Source: Michie, S., van Stralen, M.M., and West, R. (2011), ‘The behaviour change wheel: a new method for characterizing and designing behaviour change interventions’, Implementation Science, 6, 1, 42–53.

Abstract:

Background

Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterizing interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations.

Methods

A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity.

Results

Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. 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. 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'). 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. The BCW was used reliably to characterize 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.

Conclusions

Interventions and policies to change behaviour can be usefully characterized by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.

Insight: In this highly readable article, the authors undertake a systematic literature review to identify frameworks for behaviour change interventions. They synthesize a new framework, based on 19 identified extant behaviour change intervention frameworks, which they call the ‘COM-B system’. The COM-B system explains how behavioural change should be analysed from the perspective of the capabilities, opportunities, and motivations that target audiences have to change their behaviour, leading to the design of nine intervention functions including education, persuasion, incentivization, coercion, training, enablement, modelling, environmental restructuring, and restrictions.

URL: http://www.implementationscience.com/content/6/1/42/