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Annals of Behavioral Medicine : a... Aug 2013CONSORT guidelines call for precise reporting of behavior change interventions: we need rigorous methods of characterizing active content of interventions with precision...
The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions.
BACKGROUND
CONSORT guidelines call for precise reporting of behavior change interventions: we need rigorous methods of characterizing active content of interventions with precision and specificity.
OBJECTIVES
The objective of this study is to develop an extensive, consensually agreed hierarchically structured taxonomy of techniques [behavior change techniques (BCTs)] used in behavior change interventions.
METHODS
In a Delphi-type exercise, 14 experts rated labels and definitions of 124 BCTs from six published classification systems. Another 18 experts grouped BCTs according to similarity of active ingredients in an open-sort task. Inter-rater agreement amongst six researchers coding 85 intervention descriptions by BCTs was assessed.
RESULTS
This resulted in 93 BCTs clustered into 16 groups. Of the 26 BCTs occurring at least five times, 23 had adjusted kappas of 0.60 or above.
CONCLUSIONS
"BCT taxonomy v1," an extensive taxonomy of 93 consensually agreed, distinct BCTs, offers a step change as a method for specifying interventions, but we anticipate further development and evaluation based on international, interdisciplinary consensus.
Topics: Behavior Therapy; Cluster Analysis; Consensus; Humans; Treatment Outcome
PubMed: 23512568
DOI: 10.1007/s12160-013-9486-6 -
Journal of Autism and Developmental... Jun 2022For over 50 years, intervention methods informed by the principles of applied behavior analysis (ABA) have been empirically researched and clinically implemented for...
For over 50 years, intervention methods informed by the principles of applied behavior analysis (ABA) have been empirically researched and clinically implemented for autistics/individuals diagnosed with autism spectrum disorder (ASD). Despite the plethora of evidence for the effectiveness of ABA-based interventions, some autism rights and neurodiversity activists have expressed concerns with ABA-based interventions. Concerns have included discontent with historical events and possible harm from the procedures and goals targeted. The purpose of this manuscript is to examine some expressed concerns about ABA-based intervention and suggest productive ways of moving forward to provide the best outcomes for autistics/individuals diagnosed with ASD. The authors represent stakeholders from multiple sectors including board certified behavior analysts, licensed psychologists, parents, and autistics/individuals diagnosed with ASD.
Topics: Applied Behavior Analysis; Autism Spectrum Disorder; Autistic Disorder; Behavior Therapy; Humans; Parents
PubMed: 34132968
DOI: 10.1007/s10803-021-05137-y -
CoDAS 2013Systematic literature review about Applied Behavior Analysis (ABA) proposals directed towards persons with Autistic Spectrum Disorders aiming to contribute to a truly... (Review)
Review
PURPOSE
Systematic literature review about Applied Behavior Analysis (ABA) proposals directed towards persons with Autistic Spectrum Disorders aiming to contribute to a truly evidence-based practice.
METHODS
[corrected] References from the last five years were obtained from the Web of Science, Medline, SciELO and Lilacs databases. Papers published in peer-reviewed journals were selected. Exclusion criteria were language, type of paper, theme and repeated papers. This selection resulted in 52 articles that were completely analyzed. Information regarding author, journal and date; title; theme and approach; casuistic; inclusion and exclusion criteria and conclusion was considered.
RESULTS
The papers refer to intervention processes, literature reviews, professional education, and parents' contributions to the intervention programs. Only four papers report the parents' role in the use of ABA principles at home. Studies about Professional education emphasize the specialized education. Most of the literature review papers conclude that the intervention programs are controversial, expensive and dependent of external variables. Although the articles describing intervention processes include 663 participants, a meta-analysis is not possible due to the lack of comparable inclusion and characterization criteria.
CONCLUSION
There is not enough evidence of ABA's preponderance over other alternatives.
