The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions
Open accessAbstract
BACKGROUND: CONSORT guidelines call for precise reporting of behavior change interventions: we need rigorous methods of characterizing active content of interventions with precision and specificity. OBJECTIVES: The objective of this study is to develop an extensive, consensually agreed hierarchically structured taxonomy of techniques [behavior change techniques (BCTs)] used in behavior change interventions. METHODS: In a Delphi-type exercise, 14 experts rated labels and definitions of 124 BCTs from six published classification systems. Another 18 experts grouped BCTs according to similarity of active ingredients in an open-sort task. Inter-rater agreement amongst six researchers coding 85 intervention descriptions by BCTs was assessed. RESULTS: This resulted in 93 BCTs clustered into 16 groups. Of the 26 BCTs occurring at least five times, 23 had adjusted kappas of 0.60 or above. CONCLUSIONS: "BCT taxonomy v1," an extensive taxonomy of 93 consensually agreed, distinct BCTs, offers a step change as a method for specifying interventions, but we anticipate further development and evaluation based on international, interdisciplinary consensus.
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The motivating behavior change process comprised the "vicarious consequences" and "emotional social support" BCTs.
“The motivating behavior change process comprised of the “vicarious consequences” and “emotional social support” BCTs as the BCCTv1 dictates that cognitive behavioral therapy (CBT) and motivational interviewing (MI) frameworks should be coded as emotional social support (Michie et al., 2013).”
From Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking (2019) · cites this paper as Michie et al., 2013
Table 5 lists “social support (emotional)” as a BCT, supporting that part of the citation. The passages found do not identify “vicarious consequences” as a BCT or say that CBT and MI should be coded as emotional social support. The Future Developments section says the taxonomy specifies intervention content but does not itself make links with theory. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe BCTTv1 states that "emotional social support" extends to MI and CBT.
“For instance, the BCTTv1 states that “emotional social support” extends to MI and CBT (Michie et al., 2013).”
From Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking (2019) · cites this paper as Michie et al., 2013
Table 5 lists “Social support (emotional) [3.3]” as a BCT. The paper does not say that this technique extends to motivational interviewing (MI) or cognitive behavioral therapy (CBT); searches for those terms found no such link. The indexed passage has no page number. (LLM, conf=0.84)
Experimental — accuracy not yet measuredA strength of this review included the use of a validated taxonomy used in other areas with reasonable interrater reliability.
“A strength of this review included the use of a validated taxonomy used in other areas with reasonable interrater reliability (Michie et al., 2013).”
From Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking (2019) · cites this paper as Michie et al., 2013
The reliability-testing results report that 23 of 26 assessable techniques achieved adjusted kappa scores of at least 0.60. The Discussion qualifies this finding: reliability could not be assessed for 62 infrequently observed techniques. The paper describes a taxonomy intended for use across behavioral domains, but does not establish that the full taxonomy was validated or already used in other areas. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPsychological interventions were generally multi-component and complex, containing an average of 9.6 BCTs; the most frequently used BCTs were 'problem solving' and 'instruction on how to perform the behaviour'.
“Psychological interventions were generally multi-component and complex, containing an average of 9.6 BCTs; the most frequently used BCTs were 'problem solving' and 'instruction on how to perform the behaviour' (Michie 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Michie 2013
The Introduction (page not specified in our copy) says behavior-change interventions are typically complex and involve many interacting components, supporting the general description. It does not report an average of 9.6 BCTs for psychological interventions or identify problem solving and instruction on how to perform the behaviour as the most frequently used BCTs; the Discussion mentions the latter technique in a reliability analysis, not a frequency ranking. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe review authors contacted the authors of included trials about the content of their interventions if there was insufficient information available.
“As such, SD contacted the authors of included trials about the content of their interventions if there was insufficient information available (Michie 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Michie 2013
The Introduction (page unavailable) says that poor descriptions of interventions in published reports hinder evidence synthesis, supporting the concern about insufficient information. It does not describe contacting trial authors to obtain intervention details; SD’s reported action is the citing authors’ own procedure, not a finding established by this source. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Psychological interventions for improving adherence to inhaled therapies in people with CF may incorporate one or more BCTs (e.g.'problem-solving', defined as analysing, or prompting the person to analyse, factors influencing the behaviour and generating or selecting strategies that include overcoming barriers and/or increasing facilitators) (Michie 2013).
“Psychological interventions for improving adherence to inhaled therapies in people with CF may incorporate one or more BCTs (e.g.'problem-solving', defined as”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Michie 2013
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe Behaviour Change Technique Taxonomy (BCTT) was applied to identify effective combinations of intervention components for promoting healthy eating behaviours among adolescents.
