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Michie, Susan, Caroline E. Wood, Marie Johnston, Charles Abraham, Jill J. Francis, and Wendy Hardeman. "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)." Health Technology Assessment 19, no. 99 (November 2015): 1–188. http://dx.doi.org/10.3310/hta19990.
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BackgroundMeeting 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 Rev2012;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 participantsFour hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs.Development of the taxonomyinvolved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts;hierarchical structureof the list was developed using inductive ‘bottom-up’ and theory-driven ‘top-down’ open-sort procedures (n = 36);trainingin use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) wasevaluatedby changes in intercoder reliability and validity (agreement with expert consensus);evaluatingthe taxonomy for coding interventions was assessed by reliability (intercoder; test–retest) and validity (n = 40 trained coders); andevaluatingthe taxonomy for writing descriptions was assessed by reliability (intercoder; test–retest) and by experimentally testing its value (n = 190).ResultsNinety-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 (bothp < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (bothp < 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.ConclusionsThe 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.FundingThis project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care.
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Niedermann Schneider, K., U. Vogt, and A. K. Rausch Osthoff. "POS1559-HPR PHYSIOTHERAPISTS MAKE LIMITED USE OF BEHAVIOUR CHANGE TECHNIQUES DURING PHYSICAL ACTIVITY COUNSELLING FOR PEOPLE WITH AXIAL SPONDYLOARTHRITIS." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1125–26. http://dx.doi.org/10.1136/annrheumdis-2022-eular.4453.
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BackgroundThe 2018 EULAR recommendations for physical activity (PA) in people with inflammatory arthritis and osteoarthritis state that PA in generally recommended dose is effective, safe and feasible (1). Based on the recommendations, the Ankylosing Spondylitis Association of Switzerland (SVMB) developed a concept for their exercise groups, consisting of guidance on exercising, regular fitness assessments and individual PA counselling by the group-leading physical therapist (PT). The use of behaviour change techniques (BCTs) during PA counselling ought to support counselees’ adherence to individual, unsupervised exercising.ObjectivesTo assess the BCTs used by the PTs during their PA counselling sessions with the members of their axSpA exercise groups.MethodsAn observational cross-sectional study was performed with the first cohort of PTs (n=16) who applied the new concept and provided PA counselling, and their group members who agreed to participate. All first counselling sessions with an individual with axSpA were audiotaped, transcribed and analysed using a coding manual for BCTs (2). The manual includes 38 BCTs across the determinants ‘knowledge’ (2 BCTs), ‘awareness’ (8 BCTs), ‘social influence’ (3 BCTs), ‘attitude’ (4 BCTs)’, ‘self-efficacy’ (6 BCTs), ‘intention (6 BCTs)’, ‘action control’ (2 BCTs), ‘facilitation’ (2 BCTs), ‘maintenance’ (5 BCTs). Two raters familiar with BCTs identified the BCTs used by the PTs. They repeatedly discussed and agreed about their classifications of PTs’ phrasings to BCTs in an iterative process to achieve consistency over all counselling sessions. A BCT could be used several times within one counselling session.ResultsA total of 12 PTs (75%) who counselled 41 people with axSpA participated. All 41 PA counselling sessions, lasting between 30-55 minutes were analysed. Overall, 15 out of the 38 BCTs were identified. Across each determinant (with its number of BCTs), the most and least frequently used BCTs were as follows: 1) determinant ‘knowledge’ (1 of 2 BCTs used): ‘provide general information’ (469 times by 12 PTs); 2) ‘awareness’ (3 of 8 BCTs used): reflective listening and ‘self-monitoring of behaviour’ (328x by 12 PTs and 39x by 9 PTs respectively); 3) ‘social influence’: none of 3 BCTs used; 4) ‘attitude’ (1 of 4 BCTs used): persuasive communication (184x by 11 PTs); 5) ‘self-efficacy’ (3 of 6 BCTs used): verbal persuasion and guided practice (77x by 11 PTs and 3x by 3 PTs respectively); 6) ‘intention’ (4 of 6 BCTs used): general intention formation and develop training schedule (250x by 12 PTs and 18x by 5 PTs respectively); 7) ‘action control’ (1 of 2 BCTs used): use of cues (199x by 12 PTs), 8) ‘facilitation’: none (of 2) BCTs used; 9) ‘maintenance’ (2 of 5 BCTs used): continuous professional support and individualize regimen (137x by 12 PTs and 70x by 10 PTs respectively).ConclusionThe study identified that PTs used only a limited number of BCTs. BCTs considered less effective such as providing information were widely used, whereas BCTs that are considered effective, such as specific aims or coping with barriers were much less or not at all used. This study provides an insight in real clinical practice and may help to develop counselling training for PTs. There is a need to translate theoretical BCTs into effective measures that are easy to use in clinical practice.References[1]Rausch Osthoff A-K et al. 2018 EULAR recommendations for physical activity. Ann Rheum Dis 2018;77:1251–1260.[2]De Bruin M. et al. Coding manual for behavioral change techniques. Maastricht University, 2007.AcknowledgementsWe thank all participants for their collaborationDisclosure of InterestsNone declared
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Bourne, Jessica E., Elena Ivanova, Heather L. Gainforth, and Mary E. Jung. "Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus." Translational Behavioral Medicine 10, no. 3 (February 4, 2019): 705–15. http://dx.doi.org/10.1093/tbm/ibz008.
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Abstract Behavior change techniques (BCTs) are used to target theoretical mechanisms of action predicted to bring about behavior change. Reporting BCTs and connecting them to mechanisms of action is critical to understanding intervention processes of change. This article identifies the BCTs associated with an exercise intervention for individuals at risk of type 2 diabetes and determines the extent to which these BCTs target associated mechanisms of action. BCTs were mapped onto social cognitive theory (SCT) and the theoretical domains framework (TDF) using published literature identifying links between BCTs and SCT/TDF and expert consensus. Two coders then used the 93-item BCT taxonomy (BCTTv1) to independently code BCTs within the intervention. The BCTs used in the current intervention enabled identification of the theoretical mechanisms of action targeted in the intervention. More than 70% of the intervention content incorporated at least one BCT. More than 50% of the BCTs used targeted SCT constructs and more than 70% of BCTs used targeted at least one of the 14 TDF domains. Five BCTs did not map onto either SCT or TDF. This research provides a systematic method of linking BCTs to mechanisms of action. This process increases the transparency of intervention content and identification of the mechanisms of action targeted in the current intervention. Reporting interventions in this manner will enable the most potent mechanisms of actions associated with long-term behavior change to be identified and utilized in future work. Trial Registration: ClinicalTrials.gov # NCT02164474. Registered on June 12, 2014.
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Priesterroth, Lilli, Jennifer Grammes, Kimberly Holtz, Anna Reinwarth, and Thomas Kubiak. "Gamification and Behavior Change Techniques in Diabetes Self-Management Apps." Journal of Diabetes Science and Technology 13, no. 5 (February 14, 2019): 954–58. http://dx.doi.org/10.1177/1932296818822998.
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Background: Diabetes management apps may have positive effects on diabetes self-management. It remains unclear, however, which app features are particularly effective and encourage sustained app usage. Behavior change techniques (BCTs) and gamification are promising approaches to improve user engagement. However, little is known about the frequency BCTs and gamification techniques (GTs) are actually used. This app review aims to provide an overview of BCTs and GTs in current diabetes management apps. Methods: Google’s Play Store was searched for applications using a broad search strategy (keyword: “diabetes”). We limited our research to freely available apps. A total of 56 apps matched the inclusion criteria and were reviewed in terms of the features they offer to support self-management. We used a taxonomy comprising 29 BCTs and 17 GTs to evaluate the applications. Two independent raters tested and evaluated each app. Results: Interrater agreement was high (ICC = .75 for BCTs; ICC = .90 for GTs). An average of 7.4 BCTs (SD = 3.1) and an average of 1.4 out of 17 GTs (SD = 1.6) were implemented in each app. Five out of 29 BCTs accounted for 55.8% of the BCTs identified in total. The GT most often identified was “feedback” and accounted for 50% of the GTs. Conclusions: The potential of BCTs and GTs in diabetes management apps has not been fully exploited yet. Only very restricted sets of BCTs and gamification features were implemented. Systematic research on the efficacy of specific BCTs and GTs is needed to provide further guidance for app design.
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Dunn, Emily E., Heather L. Gainforth, and Jennifer E. Robertson-Wilson. "Behavior change techniques in mobile applications for sedentary behavior." DIGITAL HEALTH 4 (January 2018): 205520761878579. http://dx.doi.org/10.1177/2055207618785798.
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Objective Mobile applications (apps) are increasingly being utilized in health behavior change interventions. To determine the presence of underlying behavior change mechanisms, apps for physical activity have been coded for behavior change techniques (BCTs). However, apps for sedentary behavior have yet to be assessed for BCTs. Thus, the purpose of the present study was to review apps designed to decrease sedentary time and determine the presence of BCTs. Methods Systematic searches of the iTunes App and Google Play stores were completed using keyword searches. Two reviewers independently coded free ( n = 36) and paid ( n = 14) app descriptions using a taxonomy of 93 BCTs (December 2016–January 2017). A subsample ( n = 4) of free apps were trialed for one week by the reviewers and coded for the presence of BCTs (February 2017). Results In the free and paid app descriptions, only 10 of 93 BCTs were present with a mean of 2.42 BCTs (range 0–6) per app. The BCTs coded most frequently were “prompts/cues” ( n = 43), “information about health consequences” ( n = 31), and “self-monitoring of behavior” ( n = 17). For the four free apps that were trialed, three additional BCTs were coded that were not coded in the descriptions: “graded tasks,” “focus on past successes,” and “behavior substitution.” Conclusions These sedentary behavior apps have fewer BCTs compared with physical activity apps and traditional (i.e., non-app) physical activity and healthy eating interventions. The present study sheds light on the behavior change potential of sedentary behavior apps and provides practical insight about coding for BCTs in apps.
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Yu, Tao, Xingwen Sun, Yan You, Jie Chen, Jun-mei Wang, Shuo Wang, Ning Lin, Buqing Liang, and Jizong Zhao. "Symptomatic large or giant capillary telangiectasias: management and outcome in 5 cases." Journal of Neurosurgery 125, no. 1 (July 2016): 160–66. http://dx.doi.org/10.3171/2015.5.jns142805.
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Brain capillary telangiectasias (BCTs) are usually small and benign with a predilection in the pons and basal ganglion. Reports of large and symptomatic BCTs are rare. Large BCTs have a much higher risk of causing uncontrolled bleeding and severe neurological defects, and they can be fatal if left untreated. Therefore, large BCTs should be managed with special caution. Because of the lack of reports, diagnosis of large BCTs has been difficult. Strategies of management are undefined for large or giant BCTs. The current study presents 5 cases of giant and large BCTs. To the authors’ knowledge, this is the largest series of this disease ever reported. Radiological findings, histopathological characteristics, clinical presentations, and surgical management were analyzed in 5 symptomatic, unusually large BCTs (mean diameter 5.06 cm, range 1.8–8 cm). Four patients presented with focal or generalized seizures, and 1 patient presented with transient vision loss attributed to the lesions. Gross-total resection of the lesion was achieved in all patients. After surgery, the 4 patients with seizures were symptom free for follow-up periods varying from more than 1 to 5 years with no additional neurological deficits. The unique location, radiological characteristics, and clinical course suggest that giant BCTs could be a different entity from small BCTs. Surgery might be a good option for treatment of patients with intractable neurological symptoms, especially in those with surgically accessible locations. Complete removal would be anticipated to provide relief of the symptoms without causing new neurological deficits.
