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).

Establishing Components of Programmes to Reduce Restrictive Practices in Adult Mental Health Inpatient Services: A Behaviour Change Technique Analysis

2020 ◽  
Author(s):  
Kathryn Berzins ◽  
Krysia Canvin ◽  
Sarah Kendal ◽  
Iris Benson ◽  
Ian Kellar ◽  
...  
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Complex Interventions ◽  
Evidence Base ◽  
Audit And Feedback ◽  
Behaviour Change Technique ◽  
Adult Mental Health ◽  
Change Technique ◽  
Health And Social Care ◽  
Inpatient Settings

Abstract Background: Incidents that threaten service user and staff safety occur frequently in adult mental health inpatient settings, often resulting in restrictive practices such as restraint and seclusion. These carry significant risks, including physical and psychological harms to service users and staff, as well as costs to the NHS. Numerous complex interventions have been developed which aim to reduce the use of restrictive practices. Aims: The aims were to identify, standardise and report the effectiveness of components of interventions that seek to reduce restrictive practices in adult mental health inpatient settings, using the Behaviour Change Technique taxonomy. Methods: A systematic mapping review of literature identified in health and social care research databases and unpublished sources (including social media) was undertaken. Records were quality appraised using the MMAT. Records of interventions to reduce any form of restrictive practice used with adults in mental health services were included. The resulting dataset for extraction was guided by WIDER, Cochrane and theory coding guidelines. The BCT taxonomy was systematically applied to each identified intervention.Results: The final dataset comprised 175 records reporting 150 interventions, 109 of which had been formally evaluated. The most common intervention targets were seclusion and/or restraint reduction. The most common evaluation approach was a non-randomised design. There were only six randomised controlled trials. The number of BCTs identified per intervention ranged from 1-33 (mean:8). The most common strategy was staff training. BCTs from 14 of a possible 16 clusters were detected. Over two thirds of the BCTs mapped onto four of the 14 clusters: ‘Goals and planning’; ‘Antecedents’; ‘Shaping knowledge’; ‘Feedback and monitoring’. Those BCTs which were found in all the interventions were similar to those found in those interventions which demonstrated statistically significant effects. Conclusions: Studies of interventions to reduce restrictive practices appear to be diverse quality. Interventions tended to contain multiple components delivered in multiple ways. Further research could enhance the evidence base prior to future commissioning decisions. Separate testing of individual procedures, for example, audit and feedback, could ascertain the more effective intervention components and improve understanding of content and delivery. Registration: The study is registered as PROSPERO 2018 CRD42018086985 Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018086985

scholarly journals SmokefreeTXT Behaviour Change Technique Analysis

2016 ◽  
Vol 12 (4) ◽  
pp. 231-243 ◽  
Author(s):  
Iva Stoyneva ◽  
Kisha Coa ◽  
Jillian Pugatch ◽  
Amy Sanders ◽  
Mary Schwarz ◽  
...  
Keyword(s):  
Social Support ◽  
Smoking Cessation ◽  
Behaviour Change ◽  
Text Messaging ◽  
Behavioural Change ◽  
Building Blocks ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Frequency Of Use ◽  
Over Time

Mobile text-messaging smoking cessation interventions have demonstrated their efficacy in increasing cessation rates. These interventions tend to be multifaceted and there is a need to specify their building blocks. The purpose of this study was to use the Behavioural Change Techniques Taxonomy V1 (BCTTv1) to systematically analyse the behaviour change techniques present in the SmokefreeTXT (SFTXT) adult programme. The entire SFTXT library was coded using the BCTTv1. Frequencies were calculated to assess the presence of BCT groups and unique BCTs in the entire programme. The mix of BCTs was also examined by programme week and during periods of high user dropout. Of the 16 groups of behavioural techniques, 14 were present in SFTXT. Of the 93 distinct BCTs, 41 were present in the full SFTXT message library. The most prevalent BCT groups were Feedback and Monitoring, Natural Consequences, Social Support, and Shaping Knowledge. There were differences in the mix of BCTs across the duration of the intervention. The results will enable us to test how changes in the use of specific BCTs and their frequency of use over time, impact (1) engagement with the programme (particularly during the days with high dropout rates), and (2) smoking cessation outcomes over time.

