Identifying change processes in group-based health behaviour-change interventions: development of the mechanisms of action in group-based interventions (MAGI) framework

Borek, Aleksandra; Abraham, Charles; Greaves, Colin; Gillison, Fiona; Tarrant, Mark; Morgan‐Trimmer, Sarah; McCabe, Rose; Smith, Jane

doi:10.1080/17437199.2019.1625282

Cited by 128 publications

(100 citation statements)

References 66 publications

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“…As several clinical interventions building on social identity mechanism have already been implemented (e.g., Borek et al, 2019; Cruyws, Haslam, Dingle, Jetten, Haslam, Dingle, Haslam, & Jetten, 2014; Cruwys, Haslam, Fox & McMahon, 2015), we encourage clinicians and health professionals to apply a broader view of social identification when planning such interventions, accounting for the multi‐level nature of this psychological construct. Hence, group‐level processes, individual‐level processes as well as their interaction should be captured in interventions and treatments.…”

Section: Practical Implicationsmentioning

confidence: 99%

The how and the when of the social cure: A conceptual model of group‐ and individual‐level mechanisms linking social identity to health and well‐being

Häusser

Junker

Dick

2020

Euro J Social Psych

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In this article, we aim at theoretical specification and integration of mechanisms proposed within the Social Identity Approach to Health and Well‐being. We differentiate group‐level and individual‐level effects of shared social identity by distinguishing three different aspects: individual identification, group identification, and individually perceived group identification. We discuss specific group‐level mechanisms (i.e., mutual social support and collective self‐efficacy) and individual level‐mechanisms (i.e., attribution and appraisal processes regarding stressors and resources) for each of the three aspects. A core conclusion is that the positive effects of shared social identity on health and well‐being crucially depend on its close relationship with social support, and that although social support is an interindividual phenomenon, it is intraindividual mechanisms—attribution and appraisal—that shape the psychological partnership between social identity and social support. Therefore, we put special emphasis on cross‐level interactions between group‐ and individual‐level mechanisms, which have been widely neglected in earlier research.

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Section: Practical Implicationsmentioning

confidence: 99%

The how and the when of the social cure: A conceptual model of group‐ and individual‐level mechanisms linking social identity to health and well‐being

Häusser

Junker

Dick

2020

Euro J Social Psych

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“…Similarly, studies of group-based chronic disease self-management programmes showed that groups helped enhance selfefficacy for using self-management and coping strategies by providing opportunities for sharing experiences, social comparisons, and support (Abraham & Gardner, 2009;Barlow, Bancroft, & Turner, 2005;Rogers, Gately, Kennedy, & Sanders, 2009). Yet, the potential benefits of group support may not always be maximized by group facilitators in such interventions (Borek et al, 2019;Hughes et al, 2018). Yet, the potential benefits of group support may not always be maximized by group facilitators in such interventions (Borek et al, 2019;Hughes et al, 2018).…”

Section: Design Qualitativementioning

confidence: 99%

“…Research has also shown that developing a shared social identity is important in promoting health and engagement with group interventions (Tarrant, Hagger, & Farrow, 2012;Tarrant et al, 2017). Yet, the potential benefits of group support may not always be maximized by group facilitators in such interventions (Borek et al, 2019;Hughes et al, 2018). Previous studies have explored participants' experiences of health interventions in general.…”

mentioning

confidence: 99%

‘We're all in the same boat’: A qualitative study on how groups work in a diabetes prevention and management programme

Borek

Abraham

Greaves

et al. 2019

British J Health Psychol

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What is already known on this subject?Many health interventions, including programmes to help prevent or manage diabetes and facilitate weight loss, are delivered in groups. Such group-based behaviour-change interventions are often effective in facilitating psychological and behaviour change. There is considerable research and theory on individual change processes and techniques, but less is known about which change processes and techniques facilitate behaviour change in group settings. What does this study add?This study contributes to our understanding of how participating in group-based health programmes may enhance or impede individual behaviour change. It identified individual (intrapersonal) and group (interpersonal, facilitated through group interaction) change processes that were valued by group participants. The findings also show how these change processes may be affected by the group context. A diagram summarizes the identified themes helping to understand interactions between these key processes occurring in groups.The study offers an insight into participants' views on, and experiences of, attending a group-based diabetes prevention and management programme. Thus, it helps better understand how the intervention might have helped them (or not) and what processes may have influenced intervention outcomes. Key practical recommendations for designing and delivering group-based behaviour-change interventions are presented, which may be used to improve future group-based health interventions.

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“…Group interventions can present opportunities for costs savings by treating more than one person at the same time. In addition, advocates of group interventions have proposed mechanisms of action that are important for behaviour change that arise from being in a group that are not present in individual therapies, such as inter-personal change processes, universalisation, social comparison, social learning and modelling [6,7,9,10]. The role of group process and dynamics in these mechanisms is contested, with some believing that these mechanisms of action can be triggered by individual-therapist interaction [11] and others proposing that the group aspect is an essential part of the intervention [12].…”

Section: Group Interventions In Healthcarementioning

confidence: 99%

Challenges in the design, planning and implementation of trials evaluating group interventions

Biggs

Hind

Gossage-Worrall

et al. 2020

Trials

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Background: Group interventions are interventions delivered to groups of people rather than to individuals and are used in healthcare for mental health recovery, behaviour change, peer support, self-management and/or health education. Evaluating group interventions in randomised controlled trials (RCTs) presents trialists with a set of practical problems, which are not present in RCTs of one-to-one interventions and which may not be immediately obvious. Methods: Case-based approach summarising Sheffield trials unit's experience in the design and implementation of five group interventions. We reviewed participant recruitment and attrition, facilitator training and attrition, attendance at the group sessions, group size and fidelity aspects across five RCTs. Results: Median recruitment across the five trials was 3.2 (range 1.7-21.0) participants per site per month. Group intervention trials involve a delay in starting the intervention for some participants, until sufficient numbers are available to start a group. There was no evidence that the timing of consent, relative to randomisation, affected post-randomisation attrition which was a matter of concern for all trial teams. Group facilitator attrition was common in studies where facilitators were employed by the health system rather than the by the grant holder and led to the early closure of one trial; research sites responded by training 'back-up' and new facilitators. Trials specified that participants had to attend a median of 62.5% (range 16.7%-80%) of sessions, in order to receive a 'therapeutic dose'; a median of 76.7% (range 42.9%-97.8%) received a therapeutic dose. Across the five trials, 75.3% of all sessions went ahead without the pre-specified ideal group size. A variety of methods were used to assess the fidelity of group interventions at a group and individual level across the five trials. Conclusion: This is the first paper to provide an empirical basis for planning group intervention trials. Investigators should expect delays/difficulties in recruiting groups of the optimal size, plan for both facilitator and participant attrition, and consider how group attendance and group size affects treatment fidelity.

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Identifying change processes in group-based health behaviour-change interventions: development of the mechanisms of action in group-based interventions (MAGI) framework

Cited by 128 publications

References 66 publications

The how and the when of the social cure: A conceptual model of group‐ and individual‐level mechanisms linking social identity to health and well‐being

The how and the when of the social cure: A conceptual model of group‐ and individual‐level mechanisms linking social identity to health and well‐being

‘We're all in the same boat’: A qualitative study on how groups work in a diabetes prevention and management programme

Challenges in the design, planning and implementation of trials evaluating group interventions

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