Abstract. 2007, 58 (2): 191-200. First of all, it was clear it would be necessary to define terms describing categories of intervention more precisely than is done in everyday language in order to achieve coherence. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. The process of designing behaviour change interventions usually involves first of all determining the broad approach that will be adopted and then working on the specifics of the intervention design. Next, reliability of use by practitioners was assessed by asking two policy experts (the Department of Health Policy Lead for implementation of the 2010 English government tobacco control strategy and a tobacco researcher) to independently classify the 24 components of the strategy (see Additional file 1 for coding materials). This framework could be reliably applied to classify interventions within two important areas of public health. Google Scholar, Summerbell C, Waters E, Edmunds L, Kelly S, Brown T, Campbell K: Interventions for preventing obesity in children. Following this, our method involved three steps: a systematic literature review and evaluation of existing behaviour change intervention frameworks, development of a new framework, and a test of the reliability of the new framework. Table 1 lists these and their definitions (their sources are detailed in Additional file 5). 10.1136/qshc.2004.011155. Dismiss. West R, Walia A, Hyder N, Shahab L, Michie S: Behavior change techniques used by the English Stop Smoking Services and their associations with short-term quit outcomes. Given that there may be frameworks described in books and non peer-reviewed articles, we acknowledged that it was unlikely that we would arrive at a complete set, but we sought to canvass enough to be able to undertake an analysis of how well as a whole they matched the criteria described earlier and to achieve sufficient coverage of the key concepts and labels. Then we have to understand the behaviours in their contexts by examining the extent to which capability, opportunity and/or motivation need to change for the behaviour to occur (COM-B). 2006, 62 (1): 89-94. University College London. Evidence also suggests that to develop effective interventions and maintain change over time, a multi-level and sustained approach is needed which operates simultaneously and consistently at the individual, community and population level. In order to choose the interventions likely to be most effective, it makes sense to start with a model of behaviour. PubMed Central The CALO-RE taxonomy Psychology and Health. Article There is not a term in the English language to describe that we intend, so rather than invent a new term we have stayed with 'enablement. Michie, S., van Stralen, M.M. We used the following search terms to identify scholarly articles containing frameworks of behaviour change interventions: Topic = (taxonomy or framework or classification) AND Topic = ('behaviour change' or 'behavior change') AND Topic = (prevention OR intervention OR promotion OR treatment OR program OR programme OR policy OR law OR politics OR regulation OR government OR institute OR legislation). http://epoc.cochrane.org/epoc-resources-review-authors, http://www.prisma-statement.org/index.htm, Additional File 1: Applying the Behaviour Change Wheel to characterise intervention strategies: Coding Materials. Fabiana Lorencatto Centre for Behaviour Change, ... Susan Michie. For example, you can have the ‘reflective’ motivation path driving you towards a particular behaviour because you believe that enacting the behaviour will protect yourself and others. How existing frameworks map on to intervention and policy categories (PDF 27 KB), Additional file 7: Frameworks analysed by criteria of comprehensive coverage, coherence and link to a model of behaviour. 10.1093/her/5.2.125. Implementation Science, 6:42. 2000, 14 (1): 37-45. PubMed To sustain behaviours, people need to develop routines and habits, reinforced and enabled by their physical and social environments. It includes habitual processes, emotional responding, as well as analytical decision-making. There are many different ways of doing this, and no guarantees that the one arrived at here is optimal. The response to this is twofold: these are empirical questions and there is already evidence that characterising interventions by behaviour change techniques (BCTs) can be helpful in understanding which interventions are more or less effective [6, 17]; and not to embark on this enterprise is to give up on achieving a science of behaviour change before the first hurdle and condemn this field to opinion and fashion. The 6 … Motivation is defined as all those brain processes that energize and direct behaviour, not just goals and conscious decision-making. We are, as a species, highly adaptive. Thus the intervention categories identified from the 19 existing frameworks were better conceived of as non-overlapping functions: a given intervention may involve more than one of these. 