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Marques, Marta M., Alison J. Wright, Elizabeth Corker, Marie Johnston, Robert West, Janna Hastings, Lisa Zhang, and Susan Michie. "The Behaviour Change Technique Ontology: Transforming the Behaviour Change Technique Taxonomy v1." Wellcome Open Research 8 (July 17, 2023): 308. http://dx.doi.org/10.12688/wellcomeopenres.19363.1.
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Background: The Behaviour Change Technique Taxonomy v1 (BCTTv1) specifies the potentially active content of behaviour change interventions. Evaluation of BCTTv1 showed the need to extend it into a formal ontology, improve its labels and definitions, add BCTs and subdivide existing BCTs. We aimed to develop a Behaviour Change Technique Ontology (BCTO) that would meet these needs. Methods: The BCTO was developed by: (1) collating and synthesising feedback from multiple sources; (2) extracting information from published studies and classification systems; (3) multiple iterations of reviewing and refining entities, and their labels, definitions and relationships; (4) refining the ontology via expert stakeholder review of its comprehensiveness and clarity; (5) testing whether researchers could reliably apply the ontology to identify BCTs in intervention reports; and (6) making it available online and creating a machine-readable version. Results: Initially there were 282 proposed changes to BCTTv1. Following first-round review, 19 BCTs were split into two or more BCTs, 27 new BCTs were added and 26 BCTs were moved into a different group, giving 161 BCTs hierarchically organised into 12 logically defined higher-level groups in up to five hierarchical levels. Following expert stakeholder review, the refined ontology had 247 BCTs hierarchically organised into 20 higher-level groups. Independent annotations of intervention evaluation reports by researchers familiar and unfamiliar with the ontology resulted in good levels of inter-rater reliability (0.82 and 0.79, respectively). Following revision informed by this exercise, 34 BCTs were added, resulting in a final version of the BCTO containing 281 BCTs organised into 20 higher-level groups over five hierarchical levels. Discussion: The BCT Ontology provides a standard terminology and comprehensive classification system for the content of behaviour change interventions that can be reliably used to describe interventions.
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Chandrasekaran, Baskaran, Poornima P. Kundapur, and Chythra R. Rao. "Are free workplace health promotion apps adequately mapped with behavior change theories, techniques and desired features? A content analysis." Translational Behavioral Medicine 11, no. 8 (May 17, 2021): 1507–16. http://dx.doi.org/10.1093/tbm/ibab042.
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Abstract Free smartphone applications that aim to promote physical activity or reduce sedentary behavior at workplaces were questioned for its content such as technical features, behavior change techniques (BCT) and security concerns. To evaluate systematically whether smartphone apps are mapped adequately with BCTs and security concerns. Free apps in Google Play store were searched and coded for BCTs systematically in July 2020. Two reviewers independently coded apps that aimed to promote physical activity (n = 18) and reduce sedentary behavior (n = 16) using a taxonomy of 26 BCTs. BCTs, features and security concerns among apps promoting physical activity and reducing sedentary behavior were analyzed. While the features (social support, gamification, or rewards) help increase physical activity and decrease sedentary behavior, the apps do not typically include the above features. Further, the apps were based on an average of 13 (4–21) BCTs. The BCTs coded most frequently were “self-monitoring” (100%), “general encouragement” (97%), and “goal setting” (n = 94%). No significant relation between user rating and BCTs was found in the apps. Majority of the free apps that aimed to increase physical activity or reduce sedentary behavior at workplaces were not adequately based on BCTs and lacked essential features facilitating long term behavior compliance at workplaces. Hence, there is a need to develop newer applications mapped adequately with BCTs, involving the collaborative work of behavioral scientists, app developers and policymakers. Clinical Trial Registry of India CTRI/2020/03/024138.
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Connell, Lauren E., Rachel N. Carey, Marijn de Bruin, Alexander J. Rothman, Marie Johnston, Michael P. Kelly, and Susan Michie. "Links Between Behavior Change Techniques and Mechanisms of Action: An Expert Consensus Study." Annals of Behavioral Medicine 53, no. 8 (November 19, 2018): 708–20. http://dx.doi.org/10.1093/abm/kay082.
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Abstract Background Understanding the mechanisms through which behavior change techniques (BCTs) can modify behavior is important for the development and evaluation of effective behavioral interventions. To advance the field, we require a shared knowledge of the mechanisms of action (MoAs) through which BCTs may operate when influencing behavior. Purpose To elicit expert consensus on links between BCTs and MoAs. Methods In a modified Nominal Group Technique study, 105 international behavior change experts rated, discussed, and rerated links between 61 frequently used BCTs and 26 MoAs. The criterion for consensus was that at least 80 per cent of experts reached agreement about a link. Heat maps were used to present the data relating to all possible links. Results Of 1,586 possible links (61 BCTs × 26 MoAs), 51 of 61 (83.6 per cent) BCTs had a definite link to one or more MoAs (mean [SD] = 1.44 [0.96], range = 1–4), and 20 of 26 (76.9 per cent) MoAs had a definite link to one or more BCTs (mean [SD] = 3.27 [2.91], range = 9). Ninety (5.7 per cent) were identified as “definite” links, 464 (29.2 per cent) as “definitely not” links, and 1,032 (65.1 per cent) as “possible” or “unsure” links. No “definite” links were identified for 10 BCTs (e.g., “Action Planning” and “Behavioural Substitution”) and for six MoAs (e.g., “Needs” and “Optimism”). Conclusions The matrix of links between BCTs and MoAs provides a basis for those developing and synthesizing behavioral interventions. These links also provide a framework for specifying empirical tests in future studies.
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Murcia Pienkowski, Victor, Marzena Kucharczyk, Małgorzata Rydzanicz, Barbara Poszewiecka, Katarzyna Pachota, Marlena Młynek, Piotr Stawiński, et al. "Breakpoint Mapping of Symptomatic Balanced Translocations Links the EPHA6, KLF13 and UBR3 Genes to Novel Disease Phenotype." Journal of Clinical Medicine 9, no. 5 (April 25, 2020): 1245. http://dx.doi.org/10.3390/jcm9051245.
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De novo balanced chromosomal aberrations (BCAs), such as reciprocal translocations and inversions, are genomic aberrations that, in approximately 25% of cases, affect the human phenotype. Delineation of the exact structure of BCAs may provide a precise diagnosis and/or point to new disease loci. We report on six patients with de novo balanced chromosomal translocations (BCTs) and one patient with a de novo inversion, in whom we mapped breakpoints to a resolution of 1 bp, using shallow whole-genome mate pair sequencing. In all seven cases, a disruption of at least one gene was found. In two patients, the phenotypic impact of the disrupted genes is well known (NFIA, ATP7A). In five patients, the aberration damaged genes: PARD3, EPHA6, KLF13, STK24, UBR3, MLLT10 and TLE3, whose influence on the human phenotype is poorly understood. In particular, our results suggest novel candidate genes for retinal degeneration with anophthalmia (EPHA6), developmental delay with speech impairment (KLF13), and developmental delay with brain dysembryoplastic neuroepithelial tumor (UBR3). In conclusion, identification of the exact structure of symptomatic BCTs using next generation sequencing is a viable method for both diagnosis and finding novel disease candidate genes in humans.
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Senkowski, Valerie, Clara Gannon, and Paul Branscum. "Behavior Change Techniques Used in Theory of Planned Behavior Physical Activity Interventions Among Older Adults: A Systematic Review." Journal of Aging and Physical Activity 27, no. 5 (October 1, 2019): 746–54. http://dx.doi.org/10.1123/japa.2018-0103.
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Physical activity interventions among older adults vary widely in the techniques used to elicit behavior change. The purpose of this systematic review was to determine what behavior change techniques (BCTs) are used in interventions to increase physical activity among older adults using the theory of planned behavior and to make suggestions for BCTs that appear to be more effective. A database search identified peer-reviewed articles documenting interventions based on the theory of planned behavior. Seven articles (three randomized controlled trial, three quasi-experimental, and onen-of-1) from four countries (the United States, the United Kingdom, Australia, and the Netherlands) were included for review. Researchers independently coded BCTs using a hierarchical taxonomy of 93 BCTs. The most frequently coded BCTs includedGoal Setting(n = 5 studies),Action Planning(n = 5 studies), andCredible Source(n = 5 studies). Of the 93 BCTs in the taxonomy, only 26 were used, indicating potential opportunities to implement and evaluate less commonly used techniques in future studies.
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Hayman, Melanie, Kristie-Lee Alfrey, Summer Cannon, Stephanie Alley, Amanda L. Rebar, Susan Williams, Camille E. Short, et al. "Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis." JMIR mHealth and uHealth 9, no. 4 (April 7, 2021): e23649. http://dx.doi.org/10.2196/23649.
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Background Physical activity during pregnancy is associated with several health benefits for the mother and child. However, very few women participate in regular physical activity during pregnancy. eHealth platforms (internet and mobile apps) have become an important information source for pregnant women. Although the use of pregnancy-related apps has significantly increased among pregnant women, very little is known about their theoretical underpinnings, including their utilization of behavior change techniques (BCTs). This is despite research suggesting that inclusion of BCTs in eHealth interventions are important for promoting healthy behaviors, including physical activity. Objective The aim of this study was to conduct a systematic search and content analysis of app quality, features, and the presence of BCTs in apps designed to promote physical activity among pregnant women. Methods A systematic search in the Australian App Store and Google Play store using search terms relating to exercise and pregnancy was performed. App quality and features were assessed using the 19-item Mobile App Rating Scale (MARS), and a taxonomy of BCTs was used to determine the presence of BCTs (26 items). BCTs previously demonstrating efficacy in behavior changes during pregnancy were also identified from a literature review. Spearman correlations were used to investigate the relationships between app quality, app features, and number of BCTs identified. Results Nineteen exercise apps were deemed eligible for this review and they were accessed via Google Play (n=13) or App Store (n=6). The MARS overall quality scores indicated moderate app quality (mean 3.5 [SD 0.52]). Functionality was the highest scoring MARS domain (mean 4.2 [SD 0.5]), followed by aesthetics (mean 3.7 [SD 0.6]) and information quality (mean 3.16 [SD 0.42]). Subjective app quality (mean 2.54 [SD 0.64]) and likelihood for behavioral impact (mean 2.5 [SD 0.6]) were the lowest scoring MARS domains. All 19 apps were found to incorporate at least two BCTs (mean 4.74, SD 2.51; range 2-10). However, only 11 apps included BCTs that previously demonstrated efficacy for behavior change during pregnancy, the most common being provide opportunities for social comparison (n=8) and prompt self-monitoring of behavior (n=7). There was a significant positive correlation between the number of BCTs with engagement and aesthetics scores, but the number of BCTs was not significantly correlated with functionality, information quality, total MARS quality, or subjective quality. Conclusions Our findings showed that apps designed to promote physical activity among pregnant women were functional and aesthetically pleasing, with overall moderate quality. However, the incorporation of BCTs was low, with limited prevalence of BCTs previously demonstrating efficacy in behavior change during pregnancy. Future app development should identify and adopt factors that enhance and encourage user engagement, including the use of BCTs, especially those that have demonstrated efficacy for promoting physical activity behavior change among pregnant women.
