Acyclic Behavior Change Diagrams: A Tool to Report and Analyze Interventions

Despite their vital role in enhancing human health and well-being, concerns have been raised about suboptimal reporting of behavior change interventions, making analysis, replication, and re-use of interventions hard or even impossible. This paper introduces acyclic behavior change diagrams (ABCDs) to achieve more transparent development, evaluation, and reporting of behavior change interventions. ABCDs are a visual representation of the assumptions regarding causal-structural chains that underlie putative active ingredients of behavior change interventions. These causal-structural chains link the behavior change principles that are applied in an intervention to the (determinants of) behavior targeted in that intervention. This paper specifies four advantages of using ABCDs: they are helpful in making implicit assumptions explicit, they help communicate assumptions with team members and other stakeholders, they make evaluation easier, and they are machine-readable, allowing for direct import of ABCDs into a (systematic review) database with negligible costs but full accuracy and completeness.