scholarly journals Known Knowns and Known Unknowns on Behavior Change Interventions and Mechanisms of Action

2020 ◽  
Author(s):  
Martin S Hagger ◽  
Susette Moyers ◽  
Kaylyn McAnally ◽  
Lauren Mckinley
Keyword(s):  
Behavior Change ◽  
Behavioral Intervention ◽  
Mechanisms Of Action ◽  
Intervention Research ◽  
Current Evidence ◽  
Future Research ◽  
Study Quality ◽  
Behavior Change Techniques ◽  
Behavior Change Interventions ◽  
Known Unknowns

Systematic reviews and meta-analyses play an important role in summarizing current research on the efficacy of behavior change interventions and their mechanisms of action. The reviews in this special issue represent a ‘step change’ in evaluating current evidence on behavior change interventions and mechanisms. This article outlines the findings and emerging issues identified in the reviews (‘known knowns’), and summarizes evidence gaps to be addressed in future research (‘known unknowns’). Findings indicate that tests of mechanisms of behavior change interventions are not routinely conducted in primary studies and research syntheses; reviews and studies do not sufficiently account for study quality; substantive variability exists in descriptions of intervention content and putative mediators implicated in their mechanisms of action; limited data is available on the efficacy of many behavior change techniques; and moderators of intervention effects and mechanisms are seldom taken into account. Possible solutions include testing effects of isolated behavior change techniques and mechanisms of action; routine evaluation of study quality in behavioral intervention research; development of an evidence base linking behavior change techniques with theory-based constructs that comprise mechanisms of action; adoption of fit-for-purpose methods for synthesizing behavioral intervention mechanisms of action; and routine testing of moderators in intervention research.

scholarly journals Known knowns and known unknowns on behavior change interventions and mechanisms of action

2020 ◽  
Vol 14 (1) ◽  
pp. 199-212 ◽  
Author(s):  
Martin S. Hagger ◽  
Susette Moyers ◽  
Kaylyn McAnally ◽  
Lauren E. McKinley
Keyword(s):  
Behavior Change ◽  
Mechanisms Of Action ◽  
Behavior Change Interventions ◽  
Known Unknowns

Behavior change techniques in mobile apps targeting self-harm in young people: a systematic review

2021 ◽  
Author(s):  
Elena Panagiotopoulou ◽  
Celeste Peiris ◽  
Daniel Hayes
Keyword(s):  
Young People ◽  
Behavior Change ◽  
Dialectical Behavior Therapy ◽  
Mobile Apps ◽  
Mental Healthcare ◽  
Future Research ◽  
Active Components ◽  
Behavior Change Techniques ◽  
Other Information ◽  
Self Harm

Abstract Despite the high prevalence of self-harm among young people, as well as their extensive use of mobile apps for seeking support with their mental healthcare, it is unclear whether the design of mobile apps aimed at targeting self-harm is underpinned by behavior change techniques (BCTs). To systematically analyze and identify (a) what BCTs and (b) what theories are present in self-harm apps for young people in an attempt to understand their active components. Systematic searches in Apple store, followed by thorough screening, were conducted to identify free mobile apps targeting self-harm in young people. Five apps met the inclusion criteria and were used by trained researchers, who coded identified features against the BCT Taxonomy V1. Despite the majority of apps being underpinned by principles of Dialectical Behavior Therapy (DBT), no other information is available about specific theories underpinning these apps. Nineteen of the 93 BCTs were identified across the five apps. The most frequently used BCT was “Distraction” (54.2%), offering ideas for activities to distract users from self-harming. Other techniques that were used often were “Social Support (unspecified)” (27.0%) and “Behavior Substitution” (10.6%). This study provides the first analysis of BCTs present in mental health apps which are designed to target the reduction of self-harm in young people. Future research is needed to evaluate the effectiveness of the apps, as well as assess the effectiveness of the BCTs present.

scholarly journals Behavior Change Techniques and Their Mechanisms of Action: A Synthesis of Links Described in Published Intervention Literature

2018 ◽  
Author(s):  
Rachel N Carey ◽  
Lauren E Connell ◽  
Marie Johnston ◽  
Alexander J Rothman ◽  
Marijn de Bruin ◽  
...  
Keyword(s):  
Behavior Change ◽  
Mechanisms Of Action ◽  
Behavior Change Techniques

scholarly journals Behavioral Intervention Components Associated With Cost-effectiveness: A Comparison of Six Domains

