Theories and techniques of behaviour change: Developing a cumulative science of behaviour change
Open accessAbstract
As behaviour contributes to the cause of much current mortality and morbidity (Mokdad, Marks, Stroup, & Gerberding, 2000; Parkin, Boyd, & Walker, 2011), interventions to change behaviour are essent...
AI snapshot
Written from the paper’s full text.
TL;DR
This editorial argues that the science of behaviour change will only accumulate if researchers define behaviour itself as the intervention outcome, describe interventions in terms of replicable behaviour change techniques (BCTs), and connect those techniques to theoretical mechanisms of change. It reviews evidence from companion meta-analyses showing that theory-based interventions outperform merely technique-rich ones.
Key findings
- The authors identify three priorities: clarifying "behaviour" as the outcome, developing replicable reporting of BCTs, and linking interventions and BCTs to theoretical mechanisms.
- Behaviour is often mislabelled (e.g., "adherence," "physical activity") or confused with downstream outcomes such as weight or blood glucose; the apparent effectiveness of an intervention depends on which outcome type is chosen.
- In the cited meta-analyses, the sheer number of BCTs did not predict efficacy, but having an explicit theoretical basis did; Dombrowski et al. found interventions containing more BCTs congruent with Control Theory produced greater weight loss in obese adults, and Taylor et al. found the degree to which worksite physical activity interventions were theory-based predicted effectiveness.
- Taylor et al.'s meta-analysis also found smaller intervention effects when BCTs were not specified, and Dombrowski et al. identified instruction, self-monitoring and practice as effective techniques.
Methods
- Design: an editorial/commentary synthesising conceptual arguments and citing findings from the themed issue of *Health Psychology Review* and related literature; no primary data collection.
- Evidence base: secondary — meta-analyses and meta-regressions by Dombrowski et al. (2012), Taylor et al. (2012), Webb et al. (2010), Michie, Abraham et al. (2009), plus taxonomy-development work on physical activity/healthy eating, smoking, alcohol and condom use.
- Analysis: narrative argument organised around the three proposed advances; no statistical analysis performed by the authors.
Limitations
- Not stated in the paper: the editorial does not present a limitations section.
- Evident from the text: the argument rests entirely on secondary sources and illustrative examples rather than new empirical evidence, so the claims about theory–technique links are programmatic rather than tested.
- Evident from the text: the authors note that BCT taxonomies have been built inductively and their hierarchical structures have not yet been investigated, and that the mapping of BCTs to theoretical constructs remains a preliminary attempt requiring further work.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
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Claims the paper makes
0 of 22 cited sources checked · 0 supported · 0 flagged
- Premisecitation§ Behaviour is the outcome of behaviour change interventions
The Theory of Planned Behaviour may predict some behaviours better than others.
“McEachan, Conner, Taylor and Lawton's (2011) finding that the Theory of Planned Behaviour may be more effective in predicting some behaviours than others.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites McEachan, Conner, Taylor and Lawton's (2011) source
Not checked in the free run.
- Interpretationcitation§ Behaviour is the outcome of behaviour change interventions
Using outcomes further down the causal chain to judge intervention effectiveness is problematic because many factors can weaken the link between behaviour and outcome.
“The problem with evaluating intervention effectiveness in terms of outcomes further down the causal chain (Hardeman et al., 2005) is that there are a host of influences that could intervene and attenuate the link between behaviour and outcome.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hardeman et al., 2005 source
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- Premisecitation§ Behaviour is the outcome of behaviour change interventions
In some interventions, behaviour itself is the health outcome of value, such as when reducing activity limitations or increasing participation.
“For some interventions, behaviour per se is the valued health outcome, for example, in studies to reduce activity limitations or enhance participation (Johnston, Bonetti, & Pollard, 2002).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Johnston, Bonetti, & Pollard, 2002
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- Interpretationreasoning§ Behaviour change techniques
Specification also makes systematic classification possible.
“Specification also enables a further step underpinning scientific investigation, systematic classification.”
Quote in the paperSubstantial claim - Premisenone given§ Behaviour change techniques
Scientific standards that are required and successful for biomedical interventions are often disregarded when the intervention is behavioural.
