scholarly journals Designing interventions to change eating behaviours

2015 ◽  
Vol 74 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Lou Atkins ◽  
Susan Michie
Keyword(s):  
Behaviour Change ◽  
Design Process ◽  
Theoretical Domains Framework ◽  
Research Literature ◽  
Intervention Design ◽  
Eating Behaviours ◽  
Behavioural Science ◽  
Behaviour Change Technique ◽  
Behaviour Change Wheel ◽  
Intervention Content

Understanding and changing eating behaviours are central to the work of Nutrition Society members working in both research and applied settings. The present paper describes a recently published resource to guide the design of interventions to change behaviour, The Behaviour Change Wheel: A Guide to Designing Interventions (BCW Guide). This is a practical guide to intervention design that brings together recently-developed theory-based tools in behavioural science into a coherent step-by-step design process. It is based on the BCW, a synthesis of nineteen frameworks of behaviour change found in the research literature. The BCW has at its core a model of behaviour known as ‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’. The model recognises that behaviour is part of an interacting system involving all these components. The BCW identifies different intervention options that can be applied to changing each of the components and policies that can be adopted to deliver those intervention options. The book shows how the BCW links to theory-based frameworks to understand behaviour such as the Theoretical Domains Framework and the recently developed Behaviour Change Technique Taxonomy v1 for specifying intervention content. In essence, it shows how to link what is understood about a given behaviour to types of intervention likely to be effective and then translate this into a locally relevant intervention. In addition, the present paper sets out some principles of intervention design.

scholarly journals Using the behaviour change wheel approach to optimise self-sampling packs for sexually transmitted infections and blood borne viruses

2021 ◽  
Author(s):  
Paul Flowers ◽  
Gabriele Vojt ◽  
Maria Pothoulaki ◽  
Fiona Mapp ◽  
Melvina Woode-Owusu ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Behaviour Change Wheel ◽  
Qualitative Work ◽  
Sexual Health Clinics

Purpose: This paper describes the process of optimising a widely offered intervention - the self-sampling pack for sexually transmitted infections (STIs) and blood born viruses (BBVs). We drew upon the BCW approach, incorporating the theoretical domains framework (TDF) and the behaviour change technique taxonomy (BCTT) to systematically specify potential intervention components that may optimise the packs. Methods: A behaviour change wheel analysis built upon prior thematic analyses of qualitative data collected through focus groups and interviews with members of the public and people recruited from sexual health clinics in Glasgow and London (n=56). Salient barriers and facilitators to specific sequential behavioural domains associated with wider behavioural system of pack-use were subjected to further analyses, coding them in relation to the TDF, the BCWs intervention functions, and finally specifying potential optimisation in relation to behaviour change techniques (BCTs). Results: Our TDF analysis suggested that across the overall behavioural system of pack use the most important theoretical domains were beliefs about consequences and memory, attention and decision-making. BCW analysis on the overall pack suggested useful intervention functions should focus on environmental restructuring, persuasion, enablement, education and modelling. Ways of optimising the intervention were also specified in relation to potentially useful behaviour change techniques (BCTs). Conclusions: A detailed behavioural analysis building on earlier qualitative work using the TDF and the BCW provided a systematic approach to optimising an existing intervention. The approach enabled the specification of highly specific, evidence-based, and theoretically informed recommendations for intervention optimisation.

scholarly journals Testing Stratified Care for Musculoskeletal Pain in General Practice: Integrating Clinician Support and Intervention Design

2021 ◽  
Author(s):  
Joanne Protheroe ◽  
Benjamin Saunders ◽  
Jonathan C Hill ◽  
Adrian Chudyk ◽  
Nadine E Foster ◽  
...  
Keyword(s):  
General Practice ◽  
Behaviour Change ◽  
Early Treatment ◽  
Treatment Options ◽  
Theoretical Domains Framework ◽  
Stepped Care ◽  
Intervention Design ◽  
Behaviour Change Technique ◽  
Stratified Care ◽  
Clinician Support

Abstract Background Stratified care involves subgrouping patients based on key characteristics, e.g. prognostic risk, and matching these subgroups to early treatment options. The STarT-MSK programme developed and tested a new stratified primary care intervention for patients with common musculoskeletal (MSK) conditions in general practice. Stratified care involves changing General Practitioners’ (GPs) behaviour, away from the current ‘stepped’ care approach to identifying early treatment options matched to patients’ risk of persistent pain. Changing healthcare practice is challenging, and to aid the successful delivery of stratified care, education and support for GPs was required from the initial stages of the programme. This paper details the steps in integrating the development of a clinician support package throughout the 6-year programme, to support GP engagement in delivering the STarT MSK intervention. Practical recommendations are made for future general practice interventions. Methods Clinician support was developed through an iterative, mixed methods approach. Qualitative research with patients and GPs identified barriers and facilitators to the adoption of stratified care, which were mapped onto the Theoretical Domains Framework (TDF) and Behaviour Change Technique (BCT) taxonomy. Identified domains/BCTs were ‘translated’ into an educational paradigm, and an initial version of the support package developed. This was further refined following a feasibility and pilot RCT, and a finalised support package was developed for the main RCT. Results The clinician support package comprised face-to-face sessions combining adult-learning principles with behaviour change theory in a multimethod approach, which included group discussion, simulated consultations, patient vignettes and model consultation videos. Structured support for GPs was crucial in enabling fidelity and, ultimately, a successful trial. Results highlighted that clinician support is a two-way process– the study team can learn from and adapt to specific local factors and issues not previously identified. The support from senior clinicians was also required to ensure ‘buy in’, and results indicated the importance of monitoring GP performance and providing regular feedback. Conclusion Designing effective clinician support from the onset of trial intervention design, in an evidence-based, theory-informed manner, is crucial to encourage active engagement and intervention fidelity within the trial, enabling the delivery of a robust and reliable proof of principle trial.

