Changing environments to change behaviour: development of TIPPME (Typology of Interventions in Proximal Physical Micro-Environments)

Abstract

Background: Reflecting widespread interest in concepts of ‘nudging’ and ‘choice architecture’, increasing research and policy attention is being applied to altering aspects of the small-scale physical environment, such as portion sizes or product positioning, to change health-related behaviour at population level. However, there is no reliable framework that incorporates standardised labels and definitions, hampering both the synthesis of cumulative evidence about intervention effects, and the identification and discussion of intervention opportunities. To address this, a new tool, TIPPME (Typology of Interventions in Proximal Physical Micro-Environments) has been developed. Methods: TIPPME was developed and assessed over three phases of work (identifying need for a typology; developing and elaborating on this typology; reliability testing and finalising), comprising seven main stages of development. This included two reliability testing exercises completed by behaviour change experts (n=37) to assess how reliably it can be used to characterise intervention content. Findings: TIPPME comprises a matrix classification structure defining six intervention types (Availability; Position; Functionality; Presentation; Size; Information) and three different spatial foci (Product; Related objects; Wider environment). The typology can be applied reliably, with reliability testing exercises demonstrating strong levels of agreement between participants (kappa =.77 (exercise 1) and .87 (exercise 2)). Discussion: TIPPME provides a framework to reliably classify and describe an important class of interventions, and enable more systematic design, reporting and analysis of interventions to change health-related behaviour. It makes a distinct, novel contribution to collective efforts to build the cumulative evidence base for effective ways of changing behaviour across populations.