How do you select the most appropriate behaviour change intervention?

Try the APEASE criteria. Developed by Prof. Susan Michie’s team in 2019 it is a set of criteria that can be applied to assess the appropriateness of potential or existing interventions. It can be used for interventions that are still being developed and those that have already been implemented, as a means of evaluation.

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How do you design an intervention in the first place?

Behaviour change interventions involve creating activities, policies, products and services that aim to change how people act; either to adopt a specific desirable behaviour (such as recycling)or discontinue an undesirable behaviour (i.e. smoking).

Interventions are designed by firstly identifying the target behaviour that you want to change; developing a good understanding of the needs and motivations of a target population that needs to perform the target behaviour; and, finally, mapping these motivations to a range of suitable intervention functions, such as persuasion or enablement.

Tools that can assist you in understanding the target audience and mapping audience insights to intervention types include the COM-B model and the Behaviour Change Wheel. Find out more about these resources/tools in this blog, that we published earlier in the year.

The intervention functions that you determine to be appropriate for your target audience, such as persuasion or enablement, can be implemented in a range of ways, depending on what suits your context. Here is where you can be creative and innovative, in the way you design your interventions. Always start with a range of interventions ideas and designs, to set yourself up with selecting the most appropriate, using APEASE.

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So where to from here?

This is where careful collaboration starts; before jumping into implementing any intervention, work closely with your key stakeholders to decide which APEASE criteria (summarised in the table below)are more important than others, e.g. is affordability more important than effectiveness in this context?  Are the possible side effects a major concern or not an issue?  

Then, score each of your intervention options against this criteria, to systematically and objectively decide on an intervention - the more you collaborate in this decision-making process, the closer you get to landing on an appropriate outcome for the context.

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In addition to this collaboration,  Michie (2019) encourages individuals to conduct literature reviews on what has or hasn’t worked in similar contexts to help form judgements on each of the APEASE criteria and be open to adjusting the interventions as necessary following research and workshopping.

How does APEASE work in action?

These criteria can be applied in a variety of ways - one of them being a numerical rating method as illustrated below.However, you could also assess interventions qualitatively. You also don’t have to conduct formal data gathering; APEASE assessment can simply look like a structured discussion with the key collaborators/stakeholders.

By considering all of these criteria factors when designing an intervention, you’re more likely to design an intervention that can realistically be carried out, and effect the desired behavioural change.

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Case study:

Alex Waddell recently delivered a project that aimed to improve shared decision-making between clinicians and women during pregnancy. After speaking with a range of women about their pregnancy journey, Alex and her team developed nine possible intervention options, based on the Behaviour Change Wheel, to facilitate shared decision-making specifically around pain relief during childbirth.

These potential interventions were brought to workshops with key collaborators from the hospital, they were discussed, and the APEASE criteria were applied, to identify the top 3 intervention ideas that were perceived to be most appropriate or feasible. The most important APEASE criteria were affordability, acceptability, practicability, effectiveness, and side-effects (or the lack thereof).

The intervention options that were rated as the most appropriate and feasible were then co-designed with collaborators.

To read about this case study in further detail, access the academic paper that was published in 2023 in the journal Health Research Policy and Systems.

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In summary

Behaviour change interventions are useful for addressing issues where human behaviour is, in part, a contributor to the problem. Once you have your intervention: you can apply the APEASE criteria to ensure that you take the steps needed to evaluate which of a range of intervention ideas will be most appropriate.

If you want to find out more about behavioural change frameworks and how they can be applied, consider checking out the training courses available at BehaviourWorks Australia .org.

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