Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data)
Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data)
复制标题
DOI：
10.3310/hta19990
复制
发表时间：
2015-11-01
影响因子：
3.6
通讯作者：
Hardeman, Wendy
中科院分区：
文献类型：
--
作者：
Michie, Susan;Wood, Caroline E.;Hardeman, Wendy
应对全球卫生挑战需要有效的行为改变干预措施。这取决于推进行为改变科学，而行为改变科学又取决于准确的干预报告。目前的报告往往缺乏细节，妨碍了准确的复制和执行。最近的事态发展已将干预内容具体纳入行为改变技术-“积极因素”，例如设定目标、自我监测行为。BCT是与保留假定的活性成分（即拟议的变化机制）相容的最小组分。它们可以单独使用或与其它BCT组合使用（米吉S，约翰斯顿M.行为改变的理论与技术：发展行为改变的累积科学。Health Psychol Rev 2012; 6：1-6）。BCT的特定领域分类已经开发出来，例如健康饮食和体育活动，戒烟和饮酒。我们需要在此基础上发展一种国际通用的语言，用于具体说明和制定干预措施。这项技术可用于综合证据，实施有效的干预措施和测试理论。研究目的：（1）建立一种以BCT为基础的BCI分类方法;（2）为建立一种适用于不同类型复杂干预的综合方法学奠定基础;（3）为BCI分类的应用提供资源支持;（4）为BCI分类的发展提供参考。及（4）为未来发展取得多学科及国际认可。设计及参与者：400名参与者来自12个参与调查、设计和/或提供商业行为指标的国家的专家（系统审评员、研究人员、从业人员、政策制定者）。分类法的制定涉及一个德尔菲程序，一个反复修订和与41名国际专家协商的过程;使用归纳的“自下而上”和理论驱动的“自上而下”开放排序程序制定了清单的层次结构（n = 36）;分类法使用培训（1天的研讨会和远程小组教程）（n = 161）进行了评价的变化，编码器的信度和效度（与专家共识一致）;通过可靠性评估编码干预措施的分类（编码器间;重测）和有效性（n = 40名受过训练的编码员）;并通过可靠性评估写作描述的分类结果：93个不同的、不重叠的、具有明确标签和定义的BCT形成了行为改变技术分类学版本1（BCTTv 1）。使用“自下而上”的开放式排序程序将BCT聚类为16个分组;这些分组与理论驱动的“自上而下”程序产生的分组之间存在重叠。两种训练方法都提高了有效性（均p < 0.05），使编码器达到能力的比例增加了一倍，并提高了在研讨会中识别BCT的信心（均p < 0.001），但没有提高编码器间的可靠性。93个BCT中有80个观察到良好的编码器间可靠性。1个月后观察到良好的编码器内一致性（p < 0.001）。描述中15个BCT中有14个效度良好。BCTTv 1的有用性，报告所观察到的干预措施的描述有喜忧参半的result.Conclusions：发达的分类（BCTTv 1）提供了一种方法，用于确定复杂的BCI的内容和国际跨学科合作的基础，开发更有效的干预措施，以改善健康。需要进一步开展工作，审查其对报告干预措施的有用性。
Background: Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) -the 'active ingredients', for example goal-setting, self-monitoring of behaviour. BCTs are 'the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs' (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012; 6: 1-6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health.Objective: (1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development.Design and participants: Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive 'bottom-up' and theory-driven 'top-down' open-sort procedures (n = 36); training in use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) was evaluated by changes in intercoder reliability and validity (agreement with expert consensus); evaluating the taxonomy for coding interventions was assessed by reliability (intercoder; test-retest) and validity (n = 40 trained coders); and evaluating the taxonomy for writing descriptions was assessed by reliability (intercoder; test-retest) and by experimentally testing its value (n = 190).Results: Ninety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a 'bottom-up' open-sort procedure; there was overlap between these and groupings produced by a theory-driven, 'top-down' procedure. Both training methods improved validity (both p < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (both p < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results.Conclusions: The developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions.