Developing examples of behaviour change techniques for use in nutrition and dietetics: An international Delphi study

Introduction: Behaviour change techniques (BCTs) are key components of interventions designed to improve health behaviours including eating and drinking. The Behaviour Change Technique Taxonomy v1 (BCTTv1) identifies 93 distinct BCTs. To effectively support practitioners and researchers in nutrition and dietetics, practical examples of these are essential. The aims of this study were to develop examples that illustrate the 93 BCTs in the BCTTv1, focusing on clinical nutrition (CN) and public health nutrition (PHN), and use a Delphi technique to achieve a consensus on their applicability and usefulness. Methods: Examples of BCTs, described in the BCTTv1, were drafted for CN and PHN. Experts were invited to evaluate them using a 0–5 score and provide comments. Following an initial assessment round, the examples were revised in response to feedback, and a second round of evaluations was conducted. BCTs achieving a mean score of ≥ 4.0 were considered to have reached consensus. Results: Fourteen experts from eight countries participated, including researchers, teachers, and practitioners. After round 1 (R1), consensus was reached in 77 CN examples and 60 PHN examples. After round 2 (R2), average scores significantly increased (CN median [range] R1 4.42 [3.33–4.92], R2 4.73 [3.72–5.00], p < 0.0001; PHN: mean [SD] 4.09 [0.34], 4.46 [0.29], p < 0.0001) and consensus was reached in 85 CN and 84 PHN examples. Conclusion: Consensus on the applicability and usefulness of 85 and 84 BCT examples was reached for CN and PHN, respectively. These examples provide a foundation for practitioners and researchers to use when designing and implementing behaviour change interventions.