scholarly journals Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review

2021 ◽  
Vol 9 (5) ◽  
pp. 1-184
Author(s):  
John Baker ◽  
Kathryn Berzins ◽  
Krysia Canvin ◽  
Iris Benson ◽  
Ian Kellar ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Behaviour Change ◽  
English Language ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Data Set ◽  
Adult Mental Health ◽  
Change Technique ◽  
Inpatient Settings

ObjectivesThe study aimed to provide a mapping review of non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings; classify intervention components using the behaviour change technique taxonomy; explore evidence of behaviour change techniques and interventions; and identify the behaviour change techniques that show most effectiveness and those that require further testing.BackgroundIncidents involving violence and aggression occur frequently in adult mental health inpatient settings. They often result in restrictive practices such as restraint and seclusion. These practices carry significant risks, including physical and psychological harm to service users and staff, and costs to the NHS. A number of interventions aim to reduce the use of restrictive practices by using behaviour change techniques to modify practice. Some interventions have been evaluated, but effectiveness research is hampered by limited attention to the specific components. The behaviour change technique taxonomy provides a common language with which to specify intervention content.DesignSystematic mapping study and analysis.Data sourcesEnglish-language health and social care research databases, and grey literature, including social media. The databases searched included British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CCRCT), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), EMBASE, Health Technology Assessment (HTA) Database, HTA Canadian and International, Ovid MEDLINE®, NHS Economic Evaluation Database (NHS EED), PsycInfo®and PubMed. Databases were searched from 1999 to 2019.Review methodsBroad literature search; identification, description and classification of interventions using the behaviour change technique taxonomy; and quality appraisal of reports. Records of interventions to reduce any form of restrictive practice used with adults in mental health services were retrieved and subject to scrutiny of content, to identify interventions; quality appraisal, using the Mixed Methods Appraisal Tool; and data extraction, regarding whether participants were staff or service users, number of participants, study setting, intervention type, procedures and fidelity. The resulting data set for extraction was guided by the Workgroup for Intervention Development and Evaluation Research, Cochrane and theory coding scheme recommendations. The behaviour change technique taxonomy was applied systematically to each identified intervention. Intervention data were examined for overarching patterns, range and frequency. Overall percentages of behaviour change techniques by behaviour change technique cluster were reported. Procedures used within interventions, for example staff training, were described using the behaviour change technique taxonomy.ResultsThe final data set comprised 221 records reporting 150 interventions, 109 of which had been evaluated. The most common evaluation approach was a non-randomised design. There were six randomised controlled trials. Behaviour change techniques from 14 out of a possible 16 clusters were detected. Behaviour change techniques found in the interventions were most likely to be those that demonstrated statistically significant effects. The most common intervention target was seclusion and restraint reduction. The most common strategy was staff training. Over two-thirds of the behaviour change techniques mapped onto four clusters, that is ‘goals and planning’, ‘antecedents’, ‘shaping knowledge’ and ‘feedback and monitoring’. The number of behaviour change techniques identified per intervention ranged from 1 to 33 (mean 8 techniques).LimitationsMany interventions were poorly described and might have contained additional behaviour change techniques that were not detected. The finding that the evidence was weak restricted the study’s scope for examining behaviour change technique effectiveness. The literature search was restricted to English-language records.ConclusionsStudies on interventions to reduce restrictive practices appear to be diverse and poor. Interventions tend to contain multiple procedures delivered in multiple ways.Future workPrior to future commissioning decisions, further research to enhance the evidence base could help address the urgent need for effective strategies. Testing individual procedures, for example, audit and feedback, could ascertain which are the most effective intervention components. Separate testing of individual components could improve understanding of content and delivery.Study registrationThe study is registered as PROSPERO CRD42018086985.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 5. See the NIHR Journals Library website for further project information.

scholarly journals What (if any) behaviour change techniques do government-led cybersecurity awareness campaigns use?

