'Behaviour change interventions' can be defined as coordinated sets of activities designed to change specified behaviour patterns. Thus, behaviour change interventions are fundamental to the effective practice of clinical medicine and public health, as indeed they are to many pressing issues facing society. Improving the implementation of evidence-based practice and public health depends on behaviour change. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions. Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions around this are placed seven categories of policy that could enable those interventions to occur. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. A new framework was developed to meet these criteria. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. MethodsĪ systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions.
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