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.

scholarly journals What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review

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

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.

scholarly journals The H2020 “NoHoW Project”: A Position Statement on Behavioural Approaches to Longer-Term Weight Management

Obesity Facts ◽  
2021 ◽  
pp. 1-13
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
Ruairi O’Driscoll ◽  
Jake Turicchi ◽  
Dominika Kwasnicka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Weight Management ◽  
Behaviour Change ◽  
Weight Regain ◽  
Position Statement ◽  
Mechanisms Of Action ◽  
Evidence Based ◽  
Behavioural Interventions ◽  
Intervention Content

There is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation.

scholarly journals Behaviour change techniques and their mechanisms of action: a synthesis of links described in published intervention literature

2018 ◽  
Author(s):  
Rachel Naomi Carey ◽  
Lauren Connell Bohlen ◽  
Marie Johnston ◽  
Alexander Rothman ◽  
Marijn de Bruin ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Systematic Investigation ◽  
Mechanisms Of Action ◽  
Behaviour Change Techniques ◽  
Test Results ◽  
Behavioural Science ◽  
Theoretical Understanding ◽  
Behavioural Interventions ◽  
Empirically Supported ◽  
Development Evaluation

Background: Despite advances in behavioural science, there is no widely shared understanding of the ‘mechanisms of action’ (MoAs) through which individual behaviour change techniques (BCTs) have their effects. Cumulative progress in the development, evaluation and synthesis of behavioural interventions could be improved by identifying the MoAs through which BCTs are believed to bring about change. Purpose: This study aimed to identify the links between BCTs and MoAs described by authors of a corpus of published literature.Methods: Links between BCTs and MoAs were extracted by two coders from 277 behaviour change intervention articles. Binomial tests were conducted to provide an indication of the relative frequency of each link. Results: Of 77 BCTs coded, 70 were linked to at least one MoA. Of 26 MoAs, all but one were linked to at least one BCT. We identified 2636 BCT-MoA links in total (mean number of links per article = 9.56, SD = 13.80). The most frequently linked MoAs were ‘Beliefs about Capabilities’ and ‘Intention’. Binomial test results identified up to five MoAs linked to each of the BCTs (M = 1.71, range: 1-5), and up to eight BCTs for each of the MoAs (M = 3.63, range: 1-8). Conclusions: The BCT-MoA links described by intervention authors and identified in this extensive review present intervention developers and reviewers with a first level of systematically collated evidence. These findings provide a resource for the development of theory-based interventions, and for theoretical understanding of intervention evaluations. The extent to which these links are empirically supported requires systematic investigation.

scholarly journals Developing and applying a framework to understand mechanisms of action in group-based, behaviour change interventions: the MAGI mixed-methods study

2019 ◽  
Vol 6 (3) ◽  
pp. 1-162
Author(s):  
Aleksandra J Borek ◽  
Jane R Smith ◽  
Colin J Greaves ◽  
Fiona Gillison ◽  
Mark Tarrant ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mixed Methods ◽  
Behaviour Change ◽  
Group Processes ◽  
Mechanisms Of Action ◽  
Change Processes ◽  
Group Level ◽  
Behaviour Change Interventions ◽  
Group Sessions ◽  
Weight Loss Interventions

