusion and mistrust of the leadership, which culminated in the replacement of the then UK Prime Minister, in September 2022.

Figure 1. Daily emotional response to COVID-19 in the UK (March 2020-August 2022). To track the COVID-19 narrative we look at all open online sources, in the UK, every day during the period. However, there is no time window. So, depending on how the narrative, self organises, it could be dominated by recent content... or not.

In the commercial world, research is not conducted out of curiosity or for academic purposes. We conduct research to help organisations make better (evidence-based) decisions. The right story, told the right way, makes it more likely that the right action will happen. Measuring and interpreting social and linguistic signals by accessing openly available online content is naturally more directly reflective of human behavior, than traditional qualitative or quantitative survey methodologies. It can provide real-time insight to facilitate better decisions. The Significance Systems axiom is to “deliver utility from the world’s narratives”, by measuring long-term engagement. The platform earth.ai, analyses millions of behavioural interactions with content, to model human interaction, and to provide an objective read on engagement, media power, and the authentic, emotional drivers of (new) behaviour. This enables one to “engage with engagement” and thus be part of the ongoing story rather than try to dominate it from the outside, which has been the traditional mass communication norm of intrusion.

Narratives can be classified for their utility by assessing their long-term engagement. Most internet exchanges are white-noise and thus most narratives, unless harnessed, are transient (82 percent), with low engagement (Beaumont & Ricketts, 2020). Those narratives with utility are transformative and timeless. Transformative narratives, in general, reflect only 2 percent, while those that are timeless account for 5 percent. In addition, one can identify tribal narratives (11 percent). These are characterised by intense debate, in a niche and thus rarely have a broad impact. The emotions stimulated by any narrative are as important to understand as the content driving engagement, since emotion precedes action. Critically one can now associate with a strong narrative, driving relevance and credibility in an engaging manner by:

• Knowing what to say;

• How to say it;

• Who to say it to;

• Where to say it.

With the pandemic, there is a new urgency for public and private institutions to reset and communicate their orientation, so that people can make sense of and engage with new paths forward. There is a greater imperative to facilitate entrepreneurship so that current peripheral initiatives can become the focus of more lives. Purpose can bring focus but the passion it also reflects needs to accept risk and focus on what works and why. Big Data and AI can help create new, currently unimagined, solutions but a critical element of a development narrative is that it is evidence-based. Our modern lives are increasingly complex with many things happening outside one’s influence. Leaders will need to be able to simplify the complex, and facilitate a learning journey by developing Strategic Leadership Narrative that has clarity and can inspire commercial and societal regeneration and entrepreneurism. Such clarity is fundamental to stimulating creativity and transformation.

The strategic leadership narrative demands that there is competence (O’Hara, & Leicester, 2021) in complexity, which can simplify providing a culture for growth, change, and social innovation. The pandemic has brought to the fore the need to go beyond traditional job descriptions and stable institutions to create comfort with, and embrace change, if we are to meet today’s complex dynamics. A core component of societal development will be an improvement in health and well-being, which will demand greater health literacy as people need to be empowered to make informed choices. This was a central motivation for creating the Virtual Living Lab that is outlined in the next section, and which forms the focus of this paper. (Lifestyle) Purpose can help people embrace change. A current notable example is that of Patagonia which has the mission statement “were in business to save our home planet”. Their enlightened founder and leader Yvon Chouinard recently transferred ownership to a Trust, because as the founder said instead of an IPO (“going public”), they were “going purpose”.

2. Virtual Living Lab

A Virtual Living Lab was created to compare the UK and Japan for the LifeStyleby Design Unit at the University of Tokyo’s, Institute for Future Initiatives. It is widely accepted that roughly 60 percent of mortality and 80 percent of the global disease burden are a function of just four lifestyle choices: lack of exercise, poor nutrition, smoking, and alcohol abuse. A key requirement to improve the dispersion of new lifestyle behaviors will be to leverage social media in a consistent and coherent manner, that is explicitly transparent and positive, and people feel empowered by being enabled to make informed choices. As a basis for investigating a broad sense of LifeStyleby Design, some potentially rich narratives (Table 1) were qualified by presearch. These form the objective basis for the empirical comparison between Japan and the UK, which, over time, will be tracked to monitor and assess best practices.

