Susan Michie

University College London | UCL · The Centre for Behaviour Change

Objectives To evaluate short-term effects of publishing revised lower risk national drinking guidelines on related awareness and knowledge. To examine where drinkers heard about guidelines over the same period. Design Trend analysis of the Alcohol Toolkit Study, a monthly repeat cross-sectional national survey. Setting England, November 2015 to M...

Background: Excessive alcohol consumption is a leading cause of death and morbidity worldwide and interventions to help people reduce their consumption are needed. Interventions delivered by smartphone apps have the potential to help harmful and hazardous drinkers reduce their consumption of alcohol. However, there has been little evaluation of th...

Background The Alcohol Toolkit Study (ATS) is a monthly survey of approximately 1700 adults per month aged 16 years of age or more in England. We aimed to explore patterns of alcohol consumption and motivation to reduce alcohol use in England throughout the year. Methods Data from 38,372 participants who answered questions about alcohol consumption...

Background: Understanding links between behaviour change techniques (BCTs) and mechanisms of action (the processes through which they affect behaviour) helps inform the systematic development of behaviour change interventions. Purpose: This research aims to develop and test a methodology for linking BCTs to their mechanisms of action. Methods:...

As more behavioral health interventions move from traditional to digital platforms, the application of evidence-based theories and techniques may be doubly advantageous. First, it can expedite digital health intervention development, improving efficacy, and increasing reach. Second, moving behavioral health interventions to digital platforms presen...

Changing behaviour at scale is needed to address the major challenges facing humanity: from preventing and treating disease to tackling the climate crisis. Developing effective interventions to achieve this requires efficient generation and use of scientific evidence. The Human Behaviour-Change Project developed an extensive ontology of behaviour c...

The World Health Organization declared COVID-19 to be a public health emergency of international concern on 30 January 2020 and then a pandemic on 11 March 2020. In early 2020, a group of UK scientists volunteered to provide the public with up-to-date and transparent scientific information. The group formed the Independent Scientific Advisory Group...

Background Advancing and applying behavioural science requires clear, consistent and coherent descriptions of behaviour change interventions. Ontologies provide a means to do this and enable information to be computer-readable. This study aimed to develop an ontology describing the ‘schedule of delivery’ of behaviour change interventions within the...

Background Using reports of randomised trials of smoking cessation interventions as a test case, this study aimed to develop and evaluate machine learning (ML) algorithms for extracting information from study reports and predicting outcomes as part of the Human Behaviour-Change Project. It is the first of two linked papers, with the second paper re...

Background Research about anxiety, depression and psychosis and their treatments is often reported using inconsistent language, and different aspects of the overall research may be conducted in separate silos. This leads to challenges in evidence synthesis and slows down the development of more effective interventions to prevent and treat these con...

Background Social anxiety is a heightened fear and discomfort in social situations which can be experienced in varying degrees of severity. Cases of elevated distress and impaired functioning and quality of life can lead to a clinical diagnosis of social anxiety disorder. Altering cognitive biases associated with social anxiety has been suggested a...

There has been a rapid expansion in the quantity and complexity of data, information and knowledge created in the behavioural and social sciences, yet the field is not advancing understanding, practice or policy to the extent that the insights warrant. One challenge is that research often progresses in disciplinary silos and is reported using incon...

Objectives To investigate worry about COVID-19 during the pandemic, and whether worry was associated with phase of the pandemic, COVID-19 death and incidence rates, Government interventions (including lockdown and advertising), age, being clinically at-risk, ethnicity, thinking that the Government had put the right measures in place, perceived risk...

Disposable diapers contribute to the generation of plastic waste globally, with more than 8 million tonnes of diapers ending up in landfills or incinerated each year. One strategy for reducing this waste while maintaining child and parent health and well-being is to increase reusable diaper use and reduce delays in toilet training. We outline a pro...

Background The HBCP knowledge system identifies and extracts entities from randomised controlled trials of behaviour change interventions organised by a behaviour change intervention ontology (BCIO) to populate: 1) an outcome prediction tool; and 2) a research browser tool. This knowledge system requires automated information extraction algorithms...

Clear communication is vital for adopting public health interventions that promote protective behaviours against respiratory infections. This systematic review and network meta-analysis assessed the effectiveness of these interventions using behavioural science frameworks, including MINDSPACE contextual influencers and behaviour change techniques (...