Background Theories and meta-analyses have elucidated individual-level mechanisms of action in behaviour change interventions. Although group-based interventions are commonly used to support health-related behaviour change, such interventions rarely consider theory and research (e.g. from social psychology) on how group-level mechanisms can also influence personal change. Objectives The aim was to enhance understanding of mechanisms of action in group-based behaviour change interventions. The objectives were to (1) develop a potentially generalisable framework of change processes in groups, (2) test the framework by analysing group session recordings to identify examples illustrating group processes and facilitation techniques and (3) explore links between group-level mechanisms and outcomes. Data sources In this mixed-methods study, the research team reviewed literature, conducted consultations and analysed secondary data (i.e. delivery materials and 46 audio-recordings of group sessions) from three group-based weight loss interventions targeting diet and physical activity: ‘Living Well Taking Control’ (LWTC), ‘Skills for weight loss Maintenance’ and ‘Waste the Waist’. Quantitative LWTC programme data on participant characteristics, attendance and outcomes (primarily weight loss) were also used. Methods Objectives were addressed in three stages. In stage 1, a framework of change processes in groups was developed by reviewing literature on groups (including theories, taxonomies of types of change techniques, qualitative studies and measures of group processes), analysing transcripts of 10 diverse group sessions and consulting with four group participants, four facilitators and 31 researchers. In stage 2, the framework was applied in analysing 28 further group sessions. In stage 3, group-level descriptive analyses of available quantitative data from 67 groups and in-depth qualitative analyses of two groups for which comprehensive quantitative and qualitative data were available were conducted to illustrate mixed-methods approaches for exploring links between group processes and outcomes. Results Stage 1 resulted in development of the ‘Mechanisms of Action in Group-based Interventions’ (MAGI) framework and definitions, encompassing group intervention design features, facilitation techniques, group dynamic and development processes, interpersonal change processes, selective intrapersonal change processes operating in groups, and contextual factors. In stage 2, a coding schema was developed, refined and applied to identify examples of framework components in group sessions, confirming the content validity of the framework for weight loss interventions. Stage 3 demonstrated considerable variability in group characteristics and outcomes and illustrated how the framework could be applied in integrating group-level qualitative and quantitative data to generate and test hypotheses about links between group mechanisms and outcomes (e.g. to identify features of more or less successful groups). Limitations The framework and examples were primarily derived from research on weight loss interventions, and may require adaptations/additions to ensure applicability to other types of groups. The mixed-methods analyses were limited by the availability and quality of the secondary data. Conclusions This study identified, defined, categorised into a framework and provided examples of group-level mechanisms that may influence behaviour change. Future work The framework and mixed-methods approaches developed provide a resource for designers, facilitators and evaluators to underpin future research on, and delivery of, group-based interventions. Funding This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research partnership.

scholarly journals A systematic review of the behaviour change techniques and digital features in technology-driven type 2 diabetes prevention interventions

2020 ◽  
Vol 6 ◽  
pp. 205520762091442 ◽  
Author(s):  
Luke Van Rhoon ◽  
Molly Byrne ◽  
Eimear Morrissey ◽  
Jane Murphy ◽  
Jenny McSharry
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Behaviour Change ◽  
Diabetes Prevention ◽  
Behaviour Change Techniques ◽  
Significant Weight Loss ◽  
Effective Interventions ◽  
Prevention Interventions ◽  
Clinically Significant

Objectives Our aim was to conduct a systematic review to determine which technology-driven diabetes prevention interventions were effective in producing clinically significant weight loss, and to identify the behaviour change techniques and digital features frequently used in effective interventions. Methods We searched five databases (CINAHL, EMBASE, MEDLINE, PsychINFO, and Pubmed) from inception to September 2018 and reviewed 19 experimental and non-experimental studies of 21 technology-driven diet plus physical activity interventions for adults (≥18 years) at risk of developing type 2 diabetes. Behaviour change techniques were coded using the BCT taxonomy v1, and digital features were identified via thematic analysis of intervention descriptions. Results Sixty-three per cent of interventions were effective in the short term (achieving ≥3% weight loss at ≤6 months), using an average of 5.6 more behaviour change techniques than non-effective interventions, and 33% were effective in the long term (achieving ≥5% weight loss at ≥12 months), using 3.7 more behaviour change techniques than non-effective interventions. The techniques of social support (unspecified), goal setting (outcome/behaviour), feedback on behaviour, and self-monitoring of outcome(s) of behaviour were identified in over 90% of effective interventions. Interventions containing digital features that facilitated health and lifestyle education, behaviour/outcome tracking, and/or online health coaching were most effective. Conclusion The integration of specific behaviour change techniques and digital features may optimise digital diabetes prevention interventions to achieve clinically significant weight loss. Additional research is needed to identify the mechanisms in which behaviour change techniques and digital features directly influence physical activity, dietary behaviours, and intervention engagement.

scholarly journals Links between behaviour change techniques and mechanisms of action: an expert consensus study

