What do cost-effective health behaviour-change interventions contain? A comparison of six domains.

Authors:
Emma Beard
Emma Beard
University College London
United Kingdom
Robert West
Robert West
University College London
United Kingdom
Fabiana Lorencatto
Fabiana Lorencatto
University College London
United Kingdom
Susan Michie
Susan Michie
University College London
United Kingdom
Lesley Owens
Lesley Owens
National Institute for Health and Care Excellence
Lion Shahab
Lion Shahab
University College London
United Kingdom

PLoS One 2019 17;14(4):e0213983. Epub 2019 Apr 17.

Department of Behavioural Science and Health, University College London, London, United Kingdom.

Objectives: To help implement behaviour change interventions (BCIs) in practice it is important to be able to characterize their key components. This study compared broad features of cost-effective BCIs that addressed smoking, diet, physical activity, alcohol and sexual health. It also assessed the association of these with the magnitude of the cost-effectiveness estimates.

Methods: A content analysis of 79 interventions based on 338 intervention descriptions was conducted, using the Behaviour Change Wheel (BCW) to classify intervention content in terms of intervention functions, and the BCT taxonomy to identify and categorise component Behaviour Change Techniques (BCT). Regression analysis identified the association of these with upper (pessimistic) and lower (optimistic) cost-effectiveness estimates.

Results: The most and least common functions and BCT clusters were education (82.3%) and shaping knowledge (79.7%), and coercion (3.8%) and covert learning (2.5%). Smoking interventions contained the largest ([Formula: see text] = 12) number of BCTs and were most cost-effective. Several other factors were associated with worse (coercionfunction βupper = 36551.24; shaping knowledgeBCT βlower = 2427.78; comparison of outcomesBCT βupper = 9067.32; repetition and substitutionBCT βupper = 7172.47) and better (modellingfunction βlower = -2905.3; environmental restructuringfunction βupper = -8646.28; reward and threatBCT βupper = -5577.59) cost-effectiveness (p<0.05).

Discussion: Cost-effective BCIs rely heavily on education with smoking interventions exhibiting the most comprehensive range of BCTs. Providing an example to aspire to, restructuring the environment and rewarding positive behaviour may be associated with greater cost-effectiveness.

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Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0213983PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469762PMC
April 2019
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Altmetric Statistics

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(Supplied by CrossRef)
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School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18
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JV Bailey et al.
Cochrane Database Syst Rev 2010
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