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Tommy van Steen ◽  
Emma Norris ◽  
Kirsty Atha ◽  
Adam Joinson
Keyword(s):  
Behaviour Change ◽  
Human Error ◽  
Behavioural Change ◽  
Behaviour Change Techniques ◽  
Direct Effects ◽  
Awareness Campaigns ◽  
Change Technique ◽  
Behaviour Change Wheel ◽  
Effectiveness Studies

Abstract With the surge in cyber incidents in recent years, many linked to human error, governments are quite naturally developing security campaigns to improve citizens’ security behaviour. However, it remains not only unclear how successful these campaigns are in changing behaviour, but also what established behaviour change techniques—if any—they employ in order to achieve this goal. To investigate this, we analysed 17 government-sponsored cybersecurity campaign materials. We coded the materials for their intervention functions according to the Behaviour Change Wheel and their behaviour change techniques in accordance with the Behavioural Change Technique Taxonomy (version 1). Our findings show that security campaigns are often focused on education and increasing awareness, under the assumption that as long as citizens are aware of the risk, and are provided with information on how to improve their security behaviour, behaviour will change. Additionally, there is a lack of published effectiveness studies investigating the direct effects of a governmental cybersecurity campaign. Proposed improvements to security campaigns are discussed.

scholarly journals Changing behaviour, ‘more or less’: do implementation and de-implementation interventions include different behaviour change techniques?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Andrea M. Patey ◽  
Jeremy M. Grimshaw ◽  
Jill J. Francis
Keyword(s):  
Behaviour Change ◽  
Implicit Theories ◽  
Cochrane Library ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Exact Test ◽  
Continuity Correction ◽  
Chi Squared ◽  
Clinician Behaviour ◽  
The Cochrane Library

Abstract Background Decreasing ineffective or harmful healthcare practices (de-implementation) may require different approaches than those used to promote uptake of effective practices (implementation). Few psychological theories differentiate between processes involved in decreasing, versus increasing, behaviour. However, it is unknown whether implementation and de-implementation interventions already use different approaches. We used the behaviour change technique (BCT) taxonomy (version 1) (which includes 93 BCTs organised into 12 groupings) to investigate whether implementation and de-implementation interventions for clinician behaviour change use different BCTs. Methods Intervention descriptions in 181 articles from three systematic reviews in the Cochrane Library were coded for (a) implementation versus de-implementation and (b) intervention content (BCTs) using the BCT taxonomy (v1). BCT frequencies were calculated and compared using Pearson’s chi-squared (χ2), Yates’ continuity correction and Fisher’s exact test, where appropriate. Identified BCTs were ranked according to frequency and rankings for de-implementation versus implementation interventions were compared and described. Results Twenty-nine and 25 BCTs were identified in implementation and de-implementation interventions respectively. Feedback on behaviour was identified more frequently in implementation than de-implementation (Χ2(2, n=178) = 15.693, p = .000057). Three BCTs were identified more frequently in de-implementation than implementation: Behaviour substitution (Χ2(2, n=178) = 14.561, p = .0001; Yates’ continuity correction); Monitoring of behaviour by others without feedback (Χ2(2, n=178) = 16.187, p = .000057; Yates’ continuity correction); and Restructuring social environment (p = .000273; Fisher’s 2-sided exact test). Conclusions There were some significant differences between BCTs reported in implementation and de-implementation interventions suggesting that researchers may have implicit theories about different BCTs required for de-implementation and implementation. These findings do not imply that the BCTs identified as targeting implementation or de-implementation are effective, rather simply that they were more frequently used. These findings require replication for a wider range of clinical behaviours. The continued accumulation of additional knowledge and evidence into whether implementation and de-implementation is different will serve to better inform researchers and, subsequently, improve methods for intervention design.

