Behaviour Change Techniques Used in Diabetes Quality Improvement Interventions: Secondary Analysis of a Systematic Review

Abstract

Background: A 2012 Lancet review identified 142 trials of interventions for quality improvement (QI) for people with diabetes, and classified interventions using broad QI categories, making analysis and replication difficult. We examined which behaviour change techniques (BCT) could be identified within these QI interventions. Methods: Three psychologists independently coded a random sample of 23 trials for healthcare professional (HCP) and/or patient behaviour, using the v1 BCT taxonomy. Rules were developed to supplement use of the framework for this literature. Findings: Only 26/93 BCTs were identified targeting HCP and 22/93 targeting patient behaviours: median=6 BCTs per trial for HCPs and 3 for patients. Interventions mainly used prompts/cues, goal setting, feedback and monitoring, social support, instruction on how to perform the behaviour, credible source, and/or add objects to the environment. Discussion: BCTs provide detailed description of QI interventions’ active ingredients, which may enable identification of effective components and help replication efforts. Many BCTs are rarely incorporated in QI interventions and may present a useful focus for future research.