Higher quantity of behaviour change techniques increases adherence in nutritional therapy

Introduction Behaviour change techniques (BCT; Michie et al., 2013) are empirically discernable, validated elements in behavioural interventions whose application in nutritional therapy for weight loss is becoming increasingly wide-spread. However, the specific effects of BCT on therapeutic outcomes in real-world settings are still ill-understood. Here, we examine the impact of the quantity of BCT on patients’ adherence in nutritional therapy in a German weight loss cohort, using real world data.

Methods We collected data from 2016 patients over the course of 14 months, who participated in mostly remotely-delivered nutritional therapy for weight loss offered by a nutritional care provider. Weight data was collected at baseline and at three months. During these three months, BCT usage data was collected including frequency and type (goal setting and action planning, problem-solving, feedback on behaviour, enabling social support, shaping knowledge) aimed at altering patients’ condition-related behaviours. Adherence data, defined by the degree of completion of the therapy, was collected continuously throughout the therapy, which varied in length.

Results Patients (1748 female, 266 male, 2 n/a, mean age 47.7, sd 12.5) lost approximately the same amount of their initial weight at 3 months (95% CI: [-2.956, -2.686]). However, the patients receiving two or more BCT (n=830) completed more sessions of the therapy than those receiving only one BCT (n=1186) (p<0.05), indicating that using multiple BCTs might drive treatment adherence in this cohort.

Conclusion This real-world data analysis provides tentative evidence for a positive effect of the quantity of BCT on patients’ adherence in nutritional therapy in a real-world setting. As adherence is a main driver of treatment success, further exploring the specific impact of amount, combination, and type of administered BCT on adherence is advisable. Moreover, refined retrospective analyses of distinct cohorts in real-world data sets for hypothesis generation and subsequent testing in randomised controlled trials for corroboration will further advance the evidence base on BCT effectiveness.

References:

Michie S, Richardson M, Johnston M, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81-95. doi:10.1007/s12160-013-9486-6

Publication History

Article published online:
14 June 2022