A Review of the Processes By Which School Psychologists and Counsellors Can Use Taxonomies to Evaluate Health-Related Apps

2018 ◽  
Vol 28 (2) ◽  
pp. 212-233 ◽  
Author(s):  
Marko Ostojic ◽  
Jasmine Chung ◽  
Michael DiMattia ◽  
Brett Furlonger ◽  
Margherita Busacca ◽  
...  
Keyword(s):  
School Psychologists ◽  
Behaviour Change ◽  
Health Conditions ◽  
Change Strategies ◽  
Clinical Use ◽  
Inclusion Criteria ◽  
School Students ◽  
Behaviour Change Technique ◽  
Change Technique ◽  
Health Related

School students are increasingly using apps for health-related purposes, either on their own or when recommended by psychologists or counsellors, as apps offer a way to assist students to change their behaviour. However, there is a growing need for psychologists and counsellors to be able to evaluate the quality and usefulness of such apps to effect behaviour change. This study was therefore undertaken to identify methods by which school psychologists and counsellors could evaluate health-related apps for clinical use or research purposes. After examining 15 studies of apps that met the inclusion criteria, it was clear that researchers used a number of taxonomies to evaluate the apps. There were seven taxonomies identified, of which five were generalisable to all health conditions, with the behaviour change technique (BCT) taxonomy being the most comprehensive, containing 13 key behaviour strategies. Despite the utility of the taxonomies to identify the amount of behaviour change content within the apps, it was difficult to determine how the behaviour change strategies were measured, thus reducing the ability to predict app effectiveness. Approaches to improving methods by which apps can be developed and evaluated are proposed.

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.

Applying the COM-B behaviour model to overcome barriers to heart failure self-care: A practical application of a conceptual framework for the development of complex interventions (ACHIEVE study)

2020 ◽  
pp. 147451512095729
Author(s):  
Amanda Whittal ◽  
Stefan Störk ◽  
Barbara Riegel ◽  
Oliver Rudolf Herber
Keyword(s):  
Heart Failure ◽  
Behaviour Change ◽  
Complex Interventions ◽  
Self Care ◽  
Intervention Development ◽  
Heart Association ◽  
Barriers And Facilitators ◽  
Behaviour Change Techniques ◽  
Anticipated Regret ◽  
Management Interventions

Background: Effective interventions to enhance adherence to self-care recommendations in patients with heart failure have immense potential to improve health and wellbeing. However, there is substantial inconsistency in the effectiveness of existing self-management interventions, partly because they lack theoretical models underpinning intervention development. Aim: To outline how the capability, opportunity and motivation behaviour model has been applied to guide the development of a theory-based intervention aiming to improve adherence to heart failure self-care recommendations. Methods: The application of the capability, opportunity and motivation behaviour model involved three steps: (a) identification of barriers and facilitators to heart failure self-care from two comprehensive meta-studies; (b) identification of appropriate behaviour change techniques to improve heart failure self-care; and (c) involvement of experts to reduce and refine potential behaviour change techniques further. Results: A total of 119 barriers and facilitators were identified. Fifty-six behaviour change techniques remained after applying three steps of the behaviour model for designing interventions. Expert involvement ( n=39, of which 31 were patients (67% men; 45% New York Heart Association II)) further reduced and refined potential behaviour change techniques. Experts disliked some behaviour change techniques such as ‘anticipated regret’ and ‘salience of consequences’. This process resulted in a final comprehensive list consisting of 28 barriers and 49 appropriate behaviour change techniques potentially enhancing self-care that was put forward for further use. Conclusion: The application of the capability, opportunity and motivation behaviour model facilitated identifying important factors influencing adherence to heart failure self-care recommendations. The model served as a comprehensive guide for the selection and design of interventions for improving heart failure self-care adherence. The capability, opportunity and motivation behaviour model enabled the connection of heart failure self-care barriers to particular behaviour change techniques to be used in practice.

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