Can the inclusion of evidence-based behaviour change techniques within a massive open online course (MOOC) be used to change behaviour and practice?
In October 2016, a 5-week MOOC aimed at increasing awareness and understanding of compassionate care was designed, developed and successfully delivered as part of a project within the Scottish Improvement Science Collaborating Centre (SISCC). Overall, the results demonstrated a high impact on self-reported attitudes and awareness, but most learners did not specify what sections, and which features, and functions they found most appealing. In terms of achieving behaviour change, most reported applying the course knowledge in their workplace, as well as in their personal life. Confidence in practising compassionate care was also reported, but whether and how they changed their behaviour was unclear since participants did not provide examples illustrating the actions toward compassionate care taken as a result of using the MOOC.
Since then, we have shortened this MOOC to 3 weeks in duration in order to address the high attrition. We now propose incorporating evidence-based behaviour content, tools and techniques targeted at those working in health and social care within this MOOC to test whether it is feasible to use this platform to change behaviour and practice.
Our Current Focus
Educational interventions (including e-learning) designed for compassionate care can raise awareness of, or promote confidence in, delivering care, and many such interventions can lead to good intentions to, for example, be more person-centred. However, intentions do not always lead to desired actions (often referred to as the intention-behaviour gap), therefore, these kinds of interventions that are mostly information-based does not always guarantee behaviour change – which is fundamental to the implementation of evidence-based practice.
Identifying and including active mechanisms for behaviour change is likely to optimise educational content for this purpose. Often referred to as behaviour change techniques (BCTs), research has shown that their inclusion within interventions can lead to behaviour change. For example, they have often been used in dietary and physical activity intervention trials to increase short and long-term weight loss. The evidence-based BCTs known to change professional behaviour in clinical settings are goal setting, self-monitoring, feedback and action planning.
Facilitation of initiation and maintenance of multiple behaviour changes requires interventions based on a good understanding of environmental, motivational and volitional processes regulating working behaviour patterns. The most effective behaviour change interventions can empower recipients to control and regulate their own thoughts, feelings and behaviours, thereby, changing the psychological determinants of, and prompts to, habitual behaviour patterns. Such interventions are self-regulatory, in that people are instructed and supported to change regulatory processes which maintain their current behaviour patterns. The question then arises: which self-regulatory behaviour change techniques are best delivered within a MOOC to change behaviour of those working in health and social care?
What's Been Happening
We aim to identify a combination of behavior change techniques (BCTs) along with actions and tools that can be delivered within health and social care. We will do this collaboratively with a range of health and social care experts, who are likely to deliver them, to ensure their fit within the working environment in which they are implemented in. We will then incorporate these within the MOOC and test and evaluate its use within a health and social care environment.