Resources

We are delighted to make publicly available, with the agreement of the publishers of the American Journal of Preventive Medicine, six papers arising from the 2015 workshop: How to create, evaluate and implement effective digital healthcare interventions: development of guidance.

Led by Professor Susan Michie, the workshop was hosted in London by the Medical Research Council, with funding from the Medical Research Council (MRC)/National Institute for Health Research (NIHR) Methodology Research Program, the NIH Office of Behavioral and Social Sciences Research (OBSSR)  and the Robert Wood Johnson Foundation.  This set of articles discusses key issues facing the development and evaluation of digital behaviour change interventions. 

To download, please click on the titles below:

• Advancing Models and Theories for Digital Behavior Change Interventions
• Current Issues and Future Directions for Research Into Digital Behavior Change Interventions
• Designing and Undertaking a Health Economics Study of Digital Health Interventions
• Digital Technologies and Disease Prevention
• Evaluating Digital Health Interventions: Key Questions and Approaches
• The Pace of Technologic Change: Implications for Digital Health Behavior Intervention Research
• Understanding and Promoting Effective Engagement With Digital Behavior Change Interventions

Further Reading?

For people who are interested in further reading we recommend the following book; CBC monograph (order online).

The Behaviour Change Wheel (BCW)

• Michie S, van Stralen M, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science. 2011;6:42. Link to pdf

Applying the COM-B model

• Jackson C, Eliasson L, Barber N, Weinman J. Applying COM-B to medication adherence: A suggested framework for research and interventions. The European Health Psychologist. 2014;16(1):7-17. Link to pdf

Behaviour Change Technique Taxonomy v1 (BCTTv1)

• Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., ... & Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of behavioral medicine, 46(1), 81-95. Link to abstract

• The BCTTv1 was developed and evaluated by a three-year project funded by the Medical Research Council. More details about the project can be found at: http://www.ucl.ac.uk/behaviour-change-techniques

• Michie, S, Richardson, M, Johnston, M, Abraham, C, Francis, J, Hardeman, W, Eccles, MP, Cane, J, Wood, CE. The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions. Annals of Behavioral Medicine. 2013;46(1):81-95. Link to abstract
• Michie, S, Abraham, C, Eccles, MP, Francis, JJ, Hardeman, W, Johnston, M. Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocol. Implementation Science. 2011:6-10. Link to pdf
• Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychology. 2008;27(3):379-87. Link to abstract
• An interactive online training site is currently available at www.bct-taxonomy.com

Behaviour Change Theory

• Davis, R., Campbell, R., Hildon, Z., Hobbs, L., & Michie, S. (2015). Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health psychology review, 9(3), 323-344. Link to paper. Read a blog post about it.

Publications citing the Behaviour Change Wheel

Please refer to this document for publication citations of the Behaviour Change Wheel.

Behavioural and social sciences in public health: The first strategy of its kind.

The Behavioural and Social Science Strategy - Improving people's health is a collaboration put together by academics, public health professionals, and representatives from funders and learned bodies to better enable the broad public health system to use behavioural and social sciences.

Applying the Behaviour Change Wheel - A very brief guide

This one page guide aims to provide a brief overview of the purpose and functionality of the behaviour change wheel.

The Learning Healthcare Project

This report, which was commissioned by The Health Foundation, outlines how routinely collected data, outcomes measurement and behaviour change techniques can enable real change within healthcare. It also explores some of the implications and looks at where the field might be going over the years to come.

This website contains most of the conducted interviews, focus groups and references.

NICE Public Health Guidance

• National Institute for Health and Care Excellence. Behaviour Change: Individual Approaches (PH49). London: National Institute for Health and Care Excellence; 2014. http://guidance.nice.org.uk/PH49
• National Institute for Health and Care Excellence. Behaviour Change: The Principles for Effective Interventions (PH6). London: National Institute for Health and Care Excellence; 2007. http://guidance.nice.org.uk/PH6

Science & Technology Committee Report

Understanding behaviour and behaviour change are necessary for developing effective and efficient policies in all areas. Although this report draws on case studies that focus on the Department of Health and the Department for Transport, conclusions and recommendations are directed to all Government departments.

