From lists of behaviour change techniques (BCTs) to structured hierarchies: Comparison of two methods of developing a hierarchy of BCTs

James Cane, Michelle Richardson, Marie Johnston, Ruhina Ladha, Susan Michie

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Behaviour change technique (BCT) Taxonomy v1 is a hierarchically grouped, consensus-based taxonomy of 93 BCTs for reporting intervention content. To enhance the use and understanding of BCTs, the aims of the present study were to (1) quantitatively examine the ‘bottom-up’ hierarchical structure of Taxonomy v1, (2) identify whether BCTs can be reliably mapped to theoretical domains using a ‘top-down’ theoretically driven approach, and (3) identify any overlap between the ‘bottom-up’ and ‘top-down’ groupings.

Methods and design
The ‘bottom-up’ structure was examined for higher-order groupings using a dendrogram derived from hierarchical cluster analysis. For the theory-based ‘top-down’ structure, 18 experts sorted BCTs into 14 theoretical domains. Discriminant Content Validity was used to identify groupings, and chi-square tests and Pearson's residuals were used to examine the overlap between groupings.

Behaviour change techniques relating to ‘Reward and Punishment’ and ‘Cues and Cue Responses’ were perceived as markedly different to other BCTs. Fifty-nine of the BCTs were reliably allocated to 12 of the 14 theoretical domains; 47 were significant and 12 were of borderline significance. Thirty-four of 208 ‘bottom-up’ × ‘top-down’ pairings showed greater overlap than expected by chance. However, only six combinations achieved satisfactory evidence of similarity.

The moderate overlap between the groupings indicates some tendency to implicitly conceptualize BCTs in terms of the same theoretical domains. Understanding the nature of the overlap will aid the conceptualization of BCTs in terms of theory and application. Further research into different methods of developing a hierarchical taxonomic structure of BCTs for international, interdisciplinary work is now required.
Original languageEnglish
Pages (from-to)130-150
Number of pages21
JournalBritish Journal of Health Psychology
Issue number1
Early online date12 May 2014
Publication statusPublished - Feb 2015

Bibliographical note

We would like to thank the BCT Taxonomy co-investigators Charles Abraham, Jill Francis, Wendy Hardeman, Martin Eccles, and CarolineWood for their comments and help in relation to this work. This work was supported through a Medical Research Council Health Service Research Collaboration grant (ref. G0901474).


  • behaviour change
  • health
  • taxonomy
  • behaviour change technique
  • theory
  • theoretical domains framework
  • domains


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