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St Quinton, Tom, and Ben Morris. "Gambling Prevention Mobile Applications: Understanding the Inclusion and Use of Behaviour Change Techniques." Journal of Gambling Issues, no. 48 (September 23, 2021): 110–21. http://dx.doi.org/10.4309/jgi.2021.48.5.
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Online gambling is emerging as a significant health behaviour of concern at a population level. Mobile applications (apps) are a popular tool to target change in health behaviour. Behaviour change techniques (BCTs) can be included within such apps to change relevant psychological mechanisms along established pathways, yet the content of apps targeting gambling problems specifically is not currently known. The purpose of the review was to identify the BCTs included in gambling prevention apps. Apps were downloaded from the Apple App Store and Google Play Store in October 2020. Apps were included if they related to gambling problems, were freely downloadable, and available in English. Once downloaded, two researchers independently coded the apps in November 2020 using the behaviour change technique taxonomy version 1 (Michie et al., 2013). The screening led to forty apps meeting the inclusion criteria (12 Apple App Store, 28 Google Play). The analyses identified 32 BCTs (20 Apple apps, 28 Google Play apps), with apps including between 0 and 9 BCTs (mean = 2.82, median = 2). The BCTs included most frequently were “3.1. Social support (unspecified),” “2.3. Self-monitoring of behaviour,” and “7.4. Remove access to the reward.” The review provides important information on the BCTs used in apps developed to reduce gambling-related problems. A limited number of BCTs were adopted within apps. Developers of apps seeking to develop effective gambling reduction products should draw upon a greater variety of BCTs.
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Düking, Peter, Marie Tafler, Birgit Wallmann-Sperlich, Billy Sperlich, and Sonja Kleih. "Behavior Change Techniques in Wrist-Worn Wearables to Promote Physical Activity: Content Analysis." JMIR mHealth and uHealth 8, no. 11 (November 19, 2020): e20820. http://dx.doi.org/10.2196/20820.
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Background Decreasing levels of physical activity (PA) increase the incidences of noncommunicable diseases, obesity, and mortality. To counteract these developments, interventions aiming to increase PA are urgently needed. Mobile health (mHealth) solutions such as wearable sensors (wearables) may assist with an improvement in PA. Objective The aim of this study is to examine which behavior change techniques (BCTs) are incorporated in currently available commercial high-end wearables that target users’ PA behavior. Methods The BCTs incorporated in 5 different high-end wearables (Apple Watch Series 3, Garmin Vívoactive 3, Fitbit Versa, Xiaomi Amazfit Stratos 2, and Polar M600) were assessed by 2 researchers using the BCT Taxonomy version 1 (BCTTv1). Effectiveness of the incorporated BCTs in promoting PA behavior was assessed by a content analysis of the existing literature. Results The most common BCTs were goal setting (behavior), action planning, review behavior goal(s), discrepancy between current behavior and goal, feedback on behavior, self-monitoring of behavior, and biofeedback. Fitbit Versa, Garmin Vívoactive 3, Apple Watch Series 3, Polar M600, and Xiaomi Amazfit Stratos 2 incorporated 17, 16, 12, 11, and 11 BCTs, respectively, which are proven to effectively promote PA. Conclusions Wearables employ different numbers and combinations of BCTs, which might impact their effectiveness in improving PA. To promote PA by employing wearables, we encourage researchers to develop a taxonomy specifically designed to assess BCTs incorporated in wearables. We also encourage manufacturers to customize BCTs based on the targeted populations.
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Dale, Hannah, Bronagh Raftery, and Heather Locke. "Behaviour change and sexual health; SHARE programme evaluation." Health Education 114, no. 1 (December 20, 2013): 2–19. http://dx.doi.org/10.1108/he-12-2012-0056.
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Purpose – The purpose of this paper is to examine a national sexual health and relationships education (SHARE) educational package for behaviour change techniques (BCTs) utilised in order to make recommendations for further improvements. Design/methodology/approach – Using BCTs taxonomy (BCT V1), two coders independently examined the 22 session plans within SHARE for their utilisation of BCTs. All three authors then examined the results, and agreed on any discrepancies. Findings – The SHARE package utilises only a small range of BCTs detailed in BCT V1. SHARE makes use of a range of techniques which may impact on the distal factors that influence sexual risk taking, such as self-esteem and building confidence to say “no” to sex. Practical implications – SHARE – and perhaps other sexual health education programmes – may need to draw on more BCTs, particularly those supported by evidence, in order to effectively reduce risky sexual behaviours among young people. Programmes may also benefit from including broader elements around pleasure, self-examination and screening behaviour. Originality/value – Sexual health packages rarely encounter such scrutiny, particularly being examined in relation to the BCTs. The new and rigorous way of rating the SHARE package has enabled a range of recommendations relating to BCTs to be made both for improving the package and other sexual health education programmes.
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Scott, Claire, Mícheál de Barra, Marie Johnston, Marijn de Bruin, Neil Scott, Catriona Matheson, Christine Bond, and Margaret C. Watson. "Using the behaviour change technique taxonomy v1 (BCTTv1) to identify the active ingredients of pharmacist interventions to improve non-hospitalised patient health outcomes." BMJ Open 10, no. 9 (September 2020): e036500. http://dx.doi.org/10.1136/bmjopen-2019-036500.
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ObjectivesThe aim of this study was to identify which behaviour change techniques (BCTs) were present in intervention and control groups of randomised controlled trials (RCTs) included in a Cochrane systematic review.SettingThe RCTs included were conducted in community, primary and/or ambulatory-care settings.ParticipantsThe data set was derived from 86 RCTs from an interim update of the Cochrane review of the effectiveness of pharmacist services on non-hospitalised patient outcomes.Primary and secondary outcome measuresThe primary outcome was the identification of BCTs scheduled for delivery in intervention and control groups of the RCTs. The secondary outcome measure was to identify which BCTs are not being utilised in intervention and control groups of the RCTs.ResultsThe intervention and control groups included 31 and 12 BCTs, respectively. The number of identifiable BCTs/study ranged from 0 to 12 in the intervention groups (mean 3.01 (SD 2.4)) and 0 to 6 in the control groups (mean 0.38 (SD 0.84)). The most commonly identified BCTs in the intervention groups were: instruction on how to perform the behaviour (55%, n=47) (also the most common BCT in control groups); problem solving (29%, n=25); information about health consequences (24%, n=21); social support (practical) (24%, n=21); and social support (unspecified) (23%, n=20) (the second most common BCT in control groups). Thirteen trials had no identifiable BCTs in either group.ConclusionThe pharmacist interventions presented in this study did not use the full range of available BCTs. Furthermore, the reporting of BCTs was incomplete for both intervention and control groups, thereby limiting the utility and reproducibility of the interventions. Future interventions should be designed and reported using relevant taxonomies and checklists for example, BCT taxonomy and TIDieR (the template for intervention description and replication).
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Bohlen, Lauren Connell, Susan Michie, Marijn de Bruin, Alexander J. Rothman, Michael P. Kelly, Hilary N. K. Groarke, Rachel N. Carey, Joanna Hale, and Marie Johnston. "Do Combinations of Behavior Change Techniques That Occur Frequently in Interventions Reflect Underlying Theory?" Annals of Behavioral Medicine 54, no. 11 (September 22, 2020): 827–42. http://dx.doi.org/10.1093/abm/kaaa078.
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Abstract Background Behavioral interventions typically include multiple behavior change techniques (BCTs). The theory informing the selection of BCTs for an intervention may be stated explicitly or remain unreported, thus impeding the identification of links between theory and behavior change outcomes. Purpose This study aimed to identify groups of BCTs commonly occurring together in behavior change interventions and examine whether behavior change theories underlying these groups could be identified. Methods The study involved three phases: (a) a factor analysis to identify groups of co-occurring BCTs from 277 behavior change intervention reports; (b) examining expert consensus (n = 25) about links between BCT groups and behavioral theories; (c) a comparison of the expert-linked theories with theories explicitly mentioned by authors of the 277 intervention reports. Results Five groups of co-occurring BCTs (range: 3–13 BCTs per group) were identified through factor analysis. Experts agreed on five links (≥80% of experts), comprising three BCT groups and five behavior change theories. Four of the five BCT group–theory links agreed by experts were also stated by study authors in intervention reports using similar groups of BCTs. Conclusions It is possible to identify groups of BCTs frequently used together in interventions. Experts made shared inferences about behavior change theory underlying these BCT groups, suggesting that it may be possible to propose a theoretical basis for interventions where authors do not explicitly put forward a theory. These results advance our understanding of theory use in multicomponent interventions and build the evidence base for further understanding theory-based intervention development and evaluation.
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Lawrenson, John G., Ella Graham-Rowe, Fabiana Lorencatto, Stephen Rice, Catey Bunce, Jill J. Francis, Jennifer M. Burr, et al. "What works to increase attendance for diabetic retinopathy screening? An evidence synthesis and economic analysis." Health Technology Assessment 22, no. 29 (May 2018): 1–160. http://dx.doi.org/10.3310/hta22290.
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BackgroundDiabetic retinopathy screening (DRS) is effective but uptake is suboptimal.ObjectivesTo determine the effectiveness of quality improvement (QI) interventions for DRS attendance; describe the interventions in terms of QI components and behaviour change techniques (BCTs); identify theoretical determinants of attendance; investigate coherence between BCTs identified in interventions and determinants of attendance; and determine the cost-effectiveness of QI components and BCTs for improving DRS.Data sources and review methodsPhase 1 – systematic review of randomised controlled trials (RCTs) evaluating interventions to increase DRS attendance (The Cochrane Library, MEDLINE, EMBASE and trials registers to February 2017) and coding intervention content to classify QI components and BCTs. Phase 2 – review of studies reporting factors influencing attendance, coded to theoretical domains (MEDLINE, EMBASE, PsycINFO and sources of grey literature to March 2016). Phase 3 – mapping BCTs (phase 1) to theoretical domains (phase 2) and an economic evaluation to determine the cost-effectiveness of BCTs or QI components.ResultsPhase 1 – 7277 studies were screened, of which 66 RCTs were included in the review. Interventions were multifaceted and targeted patients, health-care professionals (HCPs) or health-care systems. Overall, interventions increased DRS attendance by 12% [risk difference (RD) 0.12, 95% confidence interval (CI) 0.10 to 0.14] compared with usual care, with substantial heterogeneity in effect size. Both DRS-targeted and general QI interventions were effective, particularly when baseline attendance levels were low. All commonly used QI components and BCTs were associated with significant improvements, particularly in those with poor attendance. Higher effect estimates were observed in subgroup analyses for the BCTs of ‘goal setting (outcome, i.e. consequences)’ (RD 0.26, 95% CI 0.16 to 0.36) and ‘feedback on outcomes (consequences) of behaviour’ (RD 0.22, 95% CI 0.15 to 0.29) in interventions targeting patients and of ‘restructuring the social environment’ (RD 0.19, 95% CI 0.12 to 0.26) and ‘credible source’ (RD 0.16, 95% CI 0.08 to 0.24) in interventions targeting HCPs. Phase 2 – 3457 studies were screened, of which 65 non-randomised studies were included in the review. The following theoretical domains were likely to influence attendance: ‘environmental context and resources’, ‘social influences’, ‘knowledge’, ‘memory, attention and decision processes’, ‘beliefs about consequences’ and ‘emotions’. Phase 3 – mapping identified that interventions included BCTs targeting important barriers to/enablers of DRS attendance. However, BCTs targeting emotional factors around DRS were under-represented. QI components were unlikely to be cost-effective whereas BCTs with a high probability (≥ 0.975) of being cost-effective at a societal willingness-to-pay threshold of £20,000 per QALY included ‘goal-setting (outcome)’, ‘feedback on outcomes of behaviour’, ‘social support’ and ‘information about health consequences’. Cost-effectiveness increased when DRS attendance was lower and with longer screening intervals.LimitationsQuality improvement/BCT coding was dependent on descriptions of intervention content in primary sources; methods for the identification of coherence of BCTs require improvement.ConclusionsRandomised controlled trial evidence indicates that QI interventions incorporating specific BCT components are associated with meaningful improvements in DRS attendance compared with usual care. Interventions generally used appropriate BCTs that target important barriers to screening attendance, with a high probability of being cost-effective. Research is needed to optimise BCTs or BCT combinations that seek to improve DRS attendance at an acceptable cost. BCTs targeting emotional factors represent a missed opportunity to improve attendance and should be tested in future studies.Study registrationThis study is registered as PROSPERO CRD42016044157 and PROSPERO CRD42016032990.FundingThe National Institute for Health Research Health Technology Assessment programme.