2021 ◽  
Author(s):  
E Beard ◽  
F Lorencatto ◽  
B Gardner ◽  
S Michie ◽  
L Owen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Behavior Change ◽  
Lower Cost ◽  
Self Regulation ◽  
Cost Effective ◽  
Cost Effectiveness Ratio ◽  
Behavior Change Techniques ◽  
Multiple Health Behaviors ◽  
Behavior Change Interventions ◽  
Multiple Health

Abstract Background To help implement behavior change interventions (BCIs) it is important to be able to characterize their key components and determine their effectiveness. Purpose This study assessed and compared the components of BCIs in terms of intervention functions identified using the Behaviour Change Wheel Framework (BCW) and in terms of their specific behavior change techniques (BCTs) identified using the BCT TaxonomyV1, across six behavioral domains and the association of these with cost-effectiveness. Methods BCIs in 251 studies targeting smoking, diet, exercise, sexual health, alcohol and multiple health behaviors, were specified in terms of their intervention functions and their BCTs, grouped into 16 categories. Associations with cost-effectiveness measured in terms of incremental cost-effectiveness ratio (ICER) upper and lower estimates were determined using regression analysis. Results The most prevalent functions were increasing knowledge through education (72.1%) and imparting skills through training (74.9%). The most prevalent BCT groupings were shaping knowledge (86.5%), changing behavioral antecedents (53.0%), supporting self-regulation (47.7%), and providing social support (44.6%). Intervention functions associated with better cost-effectiveness were those based on training (βlow = −15044.3; p = .002), persuasion (βlow = −19384.9; p = .001; βupp = −25947.6; p < .001) and restriction (βupp = −32286.1; p = .019), and with lower cost-effectiveness were those based on environmental restructuring (β = 15023.9low; p = .033). BCT groupings associated with better cost-effectiveness were goals and planning (βlow = −8537.3; p = .019 and βupp = −12416.9; p = .037) and comparison of behavior (βlow = −13561.9, p = .047 and βupp = −30650.2; p = .006). Those associated with lower cost-effectiveness were natural consequences (βlow = 7729.4; p = .033) and reward and threat (βlow = 20106.7; p = .004). Conclusions BCIs that focused on training, persuasion and restriction may be more cost-effective, as may those that encourage goal setting and comparison of behaviors with others.

scholarly journals Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus)

2020 ◽  
Author(s):  
Marie Johnston ◽  
Rachel N Carey ◽  
Lauren E Connell Bohlen ◽  
Derek W Johnston ◽  
Alexander J Rothman ◽  
...  
Keyword(s):  
Behavior Change ◽  
Design Research ◽  
Mechanisms Of Action ◽  
Expert Consensus ◽  
Full Data ◽  
Behavior Change Techniques ◽  
Online Tool ◽  
Change Behavior ◽  
Modeling Uncertainties ◽  
Literature Synthesis

Abstract Researchers, practitioners, and policymakers develop interventions to change behavior based on their understanding of how behavior change techniques (BCTs) impact the determinants of behavior. A transparent, systematic, and accessible method of linking BCTs with the processes through which they change behavior (i.e., their mechanisms of action [MoAs]) would advance the understanding of intervention effects and improve theory and intervention development. The purpose of this study is to triangulate evidence for hypothesized BCT–MoA links obtained in two previous studies and present the results in an interactive, online tool. Two previous studies generated evidence on links between 56 BCTs and 26 MoAs based on their frequency in literature synthesis and on expert consensus. Concordance between the findings of the two studies was examined using multilevel modeling. Uncertainties and differences between the two studies were reconciled by 16 behavior change experts using consensus development methods. The resulting evidence was used to generate an online tool. The two studies showed concordance for 25 of the 26 MoAs and agreement for 37 links and for 460 “nonlinks.” A further 55 links were resolved by consensus (total of 92 [37 + 55] hypothesized BCT–MoA links). Full data on 1,456 possible links was incorporated into the online interactive Theory and Technique Tool (https://theoryandtechniquetool.humanbehaviourchange.org/). This triangulation of two distinct sources of evidence provides guidance on how BCTs may affect the mechanisms that change behavior and is available as a resource for behavior change intervention designers, researchers and theorists, supporting intervention design, research synthesis, and collaborative research.

