Review, development and manualisation of a family weight management programme, using Behaviour Change Taxonomy V.1

Abstract

Background Evaluations of community-based health behaviour change interventions such as family weight management services (FWMS) often show good acceptability and positive short-term outcomes but fail to produce sustained behaviour or weight change. This study aimed to review the content and delivery of an existing FWMS and systematically embed proven behaviour change strategies. Methods Content and methods of delivery were identified through a review of programme materials, facilitators’ verbal descriptions, and observations of delivery. Behaviour change techniques (BCTs) evident were coded using the Behaviour Change Technique Taxonomy V.1 (BCTTv.1). Available evidence was synthesised to identify appropriate BCTs for the programme. Findings The existing programme contained 13 BCTs. Key BCTs such as Goal Setting, Action Planning and Self-monitoring were delivered infrequently and/or incompletely. Facilitators prioritised participant engagement and retention over behaviour change strategies and lacked confidence to deliver BCTs in a group format with diverse families. A revised programme was designed through a collaborative, iterative process with facilitators, to ensure acceptability to the local population and practicality of delivery. A detailed manual was produced outlining; specific activities, BCTs within each activity and guidance on how to deliver them successfully. Facilitators received training in effective delivery of target BCTs. The revised programme contains 27 BCTs, ten repeated every week, with 15-30 minutes dedicated to behaviour change activities. Facilitators reported high confidence after first revised programme delivery. Discussion A novel review and re-design of a FWMS can significantly increase the proven behaviour change content of the programme, with no additional resources required for delivery.