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Durand, Hannah, Jenny Mc Sharry, Oonagh Meade, Molly Byrne, Eanna Kenny, Kim L. Lavoie, and Gerard J. Molloy. "Content analysis of behaviour change techniques in government physical distancing communications for the reopening of schools during the COVID-19 pandemic in Ireland." HRB Open Research 4 (July 22, 2021): 78. http://dx.doi.org/10.12688/hrbopenres.13357.1.
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Background: Effective government communications and leadership are central to the management of pandemics. Behavioural science can offer important insight into the development of such communications strategies. The extent to which established behaviour-change science is reflected in current government messaging campaigns to promote adherence to physical distancing measures in the context of the coronavirus disease 2019 (COVID-19) pandemic is unclear. The current study aimed to describe the behaviour-change content of a set of government-issued poster communications for the reopening of schools in Ireland during the COVID-19 pandemic in September 2020. Methods: Posters targeting physical distancing behaviours in school settings were retrieved from the Government of Ireland website for analysis. Posters were independently coded for behaviour change techniques (BCTs) using the BCT Taxonomy Version 1, a hierarchically clustered taxonomy of 93 distinct BCTs across 16 groups. The Theories and Techniques tool was used to identify mechanisms of action (MoAs) linked to each of the identified BCTs. Eight posters were independently content-analysed by two members of the research team for BCTs and linked MoAs. Results: Eight unique BCTs from six unique groups were identified in at least one poster. These BCTs were linked with 11 unique MoAs through which behaviour change is theorised to occur. Several theoretically important groups of BCTs, such as Natural Consequences, Social Support, Shaping Knowledge, and Comparison of Behaviour, were underutilised or not included in any of the posters. Conclusion: Future poster communications could benefit from including additional BCTs from key groups, particularly Natural Consequences. This article provides proof-of-concept evidence for future evaluations of government public health communications for behaviour-change content using existing taxonomies and tools.
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Farquharson, Barbara, Purva Abhyankar, Karen Smith, Stephan U. Dombrowski, Shaun Treweek, Nadine Dougall, Brian Williams, and Marie Johnston. "Reducing delay in patients with acute coronary syndrome and other time-critical conditions: a systematic review to identify the behaviour change techniques associated with effective interventions." Open Heart 6, no. 1 (February 2019): e000975. http://dx.doi.org/10.1136/openhrt-2018-000975.
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BackgroundTime to treatment in many conditions, particularly acute coronary syndrome, is critical to reducing mortality. Delay between onset of symptoms and treatment remains a worldwide problem. Reducing patient delay has been particularly challenging. Embedding behaviour change techniques (BCTs) within interventions might lead to shorter delay.ObjectiveTo identify which BCTs are associated with reductions in patient delay among people with symptoms or conditions where time to treatment is critical.MethodsThe data sources were Cochrane Library, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Study eligibility criteria include intervention evaluations (randomised controlled trials, controlled clinical trials and cohort studies) involving adults (aged >18 years) and including an outcome measure of patient delay up to August 2016. Study appraisal and synthesis methods include screening potential studies using a transparent, replicable process. Study characteristics, outcomes and BCTs were extracted from eligible studies.ResultsFrom 39 studies (200 538 participants), just over half (n=20) reported a significant reduction in delay. 19 BCTs were identified, plus 5 additional techniques, with a mean of 2 (SD=2.3) BCTs and 2 (SD=0.7) per intervention. No clear pattern between BCTs and effectiveness was found. In studies examining patient delay specifically, three of four studies that included two or more BCTs, in addition to the two most commonly used additional techniques, reported a significant reduction in delay.ConclusionsAround half of the interventions to reduce prehospital delay with time-critical symptoms report a significant reduction in delay time. It is not clear what differentiates effective from non-effective interventions, although in relation to patient delay particularly additional use of BCTs might be helpful.Trial registration numberCRD42014013106.
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Tang, Mei Yee, Debbie M. Smith, Jennifer Mc Sharry, Mark Hann, and David P. French. "Behavior Change Techniques Associated With Changes in Postintervention and Maintained Changes in Self-Efficacy For Physical Activity: A Systematic Review With Meta-analysis." Annals of Behavioral Medicine 53, no. 9 (December 9, 2018): 801–15. http://dx.doi.org/10.1093/abm/kay090.
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Abstract Background Self-efficacy is an important determinant of physical activity but it is unclear how best to increase self-efficacy for physical activity and to maintain these changes. Purpose This systematic review aimed to identify which specific behavior change techniques (BCTs), BCT clusters, and number of BCTs were associated with changes in postintervention and maintained changes in self-efficacy for physical activity across all adult populations. Methods A systematic search yielded 180 randomized trials (204 comparisons) which reported changes in self-efficacy. BCTs were coded using the BCT Taxonomy v1. Hierarchical cluster analysis explored the clustering of BCTs. Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect-size changes for self-efficacy. Results Small intervention effects were found for postintervention self-efficacy for physical activity (d = 0.26; 95% CI: [0.21, 0.31]; I2 = 75.8 per cent). “Information about social, environmental, and emotional consequences” was associated with higher effect sizes, whereas “social support (practical)” was associated with lower effect sizes. Small and nonsignificant effects were found for maintained changes in self-efficacy for physical activity (d = 0.08; CI: [−0.05, 0.21]; I2 = 83.8 per cent). Lack of meaningful clustering of BCTs was found. A significant positive relationship was found between number of BCTs and effect sizes for maintained changes in self-efficacy for physical activity. Conclusions There does not appear to be a single effective approach to change self-efficacy for physical activity in all adults: different approaches are required for different populations. Interventions with more BCTs seem more effective at maintaining changes in self-efficacy for physical activity.
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Bryant, Ashley Leak, Rachel Hirschey, Courtney Caiola, Ya-Ning Chan, Brenda Plassman, Bei Wu, Donald Bailey, and Ruth Anderson. "Refining an Oral Health Care Partner Intervention Using Behavior Change Techniques." Innovation in Aging 5, Supplement_1 (December 1, 2021): 413. http://dx.doi.org/10.1093/geroni/igab046.1599.
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Abstract Following a pilot, we refined an oral health carepartner intervention for individuals with mild dementia (IMD). In this intervention, we use behavior change techniques (BCTs) to foster changes by carepartners including using new oral-care techniques and developing skills for using cueing and communications approaches to support behavior changes by IMD (duration and frequency of toothbrushing and oral-hygiene skills); thus, improving plaque and gingival indices. We describe our approach to refining the intervention manual including a) completing the self-paced BCT taxonomy course, b) developing a coding schema, c) coding the original manual for evidence of BCTs, and d) refining the manual to improve use of BCTS in the refined intervention. Our results detail how BCTs can be applied to refine and improve interventions. This research demonstrates the value in using BCTs for interventions to address how carepartners and IMD can collaborate to improve oral hygiene care.
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Arroyo, Amber Carmen, and Matthew J. Zawadzki. "The Implementation of Behavior Change Techniques in mHealth Apps for Sleep: Systematic Review." JMIR mHealth and uHealth 10, no. 4 (April 4, 2022): e33527. http://dx.doi.org/10.2196/33527.
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Background Mobile health (mHealth) apps targeting health behaviors using behavior change techniques (BCTs) have been successful in promoting healthy behaviors; however, their efficacy with sleep is unclear. Some work has shown success in promoting sleep through mHealth, whereas there have been reports that sleep apps can be adverse and lead to unhealthy obsessions with achieving perfect sleep. Objective This study aims to report and describe the use of BCTs in mHealth apps for sleep with the following research questions: How many BCTs are used on average in sleep apps, and does this relate to their effectiveness on sleep outcomes? Are there specific BCTs used more or less often in sleep apps, and does this relate to their effectiveness on sleep outcomes? Does the effect of mHealth app interventions on sleep change when distinguishing between dimension and measurement of sleep? Methods We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to review articles on mHealth app interventions for sleep published between 2010 and 2020. Results A total of 12 studies met the eligibility criteria. Most studies reported positive sleep outcomes, and there were no negative effects reported. Sleep quality was the most common dimension of sleep targeted. Subjective measures of sleep were used across all apps, whereas objective measures were often assessed but rarely reported as part of results. The average number of BCTs used was 7.67 (SD 2.32; range 3-11) of 16. Of the 12 studies, the most commonly used BCTs were feedback and monitoring (n=11, 92%), shaping knowledge (n=11, 92%), goals and planning (n=10, 83%), and antecedents (n=10, 83%), whereas the least common were scheduled consequences (n=0, 0%), self-belief (n=0, 0%), and covert learning (n=0, 0%). Most apps used a similar set of BCTs that unfortunately did not allow us to distinguish which BCTs were present when studies reported more positive outcomes. Conclusions Our study describes the peer-reviewed literature on sleep apps and provides a foundation for further examination and optimization of BCTs used in mHealth apps for sleep. We found strong evidence that mHealth apps are effective in improving sleep, and the potential reasons for the lack of adverse sleep outcome reporting are discussed. We found evidence that the type of BCTs used in mHealth apps for sleep differed from other health outcomes, although more research is needed to understand how BCTs can be implemented effectively to improve sleep using mHealth and the mechanisms of action through which they are effective (eg, self-efficacy, social norms, and attitudes).
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Corker, Elizabeth, Marta Marques, Marie Johnston, Robert West, Janna Hastings, and Susan Michie. "Behaviour change techniques taxonomy v1: Feedback to inform the development of an ontology." Wellcome Open Research 7 (August 12, 2022): 211. http://dx.doi.org/10.12688/wellcomeopenres.18002.1.
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Background: To build cumulative evidence about what works in behaviour change interventions, efforts have been made to develop classification systems for specifying the content of interventions. The Behaviour Change Techniques (BCT) Taxonomy v1 (BCTTv1) is one of the most widely used classifications of behaviour change techniques across a variety of behaviours. The BCTTv1 was intentionally named version 1 to allow for further revisions to the taxonomy. This study aimed to gather data to inform the development of BCTTv1 into a more elaborated knowledge structure, an ontology. Methods: Feedback from users of BCTTv1 about limitations and proposed improvements was collected through the BCT website, a user survey, researchers and experts involved in the Human Behaviour Change Project, and a consultation. In addition, relevant published research reports and other classification systems of BCTs were analysed. These data were synthesised to produce recommendations to inform the development of an ontology of BCTs. Results: A total of 282 comments from six sources were reviewed and synthesised into four categories of suggestions: additional BCTs, amendments to labels and definitions of specific BCTs, amendments to the groupings, and general improvements. Feedback suggested some lack of clarity regarding understanding and identifying techniques from labels, definitions, and examples; distinctions and relations between BCTs; and knowing what they would look like in practice. Three recommendations resulted from this analysis: to review the label and definition of each BCT, the 16 groupings of BCTs, and the examples illustrating BCTs. Conclusions: This review of feedback about BCTTv1 identified the need to improve the precision and knowledge structure of the current taxonomy. A BCT ontology would enable the specification of relationships between BCTs, more precise definitions, and allow better interoperability with other ontologies. This ontology will be developed as part of the Human Behaviour Change Project.
