Behavior change techniques used to promote walking and cycling: a systematic review.

OBJECTIVE

Evidence on the effectiveness of walking and cycling interventions is mixed. This may be partly attributable to differences in intervention content, such as the cognitive and behavioral techniques (BCTs) used. Adopting a taxonomy of BCTs, this systematic review addressed two questions: (a) What are the behavior change techniques used in walking and cycling interventions targeted at adults? (b) What characterizes interventions that appear to be associated with changes in walking and cycling in adults?

METHOD

Previous systematic reviews and updated database searches were used to identify controlled studies of individual-level walking and cycling interventions involving adults. Characteristics of intervention design, context, and methods were extracted in addition to outcomes. Intervention content was independently coded according to a 26-item taxonomy of BCTs.

RESULTS

Studies of 46 interventions met the inclusion criteria. Twenty-one reported a statistically significant effect on walking and cycling outcomes. Analysis revealed substantial heterogeneity in the vocabulary used to describe intervention content and the number of BCTs coded. "Prompt self-monitoring of behavior" and "prompt intention formation" were the most frequently coded BCTs.

CONCLUSION

Future walking and cycling intervention studies should ensure that all aspects of the intervention are reported in detail. The findings lend support to the inclusion of self-monitoring and intention formation techniques in future walking and cycling intervention design, although further exploration of these and other BCTs is required. Further investigation of the interaction between BCTs and study design characteristics would also be desirable.