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Development of a formal system for representing behaviour-change theories

Nature Human Behaviour volume 3, pages 526–536 (2019)Cite this article

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Abstract

Use of natural language to represent behaviour-change theories has resulted in lack of clarity and consistency, hindering comparison, integration, development and use. This paper describes development of a formal system for representing behaviour-change theories that aims to improve clarity and consistency. A given theory is represented in terms of (1) its component constructs (for example, ‘self-efficacy’, ‘perceived threat’ or ‘subjective norm’), which are labelled and defined, and (2) relationships between pairs of constructs, which may be causal, structural or semantic. This formalism appears adequate to represent five commonly used theories (health belief model, information–motivation–behavioural skill model, social cognitive theory, theory of planned behaviour and the trans-theoretical model). Theory authors and experts judged that the system was able to capture the main propositions of the theories. Following this proof of concept, the next step is to assess how far the system can be applied to other theories of behaviour change.

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References

  1. Green, L. W., Hiatt, R. A. & Hoeft, K. S. in Oxford Textbook of Global Public Health (eds Detels, R. et al.) 218–233 (Oxford Univ. Press, 2015).

  2. Vlek, C. & Steg, L. Human behavior and environmental sustainability: problems, driving forces, and research topics. J. Soc. Issues 63, 1–19 (2007).

    Article  Google Scholar 

  3. Davis, R., Campbell, R., Hildon, Z., Hobbs, L. & Michie, S. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol. Rev. 9, 323–344 (2015).

    Article  Google Scholar 

  4. Glantz, K., Rimer, B. & Viswanath K. Health Behavior: Theory, Research, and Practice (Wiley, 2015).

  5. Craig, P. et al. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 337, a1655 (2008).

    Article  Google Scholar 

  6. Glanz, K. & Bishop, D. B. The role of behavioral science theory in development and implementation of public health interventions. Annu. Rev. Publ. Health 31, 399–418 (2010).

    Article  Google Scholar 

  7. Lippke, S. & Ziegelmann, J. P. Theory‐based health behavior change: developing, testing, and applying theories for evidence‐based interventions. Appl. Psychol. 57, 698–716 (2008).

    Article  Google Scholar 

  8. West, R. & Michie, S. A Guide to the Development and Evaluation of Digital Behaviour Change Interventions (Silverback Publishing, 2016).

  9. Armitage, C. J. & Conner, M. Social cognition models and health behaviour: a structured review. Psychol. Health 15, 173–189 (2000).

    Article  Google Scholar 

  10. Gebhardt, W. A. & Maes, S. Integrating social-psychological frameworks for health behavior research. Am. J. Health Behav. 25, 528–536 (2001).

    Article  CAS  Google Scholar 

  11. Kirscht, J. P. Preventive health behavior: a review of research and issues. Health Psychol. 2, 277–301 (1983).

    Article  Google Scholar 

  12. Michie, S. et al. Making psychological theory useful for implementing evidence based practice: a consensus approach. BMJ Qual. Saf. 14, 26–33 (2005).

    Article  CAS  Google Scholar 

  13. Garnett, C. et al. Reported theory use by digital interventions for hazardous and harmful alcohol consumption, and association with effectiveness: meta-regression. J. Med. Internet Res. 20, e69 (2018).

    Article  Google Scholar 

  14. Michie, S., West, R., Campbell, R., Brown, J. & Gainforth, H. ABC of Behaviour Change Theories: An Essential Resource for Researchers, Policy Makers and Practicioners (Silverback Publishing, 2014).

  15. Prestwich, A. et al. Does theory influence the effectiveness of health behavior interventions? Meta-analysis. Health Psychol. 33, 465–474 (2014).

    Article  Google Scholar 

  16. Dombrowski, S. U., Sniehotta, F. F., Avenell, A. & Coyne, J. C. Towards a cumulative science of behaviour change: do current conduct and reporting of behavioural interventions fall short of best practice. Psychol. Health 22, 869–874 (2007).

    Article  Google Scholar 

  17. Michie, S. & Prestwich, A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 29, 1–8 (2010).

    Article  Google Scholar 

  18. Cane, J., O’Connor, D. & Michie, S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement. Sci. 7, 37 (2012).

    Article  Google Scholar 

  19. Fisher, W., Fisher, J. & Shuper, S. Social psychology and the fight against AIDS: an information–motivation–behavioral skills model for the prediction and promotion of health behavior change. Adv. Exp. Soc. Psychol. 50, 105–193 (2014).

