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Published in: Translational Behavioral Medicine 2/2016

01-06-2016 | Essay

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

Authors: Deborah F. Tate, PhD, Leslie A. Lytle, PhD, Nancy E. Sherwood, PhD, Debra Haire-Joshu, PhD, Donna Matheson, PhD, Shirley M. Moore, PhD, RN, FAAN, Catherine M. Loria, PhD, MS, MA, FAHA, Charlotte Pratt, PhD, RD, FAHA, Dianne S. Ward, EdD, Steven H. Belle, PhD, MScHyg, Susan Michie, PhD

Published in: Translational Behavioral Medicine | Issue 2/2016

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Abstract

Deconstructing interventions into the specific techniques that are used to change behavior represents a new frontier in behavioral intervention research. This paper considers opportunities and challenges in employing the Behavior Change Techniques Taxonomy (BCTTv1) developed by Michie and colleagues, to code the behavior change techniques (BCTs) across multiple interventions addressing obesity and capture dose received at the technique level. Numerous advantages were recognized for using a shared framework for intervention description. Coding interventions at levels of the social ecological framework beyond the individual level, separate coding for behavior change initiation vs. maintenance, fidelity of BCT delivery, accounting for BCTs mode of delivery, and tailoring BCTs, present both challenges and opportunities. Deconstructing interventions and identifying the dose required to positively impact health-related outcomes could enable important gains in intervention science.
Literature
1.
go back to reference Carr AB, Ebbert J. Interventions for tobacco cessation in the dental setting. Cochrane Database Syst Rev. 2012; 6: CD005084.PubMedPubMedCentral Carr AB, Ebbert J. Interventions for tobacco cessation in the dental setting. Cochrane Database Syst Rev. 2012; 6: CD005084.PubMedPubMedCentral
2.
go back to reference Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev. 2011; 5: CD002834.PubMed Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev. 2011; 5: CD002834.PubMed
3.
go back to reference Rice VH, Hartmann-Boyce J, Stead LF. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2013; 8: Cd001188.PubMed Rice VH, Hartmann-Boyce J, Stead LF. Nursing interventions for smoking cessation. Cochrane Database Syst Rev. 2013; 8: Cd001188.PubMed
4.
go back to reference Excellence, N.I.o.H.a.C. Behaviour change at population, community and individual levels (Public Health Guidance 6). 2007. Excellence, N.I.o.H.a.C. Behaviour change at population, community and individual levels (Public Health Guidance 6). 2007.
5.
go back to reference Excellence, N.I.o.H.a.C. Behaviour change: individual approaches (Public Health Guidance 49). 2014. Excellence, N.I.o.H.a.C. Behaviour change: individual approaches (Public Health Guidance 49). 2014.
6.
go back to reference Diabetes Prevention Program Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002; 25(12): 2165-2171.CrossRef Diabetes Prevention Program Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002; 25(12): 2165-2171.CrossRef
7.
go back to reference Lemmens V et al. Effectiveness of smoking cessation interventions among adults: a systematic review of reviews. Eur J Cancer Prev. 2008; 17(6): 535-544.CrossRefPubMed Lemmens V et al. Effectiveness of smoking cessation interventions among adults: a systematic review of reviews. Eur J Cancer Prev. 2008; 17(6): 535-544.CrossRefPubMed
8.
go back to reference Booth HP et al. Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis. Fam Pract. 2014; 31(6): 643-653.CrossRefPubMedPubMedCentral Booth HP et al. Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis. Fam Pract. 2014; 31(6): 643-653.CrossRefPubMedPubMedCentral
9.
go back to reference Brown T et al. Systematic review of long-term lifestyle interventions to prevent weight gain and morbidity in adults. Obes Rev. 2009; 10(6): 627-638.CrossRefPubMed Brown T et al. Systematic review of long-term lifestyle interventions to prevent weight gain and morbidity in adults. Obes Rev. 2009; 10(6): 627-638.CrossRefPubMed
10.
