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 Links Between Behavior Change Techniques and Mechanisms of Action: An Expert Consensus Study

2018 ◽  
Vol 53 (8) ◽  
pp. 708-720 ◽  
Author(s):  
Lauren E Connell ◽  
Rachel N Carey ◽  
Marijn de Bruin ◽  
Alexander J Rothman ◽  
Marie Johnston ◽  
...  
Keyword(s):  
Behavior Change ◽  
Behavioral Interventions ◽  
Nominal Group Technique ◽  
Action Planning ◽  
Mechanisms Of Action ◽  
Expert Consensus ◽  
Nominal Group ◽  
Behavior Change Techniques ◽  
The Matrix ◽  
International Behavior

Abstract Background Understanding the mechanisms through which behavior change techniques (BCTs) can modify behavior is important for the development and evaluation of effective behavioral interventions. To advance the field, we require a shared knowledge of the mechanisms of action (MoAs) through which BCTs may operate when influencing behavior. Purpose To elicit expert consensus on links between BCTs and MoAs. Methods In a modified Nominal Group Technique study, 105 international behavior change experts rated, discussed, and rerated links between 61 frequently used BCTs and 26 MoAs. The criterion for consensus was that at least 80 per cent 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 per cent) 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 per cent) MoAs had a definite link to one or more BCTs (mean [SD] = 3.27 [2.91], range = 9). Ninety (5.7 per cent) were identified as “definite” links, 464 (29.2 per cent) as “definitely not” links, and 1,032 (65.1 per cent) 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 behavioral interventions. These links also provide a framework for specifying empirical tests in future studies.

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.

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

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).

scholarly journals Which behaviour change techniques are effective to promote physical activity and reduce sedentary behaviour in adults: a factorial randomized trial of an e- and m-health intervention

2020 ◽  
Author(s):  
Helene Schroé ◽  
Delfien Van Dyck ◽  
Annick De Paepe ◽  
Louise Poppe ◽  
Wen Wei Loh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Action Planning ◽  
Health Intervention ◽  
Health Interventions ◽  
Behaviour Change Techniques ◽  
Self Monitoring ◽  
Coping Planning ◽  
The Impact

Abstract BackgroundE- and m-health interventions are promising to change health behaviour. Many of these interventions use a large variety of behaviour change techniques (BCTs), but it’s not known which BCTs or which combination of BCTs contribute to their efficacy. Therefore, this study investigated the efficacy of three BCTs (i.e. action planning, coping planning and self-monitoring) and their combinations on physical activity (PA) and sedentary behaviour (SB).MethodsIn a 2(action planning: present vs absent) x2(coping planning: present vs absent) x2(self-monitoring: present vs absent) factorial trial, 473 adults from the general population used the self-regulation based e- and m-health intervention ‘MyPlan2.0’ for five weeks. All combinations of BCTs were considered, resulting in eight groups. Participants selected their preferred target behaviour, either PA (n = 335,age = 35.8,28.1% men) or SB (n = 138,age = 37.8,37.7% men), and were then randomly allocated to the experimental groups. Levels of PA (MVPA in minutes/week) or SB (total sedentary time in hours/day) were assessed at baseline and post-intervention using self-reported questionnaires. Linear mixed-effect models were fitted to assess the impact of the different combinations of the BCTs on PA and SB.ResultsFirst, overall efficacy of each BCT was examined. The delivery of self-monitoring increased PA (t = 2.735,p = 0.007) and reduced SB (t=-2.573,p = 0.012) compared with no delivery of self-monitoring. Also, the delivery of coping planning increased PA (t = 2.302,p = 0.022) compared with no delivery of coping planning. Second, we investigated to what extent adding BCTs increased efficacy. Using the combination of the three BCTs was most effective to increase PA (x2 = 8,849,p = 0.003) whereas the combination of action planning and self-monitoring was most effective to decrease SB (x2 = 3.918,p = 0.048). To increase PA, action planning was always more effective in combination with coping planning (x2 = 5.590,p = 0.014;x2 = 17.722,p < 0.001;x2 = 4.552,p = 0.033) compared with using action planning without coping planning. Of note, the use of action planning alone reduced PA compared with using coping planning alone (x2 = 4.389,p = 0.031) and self-monitoring alone (x2 = 8.858,p = 003), respectively.ConclusionsThis study provides indications that different (combinations of) BCTs may be effective to promote PA and reduce SB. More experimental research to investigate the effectiveness of BCTs is needed, which can contribute to improved design and more effective e- and m-health interventions in the future.Trial registrationThis study was preregistered as a clinical trial (ID number: NCT03274271). Release date: 20 October 2017, http://clinicaltrials.gov/ct2/show/NCT03274271

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

2019 ◽  
Vol 8 (1) ◽  
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).

