Content analysis of behaviour change techniques in government physical distancing communications for the reopening of schools during the COVID-19 pandemic in Ireland

Background: Effective government communications and leadership are central to the management of pandemics. Behavioural science can offer important insight into the development of such communications strategies. The extent to which established behaviour-change science is reflected in current government messaging campaigns to promote adherence to physical distancing measures in the context of the coronavirus disease 2019 (COVID-19) pandemic is unclear. The current study aimed to describe the behaviour-change content of a set of government-issued poster communications for the reopening of schools in Ireland during the COVID-19 pandemic in September 2020. Methods: Posters targeting physical distancing behaviours in school settings were retrieved from the Government of Ireland website for analysis. Posters were independently coded for behaviour change techniques (BCTs) using the BCT Taxonomy Version 1, a hierarchically clustered taxonomy of 93 distinct BCTs across 16 groups. The Theories and Techniques tool was used to identify mechanisms of action (MoAs) linked to each of the identified BCTs. Eight posters were independently content-analysed by two members of the research team for BCTs and linked MoAs. Results: Eight unique BCTs from six unique groups were identified in at least one poster. These BCTs were linked with 11 unique MoAs through which behaviour change is theorised to occur. Several theoretically important groups of BCTs, such as Natural Consequences, Social Support, Shaping Knowledge, and Comparison of Behaviour, were underutilised or not included in any of the posters. Conclusion: Future poster communications could benefit from including additional BCTs from key groups, particularly Natural Consequences. This article provides proof-of-concept evidence for future evaluations of government public health communications for behaviour-change content using existing taxonomies and tools.

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

10.31234/osf.io/x5372 ◽

2018 ◽

Cited By ~ 4

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.

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Applying translational behavioural science to improve people’s health

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1073 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Nagyova

Keyword(s):

Public Health ◽

Behaviour Change ◽

Positive Impact ◽

Behaviour Change Techniques ◽

Knowledge Mobilization ◽

Behavioural Science ◽

Holistic View ◽

Change Models ◽

The Individual ◽

Behavioural Aspects

Abstract Background The rising burden of chronic diseases poses a challenge for the whole public health system, and to deal with this we need to address the socioeconomic, cultural, and behavioural aspects of health and its determinants. While a change in individual 'lifestyle' factors, such as diet, exercise, smoking, and alcohol are often the target of intervention design, there needs to be an acknowledgement that behavioural science is much more than just 'lifestyle choice' on the individual level. Governments worldwide are increasingly incorporating the behavioural insights approach into policymaking. There has been an increasing interest in 'choice architecture' and 'nudging' to facilitate behaviour (change), often by manipulating elements of the environment. Designing interventions that target the most important determinants of behaviour, based on research evidence in the field of behavioural science, provide the best chance of changing behaviour and demonstrating a positive impact in terms of health outcomes and cost-effectiveness. However, knowing what works and how to apply it presents an ongoing challenge. Results The COM-B, EAST, and MOST are behaviour change models that were built on an impressive effort to synthesize available evidence regarding intervention development frameworks, behaviour change theories, and behaviour change techniques. They tackle determinants of behaviour in terms of capability, opportunity, and motivation on the level of the individual (micro level), alongside ways in which to intervene, at mezzo level (intervention functions) and macro level (policy categories). Conclusions These approaches take a holistic view of interventions and can contribute to the development of new scientific knowledge regarding mechanisms underlying effective knowledge mobilization in behaviour change. They are also expected to further support the adoption of the evidence-based practices within the field of public health.

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Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

Obesity Facts ◽

10.1159/000515663 ◽

2021 ◽

pp. 1-14

Author(s):

R. James Stubbs ◽

Cristiana Duarte ◽

António L. Palmeira ◽

Falko F. Sniehotta ◽

Graham Horgan ◽

...