• Science and Technology Committee. Second Report on Behaviour Change. 2011. Link to online article

BPS Behaviour Change Briefings

The British Psychological Society's (BPS) Behaviour Change Advisory Group (BCAG) works to provide expert advice on behaviour change in the context of public policy. It co-ordinates production of Society publications on behaviour change issues and supports our responses to consultations on related topics. It provides an expert interface between the Society and government and other policy making bodies in relation to behaviour change issues.

This series of short briefings is aimed at emphasising the role psychology can play in achieving behaviour change. Each of these briefings is designed to focus specifically on the role psychology can play in addressing a societal issue. This portfolio is freely available and is aimed at policy-makers and opinion formers. It will also be of interest to researchers and practitioners.

Topics include:

• School attendance, exclusion and persistent absence
• Energy conservation
• Physical (in)activity
• Tax and tax compliance
• Personal debt

MINDspace Report

Today's policy makers are in the business of influencing behaviour - they need to understand the effects their policies may be having. The aim of MINDSPACE is to help them do this, and in doing so get better outcomes for the public and society.  The report explores how behaviour change theory can help meet current policy challenges, such as how to: reduce crime, tackle obesity, ensure environmental sustainability.

Institute for Government and the Cabinet Office. MINDSPACE: Influencing behaviour through public policy. 2010 Link to pdf

Medical Research Council Guidance

• Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655. Link to pdf

The Ethics of Behaviour Change

A chapter looking at the terminology associated with behaviour change, including "nudging". Includes discussion of factors that may be relevant to determining whether a behaviour change intervention will be publicly and ethically acceptable.

• Science and Technology Committee. Second Report on Behaviour Change: Chapter 2: Definitions, Categorisation and the Ethics of Behaviour Change Interventions. 2011. Link to online article

There are several strategies to promote health in individuals and populations. Two general approaches to health promotion are behavior change and empowerment. The aim of this article is to present those two kinds of strategies, and show that the behavior-change approach has some moral problems, problems that the empowerment approach (on the whole) is better at handling.

• Tengland, Behaviour Change or Empowerment: On the ethics of health promotion strategies. Public Health Ethics. 2012; 5(2): 140-153. Link to abstract

Emphasis on personal lifestyle choices has recently come under scrutiny. Some critics point out that the attempts at risk reduction have simply not had impressive results; others have criticised the field on various ethical grounds.

• Solomon, MZ. The ethics of and efficacy of behaviour change research. The Hastings Center Report. 2001;31(1):43-45. Link to online article

The Human Behaviour Change Project (HBCP) are pleased to announce two new online tools have been launched.

The Theory & Technique Tool

The effectiveness of behaviour change interventions depends on good understanding of the links between behaviour change techniques (BCTs) and their Mechanisms of Action (MoAs) i.e. the processes through which they affect behaviour. Considerable progress has been made in developing a method for specifying BCTs. The Theories and Techniques project aimed to develop and test a methodology for linking BCTs to their hypothesised MoAs (see project protocol: rdcu.be/ORFH).

This online Theory & Techniques Tool provides a simple way of accessing the data from the project https://theoryandtechniquetool.humanbehaviourchange.org/.

You can find an introductory video about the tool here: https://www.youtube.com/watch?v=V3xpnm0s8jw

The tool is a heat map of 74 BCTs and 26 Mechanisms of Action (MoAs) resulting in 1924 cells. Each cell represents the link between a BCT and an MoA, with stronger links represented in green. The strength of a link is determined by the triangulation of data from two studies, a literature synthesis study and an expert consensus study. Within each BCT-MoA cell, you will find the results of the literature, expert consensus and triangulation studies. By clicking on a cell, you will find the data from all contributing studies.

The website provides an introduction to the tool and guidance on how to use it.