10.1093/bmb/ldl012. All, apart from reflective motivation, are necessary for a given behaviour but it is possible to generate a profile of which should be targeted to achieve the behavioural target. Johnston M, Dixon D: Current issues and new directions in psychology and health: What happened to behaviour in the decade of behaviour?. Sort. However, the categories are very broad and within each is a mixture of different types of interventions at different conceptual levels. It must be recognised that there are a near infinite number of ways of classifying interventions and intervention functions. Capability is defined as the individual's psychological and physical capacity to engage in the activity concerned. Several things became apparent when reviewing the frameworks. Analysis of smoking cessation activities stimulated by the quality and outcomes framework. Susan Michie is Director of the Centre for Behaviour Change and of the Health Psychology Research Group at UCL. It should also be noted that even when interventions are said to be guided by theory, in practice they are often not or are only minimally . and PsycInfo were supplemented by consulting with eight international experts in behaviour change, drawn from the disciplines of psychology, health promotion, epidemiology, public health, and anthropology. Following reliability testing and discussion of any disagreements, a 'gold standard' was established. Once one has done this, one would decide on the specific intervention components. 1990, 5 (2): 125-37. Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. View Susan Michie’s profile on LinkedIn, the world’s largest professional community. Health Psychol. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on WhatsApp (Opens in new window), Bean there, done that : why we should eat more beans and legumes in general, The differences between SARS-CoV-1 and SARS-CoV-2. Dismiss. Implementation Science In light of the above, this paper aims to: Review existing frameworks of behavioural interventions to establish how far each meets the criteria of usefulness, and to identify a comprehensive list of intervention descriptors at a level of generality that is usable by intervention designers and policy makers. A new framework was developed to meet these criteria. Strack F, Deutsch R: Reflective and impulsive determinants of social behavior. One reason for this may be that these frameworks do not meet their needs. For example, a specific instance of brief physician advice to reduce alcohol consumption may involve the three different functions of education, persuasion, and enablement, whereas another may involve only one or two of these. Under US criminal law, in order to prove that someone is guilty of a crime one has to show three things: means or capability, opportunity, and motive. Psychology. Linking interventions to components of the behaviour system was achieved with the help of a broad theory of motivation that encapsulated both reflective and automatic aspects, and focused on the moment to moment control of behaviour by the internal and external environment which in turn is influenced by that behaviour and the processes leading up to it . If people perceive a serious threat, then they will adapt their behaviour often to considerable degrees as we have seen over the last few weeks. The inter-rater agreement for the NICE Obesity Guidance was 79%. There are a number of limitations to the research described in this paper. Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A: Making psychological theory useful for implementing evidence based practice: a consensus approach. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. How does people’s behaviour affect the spread and containment of an infectious disease, such as COVID-19? 10.1093/ntr/ntq074. 2009, 28 (6): 690-701. Behaviour at the hub …. 2007, London NICE, Information Centre: Statistics on NHS Stop-Smoking Services 2009/10. We and others are also working on how one identifies specific component 'behaviour change techniques' [4, 5]. Manage cookies/Do not sell my data we use in the preference centre. This simple, comprehensive model of behaviour in its context is called “COM-B” (Capability-Opportunity-Motivation-Behaviour). The International Association of Applied Psychology Handbook of Applied Psychology. See the complete profile on LinkedIn and discover Susan’s connections and jobs at similar companies. The UK government’s action plan on coronavirus issued today (3 March 2020) briefly mentions the role the public can play in supporting this response, including following public health authorities’ advice, for example on hand washing. Additional file 4 shows the frameworks and gives a