Advancing self-care support for people with chronic

diseases

Contribution of behaviour change science

Marta M. Marques
Marie-Curie Research Fellow, ADAPT Centre & Trinity Practice Health Care
Innovation, Trinity College Dublin, Ireland
Research Fellow & Associate at Centre for Behavior Change, University College
London, UK

marta_m_marques


•  High variability in the effects of interven8ons to change

health behaviours

•  To design effec8ve interven8ons we need to understand:
•  Why they vary across behaviour, popula8on and context
•  Which components are effec8ve
•  What is the specific content Effect
•  Why are they effec8ve

•  …AND use systema'c methods from behaviour science

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 2

 Behaviour change Science

Theory

Interven'on Source(s)
Health
Behaviour Change Mechanism(s) of Behaviour(s) Outcome(s)
Techniques - BCTs ac'on

Marques & Teixeira, 2014

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 3

 Behaviour change Science
•  Frameworks and theory to guide the development,
implementa8on and evalua8on of interven8ons
• E.g. Behaviour Change Wheel (Michie et al 2011,2014)

•  Use of standardised language to describe and organize

components of behaviour change interven8ons
• E.g. Behaviour Change Techniques Taxonomy V1 (Michie et al 2013,2015)

•  Frameworks for describing the competences required to deliver

behaviour change interven8ons
• E.g. Train4Health Competency Framework (Cadogan et al)

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 4

 When aDending the GP ….

1.  Examine
the problem Approach behaviour change
interventions in similar manner…
2. Make a
formula8on and
Systematically select intervention
diagnosis
strategies based on thorough
‘behavioural diagnosis’
3. Prescribe a treatment

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 5

 The Behaviour Change Wheel (BCW)

Integra8ve framework to aid the

systema8c development and evalua8on
of behaviour change interven8ons

Derived from a synthesis of 19
frameworks of behavior
change iden8fied in a systema8c
literature review

Michie, Van Stralen, & West, 2011; Michie, Atkins, & West, 2014

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 6

 Define ‘problem’ in
STEP 1
What behaviour(s) are you trying to
behavioural terms
change?

STEP 2

What will it take to bring about change? COM-B

STEP 3

What interven8ons might work? Behaviour Change Wheel

& Taxonomy of BCTs
STEP 4

Which specific components should the

interven8on involve?

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 7

 Behaviour change Science

Theory

Source(s)
Interven'on Health
Mechanism(s) of Behaviour(s) Outcome(s)
BCTs ac'on

Marques & Teixeira, 2014

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 8

•  Changing behaviour requires changing the sources of those
behaviours

COM-B Model

Michie, Van Stralen, & West, 2011; Michie, Atkins, & West, 2014

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 9

 Behaviour change Science

Theory

Source(s)
Interven'on Health
Mechanism(s) of Behaviour(s) Outcome(s)
BCTs ac'on

Marques & Teixeira, 2014

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 10

 A common language: Taxonomies of BCTs

•  Agreed, standard method of describing

interven8on content
•  ‘Periodic table’ of BCTs
•  Consistent terminology & clear labels

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 11

 A common language: Taxonomies of BCTs
•  Describe interven8ons as accurately as possible

•  Evaluate e.g. in factorial designs

•  Synthesise published reports in systema8c reviews

•  Design interven8ons

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 12

 BCT Taxonomy v1

•  Developed by 400 experts from 12

countries
•  Clearly labelled, well defined, dis8nct,
precise
•  Hierarchically organised to improve
ease of use
•  Applies to an extensive range of
behaviour change interven8ons

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 13

 BCT Taxonomy v1: 93 items in 16 groups

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 ' on’
biliz a
nac ta
lf - e
’Se

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 How to select a BCT?

•  Depends on the source of the behaviour

•  Evidence-based – from meta-analysis/reviews

•  Guidance from Behavior Change Wheel and other
frameworks
•  Guidance from the theory being used

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 16

 Human Behaviour Change Interven8on Ontology

www.humanbehaviourchange.org

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Some resources from the Centre for Behaviour Change

All proceeds from CBC teaching, training, books and products go to

further development

www.ucl.ac.uk/behaviour-change

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 Formal theories

•  83 theories
•  1738 constructs

Davis et al, Health Psychology Review, 2014

Michie et al, www.behaviourchangetheories.com, 2014

Courtesy: Susan Michie

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 There is an urgent need…
To develop an understanding of human behaviour to
answer variants of the ‘big ques8on’

When it comes to behaviour change interven7ons:

what works, compared with what, for what behaviours, how
well, for how long, with whom, in what selng, and why?

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 20

Event: Webinar#2: Advancing self-care support for people with chronic diseases 16th July 2020 21

Train4Health has received funding from the European Union’s
Erasmus+ Programme under grant agreement no. 2019-1-
PT01-KA203-061389

The European Commission’s support for the produc8on of this
publica8on does not cons8tute an endorsement of the
contents, which reflect the views only of the authors, and the
Commission cannot be held responsible for any use which may
be made of the informa8on contained therein.