Mathehu's Weblog

mulling over (research) ideas

Improving learning, teaching and engagement: What can we learn from behaviour change research?

This blog is based on discussions with a colleague on a range of topics surrounding behaviour change, (psycho)education and engaging clients.

One branch of our discussions has explored the utility of behaviour change models and techniques for learning, teaching, and client engagement with online mental health and (psycho)education tools.

It was hardly surprising that there is a wealth of literature surrounding the idea of changing people’s behaviour. I was particularly impressed with the work of Susan Michie and colleagues.

I particularly like their attempt at creating a taxonomy of behaviour change techniques inclusive of links to underlying theoretical frameworks. The following table provides an overview of their findings (Michie & Abraham, 2008, p. 382):

Another team of leading UK psychologists, including Michie and Abraham, summarised  and commented on the content of a national guidance document (published by NICE at) on behaviour change. Again, I provide a verbatim quote from their text but here is also a link to the recommendations section in the actual NICE document.

A framework for good practice in BCI design and evaluation
Following an introduction, the guidance discusses various considerations that were taken into account in drawing up the recommendations and particularly the integration of individual and social approaches to behaviour change.

The recommendations, themselves, are organised into eight principles of good practice which correspond closely to the principles of intervention mapping …

First, ‘planning of interventions’ should take account of socioeconomic and cultural contexts and strengths and skills of target groups. Planning should also anticipate barriers to change, ensure that BCI content is evidence-based and that ineffective interventions are discontinued.

The second, related principle concerns ‘assessing the social context’ in which interventions are situated including identifying and attempting to remove social, financial and environmental barriers that prevent people from making positive changes in their lives by, for example, tackling local poverty, limited employment and education opportunities.

The third principle concerns the ‘education and training’ of those responsible for BCI planning, implementation and evaluation.

The fourth, focussing on ‘individual-level interventions’, concerns application of psychological concepts to optimise motivation and support behaviour change.

Principle five, focusses on ‘community level interventions’ and concerns investment in
the strengths of individuals and communities. This principle underlines the importance of social relationships in facilitating behaviour change.

Principle six advocates that ‘population-level interventions’, including policy and legislative interventions are based on good information about the context, needs and behaviours of the target population(s) and are consistent with interventions delivered to individuals and communities.

Principle seven proposes that all interventions (and therefore funding for interventions) make provision for ‘rigorous monitoring and evaluation’ including use of appropriate process and outcome measures.

Finally, principle eight emphasises the need to ‘assess cost effectiveness’ and to ensure that this is central to intervention planning, evaluation and adoption” (Abraham, Kelly, West & Michie, 2009, p.3).

Particularly relevant to this blog is their expansion on the fourth recommendation, which follows below:

“(K)ey psychological targets worthy of consideration include:

  • Knowledge and outcome expectancies (helping people to develop accurate knowledge about the health consequences of their behaviours)
  • Personal relevance (emphasising the personal salience of health behaviours, that is, what the consequences mean for individuals)
  • Positive affective attitudes (promoting positive feelings towards the outcomes of behaviour change)
  • Descriptive norms (promoting the visibility of positive health behaviours in people’s reference groups – that is, the groups they compare themselves with, or aspire to)
  • Subjective norms (enhancing social approval for positive health behaviours in significant others and reference groups)
  • Personal and moral norms (promoting personal and moral commitments to behaviour change)
  • Self-efficacy (enhancing people’s belief in their ability to change) .
  • Intention/goal setting and the formation of concrete plans (helping people to form
    Behavioural contracts (inviting people to commit to their plans with others).
  • Social relationships (helping people recognise how their social contexts and relationships may affect their behaviour) plans and goals in graded steps, over time and in specific contexts, including making if-then plans and developing appropriate coping strategies)
  • Relapse prevention (helping people to develop skills to cope with difficult situations and conflicting goals once they have initiated change)” (Abraham, Kelly, West & Michie, 2009, p. 4-5).

What I particularly like about this last list of psychological targets is that they do not exclusively focus on the components of, for example, a functional analysis. They do not stop at considering antecedents, beliefs/behaviours, and consequences. They allude to the importance of working with people’s aspirations, the meaning they find in their actions as well as the social and physical context affecting them. If anything, these drivers of behaviour would deserve more attention in lists like the above.

Now, I maneuvered myself to a place where I can start talking about Salutogenesis and its focus on “comprehensibility—the cognitive component; (ii) manageability—the instrumental or behavioural component; and (iii) meaningfulness—the motivational component” (Lindstroem & Eriksson, 2006, p. 31).

But that’s for another blog…

References:

Abraham C, Kelly MP, West R, & Michie S. (2009). The UK national institute for health and clinical excellence public health guidance on behaviour change: a brief introduction. Psychology, Health & Medicine, 14(9), 1-8.

Lindström, B., & Eriksson, M. (2006). Contextualizing salutogenesis and Antonovsky in public health development. Health promotion international, 21(3), 238-44. doi: 10.1093/heapro/dal016.

Michie S, Abraham C. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27(3), 379-87.

NICE. (2007). Behaviour change. Retrieved from http://www.nice.org.uk/Guidance/PH6.

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April 14, 2010 - Posted by | Uncategorized

1 Comment »

  1. […] of a framework for improving L&T based on findings from psychology behavior change research. The second from Markus that expands on the potential psychological foundations for this thinking by […]

    Pingback by Further thinking – behaviour change and improving L&T « The Weblog of (a) David Jones | April 15, 2010 | Reply


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