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Corker, Elizabeth, Marta Marques, Marie Johnston, Robert West, Janna Hastings, and Susan Michie. "Behaviour change techniques taxonomy v1: Feedback to inform the development of an ontology." Wellcome Open Research 7 (January 20, 2023): 211. http://dx.doi.org/10.12688/wellcomeopenres.18002.2.
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Background: To build cumulative evidence about what works in behaviour change interventions, efforts have been made to develop classification systems for specifying the content of interventions. The Behaviour Change Techniques (BCT) Taxonomy v1 (BCTTv1) is one of the most widely used classifications of behaviour change techniques across a variety of behaviours. The BCTTv1 was intentionally named version 1 to allow for further revisions to the taxonomy. This study aimed to gather data to improve the BCTTv1 and provide recommendations for developing it into a more elaborated knowledge structure, an ontology. Methods: Feedback from users of BCTTv1 about limitations and proposed improvements was collected through the BCT website, user survey, researchers and experts involved in the Human Behaviour-Change Project, and a consultation. In addition, relevant published research reports and other classification systems of BCTs were analysed. These data were synthesised to produce recommendations to inform the development of an ontology of BCTs. Results: A total of 282 comments from six sources were reviewed and synthesised into four categories of suggestions: additional BCTs, amendments to labels and definitions of specific BCTs, amendments to the groupings, and general improvements. Feedback suggested some lack of clarity regarding understanding and identifying techniques from labels, definitions, and examples; distinctions and relations between BCTs; and knowing what they would look like in practice. Three recommendations to improve the BCTTv1 resulted from this analysis: to review the label and definition of each BCT, the 16 groupings of BCTs, and the examples illustrating BCTs. Conclusions : This review of feedback about BCTTv1 identified the need to improve the precision and knowledge structure of the current taxonomy. A BCT ontology would enable the specification of relationships between BCTs, more precise definitions, and allow better interoperability with other ontologies. This ontology will be developed as part of the Human Behaviour-Change Project.
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Yoong, Sze Lin, Alix Hall, Fiona Stacey, Nicole Nathan, Kathryn Reilly, Tessa Delaney, Rachel Sutherland, Rebecca Hodder, Sharon Straus, and Luke Wolfenden. "An exploratory analysis to identify behavior change techniques of implementation interventions associated with the implementation of healthy canteen policies." Translational Behavioral Medicine 11, no. 8 (May 5, 2021): 1606–16. http://dx.doi.org/10.1093/tbm/ibab036.
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Abstract Empirical studies to disentangle the effects of multicomponent implementation interventions are needed to inform the development of future interventions. This study aims to examine which behavior change techniques (BCTs) primarily targeting canteen manager are associated with school’s healthy canteen policy implementation. This is a secondary data analysis from three randomized controlled trials assessing the impact of a “high,” “medium,” and “low” intensity intervention primarily targeting canteen managers on school’s implementation of a healthy canteen policy. The policy required primary schools to remove all “red” (less healthy items) or “banned” (sugar sweetened beverages) items from regular sale and ensure that “green” (healthier items) dominated the menu (>50%). The delivery of BCTs were retrospectively coded. We undertook an elastic net regularized logistic regression with all BCTs in a single model. Five k-fold cross-validation elastic net models were conducted. The percentage of times each strategy remained across 1,000 replications was calculated. For no “red” or “banned” items (n = 162), the strongest BCTs were: problem solving, goal setting (behavior), and review behavior goals. These BCTs were identified in 100% of replications as a strong predictor in the cross-validation elastic net models. For the outcome relating to >50% “green” items, the BCTs problem solving, instruction on how to perform behavior and demonstration of behavior were the strongest predictors. Two strategies were identified in 100% of replications as a strong (i.e., problem solving) or weak predictor (i.e., feedback on behavior). This study identified unique BCTs associated with the implementation of a healthy canteen policy.
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Weikart, Christopher M., Adam P. Breeland, Matt S. Wills, and Martin E. Baltazar-Lopez. "Hybrid Blood Collection Tubes: Combining the Best Attributes of Glass and Plastic for Safety and Shelf life." SLAS TECHNOLOGY: Translating Life Sciences Innovation 25, no. 5 (May 19, 2020): 484–93. http://dx.doi.org/10.1177/2472630320915842.
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SiO2 Medical Products, Inc. developed hybrid blood collection tubes (BCTs) that combine the breakage resistance of plastic and a shelf life approaching that of glass. These blended attributes provide improved BCT safety and reliability for patients and clinical workers. A shelf life of at least 2 y with less than 10% draw volume variation was demonstrated on evacuated hybrid BCTs, which is approximately 7 times longer than standard polyethylene terephthalate (PET) BCTs. This translates into more consistent and reliable blood draw volumes over a longer shelf life. The moisture vapor barrier of hybrid BCTs is 5 times lower than that of PET BCTs, which significantly reduces preservative evaporation over their shelf life. As a result, the risk of preservative gelation and alteration to the blood-to-preservative ratio mix is practically eliminated. Cyclic olefin polymer (COP) exhibits superior impact resistance to breakage because of its high ductility and impact strength and is not influenced by defects and flaws as is glass. Although COP has a mechanical toughness comparable with that of PET, it maintains this over a wider range of temperatures (–70 to 121 °C). As a result, COP can tolerate steam sterilization and cold storage temperatures without mechanical fatigue, deformation, or breakage. Lastly, extreme centrifugation of water-filled BCTs did not impose breakage of any kind.
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Sayama, Christina M., Anne G. Osborn, Steven S. Chin, and William T. Couldwell. "Capillary telangiectasias: clinical, radiographic, and histopathological features." Journal of Neurosurgery 113, no. 4 (October 2010): 709–14. http://dx.doi.org/10.3171/2009.9.jns09282.
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Object Brain capillary telangiectasias (BCTs) are small, clinically benign, angiographically occult lesions that are usually incidental findings. Large capillary telangiectasias have not been reported previously as most BCTs are very small. Symptomatic BCTs are also rare, with few reports in the literature. The authors review the clinical manifestations, imaging, and histopathological characteristics of BCTs to further elucidate the diagnostic and clinical features of these vascular malformations. Methods The authors completed a retrospective radiological review of all cases of BCTs in the neuroradiology database at the University of Utah involving patients treated between January 1993 and December 2007. The MR imaging scans were reviewed, and the BCT was measured in 2 dimensions. They arbitrarily chose > 1 cm to define a large BCT as a majority of these lesions were smaller than that. The medical chart and the electronic database were used to gather each patient's clinical information. Results One hundred thirty patients were identified in the archived neuroradiology database of capillary telangiectasias. Cases involving 105 patients with definite capillary telangiectasias were reviewed, and from these, 7 patients were identified to have a large capillary telangiectasia measuring > 1 cm. Upon further review, 2 of these patients were identified as having symptoms likely related to their capillary telangiectasia. These 2 cases are reported in the article. No patients with smaller BCTs were found to have symptoms related to their lesion. Conclusions Brain capillary telangiectasias are small vascular malformations that rarely cause symptoms. They are often overlooked on imaging because of their clinically benign nature; however, they have been misdiagnosed as glial tumors in the past. Specific MR imaging sequences (T1-weighted postcontrast and gradient refocused echo) are valuable in aiding diagnosis, as histopathological diagnosis is often not possible. These cases highlight that BCTs can cause symptoms, a finding that may actually be related to the size of the lesion (28.6% of large BCTs in this series were symptomatic, whereas none of the small ones were).
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Simeon, Rosiane, Omar Dewidar, Jessica Trawin, Stephanie Duench, Heather Manson, Jordi Pardo Pardo, Jennifer Petkovic, et al. "Behavior Change Techniques Included in Reports of Social Media Interventions for Promoting Health Behaviors in Adults: Content Analysis Within a Systematic Review." Journal of Medical Internet Research 22, no. 6 (June 11, 2020): e16002. http://dx.doi.org/10.2196/16002.
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Background Social media are an increasingly commonly used platform for delivering health promotion interventions. Although recent research has focused on the effectiveness of social media interventions for health promotion, very little is known about the optimal content within such interventions, and the active ingredients to promote health behavior change using social media are not clear. Identifying which behavior change techniques (BCTs) are reported may help to clarify the content of interventions using a generalizable terminology that may facilitate future intervention development. Objective This study aimed to identify which BCTs are reported in social media interventions for promoting health behavior change in adults. Methods We included 71 studies conducted with adult participants (aged ≥18 years) and for which social media intervention was considered interactive in a Cochrane review of the effectiveness of such interventions. We developed a coding manual informed by the Behavior Change Technique Taxonomy version 1 (BCTTv1) to identify BCTs in the included studies. We identified BCTs in all study arms (including control) and described BCTs in the group and self-directed components of studies. We characterized the dose of delivery for each BCT by low and high intensity. We used descriptive analyses to characterize the reported BCTs. Results Our data consisted of 71 studies published from 2001 to 2017, mainly conducted in high-income countries (n=65). Most studies (n=31) used tailored, interactive websites to deliver the intervention; Facebook was the most used mainstream platform. In developing our coding manual, we adapted some BCTTv1 instructions to better capture unique nuances of how BCTs were operationalized in social media with respect to likes, retweets, smiles, congratulations, and badges. Social support (unspecified), instruction on how to perform the behavior, and credible source were most frequently identified BCTs in intervention arms of studies and group-delivery settings, whereas instruction on how to perform the behavior was most commonly applied in self-directed components of studies, control arms, and individual participant settings. Instruction on how to perform the behavior was also the most frequently reported BCT in both intervention and control arms simultaneously. Instruction on how to perform the behavior, social support (unspecified), self-monitoring of behavior, information about health consequences, and credible source were identified in the top 5 BCTs delivered with the highest intensity. Conclusions This study within a review provides a detailed description of the BCTs and their dose to promote behavior change in web-based, interactive social media interventions. Clarifying active ingredients in social media interventions and the intensity of their delivery may help to develop future interventions that can more clearly build upon the existing evidence.
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Muñoz-Mancisidor, Aranzazu, Ruben Martin-Payo, Xana Gonzalez-Mendez, and María Del Mar Fernández-Álvarez. "Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores." JMIR mHealth and uHealth 9, no. 11 (November 17, 2021): e27995. http://dx.doi.org/10.2196/27995.
