Theory in practice: identifying theory-based techniques in health coaches' tailored feedback during a weight loss intervention

Psychol Health. 2020 Nov;35(11):1384-1406. doi: 10.1080/08870446.2020.1748629. Epub 2020 May 2.

Abstract

Objective: A taxonomy of ninety-three functionally different behaviour change techniques (BCTs) has been identified. However, it is not fully clear how these and other theory-based techniques are applied in the day-to-day practice of people delivering health behaviour change interventions. This study examines feedback provided by expert health coaches in a behavioural weight-loss intervention, to describe; a) what theory-based techniques are used in sessions, b) which techniques are used most frequently, c) what occurs in sessions, beyond existing theory-based techniques. Main Outcome Measures: Theory-based techniques (BCTs/tailoring strategies); relational/content-based techniques. Design: 10 tailored feedback videos from two health coaches were coded using a hybrid thematic analysis approach. Theory-based techniques were coded deductively; content not matching definitions of theory-based techniques but that addressed a determinant of behaviour change were coded inductively and relational codes were connected into themes. Results: Seventeen BCTs were coded M = 20.88 times (range:1-109). Eight tailoring techniques were coded M = 25.25 times (range:1-91). Relational themes included; 'Autonomous interpersonal coaching style,' 'Supportive accountability,' and 'Coach as expert'. Additional behavioural techniques were also identified. Conclusion: This work highlights what and how theory-based techniques are implemented in a weight-loss intervention, drawing attention to the role of tailoring techniques and health coaches in supporting behaviour change.

Keywords: Health behaviour change; behaviour change techniques (BCTs); behaviour change theory; health coaches; human support; implementation; tailoring; weight loss.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Behavior Therapy / methods
  • Feedback
  • Female
  • Health Behavior / physiology*
  • Humans
  • Male
  • Mentoring
  • Weight Loss / physiology*