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The importance of exploring the effect of individual behaviour change techniques on behaviour: goal setting as an example

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A recent taxonomy has identified 93 different behaviour change techniques (BCTs). However, the taxonomy does not indicate which of these BCTs are effective. Moreover, as many behaviour change interventions include multiple BCTs it is difficult to determine which BCT is the ‘active ingredient’ in successful interventions. One way of identifying effective BCTs is to locate all studies that compare an intervention that uses a chosen BCT with a comparison condition that is identical apart from the BCT of interest. Using meta-analysis it is possible to (a) quantify the effect of individual BCTs, (b) identify the circumstances under which the BCT is most effective, and (c) identify for whom the BCT is most effective. In addition to these practical issues this method also allows theory relating to the BCT to be tested and highlights gaps in the literature. The example of the BCT of goal setting will be used to illustrate this process

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The importance of exploring the effect of individual behaviour change techniques on behaviour: goal setting as an example

  1. 1. The importance of exploring the effect of individual BCTs on behaviour GOAL SETTING AS AN EXAMPLE Tracy Epton @tracyepton
  2. 2. Background  93 different behaviour change techniques in recent taxonomy  E.g., goal setting, self monitoring, valued self-identity  To be able to design optimally effective behaviour change interventions need to know  Which BCTs work  Who they work for  Under what circumstances they work best
  3. 3. Goals & planning Feedback & monitoring Social support Shaping knowledge Natural consequences Comparison of behaviour Associations Repetition & substitution Comparison of outcomes Reward & threat Regulation Antecedents Identity Scheduled consequences Self-belief Covert learning
  4. 4. Goals & planning Feedback & monitoring Social support Shaping knowledge Natural consequences Comparison of behaviour Associations Repetition & substitution Comparison of outcomes Reward & threat Regulation Antecedents Identity Scheduled consequences Self-belief Covert learning Identity • Identification of self as role model • Framing / reframing • Incompatible beliefs • Valued self-identity • Identity associated with changed behaviour Goals & Planning • Goal setting (behaviour) • Problem solving • Goal setting (outcome) • Action planning • Review behaviour goal(s) • Discrepancy between current behaviour and goal • Review outcome goal(s) • Behavioural contract • Commitment
  5. 5. Goals & planning Feedback & monitoring Shaping knowledge Natural consequences Comparison of behaviour Associations Repetition & substitution Comparison of outcomes Reward & threat Regulation Antecedents Identity Scheduled consequences Self-belief Covert learning Goals & planning Action planning Social support Social support Social support (emotional) Shaping knowledge Instruction on how to perform behaviour Info about antecedents Natural consequences Info about health consequences Salience of consequences Info about social and environmental consequences Anticipated regret Info about emotional consequences Comparison of behaviour Info about others’ approval Associations Prompts/ cues Repetition & substitution Behaviour substitution Regulation Reduce negative emotions Antecedents Restructure physical environment Restructure the social environment Avoid exposure to cues Distraction Identity Valued self identity Identity associated with changed behaviour
  6. 6. Problem solving Identification of self as a role model Provide info about emotional consequences Social support (practical) Verbal persuasion about capability Self talk Prompts / cues
  7. 7. Reviewing existing evidence 1. Find RCTs that have used a selected BCT (across a range of behaviours) 2. Include only those RCTs where the intervention and comparison group differ only in the BCT of interest 3. Extract data 1. Effect size 2. Sample characteristics 3. Intervention characteristics 4. Meta analyse and meta regression
  8. 8. Reviewing existing evidence  Applied issues  Determine strength of effect  Determine who it works best for  Determine circumstances under which it works best  Theoretical issues  Contribute to theory  Academic issues  Identify gaps in literature for future empirical research (avoiding duplication)  Recommendations to adapt BCT taxonomy
  9. 9. Literature review: methods  Databases: WoK, PsycInfo, PubMed, ProQuest Dissertation Databases  Search terms: 1. Goal setting 2. RCTs 3. DV (goal, behaviour, performance, outcome, consumption)  Further search: references of included articles, recent reviews and edited books of goal setting* * Thanks Reviewer 2 