Resources

You can read the results of the Theory and Techniques project in the following papers:

• Carey, R. N., Connell, L., Johnston, M., Rothman, A., de Bruin, M., Kelly, M. P., & Michie, S. (2018). Behaviour change techniques and their mechanisms of action: a synthesis of links described in published intervention literature. https://doi.org/10.1093/abm/kay078.
• Connell Bohlen, L.E., Carey, R.N., Johnston, M., Rothman, A.J., de Bruin, M., Kelly, M.P. & Michie, S. (2018, October 16). Links between behaviour change techniques and mechanisms of action: an expert consensus study. https://psyarxiv.com/fge86/.
• Johnston M, Carey RN, Connell LE, Johnston D, Rothman AJ, de Bruin M, Kelly MP, Groarke H & Michie A. (2018, October 16) Linking behaviour change techniques and mechanisms of action: Triangulation of findings from literature synthesis and expert consensus. https://psyarxiv.com/ur6kz/.

Contact

Please contact humanbehaviourchange@ucl.ac.uk

The Behaviour Change Technique Study Repository: a resource and tool to upload papers coded using Behaviour Change Techniques Taxonomy v1 (BCTTv1)

Our open access online repository of published papers reporting interventions coded by BCTTv1 has over 400 papers. This is a great resource for the research community.  We have now added instructions for users to upload new research papers with interventions coded using BCTTv1. Full guidance on how to do this is provided on the website: http://www.bct-taxonomy.com/interventions.

The usefulness of this resource will depend on the research community updating the repository with information from their own, or others', papers.

Contact

Please contact bct.theory@ucl.ac.uk

Further information on the Human Behaviour Change Project - including latest news and team - is available via the HBCP website.

The COCHRANE library - www.thecochranelibrary.com

The Cochrane Library is a collection of six databases that contain different types of high-quality, independent evidence to inform healthcare decision-making, and a seventh database that provides information about groups in The Cochrane Collaboration.

The website links through to other resources such as:

• Cochrane Database of Systematic Reviews
• Cochrane Central Register of Controlled Trials
• Cochrane Methodology Register
• Database of Abstracts of Reviews of Effects
• Health Technology Assessment Database
• NHS Economic Evaluation Database
• About The Cochrane Collaboration

NICE evidence search - www.evidence.nhs.uk

NICE Evidence Services are a suite of services that provide internet access to high quality authoritative evidence and best practice. The services cover health, social care and public health evidence. Evidence Services aim to help professionals make better and quicker evidence based decisions.

NICE Evidence Services consists of the following 6 resources:

• Evidence Search
• which provides free open access to a unique index of selected and authoritative health and social care evidence-based information.Healthcare Database Advanced Search (HDAS), which provides access to an extensive set of journals and bibliographic databases. These are purchased by NICE on behalf of the NHS.
• Clinical Knowledge Summaries (CKS) which provide primary care practitioners with access to evidence-based guidance on over 300 key conditions presenting in primary care.
• BNF microsite which provides open access to BNF content across the UK.
• UK DUETS, a database of Evidence Uncertainties which provides research funders and researchers access to the 'known unknowns' in the evidence base.
• Bulletins, Alerts and Evidence Awareness service which helps busy professionals keep up to date with important new evidence.

All Trials - www.alltrials.net

The AllTrials campaign is an initiative of Bad Science, the BMJ, Centre for Evidence-based Medicine, Cochrane Collaboration, James Lind Initiative, PLOS and Sense About Science and is being led in the US by Dartmouth's Geisel School of Medicine and the Dartmouth Institute for Health Policy and Clinical Practice. The AllTrials campaign was launched in January 2013 and calls for all past and present clinical trials to be registered and their results reported. The campaign has published a detailed plan on how all clinical trials can be registered and all results reported.

NICE guidance - www.nice.org.uk/guidance

NICE guidance sets the standards for high quality healthcare and encourages healthy living. NICE Guidance can be used by the NHS, Local Authorities, employers, voluntary groups and anyone else involved in delivering care or promoting wellbeing.