brief description of each [11, 12, 16, 27–42]. Nicotine Tob Res. However, the systematic way in which development of the BCW has been approached should enable it to provide a more robust starting point for development of improved frameworks than has hitherto been possible. Dismiss. Changing behaviours, a scientist’s opinion. A beautiful example of an incoherent classification system is the Ancient Chinese Classification of Animals: 'those that belong to the Emperor, embalmed ones, those that are trained, suckling pigs, mermaids, fabulous ones, stray dogs, those that are included in this classification, those that tremble as if they were mad, innumerable ones, those drawn with a very fine camel's hair brush, others, those that have just broken a flower vase, and those that resemble flies from a distance' (Luis Borges 'Other Inquisitions: 1937-1952'). Centre for Behaviour Change Harnessing cross-disciplinary expertise to address social, health and environmental challenges. 2010, 10: 167-10.1186/1471-2458-10-167. California Privacy Statement, This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. Ones with multiple variables. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions Ann Behav Med. The frameworks were coded according to the criteria for usefulness by RW and SM. Ann Behav Med. Just by identifying all the potential intervention functions and policy categories this framework could prevent policy makers and intervention designers from neglecting important options. 2003, St Andrews University of St Andrews. Title. Failure to do this limits the scope of the system to offer options for intervention designers that may be effective. Everyday low prices and free delivery on eligible orders. The one arrived at here will no doubt be superseded. Geller S, Berry T, Ludwig T, Evans R, Gilmore M, Clarke S: A conceptual framework for developing and evaluating behavior change interventions for injury control. People’s decisions and behaviours will be influenced by the extent to which they think there is a threat and the extent to which they think they can do anything to mitigate it. Acknowledgements • Key collaborators in this work – Prof Robert West, University College London – Prof Marie Johnston, University of Aberdeen – Health Psychology Research Group • Funders. 2010, West R, Michie S: Behaviour change: the importance of seeing the whole picture and a critique of 'Nudge': Submission to the House of Lords Science and Technology Select Committee Call for Evidence: Behaviour Change. An existing framework that has made an important contribution to making intervention design more systematic is 'intervention mapping' . Searches of Web of Science (Science and Social Science databases), Pubmed. Analysis by criteria of comprehensive coverage, coherence and link to a model of behaviour (PDF 14 KB), Additional file 8: BCW classification of the English 2010 Tobacco Control Strategy and the NICE Obesity Guidelines (2006). CAS For example, with one behavioural target the only barrier might be capability, while for another it may be enough to provide or restrict opportunities, while for yet another changes to capability, motivation, and opportunity may be required. The level of inter-rater agreement was computed and any differences resolved through discussion. We believe that this is the first attempt to undertake a systematic analysis of behaviour intervention frameworks and apply usefulness criteria to them. Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Susan Michie, Maartje M van Stralen & Robert West. SM and RW conceived the study, designed the measures, supervised the systematic review, supervised the analyses and drafted the write-up. Google Scholar, Institute for Government: MINDSPACE; Influencing behaviour through public policy. It is based on the Behaviour Change Wheel, a synthesis of 19 behaviour change frameworks that draw on a wide range of disciplines and approaches. Cited by . The COM-B system, a framework for understanding behaviour. For example, it has been used in UK parliamentary circles to demonstrate to Members of Parliament that the current UK Government is ignoring important evidence-based interventions to change behaviour in relation to public health [43, 44]. Analysis of intervention frameworks (DOC 60 KB), Additional File 5: Sources of definitions of interventions and policies. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). Qual Saf Health Care. They are based on implicit commonsense models of behaviour . Google Scholar, DEFRA: A Framework for Pro-Environmental Behaviours: Report. Use this list to construct a framework of behaviour change interventions that meets the usefulness criteria listed above. Any one intervention function is likely to comprise many individual BCTs, and the same BCT may serve different intervention functions. 