Keyword(s):

Weight Loss ◽

Behaviour Change ◽

Digital Health ◽

Self Regulation ◽

Self Management ◽

Behaviour Change Techniques ◽

Evidence Based ◽

Behavioural Science ◽

Digital Architecture

Background: Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. The Project: First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. Impact: The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

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Developing an evidence-based online method of linking behaviour change techniques and theoretical mechanisms of action: a multiple methods study

Health Services and Delivery Research ◽

10.3310/hsdr09010 ◽

2021 ◽

Vol 9 (1) ◽

pp. 1-168

Author(s):

Susan Michie ◽

Marie Johnston ◽

Alexander J Rothman ◽

Marijn de Bruin ◽

Michael P Kelly ◽

...

Keyword(s):

Behaviour Change ◽

Mechanism Of Action ◽

Behavioural Change ◽

Complex Interventions ◽

Mechanisms Of Action ◽

Behaviour Change Techniques ◽

Active Components ◽

Behaviour Change Technique ◽

Policy Makers ◽

Change Technique

Background Many global health challenges may be targeted by changing people’s behaviour. Behaviours including cigarette smoking, physical inactivity and alcohol misuse, as well as certain dietary behaviours, contribute to deaths and disability by increasing the risk of cancers, cardiovascular diseases and diabetes. Interventions have been designed to change these health behaviours with a view to reducing these health risks. However, the effectiveness of these interventions has been quite variable and further information is needed to enhance their success. More information is needed about the specific processes that underlie the effectiveness of intervention strategies. Aim Researchers have developed a taxonomy of 93 behaviour change techniques (i.e. the active components of an intervention that bring about behavioural change), but little is known regarding their potential mechanisms of action (i.e. the processes through which a behaviour change technique affects behaviour). We therefore aimed to examine links between behaviour change techniques and mechanisms of action. Method First, we conducted a literature synthesis study of 277 behaviour change intervention studies, from which we extracted information on links, described by authors, between behaviour change techniques and mechanisms of action, and identified an average of 10 links per intervention report. Second, behaviour change experts (n = 105) were engaged in a three-round consensus study in which they discussed and rated their confidence in the presence/absence of ‘links’ and ‘non-links’ between commonly used behaviour change techniques (n = 61) and a set of mechanisms of action (n = 26). Ninety links and 460 ‘non-links’ reached the pre-set threshold of 80% agreement. To enhance the validity of these results, a third study was conducted that triangulated the findings of the first two studies. Discrepancies and uncertainties between the studies were included in a reconciliation consensus study with a new group of experts (n = 25). The final results identified 92 definite behaviour change technique–mechanism of action links and 465 definite non-links. In a fourth study, we examined whether or not groups of behaviour change techniques used together frequently across interventions revealed shared theoretical underpinnings. We found that experts agreed on the underlying theory for three groups of behaviour change techniques. Results Our results are potentially useful to policy-makers and practitioners in selecting behaviour change techniques to include in behaviour change interventions. However, our data do not demonstrate that the behaviour change techniques are effective in targeting the mechanism of action; rather, the links identified may be the ‘best bets’ for interventions that are effective in changing mechanisms of action, and the non-links are unlikely to be effective. Researchers examining effectiveness of interventions in either primary studies or evidence syntheses may consider these links for further investigation. Conclusion To make our results usable by researchers, practitioners and policy-makers, they are available in an online interactive tool, which enables discussion and collaboration (https://theoryandtechniquetool.humanbehaviourchange.org/); accessed 1 March 2020. This work, building on previous work to develop the behaviour change technique taxonomy, is part of an ongoing programme of work: the Human Behaviour Change Project (www.humanbehaviourchange.org/; accessed 1 March 2020). Funding This project was funded by the Medical Research Council via its Methodology Panel: ‘Developing methodology for designing and evaluating theory-based complex interventions: an ontology for linking behaviour change techniques to theory’ (reference MR/L011115/1).