CONSORT guidelines - www.consort-statement.org

CONSORT, which stands for Consolidated Standards of Reporting Trials, encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs). The main product of CONSORT is the CONSORT Statement, which is an evidence-based, minimum set of recommendations for reporting RCTs. It offers a standard way for authors to prepare reports of trial findings, facilitating their complete and transparent reporting, and aiding their critical appraisal and interpretation.

CONSORT is part of a broader push to produce reporting guidelines (RGs) for many different types of research:

• ASSERT (A Standard for the Scientific and Ethical Review of Trials) initiative is a proposed standard for the review and monitoring of randomized clinical trials by research ethics committees. Among other items, its checklist incorporates certain elements of CONSORT, to ensure fulfillment of the requirements for scientific validity in the ethical conduct of clinical research.
• PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement provides an evidence-based minimum set of items that for reporting systematic reviews and meta-analyses, and is an update and expansion of the QUOROM Statement. Although it focuses on randomized trials, the PRISMA Statement can also be used as a basis for reporting systematic reviews of other types of research, particularly evaluations of interventions.

For information about reporting guidelines for different types of research, visit:

• EQUATOR (Enhancing the QUAlity and Transparency Of health Research) project aims to help fulfill the potential impact of reporting guidelines on the quality of research.

Jim McManus's blog

Jim McManus, Director of Public Health in Hertfordshire, sets out a conceptual framework for behaviour change in local government highlighting the need for better linkage between public health practice and academia:

• Making behaviour change work in the new world…some thoughts for the Evidence into practice conference (2014)

Prof Robert West's blog

Prof Robert West, Director of Tobacco Studies and Professor of Health Psychology at UCL, discusses topics such tobacco control, e-cigarettes, addiction, and other health relatead topics:

• http://www.rjwest.co.uk/blog.php

The Behavioural Insights team (Cabinet office 'Nudge' unit)

The Behavioural Insights Team (Director: David Halpern), often called the 'Nudge Unit', applies insights from academic research in behavioural economics and psychology to public policy and services. In addition to working with almost every UK government department, the unit works with local authorities, charities, NGOs, private sector partners and foreign government, developing proposals and testing them empirically across the full spectrum of government policy:

• Read the team's blog here: http://www.behaviouralinsights.co.uk/blog/

Prof Muki Haklay's blog

Prof Muki Haklay, Professor of Geographical Information Science at UCL, writes about, amongst other topics, behaviour change that is not planned or directed - e.g. crowdsourcing and citizen science (which are about what people do and therefore behaviour):

• Levels of participation in citizen science and scientific knowledge production (2011)
• Assertions on crowdsourced geographic information & citizen science #3 (2014)

Prof Richard Moorhead's blog

Prof Richard Moorhead, Professor of Law and Professional Ethics and Director of Centre for Ethics and Law at UCL, shares research and commentary on the Legal Professions:

• Lawyer Watch

Dr Rosie Webster's blog post

Dr Rosie Webster, Research Associate, Research Department of Primary Care and Population Health at UCL, shares her thoughts on the E-health Unit technology-sharing seminars:

• E-Health Unit technology-sharing seminars: Sharing knowledge and fostering interdisciplinary links

Dr Emma Beard's blog

During the workshop 'Using Bayesian methods for evaluating behaviour change interventions' organised by the Centre for Behaviour Change on 12 May 2014, Dr Emma Beard reported what was covered in the workshop:

• Bayesian methods for behaviour change interventions (2014)

'Health Chatter': The UCL Health Behaviour Research Centre Blog

The Health Behaviour Research Centre (HBRC) undertakes research aimed at advancing our understanding of behaviours that have a major impact on health and to contribute to the development of interventions to promote healthy lifestyles. The Centre is part of the Department of Epidemiology and Public Health, UCL.

