Behavior Change Techniques and Their Mechanisms of Action: A Synthesis of Links Described in Published Intervention Literature

Rachel N. Carey, Lauren E. Connell, Marie Johnston, Alexander J. Rothman, Marijn De Bruin, Michael P. Kelly, Susan Michie

Research output: Contribution to journalArticlepeer-review

323 Scopus citations


Background: Despite advances in behavioral science, there is no widely shared understanding of the "mechanisms of action" (MoAs) through which individual behavior change techniques (BCTs) have their effects. Cumulative progress in the development, evaluation, and synthesis of behavioral interventions could be improved by identifying the MoAs through which BCTs are believed to bring about change. Purpose: This study aimed to identify the links between BCTs and MoAs described by authors of a corpus of published literature. Methods: Hypothesized links between BCTs and MoAs were extracted by two coders from 277 behavior change intervention articles. Binomial tests were conducted to provide an indication of the relative frequency of each link. Results: Of 77 BCTs coded, 70 were linked to at least one MoA. Of 26 MoAs, all but one were linked to at least one BCT. We identified 2,636 BCT-MoA links in total (mean number of links per article = 9.56, SD = 13.80). The most frequently linked MoAs were "Beliefs about Capabilities" and "Intention." Binomial test results identified up to five MoAs linked to each of the BCTs (M = 1.71, range: 1-5) and up to eight BCTs for each of the MoAs (M = 3.63, range: 1-8). Conclusions: The BCT-MoA links described by intervention authors and identified in this extensive review present intervention developers and reviewers with a first level of systematically collated evidence. These findings provide a resource for the development of theory-based interventions, and for theoretical understanding of intervention evaluations. The extent to which these links are empirically supported requires systematic investigation.

Original languageEnglish (US)
Pages (from-to)693-707
Number of pages15
JournalAnnals of Behavioral Medicine
Issue number8
StatePublished - Oct 10 2018

Bibliographical note

Publisher Copyright:
© 2018 The Author(s).


  • Behavior change
  • Behavior change technique
  • Evidence synthesis
  • Mechanism of action
  • Methodology
  • Theory


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