scholarly journals The Health Promoting Schools Framework: Known Unknowns and an Agenda for Future Research

2016 ◽  
Vol 44 (3) ◽  
pp. 463-475 ◽  
Author(s):  
Rebecca Langford ◽  
Christopher Bonell ◽  
Kelli Komro ◽  
Simon Murphy ◽  
Daniel Magnus ◽  
...  
Keyword(s):  
Low Income ◽  
School Health ◽  
World Health ◽  
Current Evidence ◽  
Future Research ◽  
Process Data ◽  
Whole School ◽  
Health Promoting Schools ◽  
Health Promoting ◽  
Known Unknowns

The World Health Organization’s Health Promoting Schools (HPS) framework is a whole-school approach to promoting health that recognizes the intrinsic relationship between health and education. Our recent Cochrane systematic review found HPS interventions produced improvements in a number of student health outcomes. Here we reflect on what this review was not able to tell us: in other words, what evidence is missing with regard to the HPS approach. Few HPS interventions engage with schools’ “core business” by examining impacts on educational outcomes. Current evidence is dominated by obesity interventions, with most studies conducted with children rather than adolescents. Evidence is lacking for outcomes such as mental or sexual health, substance use, and violence. Activities to engage families and communities are currently weak and unlikely to prompt behavioral change. The HPS approach is largely absent in low-income settings, despite its potential in meeting children’s basic health needs. Intervention theories are insufficiently complex, often ignoring upstream determinants of health. Few studies provide evidence on intervention sustainability or cost-effectiveness, nor in-depth contextual or process data. We set out an agenda for future school health promotion research, considering implications for key stakeholders, namely, national governments, research funders, academics, and schools.

scholarly journals Peer-Based Social Media Features in Behavior Change Interventions: Systematic Review (Preprint)

2017 ◽  
Author(s):  
Sheik Mohammad Roushdat Ally Elaheebocus ◽  
Mark Weal ◽  
Leanne Morrison ◽  
Lucy Yardley
Keyword(s):  
Systematic Review ◽  
Social Media ◽  
Behavior Change ◽  
Behavioral Interventions ◽  
Selection Process ◽  
Future Research ◽  
Behavioral Risk ◽  
Lack Of Information ◽  
Behavior Change Interventions ◽  
High Level

BACKGROUND Incorporating social media features into digital behavior change interventions (DBCIs) has the potential to contribute positively to their success. However, the lack of clear design principles to describe and guide the use of these features in behavioral interventions limits cross-study comparisons of their uses and effects. OBJECTIVE The aim of this study was to provide a systematic review of DBCIs targeting modifiable behavioral risk factors that have included social media features as part of their intervention infrastructure. A taxonomy of social media features is presented to inform the development, description, and evaluation of behavioral interventions. METHODS Search terms were used in 8 databases to identify DBCIs that incorporated social media features and targeted tobacco smoking, diet and nutrition, physical activities, or alcohol consumption. The screening and review process was performed by 2 independent researchers. RESULTS A total of 5264 articles were screened, and 143 articles describing a total of 134 studies were retained for full review. The majority of studies (70%) reported positive outcomes, followed by 28% finding no effects with regard to their respective objectives and hypothesis, and 2% of the studies found that their interventions had negative outcomes. Few studies reported on the association between the inclusion of social media features and intervention effect. A taxonomy of social media features used in behavioral interventions has been presented with 36 social media features organized under 7 high-level categories. The taxonomy has been used to guide the analysis of this review. CONCLUSIONS Although social media features are commonly included in DBCIs, there is an acute lack of information with respect to their effect on outcomes and a lack of clear guidance to inform the selection process based on the features’ suitability for the different behaviors. The proposed taxonomy along with the set of recommendations included in this review will support future research aimed at isolating and reporting the effects of social media features on DBCIs, cross-study comparisons, and evaluations.

scholarly journals A Systematic Review of Single Chinese Herbs for Alzheimer's Disease Treatment

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Li-Min Fu ◽  
Ju-Tzu Li
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Quality Assessment ◽  
Senile Dementia ◽  
Mechanisms Of Action ◽  
Huperzine A ◽  
Chinese Herbs ◽  
Current Evidence ◽  
Future Research