The VLL was begun in June 2019 and between then and September 2022 there were nine separate waves of research across a consistent set of lifestyle issues. As noted above, this was a period of unprecedented social and living changes across the world. The encouraging first observation is that many timeless narratives were identified in the first wave in June 2019 (Figure 2 & Figure 4). They were currently ill-defined but as issues, these narratives were expected to persist or grow. The Timeless Japanese narratives were weaker (Figure 3) than those in the UK on average. Those at the bottom of the UK are narratives (wording) that have not as yet been captured in the vernacular and/or just have less personal engagement. The timeless narratives that are towards the top are generally about “My….” perhaps an indication of relatively greater individuality (than found in Japan)? That there are no transformational narratives in the UK analyses might be because they have moved to become timeless as they started rather earlier.

The three transient narratives (Personal Optimism, Wellness and Personal Bonding) in the bottom left of Figure 2 were not in the vernacular in June 2019

Table 1. VLL lifestyle narratives tracked in the UK and Japan.

Figure 2. VLL narrative classification in the UK (June 2019).

in the UK. Content efficiency is shown by different narrative shading (Figure 3) in the narrative landscape (Figure 2). Content Efficiency is a measure of the extent to which the existing narrative content is significant. High content efficiency means that much existing content is significant, whereas a low score means there is a gap between the needs of the narrative, and the currently-created content.

From a broad perspective, the lifestyle narratives chosen to be tracked in the VLL, (Figure 2-UK, Figure 4-Japan) where potentially important topics since the majority were timeless. The three UK narratives (Personal Optimism, Wellness, Personal Bonding) in the bottom left corner of the transient segment (Figure 2) were most likely not in the popular vernacular in June 2019.

Health (健康) in Japan, is a timeless narrative with an above average content efficiency indicated in orange (Figure 4). In June 2019, it was the narrative with the most efficient content in the VLL across Japan and the UK. At the same time, My Resilience (私の回復力) in Japan was the only transformational narrative in the VLL. Yet, it was still relatively diffuse, and the content did not provide a clear definition. My Resilience is an open narrative, here’s the opportunity to blow it up and own it. Very few narratives are transformational. Such narratives are characterised by intensely-engaged experiences with strong timeless themes. Relatively, these narratives are fast-changing, yet potentially result in lasting transformation of the world. They represent a volatile environment for themes for communications. Naturally, they provide a strong opportunity if there is positive alignment, or a great threat if an opposed perspective is mooted. Whilst transformative, this narrative is still relatively diffuse and malleable. Existing content does not provide definition, and thus there is a genuine opportunity for new approaches to content.

The first and second wave of research was before COVID-19, but the second wave was after the election of Boris Johnson, in the UK, in December 2019 when an uncertain future seemed for the British to be resolved. But all subsequent waves of research were during a time of unprecedent global change and uncertainty due to the pandemic. That said, the utility of the VLL’s narratives was evident as latterly materially more became transformational (Table 2) in September 2022, while a number remained timeless (Table 3) despite the volatility.

Importantly, what is evident in the latest wave is that the basic tenets of society are in flux, after almost two years of the pandemic which highlighted many things that were broken people are beginning to envision transformational changes in how they live both at a macro, societal level (Table 2, Social Stability) and from an individual, perspectives (Table 2, Personal…), particularly in regard their relationships and satisfaction.

The pandemic changed almost everything, and very quickly, with long-held norms being overturned. However, during the period some narratives remained

Figure 3. Narrative content efficiency.

Figure 4. VLL narrative classification in Japan (June 2019).

Table 2. VLL transformational narratives.

timeless (Table 3) and key to understanding what people felt was more than ever important. Critically, their nature and extent of the narratives changed. Motivation, Health, and Well-Being, as well as My Community came to the fore during the pandemic. Some of these are probed in more detail in the next section.

Comparing the narrative landscapes in June 2019 with September 2022 (UK: Figure 2 & Figure 5; Japan: Figure 4 & Figure 6) we see a dramatic shift in both countries demonstrating the sense that “what had been fixed is now fluid” some of the timeless narratives had become stronger but the significant majority had become transformational. The imperative during a period of such flux and volatility is for leaders to dig deep into understanding why this is happening and being able to “engage with engagement” to be credible. Change is never easy as people always talk more about it than embrace it. During this period of study change is especially hard since it appears at multiple levels, but critically people can see no end point.

