Table 1.
Behavior change techniques and number of interventions that included specific behavior change techniques, Behavior Change Techniques Taxonomy Volume 1 hierarchical clusters, and intervention content examples.
| BCTa | BCTTv1b hierarchical clusters | Examples extracted from descriptions of the interventions | Frequency | Studies that included the BCT |
| Instruction on how to perform a behavior (4.1) | Shaping knowledge | “Each participant received overall orientation on diabetes management (including how to inject insulin) as well as nutritional and exercise education” [64]. | 24 | [6,20,25,31,32,56,58-60,64-66,68-75,77-80] |
| Adding objects to the environment (12.5) | Antecedents | “Participants were provided with wireless remote monitoring tools and enhanced patient portal functions to support self- management of diabetes” [6]. | 23 | [6,20,25,31,32,56,57,60,61,64,65,67-70,73-79,81] |
| Information about health consequences (5.1) | Natural consequences | “If the sum of all high glycemic index foods in the previous 24-hour period is 5 or more servings, then it provided a more educational message regarding high and low glycemic index foods” [63]. | 21 | [6,32,33,56-58,61,63-73,75,78] |
| Self-monitoring of outcomes of behavior (2.4) | Feedback and monitoring | “...Patients could view their trends over time and make associations between their behaviors and test results” [56]. | 19 | [6,25,31,56,57,60,64,65,67-70,73-79] |
| Feedback on outcomes of behavior (2.7) | Feedback and monitoring | “If remote home-monitoring alerts are judged by the nurse to be significant, trigger an outbound call to the patient to arrange for a provider visit, additional services, or use of the emergency services, as needed” [81]. | 17 | [6,25,31,56-58,65,67-70,73-76,79,81] |
| Prompts/cues (7.1) | Associations | “An alarm activates if the blood glucose level falls below 4 mmol/L” [74]. | 16 | [6,33,56,62-64,67,68,71-76,81] |
| Goal setting (outcome) (1.3) | Goal and planning | “With health coaching assistance, clients determined health-related goals...” [80]. | 9 | [6,20,25,31,59,61,64,66,71,80] |
| Social support (unspecified) (3.1) | Social support | “Internet browser was set to a diabetes education website designed for the study, containing links to several websites with vetted content related to diabetes self-management including sites that facilitated peer-sharing and mutual support” [68]. | 9 | [33,56,57,60,62,67-69,80] |
| Action planning (1.4) | Goal and planning | “Patients received an electronic action plan every 2.5 months to support improved diabetes self-management and to serve as previsit summaries for physician office visits” [69]. | 8 | [6,25,61,62,69-71,80] |
| Self-monitoring of behavior (2.3) | Feedback and monitoring | “The intervention contained email, text, and website with self-regulation, self-monitoring, and assessment functions...food/nutrition, exercise, emotion, and general health care were included” [33]. | 8 | [32,33,60,69-71,78,80] |
| Social support (practical) (3.2) | Social support | “The nurse at the health office educated the patient face-to-face according to the physician’s recommendations” [58]. | 8 | [25,31,58,63,70,77,78,80] |
| Feedback on behavior (2.2) | Feedback and monitoring | “Care manager–participant contacts were used to review progress, reinforce nutritional and lifestyle modifications, and make medication changes” [68]. | 7 | [31,62,63,68,69,74,77] |
| Social support (emotional) (3.3) | Social support | “Patients received phone calls from diabetic educators on days 3, 7, 14, and 60 after registration for specific barrier education, data explanation, and confidence establishment” [57]. | 7 | [6,31,57,69,71,73,81] |
| Biofeedback (2.6) | Feedback and monitoring | “...Patients were provided with special blood glucose testing before and after each exercise session” [80]. | 6 | [56,59,64,69,71,80] |
| Goal setting (behavior) (1.1) | Goal and planning | “The message protocol included encouragement toward self-entered weight loss and exercise goals” [56]. | 5 | [33,56,61,78] |
| Problem solving (1.2) | Goal and planning | “Text messages were sent to solve problems, support patients’ needs, and improve skill...” [62]. | 5 | [20,57,58,61,62,71] |
| Salience of consequences (5.2) | Natural consequences | “Education using animations of how diabetes affects how glucose is processed in the body and how different medication classes, foods, and physical activity affect blood sugar. When patients consume high glycemic index foods, they received a slightly more strongly worded message that also gave information about end-organ damage when diabetes remains uncontrolled.” [61]. | 4 | [20,61,63,73] |
| Demonstration of the behavior (6.1) | Comparison of behavior | “The exercise regimen consisted of a combination of aerobic and resistance exercises of 10-minute duration each, with 5-minute warm-up and cool-down periods... The subjects were encouraged to do this at home daily or on most days of the week” [32]. | 3 | [32,61,64,79] |
| Discrepancy between current behavior and goal (1.6) | Goal and planning | “Interactive visual displays of facilitated tracking progress toward goals and correlated glucose control with medication compliance or lifestyle changes” [6]. |
2 | [6,80] |
| Information about antecedents (4.2) | Shaping knowledge | “Patients were required to test glucose whenever they had symptoms related to hypoglycemia and to record their blood glucose readings” [59]. | 2 | [59,77] |
| Social reward (10.4) | Reward and threat | “If the portion of high glycemic index foods is 0-1, they received a message of congratulations and encouragement to continue the same” [63]. | 2 | [63,76] |
| Pharmacological support (11.1) | Regulation | “The diabetes status report displays diabetes-related medications—emphasizing the medications most important to risk reduction of diabetes complications” [73]. | 2 | [58,73] |
| Reduce negative emotions (11.2) | Regulation | “Education on stress management and keeping well and healthy, participants were introduced to their self-care model and gained more confidence in the way they faced life stressors” [66]. | 2 | [66,80] |
| Restructuring the social environment (12.1) | Antecedent | “...The intervention was designed to improve skills and action plans while contacting the team in anywhere and anytime manner” [62]. | 2 | [62,80] |
| Review behavior goals (1.5) | Goal and planning | “...Participants set goals and develop specific action plans to address identified barriers or other concerns and identify specific questions and concerns to discuss with their doctor about their medications or making lifestyle changes”[61] | 1 | [61] |
| Reduce prompts/cues (7.3) | Associations | “Patients stopped self-monitoring when target blood glucose levels were achieved and resumed self-monitoring prior to quarterly visits and if 3-monthly HbA1c was >53 mmol/L (7.0%)” [25]. | 1 | [25] |
| Behavioral practice/rehearsal (8.1) | Repetition and substitution | “The technique of progressive muscular relaxation was also taught in one of the sessions, with the advice of practicing this at home whenever the subjects encounter stress” [32]. | 1 | [32] |
| Behavioral substitution (8.2) | Repetition and substitution | “...Provided education on common foods in their diet which have a high glycemic index, with low/moderate glycemic index food substitutes...” [63]. | 1 | [63] |
| Habit formation (8.3) | Repetition and substitution | “For the duration of the project, a helper is available at all times in the community centers during the group sessions...” [32]. | 1 | [32] |
| Graded tasks (8.7) | Repetition and substitution | “The insulin self-titration was based on an individualized stepwise treatment plan which contains a number of discrete successive medication doses (steps)...” [25]. | 1 | [25] |
| Body changes (12.6) | Antecedent | “Progressive muscular relaxation was taught...” [32]. | 1 | [32] |
aBCT: behavior change technique.
bBCTTv1: Behavior Change Techniques Taxonomy Volume 1.