Developing methodology for designing and evaluating theory-based complex interventions: an ontology for linking behaviour change techniques to theory

行为（如吸烟、过度饮酒、久坐不动和食用不健康食品）会导致严重疾病和过早死亡。努力改变这种行为是大多数卫生系统的一个重点。已经制定了有助于支持改变这些行为的干预措施。然而，这些干预措施由许多组成部分组成，我们往往不知道哪些组成部分负责带来变化，也不知道这种变化是如何发生的，这种变化往往是相当有限的。这限制了我们从研究中学习的能力，从而为开发更有效的干预措施提供信息。在我们对哪些技术有效的经验知识和我们对它们为什么有效的理解之间存在着差距。目前，我们对机制的理解来自于各种理论，这些理论既没有系统地与干预措施联系起来，也没有与机制联系起来——有许多技术和许多理论——但它们如何联系在一起还远不清楚。这个项目的目的是精确地建立行为改变技术和它们的作用机制之间的联系。这些联系为一个框架提供了基础，该框架可以随着时间的推移而更新，并将允许开发更先进的干预设计和评估，从而加快建立我们关于“什么有效”的知识的过程。目前，个别专家对行为改变技术和理论机制之间的联系做出判断，没有一个系统的、共享的或商定的方法来这样做。因此，我们计划与来自许多学科的大量国际专家合作，制定一种方法，以便就阐明技术和机制之间的理论联系达成共识。我们还将研究文献，以调查行为改变技术如何与已发表的行为改变干预研究中的理论联系起来。专家将考虑共识和基于文献的研究的综合发现，以产生行为改变技术和理论机制之间联系的大型矩阵（行为改变“本体”）。我们将传播我们的研究结果，以便得到国际科学界的广泛报道和讨论，并加以仔细审查。我们将提供基于网络的资源，并举办研讨会来介绍这种新工具，即行为改变（BC）本体。我们相信，这项工作将为研究人员提供一种更有力的方法，用于开发基于健全的干预措施，并解释其他研究人员设计的干预措施的发现，从而产生更有效的干预措施和健康益处。

Behaviours (such as smoking, excessive alcohol use, being sedentary and eating unhealthy foods) result in serious illness and early death. Efforts to change such behaviours are a priority in most health systems. Interventions have been developed that can help support changes in these behaviours. However, these interventions are made up of many components and we often do not know which components are responsible for bringing about change nor how this change, which is often quite limited, occurs. This restricts our ability to learn from our research to inform the development of more effective interventions. There is a gap between our empirical knowledge of which techniques work and our understanding of why they work. At the present time our understanding of the mechanisms is derived from various theories which are not linked systematically either to the interventions or the mechanisms - there are many techniques and many theories - but how they link together is far from clear. The aim of this project is to establish precisely the links between behaviour change techniques and their mechanisms of action. These links provide the basis for a framework that can be updated over time and which will permit the development of more advanced intervention design and evaluation, thus speeding up the process of building our knowledge about 'what works'. At present, individual experts make judgments about links between behaviour change techniques and theoretical mechanisms, without a systematic, shared or agreed method of doing so. We therefore plan to work with a large number of international experts from many disciplines to develop a method for reaching a consensus on articulating the theoretical links between techniques and mechanisms. We will also examine the literature to investigate how behaviour change techniques have been linked with theory in published studies of behaviour change interventions. Experts will consider the combined findings of the consensus and literature-based studies to produce a large matrix of links between behaviour change techniques and theoretical mechanisms (a behaviour change 'ontology'). We will disseminate our findings so that they are reported and discussed widely and scrutinised by the international scientific community.We will provide web-based resources and give workshops to introduce this new tool, the behaviour change (BC) ontology. We believe this work will provide a more robust method for researchers to use in developing soundly based interventions and in interpreting the findings of interventions designed by other researchers, resulting in more effective interventions and health benefits.