3. Narrative Deep Dive

To illustrate the power and utility of what can be real-time narrative analyses we will in the remaining paper dig more deeply into the granularity of several the different narratives (Table 4) in the VLL. It should be noted that, overall Japan is in a much better state than the UK in September 2022. One important element seems to be the active and positive attitude that people in Japan feel about Working from Home.

3.1. Social Stability

COVID-19 brought immediate changes in the daily lives of people throughout the world. Social Stability was a timeless narrative in June 2019 but by September 2022 it had become a transformational narrative, in both UK and Japan. The pandemic led people to question long-held traditions and behaviours, which will remain after COVID-19, (withstanding the on-going impact of long COVID), while putting healthcare systems under stress like never before. That said, the impact was not uniform as the poorest in society were generally worse hit and inequality was magnified.

Affect Orientation is a measure of the degree to which the narrative stimulates an emotional response: active or passive, positive or negative. Most narratives are simply neutral, and do not provoke any emotional response. Social Stability in the UK in June 2019 and September 2022 (Figure 7) was the same, but for different reasons. It was an active, but negative narrative due to the uncertainty associated with the then ongoing Brexit debate in June 2019, and COVID-19 in September 2022. Narratives such as this, which are driven by an active, negative engagement, will polarise opinion. Although they have the power to grow, to maximise long-term power, they must transform from destructive and oppositional, to positive and creative.

While affect is a rich measure of the emotional tone of the significant content. Understanding of the emotional drivers empower you to better understand, and

Table 3. VLL timeless narratives.

Figure 5. VLL narrative classification in the UK (September 2022).

Figure 6. VLL narrative classification in Japan (September 2022).

Table 4. VLL narratives focused on in this paper.

respond appropriately to, the emotional impact of the narrative. This is represented by an emotional wheel (Figure 8), positive emotions are highlighted in green, whereas negative emotions are red (which dominate the emotions around Social Stability in the UK (Figure 8), in September 2022, with jitteriness creating anxiety). If there is a clear tonality to the emotions expressed, such as expectation or apprehension, these are shown in purple. The intensity of the colour indicates the intensity of each emotion. The width of each arc reflects the degree to which the named emotion contributes to the overall emotional response. Broad emotions, such as fear and love, are closer to the centre of the chart. The more subtle emotions, which contribute to those broad emotions, are shown in the concentric

Figure 7. Affect orientation social stability in the UK (September 2022).

Figure 8. Emotional response social stability in the UK (September 2022).

rings further out. Moving out from the centre, each ring shows a further level of detail.

As in the UK in September 2022, in Japan Social Stability is also a transformational narrative (Figure 6 & Figure 9). However, the emotional response to the narrative is not negative like in the UK. Rather, with frankly less almost constant negative news from the UK, we see the stoic nature of the Japanese, after more than twenty months of the pandemic, being characterized by the tonality of expectation (Figure 10), and more positivity than in the UK

3.2. Well-Being

Well-being is a timeless narrative in both countries and despite its’ increasing importance the content lacks focus and is poorly defined. The affect orientation, in the UK, is positive and active and thus the narrative has momentum that can be harnessed. The emotional response of well-being in the UK (Figure 11) shows some ways in which the narrative may be leveraged by “engaging with engagement”. While there is some fear and dislike the tonal cues of astonishment and surprise coupled with clear benefits (easiness, tranquility, and calmness) associated with the need of well-being provide the focus for engagement with well-being. The relative positivity in Japan seen in probing the Social Stability narrative, is more significantly expressed in the delightful affect orientation (Figure 12) and more explicitly by the joy and happiness emotions and future expectations (Figure 13) around the well-being narrative.

3.3. My Community

My Community is consistently a timeless narrative in both Japan and the UK (Table 3). Its’ material importance came to the fore during the pandemic as people

Figure 9. VLL narrative classification social stability in Japan (September 2022).

Figure 10. Emotional response social stability in Japan (September 2022).

