From tools to practice: implementing behavioural insights - experiences from Sweden

Issue/problem

Health inequities reflect gaps between public health knowledge and implementation. While behavioural insights can address behavioural drivers of health, they are often applied through unstructured translation of tools, limiting their effectiveness in local contexts. In Sweden, a need was identified for a systematic and scalable approach to support implementation across national and local levels.

Description of the problem

In 2022, the Public Health Agency of Sweden established a multidisciplinary team to embed behavioural insights into public health practice. The aim was to move beyond translation. The work applied the World Health Organization’s Tailoring Immunization Programmes and Tailoring Health Programmes approaches across vaccination, antimicrobial resistance, environmental health, noncommunicable diseases, and sexual and reproductive health and rights. An adaptation model was developed, combining contextual tailoring, implementation support, and a train-the-trainer approach, supported by a practical implementation package. This approach replaces simple translation with a system for adaptation and capacity building designed for use across levels of the public health system. The key question was how sustainable capacity can be built across system levels.

Results

Behavioural insights were implemented across multiple public health areas, demonstrating feasibility beyond pilot work. The train-the-trainer model enabled scalable capacity building at national and regional levels. Collaboration across system levels improved alignment with local needs and supported more equitable implementation. Work on vaccine acceptance in four regions showed that combining adaptation, implementation support, and iterative learning enabled integration of behavioural insights into routine public health practice. Overall, establishing structured adaptation and implementation mechanisms contributed to addressing health inequities.

Key messages

• Moving from translation to structured adaptation enabled behavioural insights to be implemented in public health practice. This improved the relevance and equity of interventions.

• The innovation lies in shifting from translation of behavioural tools to a model integrating adaptation, implementation support, and capacity building within a public health system.