National Centre for Smoking Cessation and Training and Centre for Outcomes Research and Effectiveness, Department of Clinical, Educational, and Health Psychology, University College London, UK.
J Consult Clin Psychol. 2013 Jun;81(3):528-44. doi: 10.1037/a0032106. Epub 2013 Mar 18.
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.
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.
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.
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.
干预措施在计划中与实际执行中存在差异。除非我们了解实际提供的内容，否则我们无法理解有效的干预措施中“什么有效”。本研究旨在：(a)评估已建立的 53 种戒烟行为改变技术（BCT）分类法是否可作为一种可靠地指定戒烟行为支持咨询内容的方法加以应用或改编；(b)开发一种有效方法，用于培训研究人员和从业人员可靠应用该分类法。
使用该分类法，对来自英格兰戒烟服务机构的 15 份录音咨询记录进行成分 BCT 编码。经过 3 轮编码后，讨论了信度和对分类法进行潜在改编以改善编码的问题。通过专家共识制定了编码培训手册，并在 10 名学员中进行了试点，在培训前后评估编码可靠性和自我效能感。
在各轮次和咨询记录中，平均至少出现过 33 次分类法 BCT。咨询记录中平均包含 12 种 BCT（范围=8-31）。平均信度很高（88%的一致性）。通过合并同时出现的 BCT 和精炼 BCT 定义，对分类法进行了改编，以简化编码。所有学员在培训后的编码可靠性和自我效能感均显著提高。
可应用分类法可靠地识别和分类实际提供的戒烟行为支持中的 BCT，并培训无经验的编码员可靠地进行编码。这种方法可用于调查服务机构间提供行为支持的变异性，监测交付的忠实度，并确定培训需求。