“The scientific standards demanded, and found to be successful, for biomedical interventions are often ignored when the intervention involves behaviour change.”
Quote in the paperSubstantial claim
- Premisecitation§ Behaviour is the outcome of behaviour change interventions
When behaviour is the outcome, early causal-chain endpoints such as knowledge and attitudes are not enough, because their effects are weakened as they pass through motivational and action processes.
“However, when the outcome is behaviour, end-points that are early in the causal chain, such as knowledge and attitudes, are insufficient, as even a strong effect on these cognitive outcomes will be attenuated as they are mediated through motivational and action-oriented processes to result in behaviour (Sniehotta, 2009;Webb & Sheeran, 2006).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation§ Behaviour change techniques
Methods that seem well described, including cognitive behaviour therapy for pain, have still not been described adequately.
“Even apparently well-described methods such as cognitive behaviour therapy for pain have not been adequately described: 'the usage of the term cognitive behavior therapy varies widely and may include self-instructions . . .relaxation or biofeedback, development of coping strategies . . .goal setting' (Gatchel, Peng, Peters, Fuchs, & Turk, 2007, p. 606).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gatchel, Peng, Peters, Fuchs, & Turk, 2007 source
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- Interpretationreasoning§ Behaviour is the outcome of behaviour change interventions
The connection between a successful behaviour change and a non-behavioural health outcome depends on causal relationships established by epidemiology and medical sciences rather than behavioural sciences.
“Thus, the link between an effective change in behaviour and an effect on a non-behavioural health outcome depends on the strength of the causal relationships established by epidemiology and medical, rather than behavioural, sciences.”
Quote in the paperSubstantial claim - Premisecitation§ Behaviour is the outcome of behaviour change interventions
The apparent effectiveness of an intervention depends on which outcome type is chosen.
“the evidence of effectiveness of interventions depends on which type of outcome is specified (Dombrowski, Sniehotta, Avenell, MacLennon, & Aray `jo-Soares, 2012).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Dombrowski, Sniehotta, Avenell, MacLennon, & Aray `jo-Soares, 2012 source
Not checked in the free run.
- Interpretationreasoning§ Behaviour is the outcome of behaviour change interventions
The processes and behaviour change techniques needed may differ across behaviours in a sequence.
“The processes involved and the BCTs required for behaviour change may differ for each behaviour in the sequence.”
Quote in the paperNot a substantial claim - Interpretationreasoning§ Behaviour change techniques
Thinking of interventions as made of component techniques makes it possible to identify their active ingredients.
“Conceptualising interventions in terms of their component techniques enables the possibility of identifying the 'active ingredients' within interventions.”
Quote in the paperSubstantial claim - Premisecitation§ Behaviour is the outcome of behaviour change interventions
The association between medication-adherence behaviours and health outcomes can vary by disease and by the suitability and efficacy of the prescribed treatment.
“As Di Matteo, Haskard-Zolnierek and Martin (2012) point out, the correlation between the behaviours involved in medication adherence and health outcomes may vary with the disease condition and the appropriateness and efficacy of the treatment prescribed.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Di Matteo, Haskard-Zolnierek and Martin (2012) source
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- Interpretationreasoning§ Conclusions: developing the science and technology of behaviour change
Recent progress in classifying behaviour change techniques has started to provide the precision and specificity needed for cumulative evidence.
“Recent progress in classifying the active components of behaviour change interventions, BCTs, has begun to produce the precision and specificity required to build cumulative evidence.”
Quote in the paperSubstantial claim - Premisereasoning§ Linking BCTs with theoretical mechanisms of change
Those frameworks do not provide guidance on linking theoretical mechanisms of change to behaviour change techniques.
“However, they do not offer guidance as to how to link the postulated theoretical mechanisms of change with BCTs.”
Quote in the paperSubstantial claim - Premisecitation§ EDITORIAL Theories and techniques of behaviour change: Developing a cumulative science of behaviour change
Behaviour change interventions are typically complex and consist of multiple interacting components.