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The impact of nature-based interventions on public health: a review using pathways, mechanisms and behaviour change techniques from environmental social science and health behaviour change

Journal of the British Academy ◽

10.5871/jba/009s7.033 ◽

2021 ◽

Vol 9s7 ◽

pp. 33-61

Author(s):

Stephanie Wilkie ◽

Nicola Davinson

Keyword(s):

Public Health ◽

Social Science ◽

Health Outcomes ◽

Behaviour Change ◽

Health Behaviour ◽

Behaviour Change Techniques ◽

Change Models ◽

Health Behaviour Change ◽

The Impact ◽

Environmental Social Science

The aim of this narrative review is to explore whether nature-based interventions improved individual public health outcomes and health behaviours, using a conceptual framework that included pathways and pathway domains, mechanisms, and behaviour change techniques derived from environmental social science theory and health behaviour change models. A two-stage scoping methodology was used to identified studies published between 2000 and 2021. Peer reviewed, English-language reports of nature-based interventions with adults (N = 9) were included if the study met the definition of a health�behaviour change intervention and reported at least one measured physical/mental health outcome. Interventions focused on the restoring or building capacities pathway domains as part of the nature contact/experience pathway; varied health behaviour change mechanisms and techniques were present but environmental social-science-derived mechanisms to influence health outcomes were used less. Practical recommendations for future interventions include explicit statement of the targeted level of causation, as well as utilisation of both environmental social science and health behaviour change theories and varied public health outcomes to allow simultaneously testing of theoretical predictions.

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Influences on NHS Health Check behaviours: a systematic review

10.21203/rs.3.rs-16576/v4 ◽

2020 ◽

Author(s):

Lou Atkins ◽

Chryssa Stefanidou ◽

Tim Chadborn ◽

Katherine Thompson ◽

Susan Michie ◽

...

Keyword(s):

Systematic Review ◽

Behaviour Change ◽

Health Care Professionals ◽

Health Check ◽

Behaviour Change Techniques ◽

Behavioural Science ◽

Health Checks ◽

Intervention Content ◽

Nhs Health Checks ◽

Nhs Health Check

Abstract Background National Health Service Health Checks were introduced in 2009 to reduce cardiovascular disease (CVD) risks and events. Since then, national evaluations have highlighted the need to maximise the programme’s impact by improving coverage and outputs. To address these challenges it is important to understand the extent to which positive behaviours are influenced across the NHS Health Check pathway and encourage the promotion or minimisation of behavioural facilitators and barriers respectively. 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. Methods A systematic review of studies reporting behaviours related to 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 intervention content. To ascertain the extent to which this reflects existing interventions we recommend a review of relevant evidence.

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Application of the behaviour change technique taxonomy (BCTTv1) to an inclusive physical literacy-based sport program for children and youth

International Journal of Sports Science & Coaching ◽

10.1177/17479541211016580 ◽

2021 ◽

pp. 174795412110165

Author(s):

Shannon E Weissman ◽

Ryanne Perinpanayagam ◽

F. Virginia Wright ◽

Kelly P Arbour-Nicitopoulos

Keyword(s):

Behaviour Change ◽

Literacy Development ◽

Critical Role ◽

Children And Youth ◽

Behaviour Change Techniques ◽

Physical Literacy ◽

Behaviour Change Technique ◽

Community Based ◽

Coaching Strategies ◽

Insight Into

Coaches play a critical role in shaping the sporting experiences of children and youth. In introductory-level grassroots sport programs, the coaching strategies used can greatly influence children’s and youths’ physical literacy development. This study identified behaviour change techniques (BCTs) used by coaches in an inclusive physical literacy-based grassroots sport program for children and youth. Specifically, the study aimed to assess the type and frequency of BCTs reported by coaches in their weekly one-on-one coaching session logs. This study focused on a community-based program (Igniting Fitness Possibilities) that supports children and youth with varied abilities in becoming engaged in local physical activity opportunities. 162 weekly coaching logs from 13 coaches (n = 8 females) were coded using Michie and colleagues’ (2013) BCT Taxonomy (BCTTv1) consisting of 93 different BCTs. A codebook was developed in accordance with the BCTTv1 to assist in identifying BCTs used within the Igniting Fitness Possibilities context. Thirty-six BCTs were identified across the coaching logs, with an average of 3.62 (SD = 2.43) different BCTs coded per log. The most commonly coded BCTs were ‘demonstration of the behaviour’ (146 codings), ‘instruction on how to perform the behaviour’ (145 codings), and ‘behavioural practice/rehearsal’ (137 codings). The findings support the applicability of the BCTTv1 to a paediatric inclusive grassroots context and provide insight into BCTs that might be most relevant to target for physical literacy development in this setting. BCT identification can also promote reflective coaching practices, help identify gaps in training, and provide a foundation for evaluating the effectiveness of coaching strategies.

