Specifying the active content of behaviour change interventions: the Behaviour Change Techniques Taxonomy v1 (BCTTv1)

2013 ◽  
Vol 1 (1) ◽  
pp. 131-134 ◽  
Author(s):  
Marie Johnston ◽  
Susan Michie
Keyword(s):  
Behaviour Change ◽  
Behaviour Change Techniques ◽  
Behaviour Change Interventions ◽  
Active Content

scholarly journals A behaviour change intervention to reduce home exposure to second hand smoke during pregnancy in India and Bangladesh: a theory and evidence-based approach to development

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Veena A. Satyanarayana ◽  
Cath Jackson ◽  
Kamran Siddiqi ◽  
Prabha S. Chandra ◽  
Rumana Huque ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Behaviour Change ◽  
Delphi Survey ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behaviour Change Intervention ◽  
Behaviour Change Interventions ◽  
Modified Delphi ◽  
Qualitative Interview Study ◽  
At Home

Abstract Background Home exposure to secondhand smoke (SHS) is highly prevalent amongst pregnant women in low- and middle-income countries like India and Bangladesh. The literature on the efficacy of behaviour change interventions to reduce home exposure to SHS in pregnancy is scarce. Methods We employed a theory and evidence-based approach to develop an intervention using pregnant women as agents of change for their husband’s smoking behaviours at home. A systematic review of SHS behaviour change interventions led us to focus on developing a multicomponent intervention and informed selection of behaviour change techniques (BCTs) for review in a modified Delphi survey. The modified Delphi survey provided expert consensus on the most effective BCTs in reducing home exposure to SHS. Finally, a qualitative interview study provided context and detailed understanding of knowledge, attitudes and practices around SHS. This insight informed the content and delivery of the proposed intervention components. Results The final intervention consisted of four components: a report on saliva cotinine levels of the pregnant woman, a picture booklet containing information about SHS and its impact on health as well strategies to negotiate a smoke-free home, a letter from the future baby to their father encouraging him to provide a smoke-free home, and automated voice reminder and motivational messages delivered to husbands on their mobile phone. Intervention delivery was in a single face-to-face session with a research assistant who explained the cotinine report, discussed key strategies for ensuring a smoke-free environment at home and practised with pregnant women how they would share the booklet and letter with their husband and supportive family members. Conclusion A theory and evidence-based approach informed the development of a multicomponent behaviour change intervention, described here. The acceptability and feasibility of the intervention which was subsequently tested in a pilot RCT in India and Bangladesh will be published later.

scholarly journals The Development of Theory-Informed Participant-Centred Interventions to Maximise Participant Retention in Randomised Controlled Trials

2021 ◽  
Author(s):  
Rumana Newlands ◽  
Eilidh Duncan ◽  
Shaun D Treweek ◽  
Jim Elliott ◽  
Justin Presseau ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Potential Effect ◽  
Ethics Committee ◽  
Behaviour Change Techniques ◽  
Clinic Attendance ◽  
Behaviour Change Interventions ◽  
Randomised Controlled ◽  
Trial Participants

Abstract BackgroundA failure of clinical trials to retain participants can influence the trial findings and significantly impact the potential of the trial to influence clinical practice. Retention of participants involves people, often the trial participants themselves, performing a behaviour (e.g. returning a questionnaire or attending a follow-up clinic as part of the research). Most existing interventions that aim to improve the retention of trial participants fail to describe any theoretical basis for the potential effect (on behaviour) and also whether there was any patient and/or participant input during development. The aim of this study was to address these two problems by developing theory- informed, participant-centred, interventions to improve trial retention. MethodsThis study used a multi-phase sequential mixed methods approach informed by the Theoretical Domains Framework and Behaviour Change Techniques Taxonomy to match participant reported determinants of trial retention to theoretically informed behaviour change strategies. The prototype interventions based on participant accounts were described and developed in a co-design workshop with trial participants. We then assessed acceptability and feasibility of two of the prioritised retention interventions during a focus group, which also included a questionnaire, involving a range of trial stakeholders (e.g. trial participants, trial managers, research nurses, trialists, research ethics committee members). ResultsEight trial participants contributed to the co-design of the retention interventions. Four behaviour change interventions were designed based on suggestions provided by trial participants: 1. Incentives and rewards for follow-up clinic attendance; 2. Goal setting for improving questionnaire return; 3. Self-monitoring to improve questionnaire return and/or clinic attendance; and 4. Motivational information to improve questionnaire return and clinic attendance. Seventeen trial stakeholders (participants, trialists, ethics committee members) contributed to the evaluation of acceptability and feasibility of the retention interventions, which were generally positive with some areas for consideration highlighted. ConclusionsThis is the first study to develop interventions to improve trial retention that are based on the accounts of trial participants and also conceptualised and developed as behaviour change interventions (to encourage attendance at trial research visit or return a trial questionnaire). Further testing of these interventions is required to assess their effectiveness and assess resource implications.