Topics: Behavior Therapy; Child Development Disorders, Pervasive; Evidence-Based Medicine; Humans; Journal Impact Factor
PubMed: 24408342
DOI: 10.1590/s2317-17822013000300016 -
Health Psychology Review Sep 2016In this paper, we introduce the Intervention Mapping (IM) taxonomy of behaviour change methods and its potential to be developed into a coding taxonomy. That is,... (Review)
Review
In this paper, we introduce the Intervention Mapping (IM) taxonomy of behaviour change methods and its potential to be developed into a coding taxonomy. That is, although IM and its taxonomy of behaviour change methods are not in fact new, because IM was originally developed as a tool for intervention development, this potential was not immediately apparent. Second, in explaining the IM taxonomy and defining the relevant constructs, we call attention to the existence of parameters for effectiveness of methods, and explicate the related distinction between theory-based methods and practical applications and the probability that poor translation of methods may lead to erroneous conclusions as to method-effectiveness. Third, we recommend a minimal set of intervention characteristics that may be reported when intervention descriptions and evaluations are published. Specifying these characteristics can greatly enhance the quality of our meta-analyses and other literature syntheses. In conclusion, the dynamics of behaviour change are such that any taxonomy of methods of behaviour change needs to acknowledge the importance of, and provide instruments for dealing with, three conditions for effectiveness for behaviour change methods. For a behaviour change method to be effective: (1) it must target a determinant that predicts behaviour; (2) it must be able to change that determinant; (3) it must be translated into a practical application in a way that preserves the parameters for effectiveness and fits with the target population, culture, and context. Thus, taxonomies of methods of behaviour change must distinguish the specific determinants that are targeted, practical, specific applications, and the theory-based methods they embody. In addition, taxonomies should acknowledge that the lists of behaviour change methods will be used by, and should be used by, intervention developers. Ideally, the taxonomy should be readily usable for this goal; but alternatively, it should be clear how the information in the taxonomy can be used in practice. The IM taxonomy satisfies these requirements, and it would be beneficial if other taxonomies would be extended to also meet these needs.
Topics: Behavior Therapy; Health Behavior; Humans; Research Design
PubMed: 26262912
DOI: 10.1080/17437199.2015.1077155 -
Health Technology Assessment... Jun 2016Obsessive-compulsive disorder (OCD) is a relatively common and disabling condition. (Meta-Analysis)
Meta-Analysis Review
A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults.
BACKGROUND
Obsessive-compulsive disorder (OCD) is a relatively common and disabling condition.
OBJECTIVES
To determine the clinical effectiveness, acceptability and cost-effectiveness of pharmacological and psychological interventions for the treatment of OCD in children, adolescents and adults.
DATA SOURCES
We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Trials Registers, which includes trials from routine searches of all the major databases. Searches were conducted from inception to 31 December 2014.
REVIEW METHODS
We undertook a systematic review and network meta-analysis (NMA) of the clinical effectiveness and acceptability of available treatments. Outcomes for effectiveness included mean differences in the total scores of the Yale-Brown Obsessive-Compulsive Scale or its children's version and total dropouts for acceptability. For the cost-effectiveness analysis, we developed a probabilistic model informed by the results of the NMA. All analyses were performed using OpenBUGS version 3.2.3 (members of OpenBUGS Project Management Group; see www.openbugs.net ).
RESULTS
We included 86 randomised controlled trials (RCTs) in our systematic review. In the NMA we included 71 RCTs (54 in adults and 17 in children and adolescents) for effectiveness and 71 for acceptability (53 in adults and 18 in children and adolescents), comprising 7643 and 7942 randomised patients available for analysis, respectively. In general, the studies were of medium quality. The results of the NMA showed that in adults all selective serotonin reuptake inhibitors (SSRIs) and clomipramine had greater effects than drug placebo. There were no differences between SSRIs, and a trend for clomipramine to be more effective did not reach statistical significance. All active psychological therapies had greater effects than drug placebo. Behavioural therapy (BT) and cognitive therapy (CT) had greater effects than psychological placebo, but cognitive-behavioural therapy (CBT) did not. BT and CT, but not CBT, had greater effects than medications, but there are considerable uncertainty and methodological limitations that should be taken into account. In children and adolescents, CBT and BT had greater effects than drug placebo, but differences compared with psychological placebo did not reach statistical significance. SSRIs as a class showed a trend for superiority over drug placebo, but the difference did not reach statistical significance. However, the superiority of some individual drugs (fluoxetine, sertraline) was marginally statistically significant. Regarding acceptability, all interventions except clomipramine had good tolerability. In adults, CT and BT had the highest probability of being most cost-effective at conventional National Institute for Health and Care Excellence thresholds. In children and adolescents, CBT or CBT combined with a SSRI were more likely to be cost-effective. The results are uncertain and sensitive to assumptions about treatment effect and the exclusion of trials at high risk of bias.
LIMITATIONS
The majority of psychological trials included patients who were taking medications. There were few studies in children and adolescents.
