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What do cost-effective health behaviour-change interventions contain? A comparison of six domains

Beard, E; West, R; Lorencatto, F; Gardner, B; Michie, S; Owens, L; Shahab, L; (2019) What do cost-effective health behaviour-change interventions contain? A comparison of six domains. PLoS One , 14 (4) , Article e0213983. 10.1371/journal. pone.0213983. Green open access

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Abstract

Objectives: 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. Methods: 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. Results: 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 (M ̅=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). Discussion: 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.

Type: Article
Title: What do cost-effective health behaviour-change interventions contain? A comparison of six domains
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal. pone.0213983
Publisher version: https://doi.org/10.1371/journal. pone.0213983
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Behaviour Change Techniques, Cost-effectiveness, Behavioural domains
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: http://discovery.ucl.ac.uk/id/eprint/10070411
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