“Behaviour change interventions are usually complex, comprising many interacting components (Craig et al., 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Craig et al., 2008 source
Not checked in the free run.
- Classified as probably not a substantial claim. 1
- May combine two claims. 9
Classified as probably not a substantial claim.
Premisecitation§ EDITORIAL Theories and techniques of behaviour change: Developing a cumulative science of behaviour changeBehaviour contributes to a large share of current mortality and morbidity.
“As behaviour contributes to the cause of much current mortality and morbidity (Mokdad, Marks, Stroup, & Gerberding, 2000;Parkin, Boyd, & Walker, 2011)”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Mokdad, Marks, Stroup, & Gerberding, 2000
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- cites Parkin, Boyd, & Walker, 2011
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May combine two claims.
Premisenone given§ Behaviour change techniquesBehaviour change interventions are often poorly specified, which prevents high-fidelity replication, and are delivered by people whose competence is not reported.
“whilst behaviour change interventions are often poorly specified, preventing high-fidelity replication and, despite being complex, delivered by individuals of unreported competence.”
Quote in the paperSubstantial claimMay combine two claims.
Premisecitation§ Behaviour change techniquesSpecifying behaviour change techniques precisely may improve interventions; meta-analysis found smaller effects when techniques were not specified.
“Precise specification of BCTs may also enhance the intervention: Taylor et al.'s (2012) meta-analysis found that when BCTs were not specified, intervention effects were smaller.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Taylor et al.'s (2012)
Not checked in the free run.
May combine two claims.
Premisecitation§ Linking BCTs with theoretical mechanisms of changeImportant frameworks for intervention design and evaluation stress that theory should inform design and that interventions should be specified by component techniques.
“Key frameworks for designing and evaluating behaviour change interventions (Collins et al., 2011;Craig et al., 2008) emphasise the importance of using theory to inform intervention design as well as specifying interventions in terms of component BCTs.”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
Premisecitation§ Linking BCTs with theoretical mechanisms of changeWhether an intervention had a theoretical basis predicted efficacy, whereas the count of techniques used did not.
“Both Dombrowski et al. (2012) and Taylor et al. (2012) found that the number of BCTs used did not predict efficacy but having a theoretical basis for the intervention did.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Dombrowski et al. (2012) source
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- cites Taylor et al. (2012)
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May combine two claims.
Premisecitation§ Linking BCTs with theoretical mechanisms of changeInterventions with more techniques congruent with Control Theory were linked to greater weight loss in obese adults, repeating a finding in the general adult population.
“interventions including more BCTs that were congruent with Control Theory (Carver & Scheier, 1982) were associated with greater weight loss (in this case, a proxy for healthy eating) in obese adult patients, replicating a similar finding by Michie, Abraham, et al. (2009) in the general adult population.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Carver & Scheier, 1982 source
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- cites Michie, Abraham, et al. (2009)
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May combine two claims.
Premisecitation§ Behaviour is the outcome of behaviour change interventionsBehaviour can involve a complex sequence of actions over time; medication adherence requires at least four behaviours.
“Behaviour may involve the performance of a complex sequence of actions over time; for example, Di Matteo and colleagues identify a sequence of at least four behaviours necessary to adhere to medication advice.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Di Matteo and colleagues
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May combine two claims.
Premisecitation§ Linking BCTs with theoretical mechanisms of changeThe degree to which worksite physical activity interventions were explicitly theory-based predicted their effectiveness, matching findings for internet interventions.
“Taylor et al. also found that the extent to which worksite physical activity interventions were explicitly based on theory (using Michie & Prestwich's (2010) theory coding scheme) predicted their effectiveness, a finding consistent with a similar analysis of internet interventions (Webb, Joseph, Yardley, & Michie, 2010).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Michie & Prestwich's (2010) source
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- cites Webb, Joseph, Yardley, & Michie, 2010
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May combine two claims.
Premisecitation§ Behaviour change techniquesWith a reliable BCT coding scheme, instruction, self-monitoring and practice were found to be effective techniques.
“For example, using a reliable BCT coding scheme, Dombrowski et al. (2012) found that instruction, self-monitoring and practice were effective techniques.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Dombrowski et al. (2012) source
Not checked in the free run.