Background Artificial intelligence (AI) has considerable potential to enhance public health. People using AI systems for public health decisions, or who are affected by such decisions, may need to understand how these systems work, or articulate how much they want decision-makers to trust the system. This public engagement project, part of the Huma...

Background The Human Behaviour-Change Project (HBCP) aims to improve evidence synthesis in behavioural science by compiling intervention reports, annotating them according to an ontology, and using the resulting data to train information extraction and prediction algorithms. The HBCP used smoking cessation as the first ‘proof of concept’ domain but...

This is a process evaluation of a large UK-based randomised controlled trial (RCT) ( n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants’ engagement (‘self-r...

Background Behaviour change interventions influence behaviour through causal processes called “mechanisms of action” (MoAs). Reports of such interventions and their evaluations often use inconsistent or ambiguous terminology, creating problems for searching, evidence synthesis and theory development. This inconsistency includes the reporting of MoA...

Introduction This study evaluated a series of disposal instruction labels for their effectiveness in enabling the desired disposal of compostable plastic packaging. Methods Mixed methods were employed: an online experiment and a survey. UK citizens ( n = 1,008) completed a task, sorting packaging labelled with various disposal instructions into on...

Background Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs’ enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and a...

Background The Behaviour Change Technique Taxonomy v1 (BCTTv1) specifies the potentially active content of behaviour change interventions. Evaluation of BCTTv1 showed the need to extend it into a formal ontology, improve its labels and definitions, add BCTs and subdivide existing BCTs. We aimed to develop a Behaviour Change Technique Ontology (BCTO...

Background Human behaviours have been classified in areas such as health, occupation and sustainability. We aimed to develop a more broadly applicable framework for behaviours to facilitate integrating evidence across domains. Methods The Human Behaviour Ontology (HBO), a part of the Behaviour Change Intervention Ontology (BCIO), was developed by:...

Background Trace amine-associated receptor 1 (TAAR1) agonism shows promise for treating psychosis, prompting us to synthesise data from human and non-human studies. Methods We co-produced a living systematic review of controlled studies examining TAAR1 agonists in individuals (with or without psychosis/schizophrenia) and relevant animal models. Two...

Background The Behaviour Change Intervention Ontology (BCIO) aims to improve the clarity, completeness and consistency of reporting within intervention descriptions and evidence synthesis. However, a recommended method for transparently annotating intervention evaluation reports using the BCIO does not currently exist. This study aimed to develop a...

Background Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs’ response by providing insights into human behaviour and informing tailored...

Background The Behaviour Change Techniques Taxonomy v1 (BCTTv1) is the most widely used classification of behaviour change techniques (BCTs), contributing to the accurate report and evaluation of behaviour change interventions and accumulation of evidence. This study reports a structured approach to adapt the BCTTv1 into European Portuguese (BCTTv1...

Background Digital interventions, including apps and websites, can be effective for reducing alcohol consumption. However, many are not evidence- or theory-informed and have not been evaluated. We tested the effectiveness of the Drink Less app for reducing alcohol consumption compared with usual digital care in the UK. Methods In this two-arm, par...

Background Research about anxiety, depression and psychosis and their treatments is often reported using inconsistent language, and different aspects of the overall research may be conducted in separate silos. This leads to challenges in evidence synthesis and slows down the development of more effective interventions to prevent and treat these con...

Background Personal protective behaviours (PPBs) played a crucial role in limiting the spread of infection during the COVID-19 pandemic, yet adherence to these behaviours varied at population level. Understanding the factors influencing adherence to protective behaviours is important, as PPBs will be a critical part of the response in future pandem...

This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5,602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants’ engagement (‘self-r...

Background Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs’ response by providing insights into human behaviour and informing tailored...

Background Systematic reviews of effectiveness estimate the relative average effects of interventions and comparators in a set of existing studies e.g., using rate ratios. However, policymakers, planners and practitioners require predictions about outcomes in novel scenarios where aspects of the interventions, populations or settings may differ. Th...

Issue/problem Effective communication between academics and policy makers can be challenging due to differences in language, priorities, and deadlines. Policy makers are often pressed for time and require concise and actionable information to inform their decisions. Description of the problem Policy briefs are a useful tool for bridging the gap be...

