Understanding behaviour change in context: examining the role of midstream social marketing programmes

Nadina Raluca Luca, Sally Hibbert, Ruth McDonald

Research output: Contribution to journalArticlepeer-review


This research examines how midstream social marketing programmes that adopt a relational and community-based approach create opportunities for individuals to make incremental changes to health behaviour. Specifically, it applies Bourdieusian theory to explore how interactions between community healthcare workers (CHWs) and members of the public generate impetus for change and foster individual agency for improved health. Qualitative interviews were carried out with members of the public and CHWs engaged in a Smokefree home and cars initiative. The findings suggest that although CHWs are challenged by resource constraints, their practices in working with individuals and families build trust and enable dialogue that bridges smoking-related health insight with home logics. These interactions can promote individual agency with a transformative effect through small changes to smoking-related dispositions, norms and practices. However, tensions with the habitus of other household members and other capital deficits can inhibit progress towards embedding new practices. The study concludes that interventions built upon community relationships show potential for addressing limitations of information-focused campaigns but there is a need to also respond to key social structures relating to the field of action for new health dispositions to become embedded in practice.

Original languageEnglish
Pages (from-to)1373-1395
Number of pages23
JournalSociology of health & illness
Issue number7
Early online date16 May 2019
Publication statusPublished - 21 Sep 2019

Bibliographical note

© 2019 Foundation for the Sociology of Health & Illness. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.


  • Bourdieu
  • midstream social marketing
  • transformative agency
  • social context
  • behaviour change

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