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Background Women consult information in mobile apps (apps) during pregnancy, and even obstetrics specialists highlight that pregnancy is the ideal moment for the use of apps as consultation sources. However, the high number of apps designed for pregnancy requires a careful assessment to determine their suitability before recommendation. Objective The aim of this study is to identify the apps available in Spanish that can be recommended based on their content, behavior change techniques (BCTs), and quality as a complementary tool during pregnancy. Methods A systematic search on app stores to identify apps was performed in the Apple App Store and Google Play with the subject term “pregnancy.” The apps meeting the following criteria were chosen: pregnancy-related content, free, and available in Spanish. An app was excluded if it was classified as a game or entertainment and thus lacking an educational or health aim and if it did not target the population under study. The selected apps were downloaded, and their quality was assessed using the Mobile Application Rating Scale (MARS), with the BCTs included evaluated using the BCT taxonomy version 1 and its content. Results A total of 457 apps were identified, 25 of which were downloaded for assessment (5.6%). The median for objective and subjective quality was 2.94 (IQR 2.71-3.46) and 1.75 (IQR 1.25-2.25), respectively. Regarding content, the median of topics included in the apps was 23 (IQR 16-23), with weight gain, nutrition, fetal development, and physical activity being the most common. The median number of BCTs was 12 (IQR 0.5-3.5). The most frequently identified BCTs in the apps were “Self-Monitoring of Outcomes,” followed by “Goal Behavior” and “Instructions.” Statistically significant correlations were observed between objective quality and content (ρ=0.624; P=.001), subjective quality and content (ρ=0.638; P=.001), objective quality and BCTs (ρ=0.672; P<.001), subjective quality and BCTs (ρ=0.623; P<.001), and BCTs and content (ρ=0.580; P=.002). Conclusions The results of this study suggest that only a small percentage of free pregnancy apps available in Spanish should be recommended. The apps with the best MARS scores were those that addressed a higher number of topics and included a higher number of BCTs. Those with the best content and quality, and a higher number of BCTs included could be recommended by health professionals.
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Mazzoni, Anne-Sophie, Hannah L. Brooke, Sveinung Berntsen, Karin Nordin, and Ingrid Demmelmaier. "Exercise Adherence and Effect of Self-Regulatory Behavior Change Techniques in Patients Undergoing Curative Cancer Treatment: Secondary Analysis from the Phys-Can Randomized Controlled Trial." Integrative Cancer Therapies 19 (January 2020): 153473542094683. http://dx.doi.org/10.1177/1534735420946834.
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Introduction: Adherence to exercise interventions in patients with cancer is often poorly described. Further, it is unclear if self-regulatory behavior change techniques (BCTs) can improve exercise adherence in cancer populations. We aimed to (1) describe exercise adherence in terms of frequency, intensity, time, type (FITT-principles) and dropouts, and (2) determine the effect of specific self-regulatory BCTs on exercise adherence in patients participating in an exercise intervention during curative cancer treatment. Methods: This study was a secondary analysis using data from a Swedish multicentre RCT. In a 2×2 factorial design, 577 participants recently diagnosed with curable breast, colorectal or prostate cancer were randomized to 6 months of high (HI) or low-to-moderate intensity (LMI) exercise, with or without self-regulatory BCTs (e.g., goal-setting and self-monitoring). The exercise program included supervised group-based resistance training and home-based endurance training. Exercise adherence (performed training/prescribed training) was assessed using attendance records, training logs and heart rate monitors, and is presented descriptively. Linear regression and logistic regression were used to assess the effect of self-regulatory BCTs on each FITT-principle and dropout rates, according to intention-to-treat. Results: For resistance training (groups with vs without self-regulatory BCTs), participants attended on average 52% vs 53% of prescribed sessions, performed 79% vs 76% of prescribed intensity, and 80% vs 77% of prescribed time. They adhered to exercise type in 71% vs 68% of attended sessions. For endurance training (groups with vs without self-regulatory BCTs), participants performed on average 47% vs 51% of prescribed sessions, 57% vs 62% of prescribed intensity, and 71% vs 72% of prescribed time. They adhered to exercise type in 79% vs 78% of performed sessions. Dropout rates (groups with vs without self-regulatory BCTs) were 29% vs 28%. The regression analysis revealed no effect of the self-regulatory BCTs on exercise adherence. Conclusion: An exercise adherence rate ≥50% for each FITT-principle and dropout rates at ~30% can be expected among patients taking part in long-term exercise interventions, combining resistance and endurance training during curative cancer treatment. Our results indicate that self-regulatory BCTs do not improve exercise adherence in interventions that provide evidence-based support to all participants (e.g., supervised group sessions). Trial registration: NCT02473003
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Bartlett, Yvonne Kiera, Andrew Farmer, Rustam Rea, and David P. French. "Use of Brief Messages Based on Behavior Change Techniques to Encourage Medication Adherence in People With Type 2 Diabetes: Developmental Studies." Journal of Medical Internet Research 22, no. 5 (May 13, 2020): e15989. http://dx.doi.org/10.2196/15989.
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Background Brief messages are a promising way to improve adherence to medication for people with type 2 diabetes. However, it is often unclear how messages have been developed and their precise content, making it difficult to ascertain why certain messages are successful and some are not. Objective The goal of the research was to develop messages that have proven fidelity to specified evidence-derived behavior change techniques (BCTs) and are acceptable to people with type 2 diabetes. Methods Four studies were conducted: (1) a workshop (n=21) where behavioral change researchers and health care professionals developed messages based on specific BCTs or beliefs or concerns related to taking medication, (2) a focus group study with people with type 2 diabetes (n=23) to assess acceptability of the approach, (3) a survey to ascertain the acceptability of a subset of messages to people with type 2 diabetes (n=61) and, (4) a survey with behavior change researchers to assess the fidelity of a subset of messages to their intended BCT (n=18). Results In study 1, 371 messages based on 38 BCTs and beliefs/concerns were developed. Workshop participants rated BCTs to be relevant to medication adherence (mean 7.12/10 [SD 1.55]) and messages to have good fidelity (mean 7.42/10 [SD 1.19]). In study 2, the approach of providing medication adherence support through text messages was found to be acceptable. In study 3, mean acceptability of all BCTs was found to be above the midpoint (mean 3.49/5 [SD 0.26]). In study 4, mean fidelity for all BCTs was found to be above the midpoint (mean 7.61/10 [SD 1.38]). Conclusions A library of brief messages acceptable to people with type 2 diabetes and representative of specific evidence-derived BCTs was developed. This approach allowed brief messages to be developed with known content that can be used to test theory.
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Kleinert, Jens. "Psychosoziale Maßnahmen zur Sport- und Bewegungsförderung bei Menschen mit Übergewicht: Konzeptionelle Überlegungen und Übersicht zur Forschungslage." Adipositas - Ursachen, Folgeerkrankungen, Therapie 17, no. 01 (March 2023): 38–45. http://dx.doi.org/10.1055/a-1973-8838.
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ZusammenfassungMenschen mit Übergewicht oder Adipositas treiben weniger Sport und sind weniger aktiv als normalgewichtige Menschen. Ein Grund hierfür ist, dass diese Menschen schwerer zu Sport oder körperlicher Aktivität motiviert werden können als normalgewichtige Menschen, was an spezifischen psychischen und psychosozialen Problemen der Verhaltensregulation liegt. Diese Probleme hängen vor allem mit (Selbst-) Stigmatisierung, defizitärer Selbstwahrnehmung, Depression, Angststörungen und einer sozial kontrollierte Motivationslage der Menschen mit Übergewicht zusammen. Hieraus ergeben sich Verhaltensbarrieren, die durch volitionale und motivationale Ansatzstellen beseitigt oder verringert werden können. Hierzu dienen verhaltensmodifizierende Techniken (BCTs), die vor allem auf Handlungsziele, Handlungsplanung, Selbstregulation, Selbstreflexion und soziale Unterstützung ausgerichtet sind. Der positive Effekt vieler dieser BCTs für die Sport- und Bewegungsförderung von Menschen mit Übergewicht und Adipositas ist durch Reviews belegt. Wenig erforscht sind konkrete Wirkmechanismen dieser BCTs sowie Bedingungen, die den Effekt von BCTs hemmen oder fördern.
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Jagroep, Warsha, Jane M. Cramm, Semiha Denktaș, and Anna P. Nieboer. "Behaviour change interventions to promote health and well-being among older migrants: A systematic review." PLOS ONE 17, no. 6 (June 16, 2022): e0269778. http://dx.doi.org/10.1371/journal.pone.0269778.
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Background Whether behaviour change interventions are effective for the maintenance of older migrants’ health and well-being is uncertain. A systematic review was conducted to assess evidence for the capacity of behaviour change techniques (BCTs) to promote the health and well-being of older migrants. Methods Electronic databases (Cochrane CENTRAL, Embase, Ovid MEDLINE and Web of Science) were searched systematically to identify relevant randomised controlled trials, pre–post studies and quasi-experimental studies published before March 2021. Additional articles were identified through citation tracking. Studies examining BCTs used to promote the health and/or well-being of older migrants were eligible. Two independent reviewers used the Behaviour Change Technique Taxonomy version 1 to extract data on BCTs. Data on intervention functions (IFs) and cultural adaption strategies were also extracted. Intervention contents (BCTs, IFs, culture adaption strategies) were compared across effective and ineffective interventions according to health and well-being outcome clusters (anthropometrics, health behaviour, physical functioning, mental health and cognitive functioning, social functioning and generic health and well-being). Results Forty-three studies (23 randomised controlled trials, 13 pre–post studies and 7 quasi-experimental studies) reporting on 39 interventions met the inclusion criteria. Thirteen BCTs were identified as promising for at least one outcome cluster: goal-setting (behaviour), problem-solving, behavioural contract, self-monitoring of behaviour, social support (unspecified), instruction on how to perform the behaviour, information about health consequences, information about social and environmental consequences, demonstration of the behaviour, social comparison, behavioural practice/rehearsal, generalisation of a target behaviour and addition of objects to the environment. Three BCTs (instruction on how to perform the behaviour, demonstration of the behaviour, and social comparison) and two IFs (modelling and training) were identified as promising for all outcome clusters. Conclusions Thirteen distinct BCTs are promising for use in future interventions to optimise health and well-being among older migrants. Future research should focus on the effectiveness of these BCTs (combinations) in various contexts and among different subgroups of older migrants, as well as the mechanisms through which they act. Given the scarcity of interventions in which cultural adaption has been taken into account, future behavioural change interventions should consider cultural appropriateness for various older migrant (sub)groups. Trial registration PROSPERO CRD42018112859.
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Aguiar, Maria, Maria Trujillo, Deisy Chaves, Roberto Álvarez, and Gorka Epelde. "mHealth Apps Using Behavior Change Techniques to Self-report Data: Systematic Review." JMIR mHealth and uHealth 10, no. 9 (September 9, 2022): e33247. http://dx.doi.org/10.2196/33247.
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Background The popularization of mobile health (mHealth) apps for public health or medical care purposes has transformed human life substantially, improving lifestyle behaviors and chronic condition management. Objective This review aimed to identify behavior change techniques (BCTs) commonly used in mHealth, assess their effectiveness based on the evidence reported in interventions and reviews to highlight the most appropriate techniques to design an optimal strategy to improve adherence to data reporting, and provide recommendations for future interventions and research. Methods We performed a systematic review of studies published between 2010 and 2021 in relevant scientific databases to identify and analyze mHealth interventions using BCTs that evaluated their effectiveness in terms of user adherence. Search terms included a mix of general (eg, data, information, and adherence), computer science (eg, mHealth and BCTs), and medicine (eg, personalized medicine) terms. Results This systematic review included 24 studies and revealed that the most frequently used BCTs in the studies were feedback and monitoring (n=20), goals and planning (n=14), associations (n=14), shaping knowledge (n=12), and personalization (n=7). However, we found mixed effectiveness of the techniques in mHealth outcomes, having more effective than ineffective outcomes in the evaluation of apps implementing techniques from the feedback and monitoring, goals and planning, associations, and personalization categories, but we could not infer causality with the results and suggest that there is still a need to improve the use of these and many common BCTs for better outcomes. Conclusions Personalization, associations, and goals and planning techniques were the most used BCTs in effective trials regarding adherence to mHealth apps. However, they are not necessarily the most effective since there are studies that use these techniques and do not report significant results in the proposed objectives; there is a notable overlap of BCTs within implemented app components, suggesting a need to better understand best practices for applying (a combination of) such techniques and to obtain details on the specific BCTs used in mHealth interventions. Future research should focus on studies with longer follow-up periods to determine the effectiveness of mHealth interventions on behavior change to overcome the limited evidence in the current literature, which has mostly small-sized and single-arm experiments with a short follow-up period.
