Links between behaviour change techniques and mechanisms of action: evidence from the published intervention literature

Abstract

Background: This study aimed to examine links between behaviour change techniques (BCTs) and mechanisms of action, as explicitly hypothesised in a corpus of published reports of behaviour change interventions. Methods: Data on hypothesised links between BCTs and mechanisms of action were extracted from >300 published intervention reports. The frequency (e.g. number of times a link was reported), explicitness (whether or not coding the link required inference) and precision (whether or not there were multiple links to the same BCT/mechanism of action) of each link was examined. Findings: Approximately 10 links per intervention paper were identified, and there was substantial variation in the level of explicitness afforded to their description, with 30% of papers requiring some inference to code a link. High frequency BCTs and mechanisms of action included Goal Setting (Behaviour) and self-efficacy, respectively. BCTs found to frequently link to self-efficacy included Behavioural Practice/Rehearsal and Instruction on How to Perform the Behaviour. The frequency of each BCT-mechanism of action link as reported in the literature corpus is represented in a heat map. Discussion: There is a need for reports of behaviour change interventions to more explicitly state the full causal sequence hypothesised to underlie intervention effects (i.e. BCT – mechanism of action – behaviour), as well as the rationale behind these hypotheses. The heat map of BCT-mechanism of action links resulting from this study contributes to our understanding of the processes that have been hypothesised to underlie individual behaviour change intervention components within the published literature.