scholarly journals Using the Behaviour Change Wheel (BCW) to Characterise Parenting Interventions to Prevent Intergenerational Child Abuse

2021 ◽  
Author(s):  
Fatima Younas ◽  
Leslie Morrison Gutman
Keyword(s):  
Social Support ◽  
Child Abuse ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Mechanisms Of Change ◽  
Parenting Interventions ◽  
Framework Analysis ◽  
Behaviour Change Technique ◽  
Behaviour Change Wheel ◽  
History Of

Abstract  Research shows that parents with a history of child abuse are at risk of perpetuating the cycle of abuse; however, exploration of intervention content is still a neglected area. This qualitative study identifies intervention components and corresponding mechanisms of change of parenting interventions to prevent intergenerational child abuse. Interviews with ten heads of interventions from the UK and USA were coded using deductive framework analysis. The Behaviour Change Technique (BCT) Taxonomy and Behaviour Change Wheel were used to code intervention components including BCTs and intervention functions. Mechanisms of change were coded using the Theoretical Domains Framework. Twelve BCTs and eight intervention functions were identified including education, enablement and training delivered through BCTs of instruction on how to perform a behaviour, restructuring the environment and social support. Corresponding mechanisms of change include behaviour regulation, knowledge and social influences, among others. This study offers insight into targeting and tailoring services to improve outcomes for parents with a history of child abuse. Findings suggest that there are possible mechanisms through which vulnerable parents can be helped to break the cycle of abuse including promoting social support, regulating parents’ behaviour through trauma-informed approaches and enhancing knowledge, self-esteem and confidence in parenting.

Human behaviour change models for improving animal welfare.

2021 ◽  
pp. 91-106
Author(s):  
Grace A. Carroll ◽  
Jenny M. Groarke ◽  
Lisa Graham-Wisener
Keyword(s):  
Animal Welfare ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Human Behaviour ◽  
Behaviour Change Technique ◽  
Change Models ◽  
Behaviour Change Interventions ◽  
Change Technique ◽  
Behaviour Change Wheel

Abstract In this chapter, three key frameworks will be outlined, as well as how they fit together. This will allow animal welfare scientists to develop human behaviour change plans from start to finish. These three frameworks are (i) the theoretical domains framework (TDF; Michie et al., 2005); (ii) the behaviour change wheel (BCW; Michie et al., 2011, 2014); and (iii) the behaviour change technique taxonomy (BCTT; Michie et al., 2013). Each framework is described, and guidance is provided for applying these models to design effective human behaviour change interventions. Common pitfalls are outlined, and animal welfare examples are provided throughout to aid understanding.

scholarly journals Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

2019 ◽  
Author(s):  
Samson O Ojo ◽  
Daniel P. Bailey ◽  
Marsha L. Brierley ◽  
David J. Hewson ◽  
Angel M. Chater
Keyword(s):  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Office Workers ◽  
Sitting Time ◽  
Mental Wellbeing ◽  
Behaviour Change Techniques ◽  
Tailored Intervention ◽  
Structured Interviews ◽  
Behaviour Change Technique ◽  
Break Up

Abstract Background: The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. Methods: The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD=10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation – Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. Results: Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Reflective and automatic Motivation was highlighted as a core target for intervention. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. Conclusions: The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease prolonged sitting in the workplace.

scholarly journals Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

2019 ◽  
Author(s):  
Samson O Ojo ◽  
Daniel P. Bailey ◽  
Marsha L. Brierley ◽  
David J. Hewson ◽  
Angel M. Chater
Keyword(s):  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Office Workers ◽  
Sitting Time ◽  
Mental Wellbeing ◽  
Behaviour Change Techniques ◽  
Tailored Intervention ◽  
Structured Interviews ◽  
Behaviour Change Technique ◽  
Break Up

Abstract Background: The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers. Methods: The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD=10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation – Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention. Results: Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Reflective and automatic Motivation was highlighted as a core target for intervention. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace. Conclusions: The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease prolonged sitting in the workplace.