CONCLUSIONS
In adults, psychological interventions, clomipramine, SSRIs or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Future RCTs should improve their design, in particular for psychotherapy or combined interventions.
STUDY REGISTRATION
The study is registered as PROSPERO CRD42012002441.
FUNDING DETAILS
The National Institute for Health Research Health Technology Assessment programme.
Topics: Adolescent; Adult; Antidepressive Agents; Behavior Therapy; Child; Cognitive Behavioral Therapy; Cost-Benefit Analysis; Humans; Interatrial Block; Models, Econometric; Network Meta-Analysis; Obsessive-Compulsive Disorder; Quality-Adjusted Life Years; State Medicine; United Kingdom
PubMed: 27306503
DOI: 10.3310/hta20430 -
Annals of Behavioral Medicine : a... Jul 2019Despite advances in behavioral science, there is no widely shared understanding of the "mechanisms of action" (MoAs) through which individual behavior change techniques... (Review)
Review
BACKGROUND
Despite advances in behavioral science, there is no widely shared understanding of the "mechanisms of action" (MoAs) through which individual behavior change techniques (BCTs) have their effects. Cumulative progress in the development, evaluation, and synthesis of behavioral interventions could be improved by identifying the MoAs through which BCTs are believed to bring about change.
PURPOSE
This study aimed to identify the links between BCTs and MoAs described by authors of a corpus of published literature.
METHODS
Hypothesized links between BCTs and MoAs were extracted by two coders from 277 behavior change intervention articles. Binomial tests were conducted to provide an indication of the relative frequency of each link.
RESULTS
Of 77 BCTs coded, 70 were linked to at least one MoA. Of 26 MoAs, all but one were linked to at least one BCT. We identified 2,636 BCT-MoA links in total (mean number of links per article = 9.56, SD = 13.80). The most frequently linked MoAs were "Beliefs about Capabilities" and "Intention." Binomial test results identified up to five MoAs linked to each of the BCTs (M = 1.71, range: 1-5) and up to eight BCTs for each of the MoAs (M = 3.63, range: 1-8).
CONCLUSIONS
The BCT-MoA links described by intervention authors and identified in this extensive review present intervention developers and reviewers with a first level of systematically collated evidence. These findings provide a resource for the development of theory-based interventions, and for theoretical understanding of intervention evaluations. The extent to which these links are empirically supported requires systematic investigation.
Topics: Behavior Therapy; Humans; Psychological Theory
PubMed: 30304386
DOI: 10.1093/abm/kay078 -
Implementation Science : IS Apr 2012An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of...
BACKGROUND
An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework.
METHODS
Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis.
RESULTS
There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): 'Knowledge', 'Skills', 'Social/Professional Role and Identity', 'Beliefs about Capabilities', 'Optimism', 'Beliefs about Consequences', 'Reinforcement', 'Intentions', 'Goals', 'Memory, Attention and Decision Processes', 'Environmental Context and Resources', 'Social Influences', 'Emotions', and 'Behavioural Regulation'.
CONCLUSIONS
The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development.
Topics: Adult; Behavior Control; Behavior Therapy; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Reproducibility of Results; Young Adult
PubMed: 22530986
DOI: 10.1186/1748-5908-7-37 -
BMC Psychiatry Aug 2020Comorbidity between Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) is high. There is growing motivation among clinicians to offer PTSD... (Randomized Controlled Trial)
Randomized Controlled Trial
A randomized controlled trial comparing the clinical efficacy and cost-effectiveness of eye movement desensitization and reprocessing (EMDR) and integrated EMDR-Dialectical Behavioural Therapy (DBT) in the treatment of patients with post-traumatic stress disorder and comorbid (Sub)clinical...
BACKGROUND
Comorbidity between Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) is high. There is growing motivation among clinicians to offer PTSD treatments - such as Eye Movement Desensitization and Reprocessing (EMDR) - to patients with PTSD and comorbid BPD. However, a large subgroup with comorbid BPD does not sufficiently respond to PTSD treatment and is more likely to be excluded or to dropout from treatment. Dialectical Behaviour Therapy (DBT) for BPD is well established and although there is some evidence that DBT combined with DBT Prolonged Exposure (DBT + DBT PE) is twice as effective in reducing PTSD symptoms than DBT alone, the comparative efficacy of integrated PTSD-DBT and PTSD-only treatment has not been investigated yet. The current study will therefore evaluate the comparative clinical efficacy and cost-effectiveness of EMDR-DBT and EMDR-only in patients with PTSD and comorbid (sub)clinical BPD. Moreover, it is not clear yet what treatment works best for which individual patient. The current study will therefore evaluate neurobiological predictors and mediators of the individual response to treatment.
