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Background: Behaviour change interventions are likely to be reproducible only if reported clearly. We assessed whether the behaviour change technique taxonomy version 1 (BCTTv1), with and without training in identifying BCTs, improves the clarity and replicability of written reports of observed behaviour change interventions., Methods: Three studies assessed effects of using and training in the use of BCTTv1 on the clarity and replicability of intervention descriptions written after observing videos of smoking cessation interventions. Study 1 examined the effects of using and not using BCTTv1. Study 2 examined the effects of using BCTTv1 and training in use of BCTTv1 compared no use and no training. Study 3 employed a within-group design to assess change in descriptions written before and after training. One-hundred and 66 'writers' watched videos of behaviour change interventions and wrote descriptions of the active components delivered. In all studies, the participants' written descriptions were evaluated by (i) 12 'raters' (untrained in BCTTv1) for clarity and replicability and (ii) 12 'coders' (trained in BCTTv1) for reliability of BCT coding. Writers rated the usability and accessibility of using BCTTv1 to write descriptions., Results: Ratings of clarity and replicability did not differ between groups in study 1 (all ps > 0.05), were poorer for trained users in study 2 (all ps < 0.01) and improved following training in study 3 (all ps < 0.05). BCT identification was more reliable from descriptions written by trained BCTTv1 users (p < 0.05; study 2) but not simple use of BCTTv1 (p = 0.93; study 1) or by writers who had written a description without BCTTv1, before training (p = 0.50; study 3). Writers reported that using BCTTv1 was difficult but 'useful', 'good' and 'desirable' and that their descriptions would be clear and replicable (all means above mid-point of the scale)., Conclusions: Effects of training to use BCTTv1 on the quality of written reports of observed interventions were mixed, with some suggestion of improved clarity and replicability of reporting in the within- (study 3) but not the between-group studies (studies 1 and 2). Potential benefits of using BCTTv1 may have been limited by the artificial nature and time constraints of the task.

Purpose: The aim of this paper is to assess the frequency of identification as well as the inter-coder and test-retest reliability of identification of behavior change techniques (BCTs) in written intervention descriptions., Methods: Forty trained coders applied the "Behavior Change Technique Taxonomy version 1" (BCTTv1) to 40 intervention descriptions published in protocols and repeated this 1 month later., Results: Eighty of 93 defined BCTs were identified by at least one trained coder, and 22 BCTs were identified in 16 (40 %) or more of 40 descriptions. Good inter-coder reliability was observed across 80 BCTs identified in the protocols: 66 (80 %) achieved mean prevalence and bias-adjusted kappa (PABAK) scores of 0.70 or greater, and 59 (74 %) achieved mean scores of 0.80 or greater. There was good within-coder agreement between baseline and 1 month, demonstrating good test-retest reliability., Conclusions: BCTTv1 can be used by trained coders to identify BCTs in intervention descriptions reliably. However, some frequently occurring BCT definitions require further clarification.

Background: Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) - the 'active ingredients', for example goal-setting, self-monitoring of behaviour. BCTs are 'the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs' (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012;6:1-6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health., Objective: (1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development., Design and Participants: Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive 'bottom-up' and theory-driven 'top-down' open-sort procedures (n = 36); training in use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) was evaluated by changes in intercoder reliability and validity (agreement with expert consensus); evaluating the taxonomy for coding interventions was assessed by reliability (intercoder; test-retest) and validity (n = 40 trained coders); and evaluating the taxonomy for writing descriptions was assessed by reliability (intercoder; test-retest) and by experimentally testing its value (n = 190)., Results: Ninety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a 'bottom-up' open-sort procedure; there was overlap between these and groupings produced by a theory-driven, 'top-down' procedure. Both training methods improved validity (both p < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (both p < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results., Conclusions: The developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions., Funding: This project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care.

