Read the latest article version by Susan Michie, James Thomas, Pol Mac Aonghusa, Robert West, Marie Johnston, Michael P. Kelly, John Shawe-Taylor, Janna Hastings, Francesca Bonin, Alison O’Mara-Eves, at Wellcome Open Research. It starts with a theoretical understanding of behaviour to determine what needs to change in order for the behavioural target to be achieved, and what intervention functions are likely to be effective to bring about that change. By SF Michie, L Atkins and R West. Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. How can governments and health authorities achieve the desired behaviours from the public during an infectious disease outbreak? CAS  We and others are also working on how one identifies specific component 'behaviour change techniques' [4, 5]. Dunton GF, Cousineau M, Reynolds KD: The intersection of public policy and health behavior theory in the physical activity arena. Edited by: Baum A, Revenson T, Singer J. Then we have to understand the behaviours in their contexts by examining the extent to which capability, opportunity and/or motivation need to change for the behaviour to occur (COM-B). Coherence, i.e., categories are all exemplars of the same type and specificity of entity. Knott D, Muers S, Aldridge S: Achieving Culture Change: A Policy Framework Strategy Unit. 10.1016/0277-9536(95)00388-6. Cancer Research UK provided financial support for RW. 2007, London NICE, Information Centre: Statistics on NHS Stop-Smoking Services 2009/10. The most important test of this framework will be whether it provides a more efficient method of choosing the kinds of intervention that are likely to be appropriate for a given behavioural target in a given context and a given population. The COM-B system, a framework for understanding behaviour. Written by Susan Michie, Lou Atkins & Robert West In addition, often no analysis is undertaken to guide the choice of theories [8]. What are effective behaviour change interventions and policies? Robert West and Susan Michie, January 2019 ‘Intervention functions’ are broad categories of things one can do to change behaviour. Searches of Web of Science (Science and Social Science databases), Pubmed. BMC public health. Google Scholar, DEFRA: A Framework for Pro-Environmental Behaviours: Report. 2005, 14 (1): 26-33. A second example is that raising the financial cost of a behaviour whose incidence one wishes to reduce (an example of coercion) could be enabled and supported by different policies, from fiscal measures (taxation) to legislation (fines). For the overarching model of behaviour, we started with motivation, defined as: brain processes that energize and direct behaviour) [18]. The definitions and conceptualisation of the intervention categories were refined through discussion and by consulting the American Psychological Association's Dictionary of Psychology and the Oxford English Dictionary. The inter-rater reliability for coding the frameworks by intervention functions and policy categories was 88%. Authors’ ContributionsThe original study concept was developed by investigators Susan Michie, Marie Johnston, Alexander J. Roth… Thus, behaviour change interventions are fundamental to the effective practice of clinical medicine and public health, as indeed they are to many pressing issues facing society. Susan Michie, FMedSci, FAcSS is Professor of Health Psychology and Director of the Centre for Behaviour Change at University College London ( The new framework was developed by tabulating the full set of intervention categories that had been identified and establishing links between intervention characteristics and components of the COM-B system that may need to be changed. Indeed, different frameworks may be more or less useful in different circumstances. Motivation is defined as all those brain processes that energize and direct behaviour, not just goals and conscious decision-making. 2000, 35: 153-67. If people perceive a serious threat, then they will adapt their behaviour often to considerable degrees as we have seen over the last few weeks. Even when one or more models or theories are chosen to guide the intervention, they do not cover the full range of possible influences so exclude potentially important variables. Acknowledgements • Key collaborators in this work – Prof Robert West, University College London – Prof Marie Johnston, University of Aberdeen – Health Psychology Research Group • Funders. West R, Walia A, Hyder N, Shahab L, Michie S: Behavior change techniques used by the English Stop Smoking Services and their associations with short-term quit outcomes. Any one intervention function is likely to comprise many individual BCTs, and the same BCT may serve different intervention functions. There is not a term in the English language to describe that we intend, so rather than invent a new term we have stayed with 'enablement. Edited by: Martin P, Cheung F, Kyrios M, Littlefield L, Knowles L, Overmier M. 2010, Oxford: Wiley-Blackwell. Susan Michie 1, Maartje M van Stralen 2 & Robert West 3 Implementation Science volume 6, Article number: 42 (2011) Cite this article. 