    Article  Google Scholar 

  20. El-Sayed, A. M. & Galea, S. Systems Science and Population Health (Oxford University Press, 2017).

  21. Vries, H. D. & Mudde, A. N. Predicting stage transitions for smoking cessation applying the attitude-social influence-efficacy model. Psychol. Health 13, 369–385 (1998).

    Article  Google Scholar 

  22. Painter, J. E., Borba, C. P., Hynes, M., Mays, D. & Glanz, K. The use of theory in health behavior research from 2000 to 2005: a systematic review. Ann. Behav. Med. 35, 358–362 (2008).

    Article  Google Scholar 

  23. Rosenstock, I. M. Historical origins of the health belief model. Health Educ. Monogr. 2, 328–335 (1974).

    Article  Google Scholar 

  24. Fisher, J. D. & Fisher, W. A. Changing AIDS-risk behavior. Psychol. Bull. 111, 455–474 (1992).

    Article  CAS  Google Scholar 

  25. Bandura, A. Social Foundation of Thought and Action: A Social-Cognitive View (Englewood Cliffs, 1986).

  26. Ajzen, I. The theory of planned behaviour. Organ. Behav. Hum. Decis. Process. 50, 179–211 (1991).

    Article  Google Scholar 

  27. DiClemente, C. C. et al. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J. Consult. Clinic. Psychol. 59, 295–304 (1991).

    Article  CAS  Google Scholar 

  28. Hastings, J. in The Gene Ontology Handbook (eds Dessimoz, C. & Škunca, N.) 3–13 (Springer, 2017).

  29. Pearl, J. Causality: Models, Reasoning, and Inference (Cambridge Univ. Press, 2000).

  30. VandenBos, G. R. (dd). APA Dictionary of Psychology (American Psychology Association, 2007).

  31. Oxford English Dictionary. OED Online (2nd edn.) https://www.oed.com (accessed March 2008).

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Acknowledgements

We are grateful to the theory authors and experts who commented on the construct definitions and theory representations: I. Ajzen (TPB), J. Annesi (SCT), C. DiClemente (TTM), W. Fisher (IBM) and V. Strecher (HBM). We are grateful to K. Sheals for assistance with coding the theories and drafting the paper. We are also grateful to M. Johnston for early discussions about this piece of work and to M. Marques, A. Wright, C. Garnett, A. Direito, H. Groarke, H. Walton and T. Revenson who assisted with the drafting of the paper. This work was also supported by a grant from the UK Medical Research Council (grant number MR/L011115/1) and by a National Institute of Health Research Senior Investigator’s award held by S.M. The contribution of R.W. contribution was partly funded by Cancer Research UK. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Behavioural Science and Health, University College London, London, UK

    Robert West

  2. Centre for Behaviour Change, University College London, London, UK

    Cristina A. Godinho, Lauren Connell Bohlen, Rachel N. Carey, Carmen E. Lefevre & Susan Michie

  3. Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisboa, Portugal

    Cristina A. Godinho

  4. Department of Kinesiology, University of Rhode Island, Kingston, RI, USA

    Lauren Connell Bohlen

  5. Zinc, London, UK

    Rachel N. Carey

  6. Department of Biological Sciences, University of Cambridge, Cambridge, UK

    Janna Hastings

  7. Healthbridge Ltd, London, UK

    Carmen E. Lefevre

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  1. Robert West
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  4. Rachel N. Carey
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  6. Carmen E. Lefevre
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  7. Susan Michie
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Contributions

R.W. contributed to study conception, revised coding of theories and led on preparation of the manuscript. S.M. conceived the project and contributed to manuscript preparation. L.C.B., R.N.C. and C.A.G. undertook initial coding of theories, contributed to study conception and commented on manuscript drafts. C.A.G., J.H. and C.E.L. contributed to manuscript preparation.

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Correspondence to Robert West.

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Competing interests

RW has undertaken research and consultancy from companies that develop and manufacture smoking cessation medicines (Pfizer, GSK, J&J).

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West, R., Godinho, C.A., Bohlen, L.C. et al. Development of a formal system for representing behaviour-change theories. Nat Hum Behav 3, 526–536 (2019). https://doi.org/10.1038/s41562-019-0561-2

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