go back to reference Hutchesson MJ, et al. eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis. Obes Rev. 2015. Hutchesson MJ, et al. eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis. Obes Rev. 2015.
11.
go back to reference Lin JS et al. Behavioral counseling to promote a healthy lifestyle in persons with cardiovascular risk factors: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014; 161(8): 568-578.CrossRefPubMed Lin JS et al. Behavioral counseling to promote a healthy lifestyle in persons with cardiovascular risk factors: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014; 161(8): 568-578.CrossRefPubMed
12.
go back to reference Safron M et al. Effects of school-based interventions targeting obesity-related behaviors and body weight change: a systematic umbrella review. Behav Med. 2011; 37(1): 15-25.CrossRefPubMed Safron M et al. Effects of school-based interventions targeting obesity-related behaviors and body weight change: a systematic umbrella review. Behav Med. 2011; 37(1): 15-25.CrossRefPubMed
13.
go back to reference Schwingshackl L, Dias S, Hoffmann G. Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network meta-analysis. Syst Rev. 2014; 3: 130.CrossRefPubMedPubMedCentral Schwingshackl L, Dias S, Hoffmann G. Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network meta-analysis. Syst Rev. 2014; 3: 130.CrossRefPubMedPubMedCentral
14.
go back to reference Terranova CO et al. Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. 2015; 17(4): 371-378.CrossRefPubMed Terranova CO et al. Effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes Obes Metab. 2015; 17(4): 371-378.CrossRefPubMed
15.
go back to reference Glasgow RE et al. National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012; 102(7): 1274-1281.CrossRefPubMedPubMedCentral Glasgow RE et al. National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012; 102(7): 1274-1281.CrossRefPubMedPubMedCentral
16.
go back to reference Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. London: Silverback Publishing; 2014. Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. London: Silverback Publishing; 2014.
17.
go back to reference Glanz K, Rimer BK, Viswanath K. Health behavior and health e: theory, research, and practice. 4th ed. San Francisco: Jossey-Bass; 2008. Glanz K, Rimer BK, Viswanath K. Health behavior and health e: theory, research, and practice. 4th ed. San Francisco: Jossey-Bass; 2008.
18.
go back to reference Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996; 10(4): 282-298.CrossRefPubMed Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996; 10(4): 282-298.CrossRefPubMed
19.
go back to reference Pearson TA et al. Dissecting the “black box” of community intervention: lessons from community-wide cardiovascular disease prevention programs in the US and Sweden. Scand J Public Health Suppl. 2001; 56: 69-78.PubMed Pearson TA et al. Dissecting the “black box” of community intervention: lessons from community-wide cardiovascular disease prevention programs in the US and Sweden. Scand J Public Health Suppl. 2001; 56: 69-78.PubMed
20.
go back to reference Levesque L et al. Unpacking the black box: a deconstruction of the programming approach and physical activity interventions implemented in the Kahnawake Schools Diabetes Prevention Project. Health Promot Pract. 2005; 6(1): 64-71.CrossRefPubMed Levesque L et al. Unpacking the black box: a deconstruction of the programming approach and physical activity interventions implemented in the Kahnawake Schools Diabetes Prevention Project. Health Promot Pract. 2005; 6(1): 64-71.CrossRefPubMed
22.
go back to reference Belle SH, S.J., Cella D, Foltz J, Loria C, Murray D, Thom E, Arteaga S, Czajkowski S, Pratt C, Overview of the Obesity Intervention Taxonomy and Pooled Analysis Working Group. 2015. Belle SH, S.J., Cella D, Foltz J, Loria C, Murray D, Thom E, Arteaga S, Czajkowski S, Pratt C, Overview of the Obesity Intervention Taxonomy and Pooled Analysis Working Group. 2015.
23.
go back to reference Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010; 31: 399-418.CrossRefPubMed Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health. 2010; 31: 399-418.CrossRefPubMed
24.
