Department of Behavioural Science and Health, University College London, London, United Kingdom.
Department of Clinical, Educational and Health Psychology, Centre for Outcomes Research and Effectiveness, University College London, London, United Kingdom.
PLoS One. 2019 Apr 17;14(4):e0213983. doi: 10.1371/journal.pone.0213983. eCollection 2019.
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.
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.
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).
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.
为了帮助在实践中实施行为改变干预（BCIs），能够描述其关键组成部分非常重要。本研究比较了针对吸烟、饮食、身体活动、酒精和性健康的具有成本效益的 BCI 的广泛特征。它还评估了这些特征与成本效益估计值的大小之间的关联。
使用行为改变轮（BCW）根据 338 个干预描述对 79 个干预措施进行内容分析，将干预内容分类为干预功能，并使用 BCT 分类法识别和分类组成行为改变技术（BCT）。回归分析确定了这些与较高（悲观）和较低（乐观）成本效益估计值之间的关联。
最常见和最不常见的功能和 BCT 集群是教育（82.3%）和知识塑造（79.7%），以及强制（3.8%）和隐性学习（2.5%）。吸烟干预包含最多的 BCT（[公式：见文本] = 12），并且最具成本效益。其他一些因素与成本效益较差（强制功能β上限= 36551.24；知识塑造 BCTβ下限= 2427.78；结果比较 BCTβ上限= 9067.32；重复和替代 BCTβ上限= 7172.47）和较好（建模功能β下限= -2905.3；环境重构功能β上限= -8646.28；奖励和威胁 BCTβ上限= -5577.59）有关（p<0.05）。
具有成本效益的 BCI 严重依赖于教育，吸烟干预措施表现出最广泛的 BCT 范围。提供一个值得效仿的榜样、重构环境和奖励积极行为可能与更高的成本效益相关。
