changing health behaviours

Question 1

what are the most global deaths attributed to?

Answer 1

1. tobacco
2. inactivity
3. alcohol
4. obesity

Question 2

how are many interventions designed?

Answer 2

ISLAGIATT principle - it seemed like a good idea at the time

Question 3

what is needed to make an intervention for behavioural problems?

Answer 3

understanding the behaviours we are trying to change

Question 4

what is considered in behaviour selection?

Answer 4

what is the goals, and identifying the key specific behaviours - who, what, when, where and for how long

Question 5

why is it difficult to identify the behavioural changes?

Answer 5

the individual may stop or start, change frequency, intensity, duration and form

Question 6

how can behaviour be visualised?

Answer 6

a simple behavioural map which shows influences from family, parents, routine and HCPs

Question 7

what does assessment influence in changing behaviours?

Answer 7

behaviour selection, constructing intervention and formulating implementation strategy, selecting intervention types and COM-B diagnosis (capability, opportunity and motivation to change behaviour)

Question 8

what considerations are needed to changing health behaviours?

Answer 8

likely impact if undertaken, likelihood that such a behaviour will be implemented (easiness, cost and motivation), spilling over to other behaviours and people (every behaviour is within a network of behaviours within each person and every person is within a network of other people)

Question 9

what is the COM-B model for?

Answer 9

behavioural diagnosis - behaviour occurs as an interaction between these necessary conditions

Question 10

what is C in the com-b model?

Answer 10

it is capacity - people’s psychological and physical abilities that help them to understand why to make the change and how and have the self regulatory capacity to sustain it. Self regulation is based on reinforcement, problem solving and environmental restructure

Question 11

what is M in the com-b model?

Answer 11

influences that energise and direct behaviour such as intentions and evaluations - reflective motivations and desires emotions and habits - automatic motivations - having the financial and material resources, time, social exposure and supportive family, culture and social network

Question 12

what is the M in the com-b model?

Answer 12

opportunity - environment with which the individual will interact - physical or social and the want to engage and embrace behaviour

Question 13

what are the three areas in the selection of intervention type wheel?

Answer 13

centre - source of behaviours - COM - social, physical, psychological, automatic, reflective
middle - intervention functions
outer - policy categories

Question 14

what is a policy?

Answer 14

decision made by an authority concerning interventions

Question 15

what influences the construction of the intervention?

Answer 15

content, delivery, source, mode and schedule

Question 16

what are the intervention functions?

Answer 16

coercion, persuasion, restriction, incentivisation, education, training, enablement, monitoring

Question 17

what are successful behavioural change techniques?

Answer 17

Michie et all in 2009 did a meta-analysis of 84 healthy eating and physical activity interventions and results. Those that combines self monitoring with one other technique related to self regulation theory were twice as effective

Question 18

what are the problems with intervention?

Answer 18

long term, can you apply to all groups, consistency and other determinants of behaviour

Question 19

what are behaviour change techniques?

Answer 19

they are potentially active ingredients within an intervention designed to change behaviour

Question 20

what is behaviour?

Answer 20

it is anything a person does in response to internal or external events

Question 21

what is a mechanism of action?

Answer 21

the processes through which a behaviour change technique affects behaviour

Question 22

how do BCTs link with MoAs and behaviour?

Answer 22

BCTs affect MoAs which affect behaviour

Question 23

what are the criteria which must be followed in order to keep an intervention unchanged?

Answer 23

links to health outcomes 
self report vs objective measures 
number and quality of studies 
individual v population 
length of effects 
interactions and confounders 
modality 
use of theory 
heterogeneity 
relevance of target group

Question 24

why does intervention measuring need to be checked against evidence?

Answer 24

an intervention is only as good as the best available existing evidence