2010, [http://epoc.cochrane.org/epoc-resources-review-authors], National Institute for Health and Clinical Excellence: Behaviour change at population, community and individual levels (Public Health Guidance 6). Michie S, Fixsen D, Grimshaw JM, Eccles MP: Specifying and reporting complex behaviour change interventions: the need for a scientific method. With regard to the policies, it was possible to treat them as non-overlapping categories. PubMed PubMed The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Susan Michie Professor of Health Psychology Director of Centre for Behaviour Change University College London KT Canada November 2015 @SusanMichie The BCW is being developed into a theory- and evidence-based tool allowing a range of users to design and select interventions and policies according to an analysis of the nature of the behaviour, the mechanisms that need to be changed in order to bring about behaviour change, and the interventions and policies required to change those mechanisms. She is co-Director of NIHR’s Behavioural Science Policy Research Unit, leads UCL’s membership of NIHR’s School of Public Health Research and is an NIHR Senior Investigator. Third, any given intervention could in principle perform more than one behaviour change function. PubMed The journal of nutrition, health & aging. Addictive Behaviors. We limited the criteria to those we considered to form a basis for judging adequacy. We have built on this to add non-volitional mechanisms involved in motivation (e.g., habits) and to conceptualise causal associations between the components in an interacting system. 2010, Michie S, Hyder N, Walia A, West R: Development of a taxonomy of behaviour change techniques used in individual behavioural support for smoking cessation. The Behaviour Change Wheel: A Guide To Designing Interventions | Michie, Susan, Atkins, Lou, West, Robert | ISBN: 9781912141005 | Kostenloser Versand für … Danksagung •Geldgeber sind u.a. Development of a theory coding scheme. 2010, London: Department of Health. She is co-Director of NIHR’s Behavioural Science Policy Research Unit, leads UCL’s membership of NIHR’s School of Public Health Research and is an NIHR Senior Investigator. This can be illustrated by a study of GP advice to smokers, which found that a single variable -- degree of concern that it would harm the doctor-patient relationship -- accounted for significant variance in the rate of advice-giving . Maibach EW, Abroms LC, Marosits M: Communication and marketing as tools to cultivate the public's health: a proposed "people and places" framework. There are many reasons in which the intention to behave in a certain way is undermined by other aspects of one’s ‘behaviour system’. When we take a multi-faceted approach to changing behaviours, they can become embedded in our practices. 2005, 29 (5 Suppl 1): 139-45. PubMed Vlek C: Essential psychology for environmental policy making. Michie S, Abraham C, Whittington C, McAteer J, Gupta S: Effective techniques in healthy eating and physical activity interventions: a meta-regression. 2001, 39 (8 Suppl 2): II2-45. International Journal of Psychology. Indeed, different frameworks may be more or less useful in different circumstances. Read the latest article version by Susan Michie, James Thomas, Pol Mac Aonghusa, Robert West, Marie Johnston, Michael P. Kelly, John Shawe-Taylor, Janna Hastings, Francesca Bonin, Alison O’Mara-Eves, at Wellcome Open Research. 2010, London House of Lords, Featherstone H, Reed H, Jarvis M, Michie S, Gilmour A, West R: APPG Enquiry into the effectiveness and Cost Effectiveness of Tobacco Control: Submission to the Spending Review and Public Health White Paper Consultation Process. The Behaviour Change Wheel (BCW) was developed from 19 frameworks of behaviour change identified in a systematic literature review. It would then consider the full range of ways in which the frequency of advice-giving could be increased. Susan Michie, FMedSci, FAcSS is Professor of Health Psychology and Director of the Centre for Behaviour Change at University College London, UK 2004, Washington DC, [http://www.psilearning.com]. Only a minority of the frameworks could be regarded as coherent or linked to an overarching model of behaviour. This paper examines this first part of this process. 10.1016/0277-9536(95)00388-6. Even when one or more models or theories are chosen to guide the intervention, they do not cover the full range of possible influences so exclude potentially important variables. Edited by: Baum A, Revenson T, Singer J. Google Scholar, Gilles ME, Strayer LJ, Leischow R, Feng C, Menke JM, Sechrest L: Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000. 