A taxonomy of behavior change techniques used in interventions
Open accessAbstract
OBJECTIVE: Without standardized definitions of the techniques included in behavior change interventions, it is difficult to faithfully replicate effective interventions and challenging to identify techniques contributing to effectiveness across interventions. This research aimed to develop and test a theory-linked taxonomy of generally applicable behavior change techniques (BCTs). DESIGN: Twenty-six BCTs were defined. Two psychologists used a 5-page coding manual to independently judge the presence or absence of each technique in published intervention descriptions and in intervention manuals. RESULTS: Three systematic reviews yielded 195 published descriptions. Across 78 reliability tests (i.e., 26 techniques applied to 3 reviews), the average kappa per technique was 0.79, with 93% of judgments being agreements. Interventions were found to vary widely in the range and type of techniques used, even when targeting the same behavior among similar participants. The average agreement for intervention manuals was 85%, and a comparison of BCTs identified in 13 manuals and 13 published articles describing the same interventions generated a technique correspondence rate of 74%, with most mismatches (73%) arising from identification of a technique in the manual but not in the article. CONCLUSIONS: These findings demonstrate the feasibility of developing standardized definitions of BCTs included in behavioral interventions and highlight problematic variability in the reporting of intervention content.
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Literature suggests using BCTT with behaviour change theories and frameworks, such as goal setting theory, TTM, TRA, and COM-B framework, for more effective and sustainable behaviour change.
“Literature suggests using BCTT with behaviour change theories and frameworks, such as goal setting theory, TTM, TRA, and Capability, Opportunity, Motivation-Behaviour (COM-B) framework, for more effective and sustainable behaviour change [64–67].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [64]
In “Developing a theory-linked taxonomy of behavior change techniques” (page not provided), the paper links BCTs to TRA and goal theories and discusses the transtheoretical model. It does not mention COM-B, and its discussion of effectiveness is conditional rather than evidence that combining these frameworks with BCTs produces more effective and sustainable change. (LLM, conf=0.87)
Experimental — accuracy not yet measuredBCTT can improve intervention designs, enable cross-study analysis, and inform implementation feasibility.
“BCTT can improve intervention designs, enable cross-study analysis, and inform implementation feasibility [64, 68, 69].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [64]
The Discussion (page unavailable) says a shared BCT vocabulary would let researchers understand and compare intervention designs across studies. The paper also says standardized descriptions could help designers and support faithful replication and adoption, but it does not say the taxonomy informs whether implementation is feasible. (LLM, conf=0.82)
Experimental — accuracy not yet measuredAlthough the prototype design process listed desired outcome behaviors of the intervention, the approach lacked clearly stated behavior change techniques for each of the desired behaviors.
“Although the prototype design process listed desired outcome behaviors of the intervention, the approach lacked clearly stated behavior change techniques for each of the desired behaviors [78].”
From Development and feasibility of a digital acceptance and commitment therapy⇓based intervention for generalized anxiety disorder: Pilot acceptability study (2021) · cites this paper as [78]
The Discussion says that specifying intervention content is critical, and the section on theory-based techniques praises descriptions that clearly list discrete behavior change techniques. The paper does not establish that techniques must be stated separately for each desired outcome behavior; the assessment of the citing authors’ prototype is their own. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSince the millennium, increasing emphasis has been placed on preventative medicine, patient empowerment, and behaviour change to encourage people to moderate behaviours linked to chronic illness and disease.
“Since the millennium, increasing emphasis has been placed on preventative medicine, patient empowerment, and behaviour change to encourage people to moderate behaviours linked to chronic illness and disease”
From Mindfulness and Resilience in Britain: A Genealogy of the “Present Moment” (2021) · cites this paper as Abraham and Michie 2008
The section on developing the taxonomy describes health-behavior interventions aimed at preventing weight gain and promoting physical activity and healthy eating. That supports the sentence’s general point about changing health-related behavior, but our copy does not establish increasing emphasis since the millennium or an emphasis on patient empowerment. (LLM, conf=0.78)
Experimental — accuracy not yet measuredWhile psychosocial theories such as SCT, SLT, and TPB were most commonly used to inform the interventions, these interventions did not incorporate behaviour change taxonomy technique (BCTT).
“While psychosocial theories, such as SCT, SLT, and TPB were most commonly used to inform the interventions, these interventions did not incorporate behaviour change taxonomy technique (BCTT) [64, 65].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [64]
The ‘Developing a theory-linked taxonomy’ section links BCTs to TPB and social cognitive theory, but does not say those theories, or SLT, were most commonly used to inform the interventions in question. The Discussion says links between techniques and theories are not always clear in published descriptions; it does not establish that these interventions failed to incorporate a BCT taxonomy. Searches for the claimed theory-use pattern and taxonomy omission found no passage addressing either point. (LLM, conf=0.72)
Experimental — accuracy not yet measured
BCTTv1 incorporated a number of cross-behaviour BCT taxonomies and some behaviour-specific taxonomies for physical activity, alcohol use, smoking and condom use.
“BCTTv1 incorporated a number of cross-behaviour BCT taxonomies [25, 26] and some behaviour-specific taxonomies for physical activity [27], alcohol use [28], smoking [29] and condom use [30].”
A method developed for this purpose is the reliable specification of interventions in terms of BCTs.
