Towards a taxonomy of behavior change techniques for promoting shared decision making

Area of Science:

• Health Services Research
• Behavioral Science
• Clinical Implementation Science

Background:

• Limited understanding of functions and behavior change techniques (BCTs) for implementing shared decision making (SDM) in clinical practice.
• Need for a structured taxonomy to guide future SDM implementation initiatives.

Purpose of the Study:

• To develop a behavior change technique (BCT) taxonomy specifically for SDM implementation interventions.
• To identify intervention functions and BCTs associated with effective SDM implementation.

Main Methods:

• Secondary analysis of 87 studies from a 2018 Cochrane review on SDM implementation interventions.
• Extraction of intervention functions and BCTs using trained coders and Michie's guide.
• Descriptive statistical analysis of coded data.

Main Results:

• 87 interventions utilized 7 functions and 32 BCTs; 'Education' was most common.
• Functions 'Modeling' and 'Training', and the combination 'Education + Training + Modeling + Enablement' were linked to more effective interventions.
• The BCT 'Instruction on how to perform the behavior' was most frequent; several others, including 'Demonstration' and 'Feedback', were associated with effectiveness.
• Four novel BCTs were identified: General information, Tailoring, Exercises, and Experience sharing.

Conclusions:

• A specific BCT taxonomy for SDM implementation was established.
• Four new BCTs are proposed for addition to the BCT Taxonomy version 1 (BCTTv1).
• This taxonomy will guide future research and practice in SDM implementation.