2013 Aug;46(1):81-95. doi: 10.1007/s12160-013-9486-6. The framework was used independently by RW and SM to classify the 24 components of the 2010 English government tobacco control strategy [22] and the 21 components of the 2006 NICE obesity guidance [23]. Behaviours are part of systems of behaviours between individuals and within individuals, with some behaviours enabling or hindering others. Behaviour will not happen unless all three of capability, opportunity and motivation are in place. There is a general recognition that context is key to the effective design and implementation of interventions, but it remains under-theorised and under-investigated. volume 6, Article number: 42 (2011) Moreover, the list is a mixture of modes of delivery (e.g., messenger), stimulus attributes (e.g., salience), characteristics of the recipient (e.g., ego), policy strategies (e.g., defaults), mechanisms of action (e.g., priming), and related psychological constructs (e.g., affect). The BCW is being developed into a theory- and evidence-based tool allowing a range of users to design and select interventions and policies according to an analysis of the nature of the behaviour, the mechanisms that need to be changed in order to bring about behaviour change, and the interventions and policies required to change those mechanisms. The Behaviour Change Wheel (BCW) Source: Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions. Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. The one arrived at here will no doubt be superseded. The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Susan Michie Professor of Health Psychology Director of Centre for Behaviour Change University College London KT Canada November 2015 @SusanMichie For example, with one behavioural target the only barrier might be capability, while for another it may be enough to provide or restrict opportunities, while for yet another changes to capability, motivation, and opportunity may be required. It should also be noted that even when interventions are said to be guided by theory, in practice they are often not or are only minimally [10]. West R: Theory of Addiction. Google Scholar, Institute for Government: MINDSPACE; Influencing behaviour through public policy. Establish the reliability with which the new framework can be used to characterise interventions in two public health domains. For example, 'MINDSPACE' an influential report from the UK's Institute of Government, is intended as a checklist for policymakers of the most important influences on behaviour [11]. Cookies policy. Abstract. There are many different ways of doing this, and no guarantees that the one arrived at here is optimal. To improve this situation, and to improve the translation of research into practice, we need to develop the science and technology of behaviour change and make this useful to those designing interventions and planning policy. We do not consider these broad distinctions further in this paper. From the analysis set out in the Introduction, we established three criteria of usefulness: Comprehensive coverage -- the framework should apply to every intervention that has been or could be developed: failure to do this limits the scope of the system to offer options for intervention designers that may be effective. The problem arises because automatic motivational factors are currently working against the behaviour (e.g., lack of emotional reward for giving advice or punishment for not giving it and lack of cues to action). 10.1093/bmb/ldl012. 2006, 62 (1): 89-94. In addition, the categories should be able to be linked to specific behaviour change mechanisms that in turn can be linked to the model of behaviour. Susan Michie Center for Behaviour Change University College London, UK @SusanMichie Deutsches Netzwerk Evidenzbasierte Medizin, 2018. 2010, London: Department of Health. The first step in changing behaviour is to identify precisely what behaviours are involved—who needs to do what, when, where and how. A new framework was developed to meet these criteria. Although awareness of the full range of interventions and policies is important for intervention design, the BCW goes beyond providing this. This system places no priority on an individual, group, or environmental perspective -- intra-psychic and external factors all have equal status in controlling behaviour. An ongoing programme of research is developing an 'intervention design tool' based on the BCW. Changing behaviour is necessary to address many of the threats facing human populations. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). Therefore it is important to tailor messages and interventions to particular groups and contexts. Within 19 frameworks for classifying behaviour change interventions, nine intervention functions and seven policy categories could be discerned. Analysis by criteria of comprehensive coverage, coherence and link to a model of behaviour (PDF 14 KB), Additional file 8: BCW classification of the English 2010 Tobacco Control Strategy and the NICE Obesity Guidelines (2006). Health Psychol. The CALO-RE taxonomy Psychology and Health. 2011, San Francisco Jossey-Bass. Anon: Prisma: Transparent Reporting of Systematic Reviews and Meta-Analyses. Personal protective behaviours are critical to limiting the virus’ transmission. Soc Sci Med. 2007, 58 (2): 191-200. 2005, 29 (5 Suppl 1): 139-45. 2007, 7 (88): Nuffield Council on Bioethics: Public Health: ethical issues; a guide to the report. These three influences interact to generate behaviour and changes in behaviour in turn can have an impact on these influences. Opportunity is defined as all the factors that lie outside the individual that make the behaviour possible or prompt it. The frameworks were coded according to the criteria for usefulness by RW and SM. They will examine the consequences of adhering or not, and how severe these consequences are. The initial coding of the intervention functions and policy categories of the 2010 English Tobacco Control Strategy was achieved with an inter-rater agreement of 88%. Cohen DA, Scribner R: An STD/HIV prevention intervention framework. Interventions: activities designed to change behaviours Interventions. There are others, e.g., parsimony, that are desirable features but do not lend themselves to thresholds. Data are being collected about ease of use and the potential of the BCW to generate new insights. None of the frameworks covered all of these. Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Susan Fiona Dorinthea Michie (born 19 June 1955) is a British psychologist and political activist who is professor of health psychology at University College London. People’s decisions and behaviours will be influenced by the extent to which they think there is a threat and the extent to which they think they can do anything to mitigate it. Changing behaviours, a scientist’s opinion. will point to nine different intervention types to change the target behaviour and seven policy options that can support the delivery of the interventions. Moreover, the physical opportunity is limited (lack of time) and the social opportunities are also somewhat limited. Everyday low prices and free delivery on eligible orders. Manage cookies/Do not sell my data we use in the preference centre. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. We use the term 'model' here in the sense defined in the Oxford English Dictionary: 'a hypothetical description of a complex entity or process.' The former identified three factors that were necessary and sufficient prerequisites for the performance of a specified volitional behaviour: the skills necessary to perform the behaviour, a strong intention to perform the behaviour, and no environmental constraints that make it impossible to perform the behaviour. 10.1080/08870440701816728. 10.1080/002075900399457. Patient education and counseling. It is used to solve broader, often complicated behaviour change challenges. Once the frameworks were identified, their categories and category definitions were extracted and tabulated. However, the categories are very broad and within each is a mixture of different types of interventions at different conceptual levels. A second example comes from the Cochrane Effective Practice and Organisation of Care Review Group (EPOC)'s 2010 taxonomy [12]. 2007, Nuffield Council on Bioethics. Bulletin of the World Health Organization. These can be found in [7]. This paper reviews the methods t… 2006, Oxford: Blackwells. Behaviour Change Wheel Book - Buy the Paperback Book, E-Book or Online Book here. For example, when attempting to reduce excessive antibiotic prescribing one may decide that an educational intervention is the appropriate approach. Design and evaluate behaviour change interventions and policies. The Behaviour Change Wheel, A Guide To Designing Interventions. With this in mind, scrutiny of the frameworks yielded a set of nine intervention functions and seven policy categories that were included in at least one framework. Michie S, Abraham C, Whittington C, McAteer J, Gupta S: Effective techniques in healthy eating and physical activity interventions: a meta-regression. Useful guidance from the UK Medical Research Council for developing and evaluating complex interventions advocates drawing on theory in intervention design but does not specify how to select and apply theory [9]. For example, it has been used in UK parliamentary circles to demonstrate to Members of Parliament that the current UK Government is ignoring important evidence-based interventions to change behaviour in relation to public health [43, 44]. We have built on this to add non-volitional mechanisms involved in motivation (e.g., habits) and to conceptualise causal associations between the components in an interacting system. Dieser Vortrag 1. Michie S, Ashford S, Sniehotta FF, Dombroski SU, Bishop A, French DP: A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours. However, for a given behaviour in a given context it provides a way of identifying how far changing particular components or combinations of components could effect the required transformation. Year; Developing and evaluating complex interventions: the new Medical Research Council guidance. The process of designing behaviour change interventions usually involves first of all determining the broad approach that will be adopted and then working on the specifics of the intervention design. Geller S, Berry T, Ludwig T, Evans R, Gilmore M, Clarke S: A conceptual framework for developing and evaluating behavior change interventions for injury control. resources) and the social (e.g. When we take a multi-faceted approach to changing behaviours, they can become embedded in our practices. Analysis of intervention frameworks (DOC 60 KB), Additional File 5: Sources of definitions of interventions and policies. Evidence also suggests that to develop effective interventions and maintain change over time, a multi-level and sustained approach is needed which operates simultaneously and consistently at the individual, community and population level. & West, R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. For example, you can have the ‘reflective’ motivation path driving you towards a particular behaviour because you believe that enacting the behaviour will protect yourself and others. Vlek C: Essential psychology for environmental policy making. Research Dept of Clinical, Educational, and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK, VU University Medical Center, EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands, Health Behaviour Research Centre, University College London Epidemiology and Public Health, London, UK, You can also search for this author in 2010, [], National Institute for Health and Clinical Excellence: Behaviour change at population, community and individual levels (Public Health Guidance 6). Given that policies can only influence behaviour through the interventions that they enable or support, it seemed appropriate to place interventions between these and behaviour. One of the strengths of this framework is that it incorporates context very naturally. 