Links between behaviour change techniques and mechanisms of action: examining experts’ consensus

Abstract

Background: This study examined links between behaviour change techniques (BCTs) and mechanisms of action, as hypothesised by experts in the field using consensus methodology. Methods: 105 experts from 18 countries participated in a formal consensus development study, involving 3 rounds. Each expert was randomised to one of 5 groups, and each group was asked to consider the links between 13 or 14 BCTs (total 61) and 26 mechanisms of action. Rounds 1 and 3 asked experts to provide numerical ratings of these links, while Round 2 involved an anonymous discussion among the expert groups, to gain consensus and discuss discrepancies. Findings: For 302 (19%) of the Round 3 links, there was ≥90% agreement that a given BCT was (a) linked or (b) not linked to a given mechanism of action. Ten BCT-mechanism of action links had 100% agreement, including: Goal Setting to Behavioural Regulation, Discrepancy between Current Behaviour and Goal to Feedback Processes and Social Reward to Reinforcement. There was high disagreement for some BCT-mechanism of action links. For example, approximately 40% of experts judged the BCT Habit Formation to ‘definitely’ change behaviour through (a) Intention, and (b) Skills, while a similar percentage judged that these were ‘definitely not’ linked. Discussion: There is clear consensus for certain BCT-mechanism of action links. The development of a matrix of agreed links, which encapsulates current thinking among behaviour change experts, can aid our understanding of the processes believed to underlie effective interventions. However, further work is necessary to clarify links where disagreement persists.