Developing a method for specifying the components of behavior change interventions in practice: the example of smoking cessation
Abstract
OBJECTIVE: There is a difference between interventions as planned and as delivered in practice. Unless we know what was actually delivered, we cannot understand "what worked" in effective interventions. This study aimed to (a) assess whether an established taxonomy of 53 smoking cessation behavior change techniques (BCTs) may be applied or adapted as a method for reliably specifying the content of smoking cessation behavioral support consultations and (b) develop an effective method for training researchers and practitioners in the reliable application of the taxonomy. METHOD: Fifteen transcripts of audio-recorded consultations delivered by England's Stop Smoking Services were coded into component BCTs using the taxonomy. Interrater reliability and potential adaptations to the taxonomy to improve coding were discussed following 3 coding waves. A coding training manual was developed through expert consensus and piloted on 10 trainees, assessing coding reliability and self-perceived competence before and after training. RESULTS: An average of 33 BCTs from the taxonomy were identified at least once across sessions and coding waves. Consultations contained on average 12 BCTs (range = 8-31). Average interrater reliability was high (88% agreement). The taxonomy was adapted to simplify coding by merging co-occurring BCTs and refining BCT definitions. Coding reliability and self-perceived competence significantly improved posttraining for all trainees. CONCLUSIONS: It is possible to apply a taxonomy to reliably identify and classify BCTs in smoking cessation behavioral support delivered in practice, and train inexperienced coders to do so reliably. This method can be used to investigate variability in provision of behavioral support across services, monitor fidelity of delivery, and identify training needs.
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Coder training incorporating these principles and BCTs has previously been evaluated in applying the taxonomy to specify BCT content in written intervention descriptions of behavioural support in smoking cessation, and training in this context was a 3-hour workshop delivered to a mixture of research psychologists and non-psychologist practitioners.
“Coder training incorporating these principles and BCTs has previously been evaluated in applying the taxonomy to specify BCT content in written intervention descriptions of behavioural support in smoking cessation, and training in this context was a 3-hour workshop delivered to a mixture of research psychologists and non-psychologist practitioners.95”
The quality of published intervention descriptions is generally poor, with techniques described using different terminology and labelling.
“However, the quality of published intervention descriptions is generally poor, 95 with techniques described using different terminology and referred to using different labelling.104,105”
As the use of BCT methodology increases, BCT content as reported in intervention descriptions is likely to become clearer, leading to increased ease of identifying BCTs.
“As the use of BCT methodology increases, BCT content as reported in intervention descriptions is likely to become much clearer, leading to increased ease of identifying BCTs.95”
Training incorporating these principles and BCTs improved trainees' coding competence (agreement with expert consensus) in a prior smoking cessation study.
“This study found that training improved trainees' coding competence (i.e.their agreement with expert consensus about which BCTs are present).”
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- Authors
- Lorencatto, F., West, R., Seymour, N., & Michie, S.
- Affiliations
- University College London (GB)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2013
- Volume
- 81
- Issue
- 3
- Pages
- 528-544
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2047356023
- Cited by
- 45
- References
- 24
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 2 · 2014: 2 · 2013: 2
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Department of Health (DOH T336/BSS/M)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- smoking cessation, behaviour change techniques, smoking cessation services, inter-rater reliability, coding reliability, perceived competence
- MeSH terms
- Adult, Behavior Therapy, England, Female, Humans, Male, Pilot Projects, Reproducibility of Results, Smoking Cessation, Qualitative Research, Young Adult
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