Objectives: Behaviour change technique (BCT) Taxonomy v1 is a hierarchically grouped, consensus-based taxonomy of 93 BCTs for reporting intervention content. To enhance the use and understanding of BCTs, the aims of the present study were to (1) quantitatively examine the 'bottom-up' hierarchical structure of Taxonomy v1, (2) identify whether BCTs can be reliably mapped to theoretical domains using a 'top-down' theoretically driven approach, and (3) identify any overlap between the 'bottom-up' and 'top-down' groupings., Methods and Design: The 'bottom-up' structure was examined for higher-order groupings using a dendrogram derived from hierarchical cluster analysis. For the theory-based 'top-down' structure, 18 experts sorted BCTs into 14 theoretical domains. Discriminant Content Validity was used to identify groupings, and chi-square tests and Pearson's residuals were used to examine the overlap between groupings., Results: Behaviour change techniques relating to 'Reward and Punishment' and 'Cues and Cue Responses' were perceived as markedly different to other BCTs. Fifty-nine of the BCTs were reliably allocated to 12 of the 14 theoretical domains; 47 were significant and 12 were of borderline significance. Thirty-four of 208 'bottom-up' × 'top-down' pairings showed greater overlap than expected by chance. However, only six combinations achieved satisfactory evidence of similarity., Conclusions: The moderate overlap between the groupings indicates some tendency to implicitly conceptualize BCTs in terms of the same theoretical domains. Understanding the nature of the overlap will aid the conceptualization of BCTs in terms of theory and application. Further research into different methods of developing a hierarchical taxonomic structure of BCTs for international, interdisciplinary work is now required. Statement of contribution What is already known on this subject? Behaviour change interventions are effective in improving health care and health outcomes. The 'active' components of these interventions are behaviour change techniques and over 93 have been identified. Taxonomies of behaviour change techniques require structure to enable potential applications. What does this study add? This study identifies groups of BCTs to aid the recall of BCTs for intervention coding and design. It compares two methods of grouping--'bottom-up' and theory-based 'top-down'--and finds a moderate overlap. Building on identified BCT groups, it examines relationships between theoretical domains and BCTs., (© 2014 The British Psychological Society.)

Objective: To test and optimize the feasibility and acceptability of a physical activity (PA) and healthy eating behavior change intervention for obese adults with obesity-related co-morbidities or additional risk factors for co-morbidities., Methods: Open-pilot intervention study using an uncontrolled pre and post design with ongoing measures on intervention acceptability and feasibility. Participants received 5 weekly nurse-led one-hour long group sessions. Acceptability and feasibility were assessed throughout. PA, dietary behavior and weight were measured before and after the intervention., Results: Of 74 consenting participants, 61 (82%) received and 47 (64%) completed the intervention. Average ratings of intervention materials and components by participants ranged between 4.1 and 4.9 out of 5. Average facilitator satisfaction rating was 90% (range 75-100%). The intervention delivery was feasible as indicated by ratings and comments from participants and the facilitator. Participants lost -0.86 kg of weight t(45)=3.84, p=0.0001, and increased PA by an additional 1.6 (SD=2.7) sessions/week, t(31)=-3.3, p=0.002. No significant dietary differences emerged., Conclusion: The intervention was acceptable to the facilitator and participants and feasible for delivery. Several intervention aspects were further optimized., Practice Implications: The current study outlines a PA and dietary behavior change pilot intervention coupled with a systematic and transparent process of intervention optimization., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background: To investigate the effect of in-person delivered behavioural interventions in people with multimorbidity and which behaviour change techniques (BCTs), targeting lifestyle behaviours, are associated with better outcomes. Methods: Systematic review of randomised controlled trials. We searched MEDLINE, EMBASE, CENTRAL, and CINAHL and screened reference list of reviews including people with multimorbidity, registries, and citation tracking of included studies. Meta-analyses using random-effects model to assess the effect of behavioural interventions and meta-regression analyses and effectiveness ratios to investigate the impact of mediators on effect estimates. Cochrane 'Risk of Bias Tool' 2.0 and the GRADE assessment to evaluate the overall quality of evidence. Results: Fourteen studies involving 1,378 people. Behavioural interventions had little to no effect on physical activity (standardised mean difference 0.38, 95% CI −0.12–0.87) and the effect on weight loss was uncertain (BMI mean difference −0.17, 95% CI −1.1–0.83) at the end-treatment follow-up. Small improvements were seen in health-related quality of life (SMD 0.29, 95% CI 0.17–0.42) and physical function (SMD 0.42, 95% CI 0.12–0.73), and moderate improvements were seen for depression symptoms (SMD −0.70, 95% CI −0.97–0.42). Studies using the BCTs 'action planning' and 'social support (practical)' reported greater physical activity and weight loss. Conclusions: Behavioural interventions targeting lifestyle behaviours may improve health-related quality of life and physical function, and reduce depression, whereas little to no effect was achieved on physical activity and weight loss in people with multimorbidity. However, the evidence for physical activity and weight loss were of low quality and the end-treatment benefits diminished over time. [ABSTRACT FROM AUTHOR]