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Ramirez, Elisangela. "Bayesian confirmation, connexivism and an unkindness of ravens." Australasian Journal of Logic 15, no. 2 (July 5, 2018): 449. http://dx.doi.org/10.26686/ajl.v15i2.4868.
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Bayesian confirmation theories (BCTs) might be the best standing theories of confirmation to date, but they are certainly not paradox-free. Here I recognize that BCTs’ appeal mainly comes from the fact that they capture some of our intuitions about confirmation better than those the- ories that came before them and that the superiority of BCTs is suffi- ciently justified by those advantages. Instead, I will focus on Sylvan and Nola’s claim that it is desirable that our best theory of confirmation be as paradox-free as possible. For this reason, I will show that, as they respond to different interests, the project of the BCTs is not incompatible with Sylvan and Nola’s project of a paradox-free confirmation logic. In fact, it will turn out that, provided we are ready to embrace some degree of non-classicality, both projects complement each other nicely.
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Michie, Susan, Caroline Free, and Robert West. "Characterising the ‘Txt2Stop’ Smoking Cessation Text Messaging Intervention in Terms of Behaviour Change Techniques." Journal of Smoking Cessation 7, no. 1 (June 2012): 55–60. http://dx.doi.org/10.1017/jsc.2012.12.
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The ‘Txt2Stop’ SMS messaging programme has been found to double smokers’ chances of stopping. It is important to characterise the content of this information in terms of specific behaviour change techniques (BCTs) for the purpose of future development. This study aimed to (i) extend a proven system for coding BCTs to text messaging and (ii) characterise Txt2Stop using this system. A taxonomy previously used to specify BCTs in face-to-face behavioural support for smoking cessation was adapted for the Txt2Stop messages and inter-rater reliability for the adapted system assessed. The system was then applied to all the messages in the Txt2Stop programme to determine its profile in terms of BCTs used. The text message taxonomy comprised 34 BCTs. Inter-rater reliability was moderate, reaching a ceiling of 61% for the core program messages with all discrepancies readily resolved. Of 899 texts delivering BCTs, 218 aimed to maintain motivation to remain abstinent, 870 to enhance self-regulatory capacity or skills, 39 to promote use of adjuvant behaviours such as using stop-smoking medication, 552 to maintain engagement with the intervention and 24 were general communication techniques. The content of Txt2Stop focuses on helping smokers with self-regulation and maintaining engagement with the intervention. The intervention focuses to a lesser extent on boosting motivation to remain abstinent; little attention is given to promoting effective use of adjuvant behaviours such as use of nicotine replacement therapy. As new interventions of this kind are developed it will be possible to compare their effectiveness and relate this to standardised descriptions of their content using this system.
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Bjelobaba, Goran, Marija Paunovic, Ana Savic, Hana Stefanovic, Jelena Doganjic, and Zivanka Miladinovic Bogavac. "Blockchain Technologies and Digitalization in Function of Student Work Evaluation." Sustainability 14, no. 9 (April 28, 2022): 5333. http://dx.doi.org/10.3390/su14095333.
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Following COVID-19, new accreditation standards include digitization, entrepreneurship, social inclusion and the circular economy. Blockchain can help to simplify difficult accreditation processes that ensure worldwide teaching, learning, practice and business communication excellence. The paper proposes a Collaborative Learning and Student Work Evaluation (CLSWE) model based on blockchain technologies (BCTs) encompassing selected concepts from the scientific research peer-review process. BCTs are used to develop a safe platform for storing and exchanging data about students’ projects and evaluations. The CLSWE model offers the possibility of improving cooperation between higher-education institutions and companies that seek the “employable skills” of proactive students. Before implementing the CLSWE model, a questionnaire was conducted to survey lecturers about their attitudes related to the potential application of BCTs. The results of the surveys are encouraging and reveal a desire and willingness to introduce BCTs in education. A project scheme with the main functionalities of the model and a description of the roles of the prominent participants was designed. A platform with a database created in the MySQL language for the testing model was built. This research also contributes to higher education literature in terms of the sustainability of the education process and collaborative learning with BCTs.
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Moafa, Ibtisam, Ciska Hoving, Bart van den Borne, and Mohammed Jafer. "Identifying Behavior Change Techniques Used in Tobacco Cessation Interventions by Oral Health Professionals and Their Relation to Intervention Effects—A Review of the Scientific Literature." International Journal of Environmental Research and Public Health 18, no. 14 (July 13, 2021): 7481. http://dx.doi.org/10.3390/ijerph18147481.
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This review aimed to identify the behavioral change techniques (BCTs) used in behavioral interventions for tobacco cessation at dental practices in relation to their effect on tobacco use. Six scientific databases were searched for behavior change interventions for tobacco cessation and were coded using the BCT taxonomy of behavioral support for smoking cessation (BCTTsm). Fifteen interventions were identified, and data related to intervention characteristics were abstracted. Sixteen BCTs were identified, mainly related to increased motivation and teaching regulatory skills. Goal setting was the most commonly used BCT. Ten out of fifteen interventions effectively impacted tobacco cessation outcomes (OR = 2 to 5.25). Effective interventions more frequently included goal setting, written materials, readiness to quit and ability assessment, tobacco-use assessment, self-efficacy boost, listing reasons for quitting, action planning and environment restructuring. Other BCTs were not clearly associated with an increased effect. Among the behavioral interventions, certain techniques were associated with successful tobacco quitting. Tobacco cessation interventions in a dental setting appear to benefit from using BCTs that increase motivation and teach regulatory skills. The identified BCTs in this review could provide a source to better inform researchers and dentists about the active ingredients in behavior change interventions for tobacco cessation in a dental setting.
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Brown, Tracey J., Sarah Gentry, Linda Bauld, Elaine M. Boyle, Paul Clarke, Wendy Hardeman, Richard Holland, et al. "Systematic Review of Behaviour Change Techniques within Interventions to Reduce Environmental Tobacco Smoke Exposure for Children." International Journal of Environmental Research and Public Health 17, no. 21 (October 22, 2020): 7731. http://dx.doi.org/10.3390/ijerph17217731.
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Children are particularly vulnerable to environmental tobacco smoke (ETS). There is no routine support to reduce ETS in the home. We systematically reviewed trials to reduce ETS in children in order to identify intervention characteristics and behaviour change techniques (BCTs) to inform future interventions. We searched Medline, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Central Register of Controlled Trials, and Cochrane Tobacco Addiction Group Specialised Register from January 2017 to June 2020 to update an existing systematic review. We included controlled trials to reduce parent/caregiver smoking or ETS in children <12 years that demonstrated a statistically significant benefit, in comparison to less intensive interventions or usual care. We extracted trial characteristics; and BCTs using Behaviour Change Technique Taxonomy v1. We defined “promising” BCTs as those present in at least 25% of effective interventions. Data synthesis was narrative. We included 16 trials, of which eight were at low risk of bias. All trials used counselling in combination with self-help or other supporting materials. We identified 13 “promising” BCTs centred on education, setting goals and planning, or support to reach goals. Interventions to reduce ETS in children should incorporate effective BCTs and consider counselling and self-help as mechanisms of delivery.
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Stoyneva, Iva, Kisha Coa, Jillian Pugatch, Amy Sanders, Mary Schwarz, and Heather Cole-Lewis. "SmokefreeTXT Behaviour Change Technique Analysis." Journal of Smoking Cessation 12, no. 4 (December 20, 2016): 231–43. http://dx.doi.org/10.1017/jsc.2016.24.
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Mobile text-messaging smoking cessation interventions have demonstrated their efficacy in increasing cessation rates. These interventions tend to be multifaceted and there is a need to specify their building blocks. The purpose of this study was to use the Behavioural Change Techniques Taxonomy V1 (BCTTv1) to systematically analyse the behaviour change techniques present in the SmokefreeTXT (SFTXT) adult programme. The entire SFTXT library was coded using the BCTTv1. Frequencies were calculated to assess the presence of BCT groups and unique BCTs in the entire programme. The mix of BCTs was also examined by programme week and during periods of high user dropout. Of the 16 groups of behavioural techniques, 14 were present in SFTXT. Of the 93 distinct BCTs, 41 were present in the full SFTXT message library. The most prevalent BCT groups were Feedback and Monitoring, Natural Consequences, Social Support, and Shaping Knowledge. There were differences in the mix of BCTs across the duration of the intervention. The results will enable us to test how changes in the use of specific BCTs and their frequency of use over time, impact (1) engagement with the programme (particularly during the days with high dropout rates), and (2) smoking cessation outcomes over time.
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Jraissati, Yasmina, and Igor Douven. "Delving Deeper Into Color Space." i-Perception 9, no. 4 (July 2018): 204166951879206. http://dx.doi.org/10.1177/2041669518792062.
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So far, color-naming studies have relied on a rather limited set of color stimuli. Most importantly, stimuli have been largely limited to highly saturated colors. Because of this, little is known about how people categorize less saturated colors and, more generally, about the structure of color categories as they extend across all dimensions of color space. This article presents the results from a large Internet-based color-naming study that involved color stimuli ranging across all available chroma levels in Munsell space. These results help answer such questions as how English speakers name a more complex color set, whether English speakers use so-called basic color terms (BCTs) more frequently for more saturated colors, how they use non-BCTs in comparison with BCTs, whether non-BCTs are highly consensual in less saturated parts of the solid, how deep inside color space basic color categories extend, or how they behave on the chroma dimension.
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Rodrigues, Angela M., Angela Wearn, Anna Haste, Verity Mallion, Matthew Evison, Freya Howle, and Catherine Haighton. "Understanding the implementation strategy of a secondary care tobacco addiction treatment pathway (the CURE project) in England: a strategic behavioural analysis." BMJ Open 12, no. 6 (June 2022): e054739. http://dx.doi.org/10.1136/bmjopen-2021-054739.