Figure 11. Emotional response well-being in the UK (September 2022).

Figure 12. Affect orientation well-being in Japan (September 2022).

Figure 13. Emotional response well-being in Japan (September 2022).

found positive and active support from families and neighbours (Figure 14), as they shared a common goal. As we look to the future, we should support the things that bind us together, and invest in our communities at scale.

In Japan, in September 2022 the emotional response to the My Community narrative was almost wholly positive and optimistic (Figure 15), being a source cheerfulness and joy, with comfortableness creating a sense of belonging. The key topics driving the emotional engagement in the narrative were the focus on life, long-life and community. In the UK, at the same time, My Community also had a positive affect orientation, but it was less active than in the UK, there being more unstated expectations of hope and a relatively stronger sense of horror and fear than we saw in Japan (Figure 15). The optimism associated with community initiatives drove the narrative as well as the notion of platforms since much of the local community support was being communicated via social media initiatives such as mycommunity.org.uk, with tools, tips, and ideas. Our analyses identify and ranks media voices according to their power to lead the debate and shape perception. Social interconnectivity came of age during the pandemic as people were able to continuously support and help each other at distance. The most powerful and influential narrative does not reflect a volumetric media rating. Indeed, it is rare and not surprising that the most popular media are the one with the strongest impact on social engagement.

Figure 14. Affect orientation my community in Japan (September 2022).

Figure 15. Emotional response my community in Japan (September 2022).

3.4. My Family

At a finer level of granulation, the family unit became tighter and stronger during the pandemic, a source of real strength against the common, yet unknown, enemy. Throughout the pandemic the affect orientation of the My Family narrative was active, but over time a sense of optimism was gradually deflated, with no end in sight, to being almost neutral (Figure 16), as a stoic stance came to the fore. Some of the most powerful content enabled people to remain connected, aware of what was going on https://news.livedoor.com/, and provide ideas about how people could feel more relaxed and more empowered.

While an important support, the optimism and enthusiasm (Figure 17), provided by My Family to get through the pandemic, was countered the enduring daze people felt with a sense of sadness and disgust/dislike about the on-going situation. Within the family narrative the importance of the family and role of son came to the fore but, as of September 2022, these key topics were viewed independently.

In contrast, at the same time in the UK, the family remained a source of strength with an affect orientation that was both active and positive. The trials and tribulations of the UK government moving from one crisis to another, without seemingly understanding what was important to their people, had eroded public trust in the political leadership. The family provided a reassuring commitment in a maelstrom of uncertainty and changing expectations bring love and joy form a sense of fulfilment, satisfaction, and contentment (Figure 18), from this indomitable societal unit. It was further magnified by the passing of Queen Elizabeth II, who was branded a “class act” (Daily Express) and by King Charles III, with

Figure 16. Affect orientation my family in Japan (September 2022).

Figure 17. Emotional response my family in Japan (September 2022).

Figure 18. Emotional response my family in the UK (September 2022).

additional powerful content, in a moving speech that honoured the “beloved Queen”, while he renewed the vow of life-long service. The outpouring of love for and celebration of, Queen Elizabeth’s life further magnified the importance of family.

3.5. Personal Satisfaction

Life Satisfaction perhaps came more to the fore during the pandemic, and many now feel that improving Life Satisfaction should become a central goal of any society. Most people now realise that economic growth, however desirable, cannot solve all our problems. Furthermore, it became self-evident that a continuous flow of news items that showed changing policies, only confused, and led for a greater desire for leadership and clarity. It is incumbent on leaders to simplify the complex. On a broader basis, Streamlining will be much more important and so we need to simplify as people will reject the complex. Public and private institutions will need to accelerate digital investments and participation in ecosystems, where aligning with the important narratives is only likely to become more important.

By September 2022, Personal Satisfaction in the UK had become a transformational narrative (Table 2), having previously been consistently a timeless narrative (Table 3) such was the multiple dimensions (social, political, economic) of uncertainty that were likely to have a more dramatic and immediate effect on daily lives. It was still viewed positively but such was the uncertainty people had become more passive (Figure 19). The most powerful story leading the narrative came from https://positivepsychology.com/. It reflected a leadership response to the situation for psychologist, coach teachers… to join an interconnected community, hosted from Holland, which provided a translation of the science behind positive practical initiatives. The key topics driving the narrative

Figure 19. Affect orientation personal satisfaction in the UK (September 2022).

explicitly focused on life and happiness. Another way of improving Life Satisfaction would be to say “Can we be happier?” (Layard & Layard, 2020; Galloway, 2018). This is probed below when considering the Personal Happiness narrative (VI).