Background Using reports of randomised trials of smoking cessation interventions as a test case, this study aimed to develop and evaluate machine learning (ML) algorithms for extracting information from study reports and predicting outcomes as part of the Human Behaviour-Change Project. It is the first of two linked papers, with the second paper re...

Background: Investigating and enhancing the effectiveness of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. We need to understand not only their content, that is the specific techniques, but also the source, mode, schedule, and style in which this content is delivered. Delivery style r...

Background and Aims Inadequate reporting of smoking cessation intervention trials is common and leads to significant challenges for researchers. The aim of this study was to tailor CONSORT (Consolidated Standards of Reporting Trials)‐SPI (Social and Psychological Interventions) guidelines to improve reporting of trials of behavioural interventions...

BACKGROUND Randomised controlled trials (RCTs) with no in-person contact (i.e. remote) between researchers and participants offer savings in terms of cost and time, but present unique challenges. OBJECTIVE We examine differences between different forms of remote recruitment [e.g. National Health Service (NHS) website, social media and radio advert...

Background: Ensuring widespread COVID-19 vaccine uptake is a public health priority in Canada and globally, particularly within communities that exhibit lower uptake rates and are at a higher risk of infection. Public health units (PHUs) have leveraged many resources to promote the uptake of recommended COVID-19 vaccine doses. Understanding barrier...

Background Randomized controlled trials (RCTs) with no in-person contact (ie, remote) between researchers and participants offer savings in terms of cost and time but present unique challenges. Objective The goal of this study is to examine the differences between different forms of remote recruitment (eg, National Health Service [NHS] website, so...

Background: Behaviour change interventions influence behaviour through causal processes called “mechanisms of action” (MoAs). Reports of such interventions and their evaluations often use inconsistent or ambiguous terminology, creating problems for searching, evidence synthesis and theory development. This inconsistency includes the reporting of Mo...

Background There is growing evidence that context mediates the effects of implementation interventions intended to increase healthcare professionals’ use of research evidence in clinical practice. However, conceptual clarity about what comprises context is elusive. The purpose of this study was to advance conceptual clarity on context by developing...

Objectives: We aimed to identify psychological factors associated with the use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions. Design: Repeated cross-sectional online surveys (n ≈ 2000 adults) between August 2020 and April 2022 (68,716 responses f...

Ontologies are ways of representing aspects of the world in terms of uniquely defined classes of ‘entities’ and relationships between them. They are widely used in biological science, data science and commerce because they provide clarity, consistency, and the ability to link information and data from different sources. Ontologies offer great promi...

Background: The Behaviour Change Technique Taxonomy v1 (BCTTv1) specifies the potentially active content of behaviour change interventions. Evaluation of BCTTv1 showed the need to extend it into a formal ontology, improve its labels and definitions, add BCTs and subdivide existing BCTs. We aimed to develop a Behaviour Change Technique Ontology (BCT...

The Internet of Things (IoT) connects computing devices embedded in everyday objects via the internet, enabling them to send and receive data. Little is known about behaviours required to protect IoT users. The study sought to develop expert consensus on the key protective behaviours, risk behaviours, and threats for IoT cybersecurity. An online, t...

In anxiety, depression and psychosis, there has been frustratingly slow progress in developing novel therapies that make a substantial difference in practice, as well as in predicting which treatments will work for whom and in what contexts. To intervene early in the process and deliver optimal care to patients, we need to understand the underlying...

Background People with dementia find it increasingly difficult to carry out daily activities (activities of daily living), and may require increasing support from family carers. Researchers in the Netherlands developed the Community Occupational Therapy in Dementia intervention, which was delivered in 10 1-hour sessions over 5 weeks to people with...

Background The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy. Objective In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in...

BACKGROUND The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy. OBJECTIVE In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in...

The Capability, Opportunity, Motivation-Behaviour (COM-B) model is used to understand and predict human behaviour, and develop interventions aimed at influencing behaviour. It has been presented in several different diagrams, varying in the specification of the causal links between capability, opportunity, motivation and behaviour. The differences...