• Read the blog

Talks

• Prof Susan Michie, DHP 2014: Using the TDF to inform an intervention to promote workplace recycling

• Dr Lou Atkins, DHP 2014: An adaptive interviewing approach using the Theoretical Domains Framework to identify influences on variation in adenoma detection rates

• Theories and Techniques of Behaviour Change and their Application to Speech and Language Therapy Interventions - 8 July 2014
• Theories and Models of Behaviour Change: How useful are they? - 2 June 2014
• Designing and characterising behaviour change interventions: Launch of Behaviour Change Wheel Guide and BCTTv1 online training programme - 6 May 2014
• Improving sustainability via behaviour change - 25 March 2014

• Prof Jeremy Watson, March 2014: Design, Architecture & Engineering Influencing Behavioural Outcomes

Workshops

• Bayesian methods for evaluating behaviour change interventions - 12 May 2014

Follow us on YouTube

• www.youtube.com/user/UCLBehaviourChange

Professor Michie's presentation to the 2019 International Convention on Psychological Science

https://vimeo.com/320929188

A series of short talks by Robert West on motivation

vimeo.com/album/5038903

Event: A Cultural Tonic - Using the arts to promote health

A seminar focussed on raising awareness and understanding as to how:

• Engaging with, and experiencing, the arts can lead to better health (i.e. 'art as a health behaviour'); and
• Arts-based interventions can improve health related behaviours and outcomes (i.e. 'arts as a health intervention').

Videos

1. Intro + Dr Daisy Fancourt, Wellcome Research Fellow - 'Psychological, physiological, social and behavioural research into the effects of the arts on health'
2. Jules Ford, Senior Programme Manager & Matt Pearce, Public Health Lead, Gloucestershire Clinical Commissioning Group - 'Social Prescribing and Cultural Commissioning: Gloucestershire Clinical Commissioning Group'
3. Dr Rebecca Gordon Nesbitt, King's College London, Researcher to the All Party Parliamentary Group on Arts, Health and Wellbeing - 'Creative Health: results from a two year political inquiry'
4. Dr. Helen Chatterjee - the new Culture, Health & Wellbeing Alliance.

Prof. Michie's talk at the 10th Duodecim International Symposium 2018 - "Designing effective behaviour change interventions"

• https://vimeopro.com/user39826906/10th-duodecim-international-symposium-2018/video/276001199

Prof. Michie's talk to the Finnish Psychology Society - "Designing more effective public policy to change behaviour: The contribution of behavioural science.

• https://www.youtube.com/watch?v=-RwIYQaz_Tg

The Path To All Waking Hours

• This practical course is for intervention designers new to creating behaviour change interventions. To know why an intervention might work, or what ingredient in an intervention might work best, we need to learn from others before us. Looking to the findings of interventions before us is our best bet to creating interventions that work. Examples of interventions both successful and unsuccessful will be shared.
• You will need to create an account with Udemy to access the course.
• The password to access once an account has been created is: eyesopenearson

Mobile Data and the Search for the 'Holy Grail' in Obesity Research

• In this One-on-One interview, Medscape Editor-in-Chief Dr Eric J. Topol talks to Prof. Donna Spruijt-Metz, an expert in pediatric obesity, about how mobile data collection and wearable sensor technology can potentially reduce the epidemic of "diabesity" in the United States.

Smartphone apps to change behaviour: promises and pitfalls

• Prof Susan Michie discusses smartphone apps for behaviour change at the NUIG mHealth conference 2016

Rosalind Franklin Appathon: Prize and Tech Day 2016

• Over 100 delegates gathered at Wayra UK, Telefonica O2's startup accelerator, to hear some inspiring talks from our speakers and judges, watch pitches from the competition finalists and forge strong networks across the science and digital space.