May combine two claims.
Interpretationreasoning§ Linking BCTs with theoretical mechanisms of changeLinking theoretical mechanisms to behaviour change techniques is needed both to inform intervention development and to test theory through intervention evaluation.
“This link is necessary both to theoretically inform intervention development and to test theory by evaluating interventions.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The effectiveness of behaviour change interventions varies, and the reasons for this variation are not fully understood.
“However, their effectiveness is variable, and we do not have a full understanding of what accounts for this variability.”
The paper relies on this without support.
Ineffective techniques are still used, effective techniques are underused, hard to replicate, and their mechanisms are poorly understood.
“Ineffective techniques continue to be used, while effective techniques are underused, difficult to replicate and their mechanisms of action are poorly understood.”
The paper relies on this without support.
Basic psychological research over the past century has shown that behaviour and behaviour change follow predictable patterns.
“Basic psychological research over the last century has demonstrated that behaviour and behaviour change follow predictable patterns.”
The paper relies on this without support.
The hierarchical structures of behaviour-specific BCT classifications have not yet been studied.
“To date, their hierarchical structures have not been investigated.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Systematic reviews of knowledge translation interventions to change healthcare professionals' practice consistently indicate that interventions are haphazardly designed and poorly specified, limiting replication, understanding, and generalizability.
“Systematic reviews of KT interventions to change HCPs’ practice consistently indicate that interventions are haphazardly designed and poorly specified, limiting our ability for replication, understanding, and generalizability [5, 6].”
From Methods for designing interventions to change healthcare professionals’ behaviour: a systematic review (2017) · cites this paper as [6]
There is a recognised need to specify interventions in greater detail and with more consistent terminology and for evaluation studies to specify the components of the interventions in both the experimental and control groups.
“There is a recognised need to specify interventions in greater detail and with more consistent terminology and for evaluation studies to specify the components of the interventions in both the experimental and control groups [17–21].”
There is increased recognition of the need for systematic and extensive application of theory to the design of interventions.
“There is increased recognition of the need for systematic and extensive application of theory to the design of interventions [18, 55–59]; this is reflected, for example, in the UK Medical Research Council’s framework for designing and evaluating complex interventions [21] and the Intervention Mapping framework [60] for planning health promotion programmes.”
There is a need for a consensus about how the individual mechanisms of action specified in theories can be linked with particular intervention components.
“Thus, whilst there are integrative frameworks such as the TDF, and general intervention development frameworks such as intervention mapping and others (e.g. [21, 60, 72, 73]), there is a need for a consensus about how the individual mechanisms of action specified in these theories can be linked with particular intervention components [18, 62].”
Theories of behaviour change summarise what is known about the mechanisms of behaviour change and the conditions in which behaviour change is most likely to occur.
“Theories of behaviour change summarise what is known about the mechanisms of behaviour change and the conditions in which behaviour change is most likely to occur.8”
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”
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Translational Behavioral Medicine
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Interpersonal style should be included in taxonomies of behavior change techniques
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- Authors
- Michie, S., & Johnston, M.
- Affiliations
- University College London (GB)
- University of Aberdeen (GB)
- Corresponding author
- Michie, Susan
- Venue
- Health Psychology Review
- Publisher
- Informa UK Limited
- Published
- 2012-03
- Volume
- 6
- Issue
- 1
- Pages
- 1-6
- ISSN
- 1743-7199 (ISSN-L)
- 1743-7202
- OpenAlex
- W1969321932
- Semantic Scholar
- 5d85fd21b37860b57202f126055a9282aa1ef4ec
- Cited by
- 522
- References
- 41
- Citations by year
- 2026: 30 · 2025: 35 · 2024: 47 · 2023: 45 · 2022: 43 · 2021: 58 · 2020: 39 · 2019: 38 · 2018: 31 · 2017: 31 · 2016: 30 · 2015: 30 · 2014: 29 · 2013: 27 · 2012: 9
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health Psychology Review (publishedVersion)
- UCL Discovery (University College London) (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
- behavior change, behaviour change interventions, cumulative science, health behavior, health promotion
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