Participants’ enactment of behavior change techniques: a call for increased focus on what people do to manage their motivation and behavior

Hankonen, Nelli

doi:10.1080/17437199.2020.1814836

Cited by 30 publications

(46 citation statements)

References 38 publications

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“…Hankonen’s work on participant reception and enactment, or the extent to which participants connect with and enact the knowledge/skills learned through a health intervention, help highlight the importance of comprehensive fidelity measurement when EBI components focus on changing individuals’ behavior. The author notes that when the target of an EBI encompasses individual behavior change, the need to measure participants’ reception and enactment of intervention content becomes critical [ 54 ]. Fidelity indicators like “number of sessions delivered” or “adequate content delivered” may tell us that an actor delivered structural intervention components as intended, but such indicators may not tell us about how well the components were received by their targets, nor how able the targets were to utilize what they learned [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…The author notes that when the target of an EBI encompasses individual behavior change, the need to measure participants’ reception and enactment of intervention content becomes critical [ 54 ]. Fidelity indicators like “number of sessions delivered” or “adequate content delivered” may tell us that an actor delivered structural intervention components as intended, but such indicators may not tell us about how well the components were received by their targets, nor how able the targets were to utilize what they learned [ 54 ]. Relating back to implementation strategies and their fidelity, this point highlights again the need to adequately describe implementation strategies, their action targets, and their mechanisms most responsible for change in implementation outcomes [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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The case for prioritizing implementation strategy fidelity measurement: benefits and challenges

Akiba

Powell

Pence

et al. 2021

Translational Behavioral Medicine

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Implementation strategies are systematic approaches to improve the uptake and sustainability of evidence-based interventions. They frequently focus on changing provider behavior through the provision of interventions such as training, coaching, and audit-and-feedback. Implementation strategies often impact intermediate behavioral outcomes like provider guideline adherence, in turn improving patient outcomes. Fidelity of implementation strategy delivery is defined as the extent to which an implementation strategy is carried out as it was designed. Implementation strategy fidelity measurement is under-developed and under-reported, with the quality of reporting decreasing over time. Benefits of fidelity measurement include the exploration of the extent to which observed effects are moderated by fidelity, and critical information about Type-III research errors, or the likelihood that null findings result from implementation strategy fidelity failure. Reviews of implementation strategy efficacy often report wide variation across studies, commonly calling for increased implementation strategy fidelity measurement to help explain variations. Despite the methodological benefits of rigorous fidelity measurement, implementation researchers face multi-level challenges and complexities. Challenges include the measurement of a complex variable, multiple data collection modalities with varying precision and costs, and the need for fidelity measurement to change in-step with adaptations. In this position paper, we weigh these costs and benefits and ultimately contend that implementation strategy fidelity measurement and reporting should be improved in trials of implementation strategies. We offer pragmatic solutions for researchers to make immediate improvements like the use of mixed methods or innovative data collection and analysis techniques, the inclusion of implementation strategy fidelity assessment in reporting guidelines, and the staged development of fidelity tools across the evolution of an implementation strategy. We also call for additional research into the barriers and facilitators of implementation strategy fidelity measurement to further clarify the best path forward.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The case for prioritizing implementation strategy fidelity measurement: benefits and challenges

Akiba

Powell

Pence

et al. 2021

Translational Behavioral Medicine

View full text Add to dashboard Cite

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“…Engagement with the intervention can be subdivided into engagement with the device or software and engagement with BCTs or “active ingredients” of the intervention [ 16 , 22 ] (see Figure 1 , far left). As the DBCI is the proposed trigger for the behavior change, engagement with the health behavior is thought to depend on engagement with the DBCI [ 16 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Associations Between Behavior Change Techniques and Engagement With Mobile Health Apps: Protocol for a Systematic Review