go back to reference Craig P et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. Int J Nurs Stud. 2013; 50(5): 587-592.CrossRefPubMed Craig P et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. Int J Nurs Stud. 2013; 50(5): 587-592.CrossRefPubMed
27.
go back to reference Bartholomew K, Parcel G, Kok G, Gottlieb N. Intervention mapping: developing theory and evidence-based health education programs. Mountain View, CA: Mayfield; 2001. Bartholomew K, Parcel G, Kok G, Gottlieb N. Intervention mapping: developing theory and evidence-based health education programs. Mountain View, CA: Mayfield; 2001.
28.
go back to reference Perry C. Creating health behavior change: how to develop community-wide programs for youth. Thousand Oaks, CA: Sage Publications; 1999. Perry C. Creating health behavior change: how to develop community-wide programs for youth. Thousand Oaks, CA: Sage Publications; 1999.
29.
go back to reference Baranowski T, Anderson C, Carmack C. Mediating variable framework in physical activity interventions. How are we doing? How might we do better? Am J Prev Med. 1998; 15(4): 266-297.CrossRefPubMed Baranowski T, Anderson C, Carmack C. Mediating variable framework in physical activity interventions. How are we doing? How might we do better? Am J Prev Med. 1998; 15(4): 266-297.CrossRefPubMed
30.
go back to reference Michie S, Prestwich A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010; 29(1): 1-8.CrossRefPubMed Michie S, Prestwich A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010; 29(1): 1-8.CrossRefPubMed
31.
go back to reference Michie S et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011; 26(11): 1479-1498.CrossRefPubMed Michie S et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011; 26(11): 1479-1498.CrossRefPubMed
32.
go back to reference Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008; 27(3): 379-387.CrossRefPubMed Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008; 27(3): 379-387.CrossRefPubMed
33.
go back to reference Michie S et al. 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. 2013; 46(1): 81-95.CrossRefPubMed Michie S et al. 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. 2013; 46(1): 81-95.CrossRefPubMed
34.
go back to reference Prestwich A et al. Does theory influence the effectiveness of health behavior interventions? Meta-analysis. Health Psychol. 2014; 33(5): 465-474.CrossRefPubMed Prestwich A et al. Does theory influence the effectiveness of health behavior interventions? Meta-analysis. Health Psychol. 2014; 33(5): 465-474.CrossRefPubMed
35.
go back to reference Davis, R. et al. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol Rev. 2014; 1–22. Davis, R. et al. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol Rev. 2014; 1–22.
36.
go back to reference Begg C et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996; 276(8): 637-639.CrossRefPubMed Begg C et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996; 276(8): 637-639.CrossRefPubMed
37.
go back to reference Hoffmann TC et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014; 348: g1687.CrossRefPubMed Hoffmann TC et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014; 348: g1687.CrossRefPubMed
39.
go back to reference Schulz R et al. Introduction to the special section on Resources for Enhancing Alzheimer’s Caregiver Health (REACH). Psychol Aging. 2003; 18(3): 357-360.CrossRefPubMed Schulz R et al. Introduction to the special section on Resources for Enhancing Alzheimer’s Caregiver Health (REACH). Psychol Aging. 2003; 18(3): 357-360.CrossRefPubMed
40.
go back to reference Michie S et al. Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocol. Implement Sci. 2011; 6: 10.CrossRefPubMedPubMedCentral Michie S et al. Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocol. Implement Sci. 2011; 6: 10.CrossRefPubMedPubMedCentral
41.
go back to reference Bangdiwala SI et al. Statistical methods for designing and assessing the effectiveness of community-based interventions with small numbers. Int J Inj Control Saf Promot. 2012; 19(3): 242-248.CrossRef Bangdiwala SI et al. Statistical methods for designing and assessing the effectiveness of community-based interventions with small numbers. Int J Inj Control Saf Promot. 2012; 19(3): 242-248.CrossRef
43.