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 AB1321-HPR DEVELOPING A SELF-MANAGEMENT INTERVENTION TO MANAGE JOINT HYPERMOBILITY SYNDROME AND EHLERS-DANLOS SYNDROME HYPERMOBILITY TYPE: AN ANALYSIS INFORMED BY BEHAVIOUR CHANGE THEORY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1950.2-1950
Author(s):  
S. Bennett ◽  
N. Walsh ◽  
T. Moss ◽  
S. Palmer
Keyword(s):  
Behaviour Change ◽  
Nominal Group Technique ◽  
Joint Hypermobility ◽  
Nominal Group ◽  
Self Management ◽  
Hypermobility Syndrome ◽  
Joint Hypermobility Syndrome ◽  
Ehlers Danlos Syndrome ◽  
Modified Nominal Group Technique ◽  
Danlos Syndrome

Background:Joint Hypermobility Syndrome (JHS) and Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are heritable disorders of connective tissue that can cause joint instability and pain and are associated with increased anxiety and depression. There is currently little UK guidance for supporting patients with JHS/EDS-HT1. The analysis presented here used the Behaviour Change Wheel (made up of the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation and Behaviour (COM-B) model2) to identify possible intervention options to improve self-management in people with JHS/EDS-HT.Objectives:To determine recommendations for the components of a behaviour change intervention for people with JHS or EDS-HT.Methods:Data from: 1) A systematic review and thematic synthesis of the literature examining adults’ lived experiences of JHS/EDS3and 2) A thematic analysis of interview data where UK adults with JHS/EDS-HT (n=17, 14 women, 3 men) discussed the psychosocial impact of the condition on their lives4, were mapped onto the TDF and COM-B in a behavioural analysis. A modified Nominal Group Technique focus group (n=9, all women) explored which interventions identified by the TDF/COM-B mapping exercise were most important to them.Results:Participants prioritised a range of potential self-management interventions, including:Education: Participants wanted greater support to improve their knowledge of JHS/EDS-HT, including self-help strategies for coping with injury, fatigue and overexertion, and how to evaluate information about their condition.Training: In activity pacing, assertiveness and communication skills, and what to expect during pregnancy, when symptoms of JHS/EDS-HT can worsen.Environmental restructuring and enablement:Support from occupational therapists to maintain independence at home. Enablement of access to CBT, mindfulness and emotional support.Modelled behaviour:Positive first-person narratives that address how other patients with JHS/EDS-HT have coped with anxiety, depression, distress, fear, frustration and feelings of loss.Conclusion:This study is the first to apply theoretically-informed approaches to the management of JHS/EDS-HT. Through a modified nominal group technique, potential behaviour change interventions for addressing barriers to self-management have been prioritised. Discussion with participants indicated poor access to psychological support, occupational therapy and a lack of knowledge of JHS/EDS-HT. Future research with healthcare professional and patient stakeholder groups will further evaluate which intervention options would be most acceptable and feasible for the management of JHS/EDS-HT.References:[1]Palmer, S., Terry, R. Rimes, K.A., Clark, C., Simmonds, J. & Horwood, J. (2016). Physiotherapy management of joint hypermobility syndrome – a focus group study of patient and health professional perspectives. Physiotherapy,http://dx.doi.org/10.1016/j.physio.2015.05.001.[2]Michie, S., van Stralen, M.M. & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(42).[3]Bennett, S.E., Walsh, N., Moss, T. and Palmer, S. (2019a) “The lived experience of joint hypermobility and Ehlers-Danlos Syndromes: A systematic review and thematic synthesis.”Physical Therapy Reviews, 24 (1-2). pp. 12-28. ISSN 1083-3196[4]Bennett, S.E., Walsh, N., Moss, T. and Palmer, S. (2019b) “Understanding the psychosocial impact of Joint Hypermobility Syndrome and Ehlers-Danlos Syndrome Hypermobility Type: A qualitative interview study.”Disability and Rehabilitation. ISSN 0963-8288Disclosure of Interests:None declared

scholarly journals Does action planning reduce anger and aggression in at-risk adolescents? A randomised controlled trial

2021 ◽  
Author(s):  
Laura Castillo-Eito ◽  
Chris Armitage ◽  
Paul Norman ◽  
Richard Rowe
Keyword(s):  
At Risk ◽  
Active Control ◽  
Behaviour Change ◽  
Action Planning ◽  
Behaviour Change Techniques ◽  
Callous Unemotional ◽  
Callous Unemotional Traits ◽  
Unemotional Traits ◽  
At Risk Adolescents

Background: Interventions that include action planning are more effective than others to reduce aggression among at-risk adolescents. However, they often include other behaviour change techniques. The efficiency of interventions could be improved if action planning on its own could reduce aggression. The current study investigates the effect of a volitional help sheet (VHS) that prompts the creation of action plans to manage anger in response to specific or generic anger triggers. It was hypothesised that participants completing the VHS would have lower levels of aggression and anger at follow-up. The moderation effects of violent intentions, callous-unemotional traits and negative urgency were also tested.Methods: One hundred adolescents (10-17 years old) with behavioural problems were recruited and randomised to three conditions: specific anger triggers, generic anger trigger or active control. An active control group was used to blind participants and teachers to group allocation. Self-reported data on anger and aggression was collected at baseline, one month and six months after intervention at the participants’ schools. This trial was registered at www.clinicaltrials.gov (identification number NCT03693209).Results: Eighty-one participants completed at least one follow-up and were included in the analysis. Neither VHS had a significant effect on anger or aggression overall, but moderator effects were found; both VHS were effective for participants with high callous-unemotional traits and low negative urgency. There were no differences between specific and generic triggers.Conclusions: Adolescents with high callous-unemotional traits have traditionally been seen as a difficult population to treat. The VHS is a cost-effective technique to reduce aggression in this population which is easy to implement. Future studies are needed to identify which behaviour change techniques are needed for other groups.

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