health behaviour 2 - COM-B and BCW Flashcards
COM-B model
capability opportunity motivation - behaviour model
interactions between these:
capability –> motivation
opportunity –> motivation
COM <–> behaviour
COM-B - capability (2 components)
the ability to enact behaviour
physical capability:
- physical skill/strength to perform the behaviour
- e.g. ride a bike, lift a 20kg weight
psychological capability:
- capacity to engage in necessary thoughts processes – knowledge, reasoning
- e.g. Knowledge of COVID-19 transmission and how to avoid it
COM-B - opportunity (2 components)
environment that enables behaviour
physical opportunity:
- opportunity afforded by the environment
- e.g. close proximity to a gym, availability of cycle lanes
social opportunity:
- opportunity afforded by social/cultural norms
- e.g. people around you engaging in a behaviour, reminders to do something, having support from people around you
COM-B - motivation ( 2 components)
mechanisms that activate or inhibit behaviour
reflective motivation:
- evaluations (beliefs about what is good or bad), plans (intentions)
- e.g. drinking responsibly is a good thing to do
- e.g. planning to wake up early to go the gym
automatic motivation:
- emotional reactions, desires (wants and needs), impulses, inhibitions, habits
- anticipated pleasure at the prospect of eating a piece of cake, or from runners high
methods to collect data using COM-B (3)
questionnaires:
- specific questions about their capability/opportunity/motivation
- reach larger groups of people
interview/focus groups:
- in depth qualitative data
- ask open ended questions about capability/opportunity/motivation, barriers/facilitators of engaging in the desired behaviour
- smaller samples
observation:
- self-report data from questionnaires/interviews may be far away from the truth, observations useful tool to see what actually happens
using COM-B to explain behaviour in COVID
Gibson-Miller et al (2020)
influences of COM-B components on hygienic practices
first wave of a longitudinal survey of 2,025 adults representative of the UK population
participants self‐reported capability, opportunity, motivation to enact hygienic practices during the COVID‐19 outbreak
hygienic practices:
- hand washing frequently,
- cleansing surfaces,
- using tissues,
- avoiding touching mouth and face
results:
- all COM-B components influenced behaviour
- psychological capability, social opportunity and reflective motivation (biggest driver) positively influenced behaviour
- automatic motivation and physical opportunity negatively influenced behaviour
conclusions:
- interventions should focus on promoting and maintaining:
- reflective motivation to act (e.g. planning/goal setting)
- social opportunity (social support)
- psychological capability (knowledge of COVID-19 transmission)
using COM-B to explain physical activity behaviour
Willmott et al (2021)
cross-sectional survey
used validated measures to capture COM constructs and physical activity behaviour
administered online to a sample of young adults aged 18–35 years - N = 582
results:
- COM-B model explained 31% of variance in physical activity
- capability and opportunity were found to be associated with behaviour through the mediating effect of motivation
- increased capability + opportunity –> increased motivation –> increased physical activity
3 stages of designing interventions for behaviour change
Michie et al (2011)
- understanding the behaviour (using the COM-B model)
- identify intervention options (intervention functions and policy categories)
- identify content and implementation options (behaviour change techniques and the delivery)
designing interventions for behaviour change - the behaviour change wheel (BCW)
Michie et al (2011)
synthesis of 19 frameworks of behaviour change interventions
- comprehensive
- coherent
- linked to a model of behaviour (COM-B)
identified 9 intervention functions and 7 policy categories that could enable or support these interventions to occur
BCW - 9 intervention functions
activities designed to change behaviour
Behavioural diagnosis->aspects of COM-B that need addressing -> intervention functions to change the behaviour
- education: increasing people’s knowledge
- persuasion: using communication to induce positive or negative feelings
- incentivisation: creating an expectation of reward
- coercion: creating an expectation of cost or punishment (e.g. increase cost of unhealthy food)
- training: helping people to develop skills
- modelling: providing an example for people to aspire to or emulate
- environmental restructuring: changing the physical or social context
- restrictions: using rules to reduce opportunity to engage in target behaviour
- enablement: giving people means to engage in behaviour or reduce barriers
mnemonic = EPIC METER
BCW - 6 sources of behaviour
split by the COM-B model
capability:
- psychological
- physical
opportunity:
- social
- physical
motivation:
- automatic
- reflective
BCW - 7 policy categories
decisions made by authorities concerning interventions
- environmental/social planning: designing and/or controlling the physical or social environment
- communication & marketing: using print, electronic media, broadcasting
- legislation: making or changing law
- service provision: delivering a service
- regulation: establishing rules or principles of behaviour or practice
- fiscal measures: using the tax system to reduce or increase cost
- guidelines: creating documents that recommend or mandate a certain practice
BCW - matching intervention functions to the COM-B
enablement can use all but reflective motivation
use reflective motivation for: education, persuasion, incentivisation, coercion
LOOK AT TABLE SLIDE 47
behaviour change techniques (BCTs)
Michie et al (2013)
intervention functions are delivered by behaviour change techniques
“Active ingredients” within the intervention designed to change behaviour
these are:
- observable
- replicable
- irreducible components of an intervention
created a taxonomy of behaviour change techniques - to help specify interventions and their active ingredients in more detail
BCT has 93 different techniques
can be used alone or in combination
examples of some BCTs
93 techniques split into 19 groups, e.g:
goals and planning:
- goal setting
- problem solving
- action planning
comparison of behaviour:
- social comparison
- info about others approval
associations:
- prompts/cues
- cue signalling reward
- reduction of prompt/cues
antecedents:
- restructure physical and social environment
- avoidance of cues
- distractions
- body changes