“Additionally, we applied the Behaviour Change Technique Taxonomy (BCTT) to identify effective combinations of intervention components for promoting healthy eating behaviours among adolescents [28].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [28]
Most BCTs in Michie's taxonomy are not currently used in m-health apps for diabetes management.
“Of the 93 BCTs in Michie's taxonomy, 21 only 23 were used in the selected trials, illustrating that most BCTs in the taxonomy are not currently used in m-health apps for diabetes management.”
Behavior change techniques (BCTs) are observable and replicable components within an intervention designed to change behavior, representing the smallest identifiable components that can change behavior.
“BCTs refer to the observable and replicable components within an intervention designed to change behavior”
From Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking (2019) · cites this paper as Michie et al., 2013
Michie et al. (2013) devised a taxonomy (BCCTv1) containing 93 BCTs.
“Michie et al. (2013) devised a taxonomy (BCCTv1) containing 93 BCTs”
From Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking (2019) · cites this paper as Michie et al., 2013
The full BCCTv1 contains 93 BCTs.
“Although the full BCCTv1 contains 93 BCTs (Michie et al., 2013), the current review only identified 18 different BCTs.”
From Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking (2019) · cites this paper as Michie et al., 2013
The BCTs are helpful in providing a common language to describe processes within the programme that aim to change the behaviour of the participants.
“The BCTs are helpful in providing a common language to describe processes within the programme that aim to change the behaviour of the participants [54].”
Active ingredients or strategies facilitating behavior change were operationalized using the Behavior Change Technique Taxonomy version 1 (BCT Taxonomy v1) hierarchical clusters.
“Active ingredients or strategies facilitating behavior change were operationalized using the Behavior Change Technique Taxonomy version 1 (BCT Taxonomy v1) hierarchical clusters [20] (see the Collating, Summarizing, and Reporting the Results section for details of each).”
From Features of Structured, One-to-One Videoconference Interventions That Actively Engage People in the Management of Their Chronic Conditions: Scoping Review (2025) · cites this paper as [20]
The review authors coded extracted intervention descriptions into component BCTs using the BCTTv1, an established taxonomy of 93 BCTs, as a coding framework.
“We coded the extracted intervention descriptions into component BCTs using the BCTTv1, an established taxonomy of 93 BCTs, as a coding framework (Michie 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Michie 2013
Two independent coders will identify and record which behaviour change techniques from the BCT Taxonomy v1 are present in each intervention component.
“Two independent coders will identify and record which BCTs from the BCT Taxonomy v1 are present in each intervention component.48”
Several resources can inform the use of implementation strategies, including established taxonomies of implementation strategies and behavior change techniques, repositories of systematic reviews, methods for selecting and tailoring implementation strategies, and reporting guidelines that promote replicability.
“Several resources can inform the use of implementation strategies, including established taxonomies of implementation strategies (6, 7, 24, 25) and behavior change techniques (27, 28), repositories of systematic reviews (38, 103, 104), methods for selecting and tailoring implementation strategies (40, 55, 56), and reporting guidelines that promote replicability (4, 98–100).”
From Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda (2019) · cites this paper as [27]
Active ingredients can be categorized broadly, as is done in the interventions and policy levels of the Behavior Change Wheel, or characterized at the level of specific strategies or techniques.
“Active ingredients can be categorized broadly, as is done in the interventions and policy levels of the Behavior Change Wheel [21], or characterized at the level of specific strategies or techniques [24].”
From Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies (2014) · cites this paper as [24]
BCTTv1 is an extensive, integrated, hierarchical classification system for reliably specifying intervention components in terms of 93 BCTs, organised into 16 groupings.
“This is an extensive, integrated, hierarchical classification system for reliably specifying intervention components in terms of 93 BCTs, organised into 16 groupings [15, 16, 22–24].”
Study 1 presented the synthesis of existing BCT taxonomies into a single comprehensive, cross-context, overarching BCT taxonomy: BCTTv1.
“Study 1 presented the synthesis of existing BCT taxonomies into a single comprehensive, cross-context, overarching BCT taxonomy: BCTTv1.8,17,40”
Evidence is emerging that some BCTs from BCTTv1 occur more frequently than others in descriptions of BCIs.
“Evidence is already emerging to suggest that some BCTs from BCTTv1 occur more frequently than others in descriptions of BCIs.40”
Results from two initial phases of reliability testing indicated BCTTv1 to be reliable in specifying 26 frequently occurring BCTs when used by the taxonomy developers.