Milne‐Ives¹,

Homer²,

Andrade³

et al. 2022

JMIR Res Protoc

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Background Digitally enabled care along with an emphasis on self-management of health is steadily growing. Mobile health apps provide a promising means of supporting health behavior change; however, engagement with them is often poor and evidence of their impact on health outcomes is lacking. As engagement is a key prerequisite to health behavior change, it is essential to understand how engagement with mobile health apps and their target health behaviors can be better supported. Although the importance of engagement is emphasized strongly in the literature, the understanding of how different components of engagement are associated with specific techniques that aim to change behaviors is lacking. Objective The purpose of this systematic review protocol is to provide a synthesis of the associations between various behavior change techniques (BCTs) and the different components and measures of engagement with mobile health apps. Methods The review protocol was structured using the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) and the PICOS (Population, Intervention, Comparator, Outcome, and Study type) frameworks. The following seven databases will be systematically searched: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo, ScienceDirect, Cochrane Library, and Web of Science. Title and abstract screening, full-text review, and data extraction will be conducted by 2 independent reviewers. Data will be extracted into a predetermined form, any disagreements in screening or data extraction will be discussed, and a third reviewer will be consulted if consensus cannot be reached. Risk of bias will be assessed using the Cochrane Collaboration Risk of Bias 2 and the Risk Of Bias In Non-Randomized Studies - of Interventions (ROBINS-I) tools; descriptive and thematic analyses will be conducted to summarize the relationships between BCTs and the different components of engagement. Results The systematic review has not yet started. It is expected to be completed and submitted for publication by May 2022. Conclusions This systematic review will summarize the associations between different BCTs and various components and measures of engagement with mobile health apps. This will help identify areas where further research is needed to examine BCTs that could potentially support effective engagement and help inform the design and evaluation of future mobile health apps. Trial Registration PROSPERO CRD42022312596; https://tinyurl.com/nhzp8223 International Registered Report Identifier (IRRID) PRR1-10.2196/35172

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“…While assessing BCT delivery provides insight into how the use of BCTs can influence clients’ behavior change outcomes, very little is known about how clients’ receipt of BCTs influences behavior change outcomes (Hankonen, 2021). Assessing clients’ receipt (i.e., understanding of the delivered BCT and how to use it; O’Shea et al, 2016; Palsola et al, 2020) has been highlighted as an important way to improve fidelity assessments of behavioral change interventions (Bellg et al, 2004; Borrelli, 2011; Hankonen, 2021). As such, measuring BCT delivery and receipt within behavioral counseling sessions will provide new opportunities to understand and explain health behavioral outcomes by elucidating how counselors and clients interact with each other (Gainforth et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…A major limitation of a binary assessment of BCT delivery is that it ignores the reciprocal nature of behavioral support interventions (i.e., conversations between a counselor and client) and whether the client actually received the delivered BCT. While assessing BCT delivery provides insight into how the use of BCTs can influence clients’ behavior change outcomes, very little is known about how clients’ receipt of BCTs influences behavior change outcomes (Hankonen, 2021). Assessing clients’ receipt (i.e., understanding of the delivered BCT and how to use it; O’Shea et al, 2016; Palsola et al, 2020) has been highlighted as an important way to improve fidelity assessments of behavioral change interventions (Bellg et al, 2004; Borrelli, 2011; Hankonen, 2021).…”

Section: Introductionmentioning

confidence: 99%

Measuring behavior change technique delivery and receipt in physical activity behavioral interventions.

Hoekstra¹,

Collins²,

Dinwoodie³

et al. 2022

Rehabilitation Psychology

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Purpose/Objective: Research on physical activity behavioral support has mainly focused on measuring the absence or presence of behavior change techniques (BCTs) delivered by a counselor. We present a method to measure BCT delivery and receipt in physical activity behavioral support interventions.Research Method/Design: The method was developed and tested using transcripts from behavior change counseling sessions delivered as part of a theory-and evidence-based physical activity intervention for adults with disabilities. Using existing methods, a new method was developed to code counselor and clients' verbal statements (BCTs and other statements). Two coders independently coded 30 transcripts of audio-recorded counseling sessions. Interrater reliability was assessed using percentage agreement and Prevalence Adjusted Bias Adjusted Kappa (PABAK). Results: Forty-eight codes were developed for counselor statements (35 BCT delivery and 13 other statements) and 46 codes for client statements (34 BCT receipt and 12 other statements). The average interrater reliability was considered nearly perfect for the counselor statements (84% agreement; PABAK = .98) and client statements (86% agreement; PABAK = .98). The BCT delivered and received were most frequently related to Goals and Planning

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Participants’ enactment of behavior change techniques: a call for increased focus on what people do to manage their motivation and behavior

Cited by 30 publications

References 38 publications

The case for prioritizing implementation strategy fidelity measurement: benefits and challenges

The case for prioritizing implementation strategy fidelity measurement: benefits and challenges

Associations Between Behavior Change Techniques and Engagement With Mobile Health Apps: Protocol for a Systematic Review

Measuring behavior change technique delivery and receipt in physical activity behavioral interventions.

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