2018 ◽  
Author(s):  
Lauren Connell Bohlen ◽  
Rachel Naomi Carey ◽  
Marijn de Bruin ◽  
Alexander Rothman ◽  
Marie Johnston ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Nominal Group Technique ◽  
Action Planning ◽  
Mechanisms Of Action ◽  
Expert Consensus ◽  
Nominal Group ◽  
Behaviour Change Techniques ◽  
Behavioural Interventions ◽  
Oxford University ◽  
The Matrix

BACKGROUND: Understanding the mechanisms through which behaviour change techniques (BCTs) can modify behaviour is important for the development and evaluation of effective behavioural interventions. To advance the field, we require a shared knowledge of the mechanisms of action (MoAs) through which BCTs may operate when influencing behaviour. PURPOSE: To elicit expert consensus on links between BCTs and MoAs. METHODS: In a modified Nominal Group Technique study, 105 international behaviour change experts rated, discussed, and re-rated links between 61 frequently used BCTs and 26 MoAs. The criterion for consensus was that at least 80% of experts reached agreement about a link. Heat maps were used to present the data relating to all possible links. RESULTS: Of 1,586 possible links (61 BCTs × 26 MoAs), 51 of 61 (83.6%) BCTs had a definite link to one or more MoAs (mean (SD) = 1.44 (0.96), range= 1-4), and 20 of 26 (76.9%) MoAs had a definite link to one or more BCTs (mean (SD) = 3.27 (2.91), range=9). Ninety (5.7%) were identified as ‘definite’ links, 464 (29.2%) as ‘definitely not’ links, and 1032 (65.1%) as ‘possible’ or ‘unsure’ links. No ‘definite’ links were identified for 10 BCTs (e.g. ‘Action Planning’ and ‘Behavioural Substitution’) and for six MoAs (e.g. ‘Needs’ and ‘Optimism’).CONCLUSIONS: The matrix of links between BCTs and MoAs provides a basis for those developing and synthesizing behavioural interventions. These links also provide a framework for specifying empirical tests in future studies. Note: This article has been accepted for publication in Annals of Behavioral Medicine. Published by Oxford University Press.

scholarly journals A model of integrated remote monitoring and behaviour change for osteoarthritis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Christopher Tack
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Remote Monitoring ◽  
Patient Activation ◽  
Patient Data ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Behaviour Change Interventions ◽  
Health Technologies ◽  
Change Principles

Abstract Background The National Institute for Health and Care Excellence recommends the use of digital and mobile health technologies to facilitate behaviour change interventions. Due to its high prevalence and dependence upon patient self-management strategies, osteoarthritis is one musculoskeletal condition which may benefit from such approaches. This is particularly pertinent due to the increasing use of remote monitoring technologies to collect patient data and facilitate self-management in individuals outside of hospital clinics. In practice however, application of digital behaviour change interventions is difficult due to insufficient reporting of behaviour change theories in the current literature. When digital technologies are employed to alter behaviour change in osteoarthritis, they often focus on physical activity. Currently, such interventions focus of self-efficacy but do not often explicitly report the behaviour change techniques they use to facilitate these changes. Methods This paper proposes a new model of integrating specific behaviour change principles (persuasive design) in an integrated model of remote monitoring and digital behaviour change interventions for osteoarthritis. Results There is potential to combine remote monitoring systems of patient data through digital and mobile technologies with behaviour change principles to improve physical activity behaviours in individuals with osteoarthritis. The use of persuasive design principles (e.g. prompts or nudges) through mobile notifications and strategic system design can be directed to enhance behaviour change. A validated measure of behaviour change, such as the patient activation measure, will allow effective evaluation of such systems. Conclusions Digital behaviour change interventions should be directed towards the underlying principles of behaviour change they employ, although this is not commonly reported in practice. Such interventions can be integrated within remote monitoring pathways using persuasive design techniques to enhance patient activation. This approach can enhance self-management in individuals with musculoskeletal conditions, such as osteoarthritis.

scholarly journals Optimisation of the ActWELL lifestyle intervention programme for women attending routine NHS breast screening clinics.

