Susan Michie - The Behaviour Change Wheel - A Guide To Designing Interventions

The Behaviour

Change Wheel

A Guide to Designing Interventions

Susan Michie

Lou Atkins

Robert West

Copyright Susan Michie, Lou Atkins and Robert West 2014

The rights of Susan Michie, Lou Atkins and Robert West to be identified as the authors of this work have been asserted in accordance with the Copyright, Designs and Patents Act 1988.

This edition first published in Great Britain in 2014 by

Silverback Publishing

All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means, with prior permission in writing of the publishers or, in the case of reprographic production, in accordance with the terms of licences issued by the Copyright Licensing Agency.

ISBN: 978-1-912141-04-3

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Endorsements

It is often said that behaviour change is easy. It isnt. But help is at hand. This excellent book provides a step by step guide on how to do it. The authors recognise the practical things which that need to be done. This wisdom is derived from the authors deep understanding of the scientific evidence. This book is a major resource and should be read by all commissioners and practitioners whose work involves behaviour change.

Professor Mike Kelly, Director of the Centre of Public Health, National Institute for Health and Care Excellence (NICE)

Policy makers, practitioners and researchers need a guide to designing behaviour change interventions which is simple but does not oversimplify. Michie, Atkins and West provide an excellent step-by-step guide based on their extensive experience and expertise, using their COM-B model. They take the user through the science and the practical, real-world considerations with valuable examples and worksheets for each step. This is likely to become the basic interdisciplinary guide to designing behaviour change interventions, for a diversity of behaviours in a wide variety of contexts, in the UK and internationally.

Professor Marie Johnston, Emeritus Professor of Health Psychology, University of Aberdeen

All scientists, students and practitioners designing behaviour change interventions recognise the highly complex set of decisions that must be made to be effective. Yet many of us engage in our professional trades of behaviour change interventionswhether these trades be in research, in practice, in policy, or in teachingby simply following the unsystematic but helpful advice of our own mentors or teachers about how to design these interventions. This book offers insightful, rigorous, and standardised ways to approach behaviour change intervention development, that once read, is astonishing in its clarity and usefulness.

Professor Karina Davidson, Professor of Behavioural Medicine in Medicine, Cardiology, and Psychiatry, Columbia University

The Behaviour Change Wheel is a powerful new tool for those designing and evaluating behaviour change interventions. By setting out a systematic method for understanding behaviour, and linking this understanding to techniques known to change behaviour in a clear and engaging format, this book gives practitioners and policy-makers a scientific approach to designing interventions that are most likely to be effective. Professor Michie and her colleagues have done the field a great service by providing a step-by-step guide to designing behaviour change interventions, which will prove particularly useful in the area of public health.

Professor Kevin Fenton, Director of Health and Wellbeing, Public Health England

This is a highly practical workbook for helping practitioners develop and organise behaviour change interventions. But it is much more than that. It is a framework for thinking about behaviour change designed to not only change individual behaviour, but also to optimise the behaviour of change agents. It is simply the best attempt I have seen to lay out a taxonomy of behaviour change, from characterising the behaviours to change, through the specific techniques to produce the change, to the contextualising factors. I suspect that in future it will be seen as doing for behaviour change what Linnaeus started many centuries ago for biology.

There are some things that when you see them you wonder Why hasnt someone done this before? This is one of those ideas.

This book operationalises the intuitions of good intervention developers and implementers in ways that should make all of us better at the trade.

Professor Ron Borland, Nigel Gray Distinguished Fellow in Cancer Prevention at Cancer Council Victoria

Its great to see some of the most important recent advances in behaviour change intervention design all in one book. The COM-B model and theoretical domains framework are excellent tools for analysing behaviour. Professor Michie and her colleagues are leading the way in demonstrating a truly scientific approach to the selection and application of behavioural constructs to intervention design.

Anna Sallis, Behavioural Insights Research Advisor, Public Health England

Contents

Acknowledgements

Grateful thanks go to Marie Johnston for her pioneering work in behaviour change, her helpful comments on earlier drafts and for writing the Foreword for this book.

We are grateful to the researchers whose work forms the basis of the case studies in this book.

We would also like to thank our colleagues in the Health Psychology Research Group and the Tobacco and Alcohol Research Group at University College London for their helpful comments on earlier drafts and to Anna Sallis at Public Health England. Thanks also to the participants of many seminars and workshops whose feedback has helped shaped this book.

Website

See www.behaviourchangewheel.com for updates.

Foreword

By Professor Marie Johnston, Emeritus Professor of Health Psychology, University of Aberdeen

Changing peoples behaviour is an important aim for policy-makers, healthcare providers, educators, researchers etc., but the task is challenging and all the necessary resources are rarely available. Even when we know what we are trying to achieve, we may lack the time, the multidisciplinary team, access to the people whose behaviour needs to change, understanding of behaviour change theories or knowledge and skills relevant to changing behaviour. It is therefore timely for the publication of this book which will enable non-specialists to design an intervention to change behaviour.

The book presents a high level of scientific evidence and theory in a very practical, accessible, usable format. It takes the reader through eight steps, each with full explanations, worked examples and the worksheets necessary for the reader to do the developmental work for a new intervention. The initial steps enable the reader to clearly specify the behaviour that is the target of the intervention, followed by an introduction to a simple method of analyzing what needs to change first using the COM-B model: is greater Capability, more Opportunity or stronger Motivation required? Having identified what needs to change, the reader is guided through a series of judgements about how best to achieve change, e.g. by education, persuasion, training or changing the environment, before considering how policy such as fiscal policy or service provision might

facilitate the process. The next stage builds on the science of behaviour change and offers a wide range of techniques that are the active ingredients of every behaviour change intervention. Finally, decisions are made about how to deliver the intervention e.g. when and how often? is it best face-to-face, by internet or in some other way?