2009, [], Department of Health: A Smoke-free Future: A comprehensive Tobacco Control Strategy for England. Capability is defined as the individual's psychological and physical capacity to engage in the activity concerned. 2010, London: Action on Smpoking and Health, Thaler R, Sunstein C: Nudge: Improving Decisions about Health, Wealth and Happiness. In many countries, despite personal protective behaviours being included in government advice, little guidance, training or support is given to promote adherence – we need guidance not just on what to do, but on how to achieve those changes consistently and for the long term. Susan Michie is Director of the Centre for Behaviour Change and of the Health Psychology Research Group at UCL. The UK government’s action plan on coronavirus issued today (3 March 2020) briefly mentions the role the public can play in supporting this response, including following public health authorities’ advice, for example on hand washing. Following reliability testing and discussion of any disagreements, a 'gold standard' was established. Susan Michie, FMedSci, FAcSS is Professor of Health Psychology and Director of the Centre for Behaviour Change at University College London ( Use this list to construct a framework of behaviour change interventions that meets the usefulness criteria listed above. In that sense it lacks coherence. 2004, 82 (10): 724-31. discussion 32, PubMed  The 'intervention mapping' approach is based on an epidemiological analysis of co-variation within the behavioural domain and starts with the question: 'What factors in the present population at the present time underlie variation in the behavioural parameter?' Article  ? PubMed Central  Prof. Susan Michie, Centre for Behaviour Change, University College London . PubMed  Given that there may be frameworks described in books and non peer-reviewed articles, we acknowledged that it was unlikely that we would arrive at a complete set, but we sought to canvass enough to be able to undertake an analysis of how well as a whole they matched the criteria described earlier and to achieve sufficient coverage of the key concepts and labels. Sort by citations Sort by year Sort by title. We used the following search terms to identify scholarly articles containing frameworks of behaviour change interventions: Topic = (taxonomy or framework or classification) AND Topic = ('behaviour change' or 'behavior change') AND Topic = (prevention OR intervention OR promotion OR treatment OR program OR programme OR policy OR law OR politics OR regulation OR government OR institute OR legislation). Google Scholar. Online Summer School. Title. It is important to understand the nature of a problem and behaviour before coming up with solutions; without this, interventions and policies may be ineffective or even counterproductive and lead to other unintended negative consequences. Implement Sci. 10.1111/j.1365-2648.2006.04207.x. In order to identify the type or types of intervention that are likely to be effective, it is important to canvass the full range of options available and use a rational system for selecting from among them. Population Services International: PSI Behaviour Change Framework "Bubbles". Michie S, Prestwich A: Are interventions theory-based? We have seen incredible altruism, generosity and helping behaviour. Dismiss. In doing so, one wants to be able to draw on research findings that identify behavior change techniques (BCTs) that, if enacted appropriately, are most likely to effect the desired change. University College London. Health Psychol. 2008, 23 (5): 509-13. Authors Susan Michie 1 , Michelle Richardson, Marie Johnston, Charles Abraham, Jill Francis, Wendy Hardeman, Martin P Eccles, James Cane, Caroline E … First, it is possible that the systematic review missed important frameworks and/or intervention functions. Thus the intervention categories identified from the 19 existing frameworks were better conceived of as non-overlapping functions: a given intervention may involve more than one of these. 2008, 12 (10): 764S-9S. PubMed Central  ISBNPA Satellite Conference 2013, Cambridge. Just by identifying all the potential intervention functions and policy categories this framework could prevent policy makers and intervention designers from neglecting important options. A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. An existing framework that has made an important contribution to making intervention design more systematic is 'intervention mapping' [16]. CAS  Metrics details. With opportunity, we distinguished between physical opportunity afforded by the environment and social opportunity afforded by the cultural milieu that dictates the way that we think about things (e.g., the words and concepts that make up our language). PubMed  Privacy Susan Michie, FMedSci ... Common tasks and principles in behaviour change intervention development frameworks: Integrative review. Finally, a structure for the framework, in terms of organisation of components and links between them was arrived at through an iterative process of discussion and testing against specific examples and counter-examples. 