scholarly journals Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data)

2015 ◽  
Vol 19 (99) ◽  
pp. 1-188 ◽  
Author(s):  
Susan Michie ◽  
Caroline E Wood ◽  
Marie Johnston ◽  
Charles Abraham ◽  
Jill J Francis ◽  
...  
Keyword(s):  
Global Health ◽  
Behaviour Change ◽  
Behaviour Change Techniques ◽  
Consensus Methods ◽  
Active Ingredients ◽  
Top Down ◽  
Bottom Up ◽  
Behaviour Change Interventions ◽  
Intercoder Reliability ◽  
Effective Interventions

BackgroundMeeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) – the ‘active ingredients’, for example goal-setting, self-monitoring of behaviour. BCTs are ‘the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs’ (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change.Health Psychol Rev2012;6:1–6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health.Objective(1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development.Design and participantsFour hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs.Development of the taxonomyinvolved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts;hierarchical structureof the list was developed using inductive ‘bottom-up’ and theory-driven ‘top-down’ open-sort procedures (n = 36);trainingin use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) wasevaluatedby changes in intercoder reliability and validity (agreement with expert consensus);evaluatingthe taxonomy for coding interventions was assessed by reliability (intercoder; test–retest) and validity (n = 40 trained coders); andevaluatingthe taxonomy for writing descriptions was assessed by reliability (intercoder; test–retest) and by experimentally testing its value (n = 190).ResultsNinety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a ‘bottom-up’ open-sort procedure; there was overlap between these and groupings produced by a theory-driven, ‘top-down’ procedure. Both training methods improved validity (bothp < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (bothp < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results.ConclusionsThe developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions.FundingThis project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care.

scholarly journals Determinants of usefulness in professional behaviour change interventions: observational study of a 15-year national program

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038016
Author(s):  
Andre Q Andrade ◽  
Vanessa T LeBlanc ◽  
Lisa M Kalisch-Ellett ◽  
Nicole L Pratt ◽  
Anna Moffat ◽  
...  
Keyword(s):  
Observational Study ◽  
Goal Setting ◽  
Behaviour Change ◽  
Educational Material ◽  
Perceived Usefulness ◽  
Audit And Feedback ◽  
Behaviour Change Techniques ◽  
Professional Behaviour ◽  
Behaviour Change Interventions ◽  
Feedback Interventions

ObjectiveEducational, and audit and feedback interventions are effective in promoting health professional behaviour change and evidence adoption. However, we lack evidence to pinpoint which particular features make them most effective. Our objective is to identify determinants of quality in professional behaviour change interventions, as perceived by participants.DesignWe performed a comparative observational study using data from the Veterans’ Medicines Advice and Therapeutics Education Services program, a nation-wide Australian Government Department of Veterans’ Affairs funded program that provides medicines advice and promotes physician adoption of best practices by use of a multifaceted intervention (educational material and a feedback document containing individual patient information).SettingPrimary care practices providing care to Australian veterans.ParticipantsGeneral practitioners (GPs) targeted by 51 distinct behaviour change interventions, implemented between November 2004 and June 2018.Primary and secondary outcome measuresWe extracted features related to presentation (number of images, tables and characters), content (polarity and subjectivity using sentiment analysis, number of external links and medicine mentions) and the use of five behaviour change techniques (prompt/cues, goal setting, discrepancy between current behaviour and goal, information about health consequences, feedback on behaviour). The main outcome was perceived usefulness, extracted from postintervention survey.ResultsOn average, each intervention was delivered to 9667 GPs. Prompt and goal setting strategies in the audit and feedback were independently correlated to perceived usefulness (p=0.030 and p=0.005, respectively). The number of distinct behaviour change techniques in the audit and feedback was correlated with improved usefulness (Pearson’s coefficient 0.45 (0.19, 0.65), p=0.001). No presentation or content features in the educational material were correlated with perceived usefulness.ConclusionsThe finding provides additional evidence encouraging the use of behaviour change techniques, in particular prompt and goal setting, in audit and feedback interventions.