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Influences on NHS Health Check behaviours: a systematic review

10.21203/rs.3.rs-16576/v2 ◽

2020 ◽

Author(s):

Lou Atkins ◽

Chryssa Stefanidou ◽

Tim Chadborn ◽

Katherine Thompson ◽

Susan Michie ◽

...

Keyword(s):

Systematic Review ◽

Behaviour Change ◽

Health Care Professionals ◽

Health Check ◽

Behaviour Change Techniques ◽

Behavioural Science ◽

Health Checks ◽

Intervention Content ◽

Nhs Health Checks ◽

Nhs Health Check

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

10.2196/preprints.28200 ◽

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.

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Effect of implementation interventions on nurses’ behaviour in clinical practice: a systematic review, meta-analysis and meta-regression protocol

Systematic Reviews ◽

10.1186/s13643-019-1227-x ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Guillaume Fontaine ◽

Sylvie Cossette ◽

Marc-André Maheu-Cadotte ◽

Marie-France Deschênes ◽

Geneviève Rouleau ◽

...

Keyword(s):

Systematic Review ◽

Clinical Practice ◽

Behaviour Change ◽

Experimental Studies ◽

Mechanisms Of Action ◽

Audit And Feedback ◽

Behaviour Change Techniques ◽

Causal Processes ◽

Meta Regression ◽

Theory Use

Abstract Background Practitioner-level implementation interventions such as audit and feedback, communities of practice, and local opinion leaders have shown potential to change nurses’ behaviour in clinical practice and improve patients’ health. However, their effectiveness remains unclear. Moreover, we have a paucity of data regarding the use of theory in implementation studies with nurses, the causal processes—i.e. mechanisms of action—targeted by interventions to change nurses’ behaviour in clinical practice, and the constituent components—i.e. behaviour change techniques—included in interventions. Thus, our objectives are threefold: (1) to examine the effectiveness of practitioner-level implementation interventions in changing nurses’ behaviour in clinical practice; (2) to identify, in included studies, the type and degree of theory use, the mechanisms of action targeted by interventions and the behaviour change techniques constituting interventions and (3) to examine whether intervention effectiveness is associated with the use of theory or with specific mechanisms of action and behaviour change techniques. Methods We will conduct a systematic review based on the Cochrane Effective Practice and Organization of Care (EPOC) Group guidelines. We will search six databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science) with no time limitation for experimental and quasi-experimental studies that evaluated practitioner-level implementation interventions aiming to change nurses’ behaviour in clinical practice. We will also hand-search reference lists of included studies. We will perform screening, full-text review, risk of bias assessment, and data extraction independently with the Covidence systematic review software. We will assess the quality of evidence using the GRADEpro software. We will code included studies independently for theory use (Theory Coding Scheme), mechanisms of action (coding guidelines from Michie) and behaviour change techniques (Behaviour Change Technique Taxonomy v1) with QSR International’s NVivo qualitative data analysis software. Meta-analyses will be performed using the Review Manager (RevMan) software. Meta-regression analyses will be performed with IBM SPSS Statistics software. Discussion This review will inform knowledge users and researchers interested in designing, developing and evaluating implementation interventions to support nurses’ behaviour change in clinical practice. Results will provide key insights regarding which causal processes—i.e. mechanisms of action—should be targeted by these interventions, and which constituent components—i.e. behaviour change techniques—should be included in these interventions to increase their effectiveness. Systematic review registration The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42019130446).

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