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ObjectivesThe Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project implemented an evidence-based intervention that offers a combination of pharmacotherapy and behavioural support to tobacco-dependent inpatients. Understanding key characteristics of CURE’s implementation strategy, and identifying areas for improvement, is important to support the roll-out of nationwide tobacco dependence services. This study aimed to (1) specify key characteristics of CURE’s exiting implementation strategy and (2) develop theoretical-informed and stakeholder-informed recommendations to optimise wider roll-out.Design and methodsData were collected via document review and secondary analysis of interviews with 10 healthcare professionals of a UK hospital. Intervention content was specified through behaviour change techniques (BCTs) and intervention functions within the Behaviour Change Wheel. A logic model was developed to specify CURE’s implementation strategy and its mechanisms of impact. We explored the extent to which BCTs and intervention functions addressed the key theoretical domains influencing implementation using prespecified matrices. The development of recommendations was conducted over a two-round Delphi exercise.ResultsWe identified six key theoretical domains of influences: ‘environmental context and resources’, ‘goals’, ‘social professional role and identity’, ‘social influences’, ‘reinforcement’ and ‘skills’. The behavioural analysis identified 26 BCTs, 4 intervention functions and 4 policy categories present within the implementation strategy. The implementation strategy included half the relevant intervention functions and BCTs to target theoretical domains influencing CURE implementation, with many BCTs focusing on shaping knowledge. Recommendations to optimise content were developed following stakeholder engagement.ConclusionsCURE offers a strong foundation from which a tobacco dependence treatment model can be developed in England. The exiting strategy could be strengthened via the inclusion of more theoretically congruent BCTs, particularly relating to ‘environmental context and resources’. The recommendations provide routes to optimisation that are both theoretically grounded and stakeholder informed. Future research should assess the feasibility/acceptability of these recommendations in the wider secondary-care context.
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Panagiotopoulou, Elena, Celeste Peiris, and Daniel Hayes. "Behavior change techniques in mobile apps targeting self-harm in young people: a systematic review." Translational Behavioral Medicine 11, no. 3 (January 15, 2021): 832–41. http://dx.doi.org/10.1093/tbm/ibaa131.
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Abstract Despite the high prevalence of self-harm among young people, as well as their extensive use of mobile apps for seeking support with their mental healthcare, it is unclear whether the design of mobile apps aimed at targeting self-harm is underpinned by behavior change techniques (BCTs). To systematically analyze and identify (a) what BCTs and (b) what theories are present in self-harm apps for young people in an attempt to understand their active components. Systematic searches in Apple store, followed by thorough screening, were conducted to identify free mobile apps targeting self-harm in young people. Five apps met the inclusion criteria and were used by trained researchers, who coded identified features against the BCT Taxonomy V1. Despite the majority of apps being underpinned by principles of Dialectical Behavior Therapy (DBT), no other information is available about specific theories underpinning these apps. Nineteen of the 93 BCTs were identified across the five apps. The most frequently used BCT was “Distraction” (54.2%), offering ideas for activities to distract users from self-harming. Other techniques that were used often were “Social Support (unspecified)” (27.0%) and “Behavior Substitution” (10.6%). This study provides the first analysis of BCTs present in mental health apps which are designed to target the reduction of self-harm in young people. Future research is needed to evaluate the effectiveness of the apps, as well as assess the effectiveness of the BCTs present.
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Diaz, Inga Medina, Annette Nocon, Stefanie AE Held, Makbule Kobilay, Dirk Skowasch, Abel J. Bronkhorst, Vida Ungerer, et al. "Pre-Analytical Evaluation of Streck Cell-Free DNA Blood Collection Tubes for Liquid Profiling in Oncology." Diagnostics 13, no. 7 (March 29, 2023): 1288. http://dx.doi.org/10.3390/diagnostics13071288.
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Excellent pre-analytical stability is an essential precondition for reliable molecular profiling of circulating tumor DNA (ctDNA) in oncological diagnostics. Therefore, in vitro degradation of ctDNA and the additional release of contaminating genomic DNA from lysed blood cells must be prevented. Streck Cell-Free DNA blood collection tubes (cfDNA BCTs) have proposed advantages over standard K2EDTA tubes, but mainly have been tested in healthy individuals. Blood was collected from cancer patients (n = 53) suffering from colorectal (n = 21), pancreatic (n = 11), and non-small-cell lung cancer (n = 21) using cfDNA BCT tubes and K2EDTA tubes that were processed immediately or after 3 days (BCTs) or 6 hours (K2EDTA) at room temperature. The cfDNA isolated from these samples was characterized in terms of yield using LINE-1 qPCR; the level of gDNA contamination; and the mutation status of KRAS, NRAS, and EGFR genes using BEAMing ddPCR. CfDNA yield and gDNA levels were comparable in both tube types and were not affected by prolonged storage of blood samples for at least 3 days in cfDNA BCTs or 6 hours in K2EDTA tubes. In addition, biospecimens collected in K2EDTA tubes and cfDNA BCTs stored for up to 3 days demonstrated highly comparable levels of mutational load across all respective cancer patient cohorts and a wide range of concentrations. Our data support the applicability of clinical oncology specimens collected and stored in cfDNA BCTs for up to 3 days for reliable cfDNA and mutation analyses.
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Jakovljev, Ivana, and Suncica Zdravkovic. "The colour lexicon of the Serbian language - a study of dark blue and dark red colour categories Part 1: Colour-term elicitation task." Psihologija 51, no. 2 (2018): 197–213. http://dx.doi.org/10.2298/psi160521002j.
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In this study, we linguistically investigated Serbian colour terminology. We administrated colourterm elicitation task aiming to establish the inventory of basic colour terms (BCTs) in the Serbian language and, in particular, to investigate the salience and the status of colour terms teget ?dark blue? and bordo ?dark red?. Native speakers of Serbian (N = 83) participated in a list task (Morgan & Corbett, 1989), in which they had to list as many Serbian colour terms as possible during five minutes. Based on the collected data, we calculated frequency of each term, its mean position and two indexes of salience. Results showed that 11 Serbian most salient colour terms correspond to the eleven BCTs found by Berlin and Kay (1969), namely, plavo ?blue?, crveno ?red?, zuto ?yellow?, zeleno ?green?, crno ?black?, belo ?white?, ljubicasto ?purple?, narandzasto ?orange?, sivo ?grey?, roze ?pink?, and braon ?brown?, but that basic status of braon needs to be further examined. Teget ?dark blue? and bordo ?dark red?, along with tirkizno ?turquoise? and oker ?ochre? were frequently used, with higher salience indices than other non-BCTs. Further research is needed to find out whether teget and bordo meet criteria of BCTs in the Serbian language.
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Wu, Xiaoyuan, Libin Song, and Zhongyan Lin. "EFFECT OF BEHAVIOR CHANGE TECHNIQUES ON USERS' CONTINUANCE INTENTION OF HEALTH MANAGEMENT APPS." DYNA 97, no. 5 (September 1, 2022): 501–7. http://dx.doi.org/10.6036/10597.
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With the explosive growth of global consumer needs for mobile health services, health management applications (HM APPs) have aroused extensive social attention. Most of the existing studies have been based on Expectation Confirmation Theory, whereas few studies have explored the intention of continued use of HM APPs from the technology appropriateness perspective. This study empirically analyzed the impact of behavior change techniques (BCTs) on the continuance intention (CI) of HM APPs users by using the Partial least squares structural equation model. Data were collected from a sample of 334 Chinese users. Results demonstrate that appropriate matching of BCTs plays a notable determinative role on user CI; perceived usefulness, satisfaction, and perceived switching cost (PSC) have significant positive effects on user CI and play mediating effects between BCTs and CI. It is also found that BCTs are significant predictors for user PSC, but the positive effect of satisfaction on user PSC is insignificant. This study reveals the mechanism of how BTCs influence the users’ decision on whether or not to continue using HM APPs. The proposed implications can serve as a reference for academics and practitioners. Keywords: Behavior change techniques, health management APPs, continuance intention, expectation-confirmation theory
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Wang, Suosheng. "Tour guides’ perceptions of below-cost tours and managerial implications." Journal of Vacation Marketing 26, no. 2 (October 8, 2019): 182–94. http://dx.doi.org/10.1177/1356766719880233.
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Below-cost tours (BCTs) have long been considered a serious issue in the travel industry, yet they have rarely been discussed from a tour guides’ perspective. Today’s tour guides are mostly freelancers, hired by tour operators to lead tour groups. While previous studies cover the management and behaviors of tour guides, there is little insight into personal perceptions of their work. To better understand BCTs, this study provides an intimate look at the phenomenon through the use of semi-structured interviews from tour guides and employment of nonparticipant observation on their experiences. The structural problems of the travel industry and impacts of BCTs on tour guide performance are explored and highlighted. Framed in the agency theory, the managerial implications and solutions to the BCT problems are discussed and recommended.
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McAleese, Daniel, Manolis Linardakis, and Angeliki Papadaki. "Quality and Presence of Behaviour Change Techniques in Mobile Apps for the Mediterranean Diet: A Content Analysis of Android Google Play and Apple App Store Apps." Nutrients 14, no. 6 (March 18, 2022): 1290. http://dx.doi.org/10.3390/nu14061290.
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Smartphone apps might represent an opportunity to promote adherence to the Mediterranean diet (MedDiet). This study aimed to evaluate the quality of commercially available apps for the MedDiet and the presence of behavioural change techniques (BCTs) used by these apps. A systematic search was conducted on the Apple App and Google Play stores in November 2021. Apps were included if they provided information on the MedDiet or if their objective was to promote a healthy lifestyle through adherence to the MedDiet. Eligible apps were independently evaluated by two reviewers with regard to their quality (engagement, functionality, aesthetics and information quality) using the 5-point Mobile App Rating Scale (MARS; with higher scores indicating higher quality), and the presence of BCTs using an established 26-item BCT taxonomy. Of the 55 analysed apps, 52 (94.5%) were free, 50 (90.9%) provided recipe ideas, 29 (52.7%) provided meal plans, and 22 (40%) provided information on the health benefits of the MedDiet. The overall quality mean MARS score was 2.84 (standard deviation (SD) = 0.42), with functionality being the highest scored MARS domain (mean = 3.58, SD = 0.44) and engagement the lowest (mean = 2.29, SD = 0.61). The average number of BCTs in the analysed apps was 2.3 (SD = 1.4; range: 0–6 per app). The number of BCTs was positively correlated with app information quality (rrho = 0.269, p = 0.047), overall MARS score (rrho = 0.267, p = 0.049), app subjective quality (rrho = 0.326, p = 0.015) and app-specific quality (rrho = 0.351, p = 0.009). These findings suggest that currently available apps might provide information on the MedDiet, but the incorporation of more BCTs is warranted to maximise the potential for behaviour change towards the MedDiet.
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Booth, Natalia, Nicki A. Dowling, Jason Landon, Dan I. Lubman, Stephanie S. Merkouris, and Simone N. Rodda. "Affected Others Responsivity to Gambling Harm: An International Taxonomy of Consumer-Derived Behaviour Change Techniques." Journal of Clinical Medicine 10, no. 4 (February 4, 2021): 583. http://dx.doi.org/10.3390/jcm10040583.
Full textAbstract:
Affected others impacted by someone else’s gambling utilise numerous behaviour change strategies to minimise gambling-related harm but knowledge on what these strategies are and how they are implemented is limited. This study aimed to develop a comprehensive data-driven taxonomy of the types of self-help strategies used by affected others, and to categorize these into high-level behaviour change techniques (BCTs). Two taxonomies were developed using an inductive and deductive approach which was applied to a dataset of online sources and organised into the Rubicon model of action phases. These taxonomies were family-focused (how to reduce the impact of gambling harm on families) and gambler-focused (how to support the gambler in behaviour change). In total, 329 online sources containing 3536 different strategies were identified. The family-focused classification contained 16 BCTs, and the most frequent were professional support, financial management and planned consequences. The gambler-focused classification contained 11 BCTs, and the most frequent were feedback on behaviours, professional support and financial management. The majority of family- and gambler-focused BCTs fell under the actional phase of the Rubicon model. Grounded in lived experience, the findings highlight the need for intervention and resource development that includes a wide range of specific techniques that affected others can utilise.