Oral health promotion apps: an assessment of message and behaviour change potential

2020 ◽  
Author(s):  
Katherine H KACZMARCZYK ◽  
Kara A GRAY-BURROWS ◽  
Karen VINALL-COLLIER ◽  
Peter F DAY
Keyword(s):  
Health Promotion ◽  
Oral Health ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Health Messages ◽  
Behaviour Change Technique ◽  
Oral Health Promotion ◽  
Health Apps ◽  
Change Technique

Abstract Background Oral health worldwide needs improving: untreated dental caries is the most common health condition affecting people globally. Mobile applications (apps) have potential to provide preventative oral health interventions. This study aimed to investigate the quality of available oral health promotion apps, assessing information provided and the barriers to oral health addressed using psychological frameworks. Methods A content assessment of oral health promotion apps targeted at adults in the UK iTunes store was conducted. The quality of 22 apps was assessed against 3 objective indices derived from the Delivering Better Oral Health toolkit, Theoretical Domains Framework and Behaviour Change Technique Taxonomy. Index scores were calculated and descriptive analyses were completed. Results On average, four Delivering Better Oral Health messages, seven Theoretical Domains Framework components and eight Behaviour Change Technique Taxonomy components were addressed per app. The most common components were: ‘take at least two minutes to brush’ for the Delivering Better Oral Health index, ‘goals’ and ‘intentions’ for the Theoretical Domains Framework index and ‘goal setting (behaviour)’ for the Behaviour Change Technique Taxonomy index. Conclusion The quality of information available in oral health apps requires improvement with the majority addressing only a few barriers to oral health. Currently, there is no recognized scale for evaluating oral health apps: this study provides a suggested method for future app evaluation. There is opportunity for a new app to be created based on health behaviour change theory which includes all the Delivering Better Oral Health messages.

scholarly journals Influences on NHS Health Check behaviours: a systematic review

2020 ◽  
Author(s):  
Lou Atkins ◽  
Chryssa Stefanidou ◽  
Tim Chadborn ◽  
Katherine Thompson ◽  
Susan Michie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
National Health ◽  
Health Check ◽  
Behavioural Science ◽  
Health Checks ◽  
Digital Intervention ◽  
Intervention Content ◽  
Nhs Health Checks ◽  
Nhs Health Check

Abstract Background National Health Checks were introduced in the English National Health Service (NHS) in 2009 to reduce cardiovascular disease (CVD) risks and events. Following Public Health England’s (PHE’s) 2017 Digital review, NHS Health Checks were identified as a Digital Exemplar for PHE forming part of the Predictive Prevention programme, setting out the government’s vision for putting prevention at the heart of the nation’s health. This study applied behavioural science frameworks to: i) identify behaviours and actors relevant to uptake, delivery and follow up of NHS Health Checks and influences on these behaviours and; ii) signpost to example intervention content, with a focus on digital intervention development. Methods A systematic review of studies reporting NHS Health Check-related behaviours of patients, health care professionals (HCPs) and commissioners. Influences on behaviours were coded using theory-based models: COM-B and Theoretical Domains Framework (TDF). Potential intervention types and behaviour change techniques (BCTs) were suggested to target key influences. Results We identified 37 studies reporting nine behaviours and influences for eight of these. The most frequently identified influences were physical opportunity including HCPs having space and time to deliver NHS Health Checks and patients having money to adhere to recommendations to change diet and physical activity. Other key influences were motivational, such as beliefs about consequences about the value of NHS Health Checks and behaviour change, and social, such as influences of others on behaviour change. The following techniques are suggested for websites or smartphone apps: Adding objects to the environment, e.g. provide HCPs with electronic schedules to guide timely delivery of Health Checks to target physical opportunity, Social support (unspecified) , e.g. include text suggesting patients to ask a colleague to agree in advance to join them in taking the ‘healthy option’ lunch at work; Information about health consequences , e.g. quotes and/or videos from patients talking about the health benefits of changes they have made. Conclusions Through the application of behavioural science we identified key behaviours and their influences which informed recommendations for digital intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

scholarly journals A theory-based exploration of antibiotic use in primary healthcare in Gezira state, Sudan

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Anna-Leena Lohiniva ◽  
Einas Elwali ◽  
Duha Abuobaida ◽  
Ashwag Abdulrahim ◽  
Paul Bukuluki ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Primary Healthcare ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Local Context ◽  
Change Strategy ◽  
Qualitative Research Study ◽  
Inappropriate Use ◽  
Healthcare Settings ◽  
Behaviour Change Wheel

Abstract Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing both prescribers and patients based on factors that are driving antibiotic use in primary healthcare settings in Gezira state in Sudan. Methods The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioural domains and the Behaviour Change Wheel (BCW) to select appropriate intervention functions. The process included (1) a formative qualitative research study and (2) a knowledge co-production workshop that utilized the results of the qualitative study to design a salient, appropriate, and credible behaviour change strategy. Results The TDF domains related to prescribers that emerged from the study included knowledge, skills, and intention. The selected BCW intervention functions included education, training, modelling, and persuasion. The main TDF domains related to patients included social influences and intention. The selected BCW intervention functions included enablement and education. Conclusion Using the TDF and BCW intervention functions, the study identified behavioural domains that influence antibiotic prescription and consumption in rural primary healthcare settings in Gezira state in Sudan and appropriate intervention functions to modify these behaviours. Knowledge co-production ensured that the evidence-based strategy was acceptable and practical in the local context.

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