Background and aims: Behavioural smoking cessation trials have employed comparators that vary considerably between trials. Although some previous meta-analyses made attempts to account for variability in comparators, these relied on subsets of trials and incomplete data on comparators. This study aimed to estimate the relative effectiveness of (in...

Background The Behaviour Change Technique Taxonomy v1 (BCTTv1) specifies the potentially active content of behaviour change interventions. Evaluation of the BCTTv1 showed the need to extend it into a formal ontology, improve its labels and definitions, add BCTs and subdivide existing BCTs. We aimed to develop a Behaviour Change Technique Ontology (...

Background: Behaviour change interventions influence behaviour through causal processes called “mechanisms of action” (MoAs). Reports of such interventions and their evaluations often use inconsistent or ambiguous terminology. This includes the reporting of MoAs, creating challenges for searching, evidence synthesis and theory development. An ontol...

Background and aims: Using reports of randomised trials of smoking cessation interventions as a test case, this study aimed to develop and evaluate machine learning (ML) algorithms for extracting information from study reports and predicting outcomes as part of the Human Behaviour Change Project. Methods: Researchers manually annotated 70 items of...

Background: The route into the body for many pathogens is through the eyes, nose and mouth (i.e., the 'T-zone') via inhalation or fomite-based transfer during face touching. It is important to understand factors that are associated with touching the T-zone to inform preventive strategies. Purpose: To identify theory-informed predictors of intent...

Background: Public health and social measures (PHSM) intend to reduce the transmission of infectious diseases and to reduce the burden on health systems, economies and societies. During the COVID-19 pandemic, PHSM have been selected, combined and implemented in a variable manner and inconsistently categorized in policy trackers. This paper present...

BACKGROUND Evaluating digital interventions using remote methods enables the recruitment of large numbers of participants relatively conveniently and cheaply compared with in-person methods. However, conducting research remotely, based on participant self-report with little verification, is open to automated “bots” and participant deception. OBJEC...

Background Evaluating digital interventions using remote methods enables the recruitment of large numbers of participants relatively conveniently and cheaply compared with in-person methods. However, conducting research remotely based on participant self-report with little verification is open to automated “bots” and participant deception. Objectiv...

Key Features Virus Watch is a national community cohort study of COVID-19 in households in England and Wales, established in June 2020. The study aims to provide evidence on which public health approaches are most effective in reducing transmission, and investigate community incidence, symptoms, and transmission of COVID-19 in relation to populatio...

Objectives: To investigate knowledge of self-isolation rules and factors associated with knowledge. Methods: Repeated cross-sectional online surveys (n ≈ 2000 UK adults) between 9 November 2020 and 16 February 2022 (78,573 responses from 51,881 participants). We computed a composite measure of knowledge of self-isolation rules and investigated a...

Background: To build cumulative evidence about what works in behaviour change interventions, efforts have been made to develop classification systems for specifying the content of interventions. The Behaviour Change Techniques (BCT) Taxonomy v1 (BCTTv1) is one of the most widely used classifications of behaviour change techniques across a variety o...

Background: To build cumulative evidence about what works in behaviour change interventions, efforts have been made to develop classification systems for specifying the content of interventions. The Behaviour Change Techniques (BCT) Taxonomy v1 (BCTTv1) is one of the most widely used classifications of behaviour change techniques across a variety o...

Behavioural science as applied to human health and wellbeing is crucial for meeting the challenges facing humanity in the 21st century. Although only a small fraction of health-related research focuses on behaviour, it still represents a substantial body of evidence that is accumulating rapidly. The sheer number of publications presents a huge chal...

Objectives: We aimed to identify psychological factors associated with use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions.Design: Repeated cross-sectional online surveys (n≈ 2,000 adults) between August 2020and April 2022 (68,716 responses from 45,68...

Background The prevalence of genital chlamydia and gonorrhoea is higher in the 16–24 years age group than those in other age group. With users, we developed the theory-based safetxt intervention to reduce sexually transmitted infections. Objectives To establish the effect of the safetxt intervention on the incidence of chlamydia/gonorrhoea infecti...

Despite strong expertise and a sophisticated scientific advisory system, the UK’s response to the Covid-19 pandemic has been, and continues to be, weak in terms of preventing death and illness, and damage to the economy. This article argues that an important reason for this failure has been that the policies of the UK government have at critical ti...