2020 ◽  
Author(s):  
Annie Anderson ◽  
Angela M. Craigie ◽  
Stephanie Gallant ◽  
Chloe McAdam ◽  
E. Jane Macaskill ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Weight Loss ◽  
Weight Management ◽  
Behaviour Change ◽  
Breast Screening ◽  
Feasibility Trial ◽  
Behaviour Change Techniques ◽  
Peer Reviewers ◽  
Post Menopausal

Abstract Background Around 30% of post-menopausal breast cancer is related to excess body fat, alcohol intake and low levels of physical activity. Current estimates suggest that there is a 12% increased risk in post-menopausal breast cancer for every 5kg/m 2 increase in Body Mass Index (BMI). Despite this evidence there are few lifestyle programmes directed towards breast cancer risk reduction. This paper describes the process of optimising of the ActWELL programme which aims to support weight management in women invited to attend routine NHS breast screening clinics. Methods A feasibility study of a prototype programme aiming to change lifestyle behaviours was successfully undertaken. The programme used educational approaches and behaviour change techniques delivered by lifestyle coaches using individual face to face meetings and telephone sessions. To optimise the intervention for a definitive randomised controlled trial of weight management, data from the feasibility trial, focus group discussions conducted with the target population, feedback from the trial public advisory group and comments from peer reviewers were obtained. Concepts from implementation research provided further guidance to assist in the refinement of the intervention which was then discussed and agreed by all investigators and the trial steering group. Results The results from the feasibility trial were considered appropriate for moving on to a full trial with 70% of participants finding the programme acceptable. The primary outcomes (weight loss and physical activity) provided an important focus for design input from the target group. The contributions highlighted the need to review programme duration, coach contact time, content and use of behaviour change techniques as well as communications generally (e.g. science and evidence, non-judgemental approaches and avoiding guilt). In addition, the need for emphasis on support rather than education became apparent. The recommendations from peer reviewers focussed on the magnitude of effort required to achieve the intended weight loss and weight loss maintenance. Implementation science supported the use of the capability/opportunity/motivation (COM- B)model in overall design. Conclusions The optimisation process has facilitated the development and evaluation of a programme which enables the delivery of a promising intervention to achieve weight management in post-menopausal women.

scholarly journals One small step for man, one giant leap for men’s health: a meta-analysis of behaviour change interventions to increase men’s physical activity

2020 ◽  
Vol 54 (20) ◽  
pp. 1208-1216 ◽  
Author(s):  
Paul Sharp ◽  
John C Spence ◽  
Joan L Bottorff ◽  
John L Oliffe ◽  
Kate Hunt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Effect Size ◽  
Meta Analysis ◽  
Physical Activity Behaviour ◽  
Behaviour Change Techniques ◽  
Eligibility Criteria ◽  
Behaviour Change Interventions ◽  
Contact Frequency ◽  
Giant Leap

ObjectiveTo determine the effects of behaviour change interventions on men’s physical activity (postintervention), sustained change in physical activity behaviour (≥12 months postintervention) and to identify variations in effects due to potential moderating variables (eg, theoretical underpinning, gender-tailored, contact frequency).DesignSystematic review with meta-analysis. Pooled effect size (Cohen’s d) was calculated assuming a random-effects model. Homogeneity and subsequent exploratory moderator analyses were assessed using Q, T2 and I2.Data sourcesMedline, EMBASE, CINAHL, SportDiscus and Web of Science to April 2019.Eligibility criteria for selected studiesRandomised control trials of behaviour change interventions in men (≥18 years) where physical activity was an outcome and data were from men-only studies or disaggregated by sex.ResultsTwenty-six articles described 24 eligible studies. The overall mean intervention effect on men’s physical activity was 0.35 (SE=0.05; 95% CI 0.26 to 0.45; p<0.001). This effect size is consistent with an increase of approximately 97 min of total physical activity per week or 980 steps per day. Intervention moderators associated with greater increases in physical activity included objective physical activity outcome measures, a gender-tailored design, use of a theoretical framework, shorter length programmes (≤12 weeks), using four or more types of behaviour change techniques and frequent contact with participants (≥1 contact per week). 12 studies included additional follow-up assessments (≥12 months postintervention) and the overall mean effect was 0.32 (SE=0.09; 95% CI 0.15 to 0.48; p<0.001) for that sustained increase in physical activity.SummaryBehaviour change interventions targeting men’s physical activity can be effective. Moderator analyses are preliminary and suggest research directions.

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