Title: Linking behaviour change techniques to theory: developing and testing a methodology
Investigators: Susan Michie, Marie Johnston, Alex Rothman, Mike Kelly, Marijn de Bruin
Researchers: Rachel Carey, Lauren Connell, Hilary Groarke
Funding: UK Medical Research Council, 2014-2017
The effectiveness of behaviour change interventions depends on good understanding of the links between behaviour change techniques (BCTs) and their mechanisms of action (i.e. the processes through which they affect behaviour). Considerable progress has been made in developing a method for specifying BCTs. The aim of this research is to develop and test a methodology for linking BCTs to their mechanisms of action, based on behavioural theory.
Study 1: To synthesise evidence of links between 93 BCTs (from the 93-item BCT taxonomy, BCTTv1) and their mechanisms of action, data will be extracted from published intervention papers. The frequency, explicitness and precision with which each BCT is linked by authors to each mechanism will be reported.
Study 2: Behaviour change experts will identify the strength of links between BCTs and mechanisms of action in a formal consensus development study. They will be asked about 26 mechanisms, 12 frequently occurring in theories of behaviour change and 14 from the Theoretical Domains Framework. The data from Studies 1 and 2 will generate matrices of links between BCTs and mechanisms.
Study 3: Agreement between the matrices from Studies 1 and 2 will be evaluated using the Limits of Agreement method. A new group of experts will be consulted to discuss and resolve discrepancies. An integrated matrix of BCT-mechanism links, annotated to indicate strength of evidence, will be generated.
Study 4: To identify whether groups of co-occurring BCTs can be linked to theories, groups of two or more BCTs that work together (i.e. BCT 'clusters') will be identified from the Study 1 literature corpus using a cluster analysis. A consensus exercise will be used to rate strength of links between BCT clusters and theories, generating a matrix of links between BCT clusters and theories. A final webinar will aim to resolve discrepancies from Studies 1 and 2, and any remaining issues from Study 3.
The development of a formal methodology for linking BCTs to mechanisms of action has the potential to make a substantial contribution to the development and evaluation of behaviour change interventions. This research is a step towards developing an 'ontology' of behaviour change that specifies the relations between BCTs, theoretical mechanisms, modes of delivery, population, setting and type of behaviour.