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      Links Between Behavior Change Techniques and Mechanisms of Action: An Expert Consensus Study


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          Understanding the mechanisms through which behavior change techniques (BCTs) can modify behavior is important for the development and evaluation of effective behavioral interventions. To advance the field, we require a shared knowledge of the mechanisms of action (MoAs) through which BCTs may operate when influencing behavior.


          To elicit expert consensus on links between BCTs and MoAs.


          In a modified Nominal Group Technique study, 105 international behavior change experts rated, discussed, and rerated links between 61 frequently used BCTs and 26 MoAs. The criterion for consensus was that at least 80 per cent of experts reached agreement about a link. Heat maps were used to present the data relating to all possible links.


          Of 1,586 possible links (61 BCTs × 26 MoAs), 51 of 61 (83.6 per cent) BCTs had a definite link to one or more MoAs (mean [ SD] = 1.44 [0.96], range = 1–4), and 20 of 26 (76.9 per cent) MoAs had a definite link to one or more BCTs (mean [ SD] = 3.27 [2.91], range = 9). Ninety (5.7 per cent) were identified as “definite” links, 464 (29.2 per cent) as “definitely not” links, and 1,032 (65.1 per cent) as “possible” or “unsure” links. No “definite” links were identified for 10 BCTs (e.g., “Action Planning” and “Behavioural Substitution”) and for six MoAs (e.g., “Needs” and “Optimism”).


          The matrix of links between BCTs and MoAs provides a basis for those developing and synthesizing behavioral interventions. These links also provide a framework for specifying empirical tests in future studies.


          Experts in behaviour change science agreed on the processes through which a number of different techniques are hypothesized to change behaviour. This information will help people design behaviour change interventions and guide efforts to determine how these interventions work.

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          Most cited references7

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

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            Nominal group technique: an effective method for obtaining group consensus.

            This paper aims to demonstrate the versatility and application of nominal group technique as a method for generating priority information. Nominal group technique was used in the context of four focus groups involving clinical experts from the emergency department (ED) and obstetric and midwifery areas of a busy regional hospital to assess the triage and management of pregnant women in the ED. The data generated were used to create a priority list of discussion triggers for the subsequent Participatory Action Research Group. This technique proved to be a productive and efficient data collection method which produced information in a hierarchy of perceived importance and identified real world problems. This information was vital in initiating the participatory action research project and is recommended as an effective and reliable data collection method, especially when undertaking research with clinical experts. © 2012 Blackwell Publishing Asia Pty Ltd.
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              Does monitoring goal progress promote goal attainment? A meta-analysis of the experimental evidence.

              Control theory and other frameworks for understanding self-regulation suggest that monitoring goal progress is a crucial process that intervenes between setting and attaining a goal, and helps to ensure that goals are translated into action. However, the impact of progress monitoring interventions on rates of behavioral performance and goal attainment has yet to be quantified. A systematic literature search identified 138 studies (N = 19,951) that randomly allocated participants to an intervention designed to promote monitoring of goal progress versus a control condition. All studies reported the effects of the treatment on (a) the frequency of progress monitoring and (b) subsequent goal attainment. A random effects model revealed that, on average, interventions were successful at increasing the frequency of monitoring goal progress (d+ = 1.98, 95% CI [1.71, 2.24]) and promoted goal attainment (d+ = 0.40, 95% CI [0.32, 0.48]). Furthermore, changes in the frequency of progress monitoring mediated the effect of the interventions on goal attainment. Moderation tests revealed that progress monitoring had larger effects on goal attainment when the outcomes were reported or made public, and when the information was physically recorded. Taken together, the findings suggest that monitoring goal progress is an effective self-regulation strategy, and that interventions that increase the frequency of progress monitoring are likely to promote behavior change.

                Author and article information

                Ann Behav Med
                Ann Behav Med
                Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine
                Oxford University Press (US )
                August 2019
                19 November 2018
                19 November 2018
                : 53
                : 8
                : 708-720
                [1 ]Centre for Behaviour Change, University College London, London
                [2 ]Department of Kinesiology, University of Rhode Island, Kingston
                [3 ]Aberdeen Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen
                [4 ]Department of Psychology, University of Minnesota, Minneapolis
                [5 ]Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge
                Author notes
                Author information
                © The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Pages: 13
                Funded by: UK Medical Research Council
                Award ID: MR/L011115/1
                Regular Articles

                behavior change,theory,methodology,behavior change technique,mechanism of action,expert consensus


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