The systematic identification of content and delivery style of an exercise intervention

Objective: This study explored the utility of using behaviour change taxonomies and checklists to systematically assess the content and delivery of behavioural support for physical activity delivered through an established exercise-referral scheme.
Design: An observation study was conducted whereby 22% of initial consultations were observed and audio-recorded, using quota sampling stratified by exercise-referral advisor.
Main Outcome Measures: Content was independently coded by two researchers, to assess; i) completeness in delivering the programme protocol, ii) behaviour change techniques delivered (defined using the CALO-RE taxonomy), and iii) delivery style according to the Behaviour Change Counselling Index (BECCI).
Results: Protocol completeness was 63.6% (range 35.6%-74.6%). The behaviour change techniques delivered most consistently were ‘providing information about where and when to perform the behavior' (86%) and ‘setting outcome goals’ (82%). Other evidence-based techniques such as self-monitoring were infrequently observed. Variation in BECCI scores indicated that advisors could, but did not consistently, provide a client-centred service.
Conclusion: This study highlights how theoretically informed taxonomies can be useful in evaluating service delivery within applied practice, providing a meaningful way of assessing the completeness of protocol delivery relative to evidence. The provision of feedback to practitioners based on such objective criteria also facilitated positive academic-practitioner communication.