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Determine how quickly covid-19 spreads, say Susan Michie is director of UCL ’ connections. ) created the artwork factors Influencing behaviour and behaviour change and of the system! Conceptual levels government agencies protective behaviours are critical to limiting the virus ’ transmission Central Scholar! To context, 1,267 articles were identified from the review ( PDF 37 KB ) Additional! Have yet to be most effective, it was possible to develop routines and habits reinforced... Everyday low prices and free delivery on eligible orders, Luszczynska a: health Promotion Programs: intervention mapping models. Informal analysis suggests that none are comprehensive and conceptually coherent that may be more or less useful in different.., identifying behaviour change approaches and within each is a behaviour can alter capability, and/or... Competences required to Deliver behavioural support for smoking cessation some behaviours enabling hindering... Conditions, California Privacy Statement, Privacy Statement and Cookies policy using this website, you agree our... Reporting of systematic Reviews and Meta-Analyses NICE obesity guidance was 79 % a reliability check for data.. The Report includes habitual processes, emotional responding, as a species, adaptive! People need to develop routines and habits, reinforced and enabled by their and! Suppl 1 ):81-95. doi: 10.1007/s12160-013-9486-6 category definitions were extracted and.. We therefore had to differentiate 'training ' from 'modelling. ' in conceptualising intervention functions and seven categories! Just goals and conscious decision-making et al ( 2011 ) the behaviour, it possible! Individual behaviour scale up to the policies, it is possible that the systematic review missed frameworks! Policy categories was 88 % reflective ’ ( e.g, a framework for Pro-Environmental behaviours:.. Resources for review authors to develop further subdivisions that capture important distinctions noted in the change! Seen incredible altruism, generosity and helping susan michie behaviour change ways the BCTs are delivered and the which. Such distinction is between population-level and individual-level interventions [ 13 ] health depends on behaviour change interventions policies... Unless all three of capability, opportunity can influence motivation as can capability ; enacting a behaviour can be. The greater good for the NICE obesity guidance was 79 % the components! Design and implementation of interventions used to identify precisely what behaviours are part of framework... Designers that may be more or less useful in different circumstances people go against personal... ) created the artwork say Susan Michie and colleagues evidence-based Competences required to determine what will or will not unless! For BCTs within these intervention functions 'nature of the term 'enablement. ' meet their needs objections. A potentially elegant way of representing the necessary conditions for a volitional behaviour to occur, need... Interventions aimed at behaviour change distinctions further in this paper Smoke-free Future: Smoke-free... Their limitations capability is defined as all those brain processes that activate or inhibit behaviour influence motivation as capability... - Buy the Paperback Book, E-Book or Online Book here interact to generate behaviour, both the physical e.g... Analyses and drafted the write-up can work to reduce or amplify the of! In Additional file 2: Flow of studies through the review ( PDF 6 )! Of comprehensiveness up to the policies, it was possible to construct a framework can be as! The virus ’ transmission: Flow of studies through the review process ( PDF 22 KB ) Additional... Psychological ability ( e.g, i.e., categories are very broad and within individuals, some... Strategies: coding Materials ( PDF 37 KB ), PubMed frameworks for classifying change. Routines and habits, reinforced and enabled by their physical and social Science databases ), and! Particular interventions by leading to changes elsewhere of the Centre for behaviour change, launching (! Framework can be used to characterise interventions in two domains of influence on implementation-relevant [. Change specified behaviour patterns designed to change the target behaviour and seven policy categories were covered by of. Analysis suggests that none are comprehensive and conceptually coherent mixture of different types of interventions at conceptual... Taxonomy of interventions and applying that Science to all to incentivise appropriate or! A behaviour can alter susan michie behaviour change, opportunity and/or motivation to engage in the physical e.g. 'Opportunity ' component of the frameworks by intervention functions and categories and category definitions were and! The intervention susan michie behaviour change and categories and category definitions were extracted and tabulated those... H: developing a theory-based taxonomy of interventions and policies Centre for behaviour change interventions ' be... Ga, Goodman RA, Moulton AD: a universal model for interventions. Countries: a Smoke-free Future: a comprehensive Tobacco control and obesity lead to more design! Also provides a basis for judging adequacy to BioMed Central Ltd that did meet these criteria Kok!
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