2005, 14 (1): 26-33. Abstract. In general, these behaviour patterns are measured in terms of the prevalence or incidence of particular behaviours in specified populations (e.g., delivery of smoking cessation advice by general practitioners). In this 'behaviour system,' capability, opportunity, and motivation interact to generate behaviour that in turn influences these components as shown in Figure 1 (the 'COM-B' system). Research is needed to establish how far the BCW can lead to more efficient design of effective interventions. 10.1111/j.1365-2648.2006.04207.x. Susan Michie. Interventions are used to promote uptake and optimal use of effective clinical services, and to promote healthy lifestyles. Whilst this framework of 12 theoretical domains has proved useful in assessing and intervening with implementation problems , the domain of behaviour has remained under-theorised and therefore underused in its application. 2006, Haines A, Kuruvilla S, Borchert M: Bridging the implementation gap between knowledge and action for health. © 2021 BioMed Central Ltd unless otherwise stated. Having selected the intervention function or functions most likely to be effective in changing a particular target behaviour, these can then be linked to more fine-grained specific behaviour change techniques (BCTs). Improving the implementation of evidence-based practice and public health depends on behaviour change. It is apparent that no framework covered all the functions and categories and thus did not meet the criterion of comprehensiveness. In many countries, despite personal protective behaviours being included in government advice, little guidance, training or support is given to promote adherence – we need guidance not just on what to do, but on how to achieve those changes consistently and for the long term. Year; Developing and evaluating complex interventions: the new Medical Research Council guidance. This paper reviews the methods t… An ongoing programme of research is developing an 'intervention design tool' based on the BCW. 389k Accesses. A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. This model should capture the range of mechanisms that may be involved in change, including those that are internal (psychological and physical) and those that involve changes to the external environment. West R: Tobacco control: present and future. Coherence, i.e., categories are all exemplars of the same type and specificity of entity. Online Summer School. The report recognises two systems by which human behaviour can be influenced -- the reflective and the automatic -- but it focuses on the latter and does not attempt to link influences on behaviour with these two systems. Health Psychol. The definitions and conceptualisation of the intervention categories were refined through discussion and by consulting the American Psychological Association's Dictionary of Psychology and the Oxford English Dictionary. The areas of tobacco control and obesity reduction were chosen because these are among the most important in public health and ones where health professional behaviour has consistently been found to fall short of that recommended by evidence-based guidelines [24–26]. With this in mind, scrutiny of the frameworks yielded a set of nine intervention functions and seven policy categories that were included in at least one framework. Behaviour in context is thus the starting point of intervention design. Professor Susan Michie, behaviour change expert at UCL provides an inside track into her theories and her unique approach to behaviour change Within 19 frameworks for classifying behaviour change interventions, nine intervention functions and seven policy categories could be discerned. 2008, London: Defra. This led to a framework that met the third criterion of linkage with an overarching model of behaviour change (Tables 2 and 3). Walter I, Nutley S, Davies H: Developing a taxonomy of interventions used to increase the impact of research. Thus, behaviour change interventions are fundamental to the effective practice of clinical medicine and public health, as indeed they are to many pressing issues facing society. The framework was used independently by RW and SM to classify the 24 components of the 2010 English government tobacco control strategy  and the 21 components of the 2006 NICE obesity guidance . Thus, with regard to capability, we distinguished between physical and psychological capability (psychological capability being the capacity to engage in the necessary thought processes - comprehension, reasoning et al.). 2006, Oxford: Blackwells. One of the strengths of this framework is that it incorporates context very naturally. COM-B Behaviour at the hub …. Susan Michie, FMedSci ... Common tasks and principles in behaviour change intervention development frameworks: Integrative review. A subset was then selected using the inclusion criteria for full review. COM-B is a behaviour framework that is structured and analytical. 2010, 29 (1): 1-8. 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