scholarly journals Understanding behaviour change to promote regular dental attendance

2021 ◽  
Vol 10 (3) ◽  
pp. 55-61
Author(s):  
Jessica Holloway
Keyword(s):  
Oral Health ◽  
Behaviour Change ◽  
Systematic Approach ◽  
Health Behaviours ◽  
Behaviour Change Techniques ◽  
Behaviour Change Intervention ◽  
Behaviour Change Interventions ◽  
Dental Attendance ◽  
Behaviour Change Wheel ◽  
Oral Health Behaviours

Regular dental attendance is a key oral health behaviour. Behaviour change interventions are increasingly being used to promote positive oral health behaviours. A systematic approach to understanding behaviour has led to the development of frameworks which aim to guide the process of designing behaviour change interventions. One such framework is the Behaviour Change Wheel (BCW). This article aims to explore and identify barriers to regular dental attendance which may be targeted using behaviour change interventions based on the Capability, Opportunity and Motivation Behaviour model (COM-B) and the BCW, and suggests potential behaviour change techniques which could be utilised into a behaviour change intervention with the aim to promote regular dental attendance.

What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review (Preprint)

2021 ◽  
Author(s):  
Jorge Encantado ◽  
António L. Palmeira ◽  
Carolina Silva ◽  
Falko F. Sniehotta ◽  
R. James Stubbs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Behaviour Change ◽  
Mode Of Delivery ◽  
Weight Loss Maintenance ◽  
Mechanisms Of Action ◽  
Behaviour Change Techniques ◽  
Behavioural Interventions ◽  
Behaviour Change Interventions ◽  
Theoretical Approaches

BACKGROUND Behavioural interventions for weight loss maintenance have shown beneficial effects for weight loss maintenance. While the digital upgrade of behavioural interventions brings an enormous potential to tackle public health challenges, there is limited knowledge about the components of these interventions, i.e., its content, delivery and the theoretical approaches. OBJECTIVE To identify the core components of digital behaviour change interventions for weight loss maintenance targeting physical activity, in terms of: i) Behaviour Change Techniques; ii) Mechanisms of Action; iii) Modes of Delivery; iv) Dose; and v) Tailoring/Personalisation. In addition, the links between these components were investigated. METHODS A literature search was performed in 5 electronic databases: PubMed; Embase; CINHAL; PsycINFO, and Web of Science. Two reviewers independently screened the identified papers and extracted data related with the study characteristics and behaviour change techniques, mechanism of action, mode of delivery, dose, and tailoring, using standardized classifications whenever available (e.g., behaviour change techniques taxonomy). RESULTS Seventeen articles reporting eleven original studies were selected. Two studies were protocols, nine studies presented results for weight change and all but one showed no significant differences between the intervention and control groups. Eight studies (73%) provided adequate information on Behaviour Change Techniques. Five studies (45%) provided partial information about how the Behaviour Change Techniques were linked to mechanisms of action, and only one study (0.9%) described these links for all the techniques. Around half of the studies reported the modes through which behaviour change techniques were delivered. Descriptions of dose were present in most studies, but with minimal information. The use of tailoring or personalisation approaches was mentioned in eight studies (73%), but descriptions of what was tailored and how were minimal. CONCLUSIONS The compilation of information regarding intervention components was difficult due to the lack of information and systematisation in reporting across papers. This is particularly true for the reporting of the links between behaviour change techniques and the other core intervention components. This information is crucial to help us understand in the context of behaviour change interventions what works or does not work, how it works and why.

Family medicine physicians’ confidence and perceived effectiveness in delivering health behaviour change interventions

2020 ◽  
Vol 37 (4) ◽  
pp. 493-498
Author(s):  
Michelle D Sherman ◽  
Stephanie A Hooker
Keyword(s):  
Family Medicine ◽  
Behaviour Change ◽  
Health Behaviour ◽  
Health Behaviours ◽  
Well Being ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Perceived Effectiveness ◽  
Behaviour Change Interventions ◽  
Health Behaviour Change