Theories and Models of Behaviour Change: How useful are they? - June 2014

• Prof Susan Michie (Director, UCL Centre for Behaviour Change) introduces a panel discussion with three leading figures from three UCL Faculties addressing the question of what makes for a "good" theory and how they are best applied, and Prof Kate Jeffery (Professor of Behavioural Neuroscience, UCL Faculty of Brain Sciences) presents examples of models and theories used in neuroscience
• Prof Anthony Finkelstein (Professor of Software Systems Engineering and Dean of UCL Faculty of Engineering Science) explains how models and theories are conceptualised in Engineering
• Prof Robert West (Professor of Health Psychology, UCL Faculty of Population Sciences) demonstrates how theories and models are applied in behavioural science

Behaviour Change Wheel Guide Launch - May 2014

• Dr Lou Atkins describes how to use the Behaviour Change Wheel Guide
• Dr Kristina Curtis describes her experience of using the Behaviour Change Wheel

BCT Taxonomy Online Training Launch - May 2014

• Dr Caroline Wood introduces the BCTTv1 online training

BCT Taxonomy App Launch - May 2014

• David Crane introduces the BCTTv1 smartphone app

CBC Launch - February 2014

• Photo montage of the launch
• Intro talk by Prof Susan Michie
• Talk by Prof David Price
• Talk by Prof Alexi Marmot
• Talk by Prof Mike Kelly

The Behaviour Change Wheel - 2013

• Prof Susan Michie speaks to the Global Alliance for Chronic Diseases about the Behaviour Change Wheel

Which behaviour change approach should I use? An introduction to the Behaviour Change Wheel - 2013

• Prof Susan Michie provides an introduction to the Behaviour Change Wheel at Behaviour Works, Australia

What does it take to achieve desired behaviour change? - 2012

• Prof Susan Michie speaks to the British Nutrition Foundation about what it takes to achieve the desired behaviour change

Follow us on Soundcloud:

• https://soundcloud.com/ucl-behaviour-change

Podcasts

• ECO2015 Podcast with Professor Susan Michie

 Does personalised advice via computer or mobile devices reduce heavy drinking? 2017

• The Cochrane Drugs and Alcohol Group has produced several reviews of the effects of interventions intended to reduce heavy drinking. The collection was extended in September 2017 with an investigation of the use a computer to provide personalised advice. We asked one of the authors, Fiona Beyer from Newcastle University in the UK, to tell us what they found.

European Food Information Council (EUFIC), 2015

• Prof Susan Michie talks about the principles of behaviour change

• Prof Susan Michie gives a talk at Kellogg College for the Centre for Evidence Based Medicine, University of Oxford, providing a behavioural perspective of translating evidence to policy and practice.

Radio National Podcast: 'Health Report', Australia, 2012

• Prof Susan Michie talks with with Lynne Malcolm about behaviour change in relation to obesity. This interview recorded for the Radio National Podcast 'Health Report', presented by Norman Swan, Australia, 2012.

Royal Society for Public Health, 2012

• Prof Susan Michie discusses behaviour change and the circumstances required to support people in making changes to their lifestyles. This interview was recorded as part of the 'In Conversation with...' series of the Royal Society for Public Health, 2012.

BCT Taxonomy App

To support the BCT Taxonomy and the online training programme, an easy-to-navigate and fully searchable smartphone version of the taxonomy has been developed by Dave Crane.

Comprising 93 behaviour change techniques (BCTs) with labels, definitions and examples, organised into 16 groupings to increase speed of use, the taxonomy is a valuable tool for anyone involved in designing, reporting or evaluating interventions to change behaviour. 

Available for free at: iTunes (iOS) for iphone and ipad

and Google Play Store (Android)

Smoke Free 28 (SF28) App

SF28 offers a guide through the first 28 days of a quit attempt as well as helping prepare for quitting. It sets up the challenge of being completely smoke free for 28 days. That is the period when craving and withdrawal symptoms are at their worst and it has been shown that if people can make it through without a single puff on a cigarette they are 20 times more likely to stay off cigarettes for good.

The development was led by Robert West, based on the latest scientific research and provides a range of tools and advice on how to quit smoking for good.

Available for free at: itunes (iOS) for iphone