Behavior change method

A Behavior Change Method, or Behavior Change Technique, is a theory-based method for changing one or several psychological determinants of behavior such as a person's attitude or self-efficacy. Such behavior change methods are used in behavior change interventions. Although of course attempts to influence people's attitude and other psychological determinants were much older , especially the definition developed in the late nineties yielded useful insights , in particular three important benefits:

1. It developed a generic, abstract vocabulary that facilitated discussion of the active ingredients of an intervention
2. It emphasized the distinction between behavior change methods and practical applications of these methods
3. It included the concept of 'parameters for effectiveness', important conditions for effectiveness often neglected

Traditionally, reports of evaluations of behavior change interventions barely described the actual intervention , making it very difficult to identify the most effective methods. This was increasingly recognized in the late nineties and early twenty-first century, where behavior change methods gained increasing popularity, and another taxonomy was developed and subsequently gained popularity that enabled coding previously published interventions .

Basic definition of behavior change methods

A behavior change method is any process that has the potential to influence psychological determinants. Psychological determinants are theoretical variables in people's head, comparable to risk factors in epidemiology, but only including psychological variables. Examples of such determinants are attitude, risk perception (which is in fact an element of the attitude determinant according to the Reasoned Action Approach), self-efficacy, and habit. These determinants are included in theories of behavior explanation such as the Reasoned Action Approach and Health belief model. Other theories explain how such determinants may be changed, such as the Social Cognitive Theory (which is in fact also a theory to explain behavior) and the Extended Parallel Process Model. Examples of well-known, and frequently applied, behavior change methods are fear appeals and modelling.

The concept of a behavior change method can be illustrated, for example, using the metaphor of physical exercise. When a person wants to get larger biceps, the person can use a dumbbell and perform exercises. These exercises cause changes in the biceps that cause it to grow. The underlying principle that exercise exercising a muscle causes it to grow (in a nutshell) is called the change method. Of course, this method can have a variety of different applications depending on which muscle the person wants to train. In addition, there are certain parameters that must be satisfied for the exercises to be effective.

Behavior change methods as a vocabulary

Progress in behavior change science is realized through the accumulation of findings from many intervention evaluations . These outcomes can be integrated in a meta-analysis, allowing the most effective methods to emerge. Of course, this requires psychologists to use a more-or-less standardized vocabulary. Descriptions of behavior change methods and their definitions provide such a vocabulary, thereby enhancing the accuracy of meta-analyses.

Theoretical behavior change methods versus practical applications

The Intervention Mapping formulation of behavior change methods was the first to explicitly link a description of behavior change methods to the distinction from applications . An application is the practical incarnation of the method in a particular intervention. For example, one intervention can use modelling by using a vignette, whereas another intervention can use the exact same theoretical method (i.e. modelling), but in a completely different incarnation, for example by organizing peer education. An application, therefore, is the translation of a theoretical method to a specific context, population, culture, and often to a specific medium .

This distinction between theoretical methods and practical applications was crucial because of two reasons. First, evidence as to the effectiveness of behavior change methods is generally only available for generic behavioral methods. Second, because behavior change methods are only effective if the parameters for effectiveness are met , intervention descriptions are incomplete when they do not describe both which theoretical methods they use and to which practical applications these were translated.

Parameters for effectiveness

Each behavior change method has a set of parameters for effectiveness. For example, the popular method of fear appeals, that aims to appeal to a person's fear as a drive for behavior change, will not work when it does not manage to induce, in the targeted individuals:

1. High perceived severity of the threat at hand;
2. High perceived susceptibility to the threat;
3. High perceived self-efficacy, that is, one's ability to perform a behavior to negate the threat; and
4. High perceived response efficacy, the effectiveness of the behavior in negating the threat

The relevant theory of change, the extended parallel process model, explains that when one of these four variables is low, no behavior change will occur, and in fact, it is even possible that a person will engage in health-defeating behavior .

Thus, when someone wants to develop an intervention, and that person established that risk perception is indeed an important determinant (which is in fact rarely the case ), that person could use an appropriate method to target that determinant (fear appeals), but when this method's parameters for effectiveness are not respected, the intervention will still be ineffective.