METHOD
A randomized controlled trial comparing the clinical efficacy and cost-effectiveness of integrated EMDR-DBT (n = 63) and EMDR-only (n = 63) in treatment-seeking adult patients with PTSD and comorbid (sub)clinical BPD. In addition, neurobiological predictors and mediators of treatment outcome, such as hair cortisol, FKBP5 and BDNF protein levels and FKBP5 and BDNF methylation status, are measured through hair and blood samples.
DISCUSSION
This is the first study to compare the clinical efficacy and cost-effectiveness of integrated EMDR-DBT and EMDR-only in patients with PTSD and comorbid (sub)clinical BPD, while simultaneously identifying individual predictors and mediators of treatment response. Results will reveal which treatment works best for which individual patient, thereby guiding individual treatment choices and personalizing psychiatry.
TRIAL REGISTRATION
Clinical Trials, NCT03833453 . Retrospectively registered, 15 March 2019.
Topics: Adult; Borderline Personality Disorder; Cost-Benefit Analysis; Dialectical Behavior Therapy; Eye Movement Desensitization Reprocessing; Eye Movements; Humans; Stress Disorders, Post-Traumatic; Treatment Outcome
PubMed: 32762677
DOI: 10.1186/s12888-020-02713-x -
Psychotherapy and Psychosomatics 2022Evidence-based psychotherapies for borderline personality disorder (BPD) are lengthy, posing a barrier to their access. Brief psychotherapy may achieve comparable... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Evidence-based psychotherapies for borderline personality disorder (BPD) are lengthy, posing a barrier to their access. Brief psychotherapy may achieve comparable outcomes to long-term psychotherapy for BPD. Evidence is needed regarding the comparative effectiveness of short- versus long-term psychotherapy for BPD.
OBJECTIVE
The aim was to determine if 6 months of Dialectical Behavior Therapy (DBT) is noninferior to 12 months of DBT in terms of clinical effectiveness.
METHODS
This two-arm, single-blinded, randomized controlled noninferiority trial with suicidal or self-harming patients with BPD was conducted at two sites in Canada. Participants (N = 240, M (SD)age = 28.27 (8.62), 79% females) were randomized to receive either 6 (DBT-6) or 12 months (DBT-12) of comprehensive DBT. Masked assessors obtained measures of clinical effectiveness at baseline and every 3 months, ending at month 24. DBT-6 and DBT-12 were outpatient treatments consisting of weekly individual therapy sessions, weekly DBT skills training group sessions, telephone consultation as needed, and weekly therapist consultation team meetings.
RESULTS
The noninferiority hypothesis was supported for the primary outcome, total self-harm (6 months: margin = -1.94, Mdiff [95% CI] = 0.16 [-0.14, 0.46]; 12 months: margin = -1.47, Mdiff [95% CI] = 0.04 [-0.17, 0.23]; 24 months: margin = -1.25, Mdiff [95% CI] = 0.12 [-0.02, 0.36]). Results also supported noninferiority of DBT-6 for general psychopathology and coping skills at 24 months. Furthermore, DBT-6 participants showed more rapid reductions in BPD symptoms and general psychopathology. There were no between-group differences in dropout rates.
CONCLUSIONS
The noninferiority of a briefer yet comprehensive treatment for BPD has potential to reduce barriers to treatment access.
Topics: Female; Humans; Adult; Male; Dialectical Behavior Therapy; Borderline Personality Disorder; Referral and Consultation; Telephone; Psychotherapy; Self-Injurious Behavior; Treatment Outcome; Behavior Therapy
PubMed: 35738244
DOI: 10.1159/000525102 -
Nutrients Dec 2021The aim of the Special Issue "Implications of Nutrition Education, for Health, Behavior, and Lifestyle" is to publish original research articles and reviews that report...
The aim of the Special Issue "Implications of Nutrition Education, for Health, Behavior, and Lifestyle" is to publish original research articles and reviews that report the design and implementation of nutrition education intervention programs and their effectiveness in terms of lifestyle, health, and wellbeing [...].
Topics: Behavior Therapy; Health Education; Health Promotion; Humans; Nutrition Therapy
PubMed: 34959974
DOI: 10.3390/nu13124423