We applaud Wilson et al. for bringing the issue of behaviour change to the attention of BBS's readers. Behaviour change efforts are generally improved by use of theory (Bartholomew & Mullen Reference Bartholomew and Mullen2011; Glanz & Bishop Reference Glanz and Bishop2010), and we agree with the authors that evolutionary theory is the proper domain for the theorizing of behaviour. As evolutionary theorists working in the applied domain of public health, we have spent many years seeking to develop a more fundamentally grounded approach to changing behaviour than those currently advocated by health psychologists, behavioural economists, and consumer marketers, for example (Aunger & Curtis Reference Aunger, Curtis, Lawson and Gibson2014).

These efforts have led us in a different direction to that of Wilson and colleagues. Instead of restricting our attention to only one mechanism of behaviour change – intentional (especially “mindful”) change – they have led us to what can be called “unintentional” approaches. These include direct appeals to emotional responses (which predominate in marketing), as well as environmental manipulations that may not be recognized at the conscious level (e.g., putting pavements for walking in public areas). There are therefore other routes to changing the behaviours of interest to public health (and social welfare) than appeals to conscious cognition.

Examining the evolutionary history of adaptations to produce behaviour shows that there are three general mechanisms by which human brains produce behaviour: cue-driven reflexive behaviours, produced using mechanisms that first arose with early vertebrates; the mammalian suite of motivated behaviours that include those driven by the emotions; and the most recently evolved control system, executive control, which allows humans to plan their responses (Aunger & Curtis, in press; Bressler & Menon Reference Bressler and Menon2010; Menon Reference Menon2011; Rolls Reference Rolls2005). The existence of these alternative mechanisms for behaviour production suggests that improvement of the health and welfare of a target population need not always appeal to intentional control over behaviour. We can also manipulate the environment in ways that produce reflexive or motivated responses, leading to improvements in health (Lally et al. Reference Lally, Chipperfield and Wardle2007).

Indeed, many of the behaviours people would like to change for themselves, or that are important underlying causes of public health problems, are likely to rely on the reactive control system – in particular, the learned reflexes called habits. Behaviours often performed habitually include the use of psychoactive compounds such as cigarettes and alcohol (Everitt & Robbins Reference Everitt and Robbins2005; Orbell & Verplanken Reference Orbell and Verplanken2010), eating and exercise (Aarts et al. Reference Aarts, Paulussen and Schaalma1997; de Bruijn & Rhodes Reference de Bruijn and Rhodes2011), and hygiene practices (Curtis et al. Reference Curtis, Danquah and Aunger2009; Judah et al. Reference Judah, Gardner-Sood and Aunger2012). Habitual behaviours tend to be performed automatically in response to environmental cues and are relatively insensitive to changes in rewards (Graybiel Reference Graybiel2008; Wood & Neal Reference Wood and Neal2007; Yin & Knowlton Reference Yin and Knowlton2006), so that changing such behaviours through appeals to high-level cognition can be ineffective (Webb et al. Reference Webb, Sheeran and Luszczynska2009). Rather, we need to provide the products and cues that lead to the formation of healthier habits – for example, fruit displayed at school lunch counters (French & Stables Reference French and Stables2003) or the introduction of speed bumps to reduce driving fatalities (Afukaar Reference Afukaar2003).

A second category of behaviour is under motivated or emotional control. Our evolutionary theoretic approach posits there are 14 human motives – particular adaptations serving particular needs in the human niche (Aunger & Curtis Reference Aunger and Curtis2013). For example, nurture serves the need to rear altricial children, disgust helps keep parasites outside the body (Curtis Reference Curtis2013), affiliation promotes efforts to belong to social groups, and love drives behaviour that serves the need to pair-bond (Aunger & Curtis Reference Aunger and Curtis2013). These habitual and motivated drivers of behaviour are often more fundamental and powerful than the intentional or willful control of behaviour (Baumeister & Tierney Reference Baumeister and Tierney2012; Bechara Reference Bechara2005; Loewenstein et al. Reference Loewenstein, Brennan and Volpp2007), which suggests they should be incorporated in any comprehensive approach to behaviour change.

Our behaviour change model, which we call the Evo-Eco approach, uses evolutionary theory to identify the key psychological, environmental, and situational causes of any particular behaviour and then provides a process to help develop interventions for large-scale behaviour change promotions. An example is our recent hand-washing campaign in rural India. Formative research identified disgust, affiliation (to group norms), and nurture as key motives for hand washing. We used these insights to design a multifaceted campaign that strongly associated these powerful emotions to hand washing with soap.Footnote ¹ We also manipulated the social and physical environment to make it seem that everyone was doing hand washing (e.g., households that pledged to become hand washers had their names displayed in a prominent location). Finally, we used eye-spots in bathrooms to help cue hand-washing habits. A randomized controlled trial showed that directly observed hand washing with soap at key moments had gone from 2% to nearly 30% of the population, and it remained at that level six months after the intervention (Biran et al. Reference Biran, Schmidt, Rajaraman, Varadharajan, Greenland, Kumar, Aunger, Vas and Curtis2014). By contrast, a similar trial of an educational (intentional) behaviour change campaign in a similar area of rural India showed no significant changes in hand-washing behaviour (Biran et al. Reference Biran, Rabie, Hirve, Schmidt and Curtis2008).

In sum, we fully endorse the efforts of Wilson and colleagues to bring evolutionary theory to efforts to change socially important behaviours, but suggest that a thoroughgoing evolutionary approach implies that there are many more – and more powerful – levers that can be employed to successfully change behaviour than just conscious and mindful intentions.