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A theory-based randomised controlled trial to increase delivery of behaviour change interventions by healthcare

Chris Keyworth¹, Christopher J Armitage², Judith Johnson³

¹School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.

Social Science & Medicine (1982)

|November 13, 2025

Abstract

Background:

Public health policies require healthcare professionals to incorporate health behaviour change interventions (HBCIs) into routine consultations. This study tested whether an "if-then" planning intervention could enhance HBCI delivery.

Methods:

A randomised controlled trial involving 1008 UK NHS healthcare professionals compared an intervention group, who formed "if-then" plans, with an active control group. Data were collected at one, two, twelve, and thirteen months. Primary and secondary outcomes included the proportion of patients receiving HBCIs, time spent delivering HBCIs, and healthcare professionals' perceived capabilities, opportunities, and motivations.

Results:

The intervention group showed more sustained improvements in HBCI delivery over time compared to the control group, although the between-group difference at the final follow-up (T4) was not statistically significant. The intervention group significantly increased HBCI delivery between T1 and T2 (mean difference = 3.74; p = .009), and between T2 and T3 (mean difference = 4.45; p < .001), with delivery remaining higher at T4. The control group showed a significant increase only between T1 and T2 (mean difference = 8.79; p < .001). Statistically significant improvements were observed in psychological capability, reflective motivation, and automatic motivation to deliver HBCIs, particularly within the intervention group.

Discussion:

The if-then planning intervention led to sustained improvements in HBCI delivery, with the intervention group showing significant increases between T1 and T2, and between T2 and T3, and maintaining higher delivery at T4. Although the final time point showed no significant between-group difference, findings support "if-then" planning as a practical strategy to integrate HBCIs into routine care.

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