Abstract Background Approximately 40% of deaths in the USA are attributable to modifiable health behaviours. Despite clear recommendations and practice guidelines, primary care physicians (PCPs) generally do not dedicate much time to addressing health behaviours, thereby missing opportunities to improve patient well-being. Objective(s) To examine what health behaviour change techniques PCPs use with their patients, including frequency of use, confidence in and perceived effectiveness of those interventions. Methods Using a cross-sectional study design, family medicine resident and faculty physicians (n = 68) from three residency training programs completed an anonymous online survey. Questions explored their use of, confidence in and perceived effectiveness of health behaviour change interventions for six domains: physical activity, healthy eating, medication adherence, smoking cessation, sleep and alcohol reduction. Qualitative responses to open-ended questions were double coded by two independent raters. PCPs’ open-ended responses to questions regarding specific intervention techniques were coded using an evidence-based behaviour change taxonomy. Results Although PCPs indicated that they address health behaviour topics quite frequently with their patients, they reported only moderate confidence and low-to-moderate perceived effectiveness with their interventions. The most frequently cited technique was providing instruction (telling patients what to do). PCPs reported lowest frequency of addressing, lowest confidence and lowest effectiveness regarding helping patients decrease their use of alcohol. Insufficient time and perceived low patient motivation were commonly cited barriers. Conclusion These findings highlight the need for the development and evaluation of educational curricula to teach physicians brief, evidence-based approaches to helping patients make these changes in their health-related behaviours.

scholarly journals Studying Behaviour Change Mechanisms under Complexity

2021 ◽  
Vol 11 (5) ◽  
pp. 77
Author(s):  
Matti T. J. Heino ◽  
Keegan Knittle ◽  
Chris Noone ◽  
Fred Hasselman ◽  
Nelli Hankonen
Keyword(s):  
Complex Systems ◽  
Behaviour Change ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Systems Approach ◽  
Linear Time ◽  
Behaviour Change Techniques ◽  
Behaviour Change Interventions ◽  
Complex Adaptive ◽  
Change Mechanisms

Understanding the mechanisms underlying the effects of behaviour change interventions is vital for accumulating valid scientific evidence, and useful to informing practice and policy-making across multiple domains. Traditional approaches to such evaluations have applied study designs and statistical models, which implicitly assume that change is linear, constant and caused by independent influences on behaviour (such as behaviour change techniques). This article illustrates limitations of these standard tools, and considers the benefits of adopting a complex adaptive systems approach to behaviour change research. It (1) outlines the complexity of behaviours and behaviour change interventions; (2) introduces readers to some key features of complex systems and how these relate to human behaviour change; and (3) provides suggestions for how researchers can better account for implications of complexity in analysing change mechanisms. We focus on three common features of complex systems (i.e., interconnectedness, non-ergodicity and non-linearity), and introduce Recurrence Analysis, a method for non-linear time series analysis which is able to quantify complex dynamics. The supplemental website provides exemplifying code and data for practical analysis applications. The complex adaptive systems approach can complement traditional investigations by opening up novel avenues for understanding and theorising about the dynamics of behaviour change.

scholarly journals Studying behaviour change mechanisms under complexity

2020 ◽  
Author(s):  
Matti Toivo Juhani Heino ◽  
Keegan Phillip Knittle ◽  
Chris Noone ◽  
Fred Hasselman ◽  
Nelli Hankonen
Keyword(s):  
Complex Systems ◽  
Behaviour Change ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Systems Approach ◽  
Complex Dynamics ◽  
Behaviour Change Techniques ◽  
Behaviour Change Interventions ◽  
Complex Adaptive ◽  
Change Mechanisms

Understanding the mechanisms underlying the effects of behaviour change interventions is vital for accumulating valid scientific evidence, and useful to informing practice and policy-making across multiple domains. Traditional approaches to such evaluations have applied study designs and statistical models, which implicitly assume that change is linear, constant and caused by independent influences on behaviour (such as behaviour change techniques). This article illustrates limitations of these standard tools, and considers the benefits of adopting a complex adaptive systems approach to behaviour change research. It 1) outlines the complexity of behaviours and behaviour change interventions, 2) introduces readers to some key features of complex systems and how these relate to human behaviour change, and 3) provides suggestions for how researchers can better account for implications of complexity in analysing change mechanisms. We focus on three common features of complex systems (i.e. interconnectedness, non-ergodicity and non-linearity), and introduce Recurrence Analysis, a method for nonlinear time series analysis which is able to quantify complex dynamics. The supplemental website (https://git.io/Jffrm) provides exemplifying code and data for practical analysis applications. The complex adaptive systems approach can complement traditional investigations by opening up novel avenues for understanding and theorising about the dynamics of behaviour change.

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