“A method developed for this purpose is the reliable specification of interventions in terms of BCTs.20”
The taxonomy demonstrated reliability in identifying 22 BCTs and four BCT packages.
“The taxonomy demonstrated reliability in identifying 22 BCTs (e.g.'self-monitoring') and four BCT packages (e.g.'relapse prevention').”
Abraham and Michie developed the first cross-behaviour BCT taxonomy, building on previous intervention content analyses.
“Abraham and Michie 20 developed the first cross-behaviour BCT taxonomy, building on previous intervention content analyses.18,19”
Previous BCT groupings have been based on judgements made by the study author.
“Previous BCTs groupings have been based on judgements made by the study author.20,27,32,33”
Findings showed no significant difference between reliability scores, indicating trained coders could identify BCTs as reliably as coders involved in defining BCTs.
“Findings showed no significant difference between reliability scores indicating that trained coders could identify BCTs as reliably as coders involved in defining BCTs.”
Abraham and Michie assessed reliability between the two coders who developed the 26 BCT definitions and between the first author and two other trained coders.
“Abraham and Michie 20 assessed reliability between the two coders who developed the 26 BCT definitions (the authors) and also between the first author and two other coders trained to use the taxonomy.”
Abraham and Michie reported >93% agreement between three pairs of coders (including the authors).
“Abraham and Michie 20 reported > 93% agreement between three pairs of coders (including the authors).”
Since Abraham and Michie's initial paper, intercoder reliability has been demonstrated for various subsequent BCT taxonomies.
“Since Abraham and Michie's 20 initial paper, intercoder reliability has been demonstrated for various subsequent BCT taxonomies.20,23,27,28,30,48”
The 22 BCTs found to frequently occur in 40 intervention descriptions include 18 of the 22 BCTs included in the Abraham and Michie taxonomy based on more than 200 intervention descriptions.
“These 22 found to frequently occur in 40 intervention descriptions include 18 of the 22 BCTs including in the Abraham and Michie taxonomy 20 based on more than 200 intervention descriptions.”
As a compromise, the study selected against passive monitoring in favor of homework monitoring, an older more traditional methodology for measuring adherence to behaviorally oriented treatments.
“As a compromise we selected against the use of passive monitoring in favor of an older more traditional methodology for measuring adherence to behaviorally oriented treatments - homework monitoring [1].”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [1]
The taxonomy of Abraham and Michie was used for the description of interactive behavior change strategies.
“For consistency and comparability among studies, the taxonomy of Abraham and Michie was used for the description of interactive behavior change strategies [34].”
From Which Intervention Characteristics are Related to More Exposure to Internet-Delivered Healthy Lifestyle Promotion Interventions? A Systematic Review (2011) · cites this paper as [34]
Rehearsal is seen as very important in learning and behavior change.
“rehearsal, which is also seen as very important in learning and behavior change [37, 38]”
From Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions (2012) · cites this paper as [37]
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Self-citationHow Effective are Behavior Change Interventions Based on the Theory of Planned Behavior?
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Ten recommendations for using implementation frameworks in research and practice
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Practice Feedback Interventions: 15 Suggestions for Optimizing Effectiveness
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Using smartphones and health apps to change and manage health behaviors: a population-based survey
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Health Behavior Change: Moving from Observation to Intervention
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A meta-analytic review of the effect of implementation intentions on physical activity
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The Handbook of Behavior Change
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Self-citationGlobal health and development in early childhood
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Universal school-based prevention programs for alcohol misuse in young people
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Self-citationReflective and Automatic Processes in the Initiation and Maintenance of Dietary Change
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Evaluating mobile phone applications for health behaviour change: A systematic review
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A Review and Taxonomy of Choice Architecture Techniques
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“evidence-based behavioral medicine [37-40], persuasive technology and the media equation [7,41,42], persuasive communication research [43-45], stages of change [46,47], and community-based social marketing [48,49].”
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Using theories of behaviour change to inform interventions for addictive behaviours
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Self-citationA Meta-Analytic Review of Stand-Alone Interventions to Improve Body Image
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Identification of behaviour change techniques to reduce excessive alcohol consumption
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Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis
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Changing Behavior Using the Theory of Planned Behavior
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Gamification in apps and Technologies for Improving Mental Health and Well-Being: systematic review
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A systematic review of hand hygiene improvement strategies: a behavioural approach
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- Authors
- Abraham, C., & Michie, S.
- Affiliations
- University of Sussex (GB)
- University College London (GB)
- Venue
- Health Psychology
- Published
- 2008
- Volume
- 27
- Issue
- 3
- Pages
- 379-387
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2057181385
- Cited by
- 2,525
- References
- 53
- Citations by year
- 2026: 49 · 2025: 85 · 2024: 107 · 2023: 121 · 2022: 124 · 2021: 163 · 2020: 230 · 2019: 181 · 2018: 187 · 2017: 176 · 2016: 187 · 2015: 197 · 2014: 166 · 2013: 167 · 2012: 141
- FWCI
- 105.13
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Figshare (submittedVersion)
- 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, taxonomy (general classification scheme), behavioral interventions, intervention reporting, coding reliability, intervention manual, intervention replication
- MeSH terms
- Behavior Therapy, Humans, Psychotherapy, Health Behavior, Bibliometrics
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