- Public, Wednesday 23 September 2009 12.09 BST
Nudge, Blink and other theories want us to get out of living in a box. Photograph: Murdo Macleod
Public management theory has become increasingly interested in recent years in the way human beings behave and how they make decisions.
Best-selling books, such as Nudge and Blink have tended to a rather bleak view of human nature, where people can be easily influenced. Conservative interest in the nudge theory has been widely publicised. The attraction is clear: the theory proffers a way to get people to change their behaviour voluntarily - farewell, accusations of the nanny state, but also farewell to so called "bad behaviour" such as smoking, which costs the state a lot of money.
But alongside these theories has been another, less well-known theory of how to alter behaviour. Positive deviance has been around for many years. Developed by the late US academic Jerry Sternin and his wife Monique, this is a technique that looks in detail at how people behave, with the aim of teasing out good examples and promulgating them across a local community.
The Sternins used this to good effect in tackling childhood malnutrition in a number of developing countries and also used the theory to tackle entrenched problems in their home country, including reducing MRSA infection levels in some US hospitals, through their Positive Deviance Institute,
The theory of positive deviance is fairly straightforward. It holds that in every community or organisation, there are some people who do better than others, even though everyone has the same resources. By finding how what works well, the whole community or organisation can implement improved practices.
Only practices that everyone can use are kept. Others may be true, but unhelpful, such as the belief that "when I fall on hard times, my rich uncle helps me out". The approach is based on practical changes for the better, rather than waiting for all underlying causes to be tackled.
In this country, there are only a very few examples of the theory having been tried, a cause of some disappointment to practitioners such as consultant Jane Lewis. Lewis has been attempting to get the approach better known in the UK for several years and is about to begin a community safety project in Hampshire, where she will work with local community safety officers to look for examples of good practice within local families.
Lewis says she thought positive deviance "would be the obvious weapon of choice" for the NHS in its battle to combat infections such as MRSA, but she acknowledges that several years after the infection hit national headlines, only a couple of places, including hospitals in London and Liverpool, are starting to roll it out.
What makes it so hard to take promising new theories on board? Lewis herself acknowledges that getting people to change behaviour is no quick fix and depends on experienced facilitators to lead communities or organisations towards changing their behaviour.
There may be other factors, such as the lack of a high-profile champion within the government for such a theory, or the fact that it hasn't had a big, best-selling book behind it.