In contrast to the UK, Personal Satisfaction is a timeless narrative (Table 3) in Japan. The affect orientation is characterised by active and positive engagement which is reflective of what enables people, in the short-term, to relax and lift life beyond the “everyday”. At the time, the most powerful content reflected the Japanese passion for baseball with core topics related to the home team, upcoming games and the rest of the world. The short-term, escapism in Japan versus the commitment to the medium-term personal progresses reflective of the different emotional response in the UK (Figure 20) and Japan (Figure 21) to the Personal Satisfaction narrative. In the UK, despite being transformational the positive emotions are stronger; the intensity conveyed the different depth of colour in the emotional wheels.

3.6. Personal Happiness

In Japan, in September 2022, Personal Happiness remained a timeless narrative (Table 3). The affect orientation was active and positive. The emotional response (Figure 22) is much more positive than that associated with Personal Satisfaction. It is easier to be happy than fulfilled, there is a lower bar. Personal Happiness is characterized by positivity. It brings joy as well as satisfaction that

Figure 20. Emotional response personal satisfaction in the UK (September 2022).

Figure 21. Emotional response personal satisfaction in Japan (September 2022).

provides contentment and a sense of ego and self-pride. There also hope and expectations for improvement.

Video both YouTube and vlogging are significant channels to shape the perception of happiness, daily. That said, beyond the visual indicators of what is making people happy there was some powerful content fueling engagement with the narrative that looked at happiness in a broader context. For example, a piece

Figure 22. Emotional response personal happiness in Japan (September 2022).

by https://dot.asahi.com/, looked at how psychological well-being varied by age and highlighted the “U-bend of life”, which had been mooted by The Economist (2010), by which middle-aged people get happier as they get older.

4. Implications

Today’s fragmenting media scene is empowering people with new ways of thinking and communicating. It is bringing like-minded people together and thus facilitating dialogue focused on the issues of the moment. This paper shows how one can utilise Big Data and AI technologies to practically interpret interactions with online content in a coherent and authentic manner, in real-time, to understand what people feel is important to them. Business leaders now need to consider key environmental and social issues as part of their corporate development at the core rather than the CSR initiatives of the past which were, at best, tangential add-ons. Sustainability is redefining the leadership narratives.

In this Mess-Age, characterized by multi-dimensional, transformational dynamics leaders need to monitor what people feel and think is important. (New and simultaneous) Mega-trends are transforming tradition more quickly than ever before, and no one is immune. Such a period of rapid change, in which the nature of change itself changes is unfamiliar to many leaders and managers, alike. However, this state is familiar to, for example, capital markets and warfare (see Clausewitz’s “Fog of War” notion). In both cases, great emphasis is given to situational awareness. Decision-making and success are unlikely without this orientation. How people connect and consume information can readily create the dichotomy of In-touch/Out of Touch?! Importantly, situational awareness extends beyond the narrow confines of “business as usual” performance metrics, but extends to culture and society.

The analysis in this paper shows how it is possible, in real-time, to track what people think and feel is important, not what marketers and/or politicians say is important. The global pandemic brought a common goal, yet despite comprehensive interconnectivity, the response was not coherent. Thankfully, globalisation does not massify humanity, rather as this paper demonstrates culture becomes more to the fore, influencing behaviour (Melton & Sinclair, 2021). Thus, any global messaging demands local nuances if they are to engage and move people.

Why don’t people always do what they intend to do? In healthcare, why don’t patients change their lifestyles? Changing behaviour will increasingly be at the heart of healthcare and lifestyle choices. Understanding how people make decisions and what is important to them will help us to identify the gap between intention and action to facilitate action and progress. This can be greatly enhanced by “engaging with engagement” which with transparency is the foundation of creating a trust which has been materially undermined in traditional institutions in recent years.

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

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