Behaviour Change Wheel (BCW)
(and COM-B Model)
What is it?
The Behaviour Change Wheel (BCW) is a framework for designing interventions that is comprehensive, coherent, and links to a model of behaviour. That was developed from 19 frameworks of behaviour change identified in a systematic literature review. It provides a structured approach to designing or updating behaviour change interventions and strategies.
The hub of the wheel identifies the sources of the behaviour that could prove fruitful targets for intervention. It uses the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') model - attached is a detailed description of the model and its parts. This model recognises that behaviour is part of an interacting system involving all these components. Interventions need to change one or more of them in such a way as to put the system into a new configuration and minimise the risk of it reverting. Surrounding the hub is a layer of nine intervention functions to choose from based on the particular COM-B analysis one has undertaken. The outer layer, the rim of the wheel, identifies seven policy categories that can support the delivery of these intervention functions.
Definitions and examples of each intervention function and policy type are attached.
Why is this theory important for behaviour change?
The theory promote a systematic and comprehensive analysis of the available options using behaviour change theory and the available evidence. It facilitates application of behavioural science to ensure that component parts of an intervention or strategy act synergistically.
Example of theory applied
The process of designing an implementation intervention with the Behaviour Change Wheel for health provider smoking cessation care for Australian Indigenous pregnant women is detailed in Gould et al. (2013). How the authors applied each step of the BCW is outlined from page 5.
How could you apply this theory?
When designing a behaviour change intervention strategy:
1. Behavioural target specification: Identify the precise goal of the intervention in terms of what behaviour/s need/s to change, to what degree, in what way, and in whom.
Identify specific behaviours - who needs to do what differently, when, where, and how?When deciding which behaviours to target, we need to think about
(1) the likely impact of that behaviour on the outcome if undertaken
(2) the likelihood that such a behaviour will be implemented in the community (e.g. Cost, complexity, preference, acceptability)
Another factor to consider is the potential spill over effects of one behaviour to other behaviours and people.
2. Behavioural diagnosis: Find out what would need to change for the behaviour to change in terms of Capability (physical and psychological), Opportunity (physical and social) and/or Motivation (reflective and automatic) in the target population, group or individual.
This step is about understanding the target behaviour/s in context. Why are the behaviours as they are? What needs to change for the desired behaviours to occur? Use the COM-B system to answer this. Remember that behaviour is in the moment and there are always competing behaviours/forces
3. Intervention Strategy selection: Use the behavioural diagnosis to decide what ‘intervention functions’ to apply: Education, Persuasion, Incentivisation, Coercion, Training, Restriction, Environmental restructuring, Modelling, Enablement.
4. Implementation strategy selection: Choose from among a range of policy options to support long-term implementation: Fiscal policy, Legislation, Regulation, Environmental planning, Communications, Service provision, Guidelines development.
5. Selection of specific Behaviour Change Techniques: Develop a detailed intervention plan by selecting from among a range of specific behaviour change techniques (elementary components of interventions such as goal-setting, providing rewards etc).
Interventions are made up of behaviour change techniques (BCTs). BCTs are the 'active ingredients' in the intervention that change behaviour. They are observable, replicable, and irreducible components of an intervention. They can be used alone or in combination with other BCTs.
6. Drafting the full intervention specification: Create the detailed intervention specification covering all aspects of content and delivery of the intervention structured around the chosen behaviour change techniques (content) and modes of delivery.
The APEASE criteria (Acceptability, Practicability, Effectiveness/cost-effectiveness, Affordability, Safety/side-effects, Equity) are applied when deciding on the intervention strategy and its implementation in the given context. These criteria should be applied in a structured way using available evidence combined with expert judgement.
Constraints on the development process (budget, timescale, human resources) will determine how much time and effort can spent on the development process itself. Sometimes intervention development has to take place within a few days or weeks while on other occasions a more thorough development process is possible.
Monitoring and evaluation of performance of behaviour change interventions will usually be necessary because of the complexity of human behaviour and ever-changing contexts. There are many ways of doing this to suit different budgets and contexts. More expensive methods, such as ‘Randomised Controlled Trials’ often provide greater confidence in the findings, but not necessarily. It is important from the outset to specify how the evaluation will provide a basis for decision making and it should focus where possible on objective outcome measures
Gould, G., Bar-Zeev, Y., Bovill, M., Atkins, L., Gruppetta, M., Clarke, M., & Bonevski, B. (2017). Designing an implementation intervention with the Behaviour Change Wheel for health provider smoking cessation care for Australian Indigenous pregnant women. Implementation Science, 12(1), 1-14.
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., ... & Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of behavioral medicine, 46(1), 81-95.