  10. 10. Literature review: methods  Inclusion criteria  Compared an intervention condition with a comparison condition that differed only in goal setting  Randomisation  DV was a behaviour (e.g., eating fruit and veg) or an outcome (e.g., weight lost)  Written in English language
  11. 11. 384 tests
  12. 12. Applied issues – strength of effect  Goal setting was effective  384 tests (N = 16,523) d = .34 (CI .28 to .41)  Comparable to effects of other BCTs  Valued self identity d = .32 (Epton et al., 2015)  Action planning d = .31 (Belanger-Gravel et al, 2013)
  13. 13. Applied issues – Who does it work best for?  Goal setting most effective when sample had  more males  = -.01, p = .001, k = 268  younger participants  = -.01, p = .006, k = 123  More Asian participants  = .08, p = .005, k = 13  Were recruited from general population  = .36, p = .001, k = 375 (of which 45 were general population)  Were children  = .27, p = .008, k = 375 (of which 51 were children)  Were not university students  = -.25, p = .001, k = 375 (of which 258 were university students)
  14. 14. Applied issues – Under what circumstances does it work best?  Should use  difficult goals  = .18, p = .005, k = 244  Add goal setting to monitoring behaviour w/o feedback  = .60, p < .001, k = 384 (22 used monitoring w/o feedback)  Set publicly  = .41, p < .001, k = 255 (of which 58 public)  Group goals  = .48, p < .001, k = 384 (of which 48 group goals)  Set in school  = .23, p = .021, k = 345 (47 set in school)  Set in workplace  = .44, p < .001, k = 345 (30 set in workplace)
  15. 15. Applied issues – Under what circumstances does it work best?  Should not  Measure goal commitment  = -.19, p = .030, k = 384 (74 measured commitment)  Pair with commitment d = .20 CI .14 to .26 vs. d = .34 CI .28 to .41  Set in a university  = -.23, p = .003, k = 345 (247 set in university)  online  = -.46, p = .003, k = 276 (of which 20 online)
  16. 16. Applied issues – Under what circumstances does it work best?  No difference if  Goal was based on outcome (k = 383 of which 271 outcome) or behaviour (k = 383 of which 116 behaviour)  Goal based on current standing (k = 383 of which 112 current standing) or external standard (k = 383 of which 276 external standard)  Number of different goals set (k = 379)  Number of times goal repeated (k = 378)  Task complexity (k = 383)
  17. 17. Applied issues – Under what circumstances does it work best?  No difference with  Means which goal set  Proximity of goal  Interval between goal setting and measurement  Additional BCTs:  Feedback  Review of behaviour / outcome goals  Behavioural contract
  18. 18. Theoretical issues – goal setting theory  Goal setting theory (Locke & Latham, 2002; 2006): to be effective goals must be  Sufficiently difficult ✓  Easy: d = .25, k = 45, CI .14 to .37  Moderate: d = .25, k = 72, CI .17 to .33  Difficult: d = .45, k = 127, CI .39 to .51  People are committed to the goal ✗  Commitment d = .20 , k = 27, CI .14 to .26  No commitment d = .34, k = 384, CI .28 to .41  (but might be due to commitment only important when difficult goals)
  19. 19. Theoretical issues – goal setting theory  Task complexity is not too high ✗  low: d = .26, k = 107  medium: d = .22, k = 54  high: d = .22, k = 64  Feedback on goal progress is provided ✗  Feedback: d = .01, k = 25, CI -.27 to .29  No feedback: d = .34, k = 384, CI .28 to .41
  20. 20. Academic issues – changes to BCT taxonomy  No difference between  Goal setting (outcome)  = -.12, k = 383 (271 were outcome)  Goal setting (behaviour)  = .12, k = 383 (116 were outcome)  Is it worth distinguishing between these two?
  21. 21. Academic issues – gaps in literature  long term follow ups (longest 12m)  Not sufficiently tested in certain behavioural domains (e.g., environment), among key populations (e.g., low SES) and in key contexts (e.g., primary care)  Outcome vs. behaviour not been tested head to head  How to encourage people to set goals e.g., training, new technologies?  56 BCTs not paired with goal setting  Exploration of mediators
  22. 22. Future research – “Learning to fly”  Develop behaviour intervention based around goal setting from ground up  Phase 1: consensus approach to identify candidate BCTs that would augment goal setting  Phase 2: large online expt exploring effectiveness of pairing candidate BCTs with goal setting  Phase 3: using most promising BCTs (from phase 2) design and evaluate a complex intervention
  23. 23. Future research - CUBiC  Metaaaaaaaaaaaah  Multi-disciplinary consensus exercise to develop template for conducting BCT reviews  Phase 1: consensus exercise to develop template based on goal setting meta  Phase 2: conduct reviews using template  Phase 3: further consensus exercise to finalise template  Phase 4: get ALL the money to do ALL the reviews

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