Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus

Abstract

<p>Background: Researchers, practitioners and policymakers develop interventions to change behavior based on their understanding of how behavior change techniques (BCTs) impact the determinants of behavior. A transparent, systematic and accessible method of linking BCTs with the processes through which they change behavior (i.e. their mechanisms of action (MoAs)) would advance understanding of intervention effects, and improve theory and intervention development. Purpose: To triangulate evidence for hypothesized BCT-MoA links obtained in two previous studies and present the results in an interactive, online tool.Methods: Two previous studies generated evidence on links between 56 BCTs and 26 MoAs based on their frequency in literature synthesis and on expert consensus. Concordance between the findings of the two studies was examined using multilevel modelling. Uncertainties and differences between the two studies were reconciled by 16 behavior change experts using consensus development methods. The resulting evidence was used to generate an online tool.Results: The two studies showed concordance for 25 of the 26 MoAs and agreement for 37 links and for 460 ‘non-links’. A further 55 links were resolved by consensus (total of 92 (37+55) hypothesized BCT-MoA links). Full data on 1456 possible links was incorporated into the online interactive Theory and Technique Tool (url link removed for anonymity peer-review).Conclusions: This triangulation of two distinct sources of evidence provides guidance on how BCTs may affect the mechanisms that change behavior and is available as a resource for behavior change intervention designers, researchers and theorists, supporting intervention design, research synthesis, and collaborative research</p>

Content validity of measures of theoretical constructs in health psychology: Discriminant content validity is needed

“…If measures lack content validity but are otherwise psychometrically sound, then they may lead to misidentification of determinants of the target mood, behaviour, or symptom. Recent work has identified behaviour change techniques that are appropriate for targeting key theoretical constructs that act as mechanisms of action to determine change in the target behaviour (Carey et al ., ; Connell et al ., ; Johnston et al ., ). Clearly, success in making use of such evidence depends on valid labelling of the theoretical construct and this process may be derailed by misleading classification of measures.…”

“…If measures lack content validity but are otherwise psychometrically sound, then they may lead to misidentification of determinants of the target mood, behaviour, or symptom. Recent work has identified behaviour change techniques that are appropriate for targeting key theoretical constructs that act as mechanisms of action to determine change in the target behaviour Connell et al, 2018;Johnston et al, 2018).…”

The development of a theory informed behaviour change intervention to improve adherence to dietary and physical activity treatment guidelines in individuals with familial hypercholesterolaemia (FH)

“…Secondly, the BCTs for each identified intervention function were selected using links proposed and suggested for use in the original BCW guidance [42]. This was conducted prior to becoming aware of the mapping work which is currently being undertaken to further understand and define the links between BCTs and theoretical constructs [54][55][56]. Any future research should use the newly available Theory and Techniques tool (https://theoryandtechniquetool.humanbehaviourchange.…”

Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus

“…The three-step approach [17]. Findings from these two studies have been triangulated to highlight links between BCTs and mechanisms of action [34]. Links identified between BCTs and the 14 domains of the theoretical domains framework in the Theories and Techniques project have been compared to those identified in the current study and are presented in Supplementary File 5.…”

“…A limitation of this study is the use of earlier versions of the BCT taxonomy to an 11domain framework [13] and the most recent 14 domain TDF [28] which was conducted before the researchers were aware of the mapping working conducted by the Theory and Techniques project [17,18,34]. The Theory and Techniques project represents substantial progress in identifying hypothesized links between BCTs and mechanisms of action.…”