Behaviour Change Update: Stage 1. BCT analysis of existing, cost-effective interventions
2012
Seventy-nine cost-effective interventions across six different health
behaviours (smoking cessation, diet, physical activity, alcohol, sexual
health, multiple behaviour targets) were identified from 23 economic
reports. Interventions were mainly of high intensity, set in primary
care or the community, delivered by health professionals and aimed
at individuals from the general population, involving pharmacological
or other forms of support. Education, enablement, training and
persuasion were the focus of the majority of interventions, clustering
around BCTs concerning: shaping knowledge; goals and planning;
social support; antecedents and natural consequences of behaviour;
outcome comparison; and feedback and monitoring. Interventions
included an average of ten BCTs with ‘instructions on how to perform
a behaviour’, ‘unspecified social support’, ‘information about health
consequences’ and ‘problem solving’ included in 81%, 67%, 57% and
53% of interventions, respectively. While the use of ‘choice
architecture’ was common, being present in 71% of cost-effective
interventions, prevalence was lower (29%) when stricter criteria to
define ‘choice architecture’ were applied. Sexual health interventions
were least cost-effective but no other characteristics or BCTs were
related to cost-effectiveness estimates. However, these findings need
to be interpreted cautiously given 1.) the limitations imposed by
considering only cost-effective interventions in this report, 2.) the
reliance on often incomplete information in published papers
(possibly not accurately reflecting intervention content) and 3.) the
lack of consensus for a definition of ‘choice architecture’.
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