A critical commentary of the paradoxical ‘success’ of Making Every Contact Count (MECC)

Initially implemented within healthcare settings but more recently expanded to the wider public and third sectors, Making Every Contact Count (MECC), an opportunistic approach to health behaviour change, has been widely adopted and implemented across the UK, Ireland and beyond, despite little evidence to support improved health and wellbeing of service users. Drawing upon the contextual landscape of MECC implementation, this critical commentary explores the successful yet paradoxically diverse roll-out of MECC despite the lack of evidence to support its efficacy. Key drivers for MECC implementation are discussed and critiqued after distinguishing MECC from related interventions (e.g. motivational interviewing and brief interventions) and exploring the available MECC literature. The five key drivers are a need for prevention over treatment, the addressing of health inequalities, an increased drive for patient-centered care, cost-effective interventions, and key policy documents. In contrast to evidence-based practice, MECC implementation continues to be driven by an individuation tendency when attempting to address public health problems- as a form of ‘lifestyle drift’. Potential solutions to improve the conceptualisation of approaches to individual-level interventions are discussed, along with recommendations for future MECC research and practice within a broader public health environment.