go back to reference Saaty T, V.L. Decision making in economic, political, social and technological environments with the Analytic Hierarchy Process. Vol. II. 1994: RWS Publications. Saaty T, V.L. Decision making in economic, political, social and technological environments with the Analytic Hierarchy Process. Vol. II. 1994: RWS Publications.
44.
go back to reference Czaja SJ et al. A methodology for describing and decomposing complex psychosocial and behavioral interventions. Psychol Aging. 2003; 18(3): 385-395.CrossRefPubMed Czaja SJ et al. A methodology for describing and decomposing complex psychosocial and behavioral interventions. Psychol Aging. 2003; 18(3): 385-395.CrossRefPubMed
45.
go back to reference Belle SH et al. Using a new taxonomy to combine the uncombinable: integrating results across diverse interventions. Psychol Aging. 2003; 18(3): 396-405.CrossRefPubMedPubMedCentral Belle SH et al. Using a new taxonomy to combine the uncombinable: integrating results across diverse interventions. Psychol Aging. 2003; 18(3): 396-405.CrossRefPubMedPubMedCentral
46.
go back to reference Belle SH et al. Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial. Ann Intern Med. 2006; 145(10): 727-738.CrossRefPubMedPubMedCentral Belle SH et al. Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial. Ann Intern Med. 2006; 145(10): 727-738.CrossRefPubMedPubMedCentral
47.
go back to reference Lytle LA et al. The EARLY trials: a consortium of studies targeting weight control in young adults. Trans Behav Med. 2014; 4(3): 304-313.CrossRef Lytle LA et al. The EARLY trials: a consortium of studies targeting weight control in young adults. Trans Behav Med. 2014; 4(3): 304-313.CrossRef
48.
go back to reference Rothman AJ. Toward a theory-based analysis of behavioral maintenance. Health Psychol. 2000; 19(1 Suppl): 64-69.CrossRefPubMed Rothman AJ. Toward a theory-based analysis of behavioral maintenance. Health Psychol. 2000; 19(1 Suppl): 64-69.CrossRefPubMed
49.
go back to reference Borrelli B. The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials. J Public Health Dent. 2011; 71(Suppl 1): S52-S63.CrossRefPubMedCentral Borrelli B. The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials. J Public Health Dent. 2011; 71(Suppl 1): S52-S63.CrossRefPubMedCentral
50.
go back to reference Lorencatto F et al. A method for assessing fidelity of delivery of telephone behavioral support for smoking cessation. J Consult Clin Psychol. 2014; 82(3): 482-491.CrossRefPubMed Lorencatto F et al. A method for assessing fidelity of delivery of telephone behavioral support for smoking cessation. J Consult Clin Psychol. 2014; 82(3): 482-491.CrossRefPubMed
51.
go back to reference Hardeman W et al. Fidelity of delivery of a physical activity intervention: predictors and consequences. Psychol Health. 2008; 23(1): 11-24.CrossRefPubMed Hardeman W et al. Fidelity of delivery of a physical activity intervention: predictors and consequences. Psychol Health. 2008; 23(1): 11-24.CrossRefPubMed
52.
go back to reference Michie S et al. Investigating theoretical explanations for behaviour change: the case study of ProActive. Psychol Health. 2008; 23(1): 25-39.CrossRefPubMed Michie S et al. Investigating theoretical explanations for behaviour change: the case study of ProActive. Psychol Health. 2008; 23(1): 25-39.CrossRefPubMed
53.
go back to reference Noar SM et al. Tailored health communication to change lifestyle behaviors. Am J Lifestyle Med. 2011; 5(2): 112-122.CrossRef Noar SM et al. Tailored health communication to change lifestyle behaviors. Am J Lifestyle Med. 2011; 5(2): 112-122.CrossRef
Metadata
Title
Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions
Authors
Deborah F. Tate, PhD
Leslie A. Lytle, PhD
Nancy E. Sherwood, PhD
Debra Haire-Joshu, PhD
Donna Matheson, PhD
Shirley M. Moore, PhD, RN, FAAN
Catherine M. Loria, PhD, MS, MA, FAHA
Charlotte Pratt, PhD, RD, FAHA
Dianne S. Ward, EdD
Steven H. Belle, PhD, MScHyg
Susan Michie, PhD
Publication date
01-06-2016
Publisher
Springer US
Published in
Translational Behavioral Medicine / Issue 2/2016
Print ISSN: 1869-6716
Electronic ISSN: 1613-9860
DOI
https://doi.org/10.1007/s13142-015-0369-1

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