The objectives here are to provide a systematic review of the current evidence concerning the use of Chinese herbs in the treatment of Alzheimer's disease (AD) and to understand their mechanisms of action with respect to the pathophysiology of the disease. AD, characterized microscopically by deposition of amyloid plaques and formation of neurofibrillary tangles in the brain, has become the most common cause of senile dementia. The limitations of western medications have led us to explore herbal medicine. In particular, many Chinese herbs have demonstrated some interesting therapeutic properties. The following databases were searched from their inception: MEDLINE (PUBMED), ALT HEALTH WATCH (EBSCO), CINAH and Cochrane Central. Only single Chinese herbs are included. Two reviewers independently extracted the data and performed quality assessment. The quality assessment of a clinical trial is based on theJadadcriteria. Seven Chinese herbs and six randomized controlled clinical trials were identified under the predefined criteria.Ginkgo biloba, Huperzine A (Lycopodium serratum) and Ginseng have been assessed for their clinical efficacy with limited favorable evidence. No serious adverse events were reported. Chinese herbs show promise in the treatment of AD in terms of their cognitive benefits and more importantly, their mechanisms of action that deal with the fundamental pathophysiology of the disease. However, the current evidence in support of their use is inconclusive or inadequate. Future research should place emphasis on herbs that can treat the root of the disease.

scholarly journals Baby Buddy App for Breastfeeding and Behavior Change: Retrospective Study of the App Using the Behavior Change Wheel (Preprint)

2020 ◽  
Author(s):  
Loretta M Musgrave ◽  
Alison Baum ◽  
Nilushka Perera ◽  
Caroline SE Homer ◽  
Adrienne Gordon
Keyword(s):  
Behavior Change ◽  
Self Efficacy ◽  
Mobile App ◽  
World Health ◽  
Future Research ◽  
Potential Health ◽  
Behavior Change Techniques ◽  
Barriers And Enablers ◽  
Behavior Change Wheel ◽  
The Uk

BACKGROUND Breastfeeding plays a major role in the health of mothers and babies and has the potential to positively shape an individual’s life both in the short and long term. In the United Kingdom (UK), although 81% of women initiate breastfeeding, only 1% of women breastfeed exclusively to 6 months as recommended by the World Health Organization. In the UK, women who are socially disadvantaged and younger are less likely to breastfeed at 6 to 8 weeks postpartum. One strategy that aims to improve these statistics is the Baby Buddy app, which has been designed and implemented by the UK charity Best Beginnings to be a universal intervention to help reduce health inequalities, including those in breastfeeding. OBJECTIVE This study aimed to retrospectively examine the development of Baby Buddy by applying the Behavior Change Wheel (BCW) framework to understand how it might increase breastfeeding self-efficacy, knowledge, and confidence. METHODS Retrospective application of the BCW was completed after the app was developed and embedded into maternity services. A three-stage process evaluation used triangulation methods and formalized tools to gain an understanding of the potential mechanisms and behaviors used in apps that are needed to improve breastfeeding rates in the UK. First, we generated a behavioral analysis by mapping breastfeeding barriers and enablers onto the Capability, Opportunity, and Motivation-Behavior (COM-B) system using documents provided by Best Beginnings. Second, we identified the intervention functions and policy categories used. Third, we linked these with the behavior change techniques identified in the app breastfeeding content using the Behavior Change Techniques Taxonomy (BCTTv1). RESULTS Baby Buddy is a well-designed platform that could be used to change breastfeeding behaviors. Findings from stage one showed that Best Beginnings had defined breastfeeding as a key behavior requiring support and demonstrated a thorough understanding of the context in which breastfeeding occurs, the barriers and enablers of breastfeeding, and the target actions needed to support breastfeeding. In stage two, Best Beginnings had used intervention and policy functions to address the barriers and enablers of breastfeeding. In stage three, Baby Buddy had been assessed for acceptability, practicability, effectiveness, affordability, safety, and equity. Several behavior change techniques that could assist women with decision making around breastfeeding (eg, information about health consequences and credible sources) and possibly affect attitudes and self-efficacy were identified. Of the 39 videos in the app, 19 (49%) addressed physical capabilities related to breastfeeding and demonstrated positive breastfeeding behaviors. CONCLUSIONS Applying a theoretical framework retrospectively to a mobile app is possible and results in useful information to understand potential health benefits and to inform future development. Future research should assess which components and behavioral techniques in the app are most effective in changing behavior and supporting breastfeeding.

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