Development of a formal system for representing behaviour-change theories

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

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Supplementary Tables 1–5 and Supplementary Figure 1.

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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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