The Behaviour Change Wheel: a cross-disciplinary model Susan Michie Professor of Health Psychology, UCL UCL Grand Challenges Town meeting May 2013

Why use models and theories of behaviour change? Summarise what we know Help structure thinking and guide research Facilitate communication –Across disciplines and –between academics and “knowledge users” e.g. policy makers, intervention designers, practitioners We need simple, parsimonious, coherent and usable models

A thought experiment For behaviour to change, what three conditions need to exist?

The COM-B system: Behaviour occurs as an interaction between three necessary conditions Psychological or physical ability to enact the behaviour Reflective and automatic mechanisms that activate or inhibit behaviour Physical and social environment that enables the behaviour

In thinking about changing behaviour Start with an understanding of behaviour – a behavioural diagnosis of the target behaviour in context –COM-B Consider the full range of possible interventions Have a method for selecting the component techniques likely to be effective

Do we have a comprehensive, coherent framework? Systematic literature review identified 19 existing frameworks –Addressed behaviours relating to health, environment, culture change, social marketing etc. Synthesised into an integrated framework –Model of behaviour at the hub of a wheel –9 intervention functions each include one or more behaviour change techniques –7 policy categories that could enable or support these interventions to occur

Understand the behaviour: the hub

Behaviour at the hub …. COM-B The Behaviour Change Wheel

Interventions: activities designed to change behaviours Interventions

Use rules to reduce the opportunity to engage in the behaviour (or to increase behaviour by reducing opportunity to engage in competing behaviours) Increase knowledge or understanding Use communication to induce positive or negative feelings to stimulate action Create an expectation of reward Create an expectation of punishment or cost Imparting skills Increase means or reducing barriers to increase capability (beyond education or training) or opportunity (beyond environmental restructuring) Provide an example for people to aspire to or emulate Change the physical or social context

Intervention functions Policies: decisions made by authorities concerning interventions Policies Michie et al (2011) The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions Implementation Science

Summary Behaviour is in the moment and influenced by its context Understand behaviour as an interaction between capability, opportunity and motivation To change these, need to consider the full range of evidence-based interventions and select appropriately To be most effective, intervene at many levels simultaneously (NICE, 2007)