“Results from two initial phases of reliability testing indicated BCTTv1 to be reliable in specifying 26 frequently occurring BCTs when used by the taxonomy developers.40”
The extensive discussions in taxonomy development might result in enhanced agreement owing to tacit knowledge beyond explicit labels and definitions.
“The extensive discussions involved in taxonomy development described by Michie et al. 40 might result in enhanced agreement owing to tacit knowledge beyond the explicit BCT labels and definitions.”
Of the 26 BCTTv1 BCTs meeting the criterion, nine had 'outstanding' and 14 'substantial' reliabilities.
“Of the 26 BCTTv1 BCTs meeting this criterion, nine were found to have 'outstanding' and 14 'substantial' reliabilities.”
Most researchers would probably accept that BCT definitions generating kappa scores of 0.70 can be reliably identified but may have reservations about lower scores.
“Most researchers would probably accept that BCTs definitions generating kappa scores of 0.70 can be reliably identified but may have reservations about those with lower scores.108”
Byrt et al. proposed PABAK, which results in more meaningful indices for data such as BCT coding when prevalence is low and bias may occur; it was chosen by Michie et al. as most appropriate for BCTTv1.
“Byrt et al. 99 proposed the 'PABAK', which results in considerably more meaningful indices for data such as BCT coding when the prevalence of each BCT is low and bias may occur; therefore, it was the statistic chosen by Michie et al. 40 as the most appropriate to measure intercoder reliability in applying BCTTv1.”
Successful outcomes of public health interventions depend not only on the existence of the specific intervention components needed to achieve behaviour change but also on the extent to which they are implemented in the real world setting.
“There is empirical evidence to suggest that successful outcomes of public health interventions depend not only on the existence of the specific intervention components needed to achieve behaviour change [11] but also on the extent to which they are implemented in the real world setting [12].”
From Barriers, facilitators and capacities for childhood obesity prevention in 12 European nations: results of a policy-maker survey (2018) · cites this paper as [11]
User interaction data present interpretational challenges, such as difficulty distinguishing online versus offline interactions and implications for intervention exposure, and there is an absence of frameworks identifying meaningful interaction sequences that translate to specific BCTs.
“This assumption is problematic because of the current limited interpretational challenges user interaction data present, such as the difficulty in distinguishing online versus offline interactions and the implications for intervention exposure, or the absence of frameworks that identify unique meaningful interaction sequences with digital features that translate to specific behavior change”
From Understanding Health Behavior Technology Engagement: Pathway to Measuring Digital Behavior Change Interventions (2019) · cites this paper as [10]
BCTs are the smallest component parts of widely used theories of health behavior, sourced from various fields and through consensus of experts.
“Behavior change techniques are the smallest component parts of widely used theories of health behavior, sourced from various fields and through consensus of experts [10].”
From Understanding Health Behavior Technology Engagement: Pathway to Measuring Digital Behavior Change Interventions (2019) · cites this paper as [10]
Published descriptions of what the intervention consists of are often remarkably poor.
“Moreover, published descriptions of what the intervention consists of are often, and unfortunately, remarkably poor.38 39”
From Demystifying theory and its use in improvement (2015) · cites this paper as [38]
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Schneider, C., Weinmann, M., & Brocke, J. V. (2018) · Communications of the ACM · doi:10.1145/3213765 · Cited by 269 · see citing works
- Authors
- Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E.
- Affiliations
- University College London (GB)
- University of Exeter (GB)
- University of Aberdeen (GB)
- City, University of London (GB)
- University of Cambridge (GB)
- Newcastle University (GB)
- University of Kent (GB)
- Corresponding author
- Michie, Susan
- ORCID
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-03-20
- Volume
- 46
- Issue
- 1
- Pages
- 81-95
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- OpenAlex
- W2169434152
- Cited by
- 7,629
- References
- 49
- Citations by year
- 2026: 644 · 2025: 771 · 2024: 824 · 2023: 846 · 2022: 906 · 2021: 834 · 2020: 757 · 2019: 550 · 2018: 489 · 2017: 325 · 2016: 280 · 2015: 229 · 2014: 130 · 2013: 34 · 2012: 3
- FWCI
- 342.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Kent Academic Repository (University of Kent) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Medical Research Council
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- behaviour change techniques, BCT taxonomy, behaviour change interventions, intervention reporting, interobserver agreement, consensus development, hierarchical clustering
- MeSH terms
- Behavior Therapy, Consensus Statements as Topic, Humans, Cluster Analysis, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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