Behaviour change strategies for reducing blood pressure-related disease burden: Findings from a global implementation research programme

David Peiris, Simon R. Thompson, Andrea Beratarrechea, María Kathia Cárdenas, Francisco Diez-Canseco, Jane Goudge, Joyce Gyamfi, Jemima Hoine Kamano, Vilma Irazola, Claire Johnson, Andre P. Kengne, Ng Kien Keat, J. Jaime Miranda, Sailesh Mohan, Barbara Mukasa, Eleanor Ng, Robby Nieuwlaat, Olugbenga Ogedegbe, Bruce Ovbiagele, Jacob Plange-RhuleDevarsetty Praveen, Abdul Salam, Margaret Thorogood, Amanda G. Thrift, Rajesh Vedanthan, Salina P. Waddy, Jacqui Webster, Ruth Webster, Karen Yeates, Khalid Yusoff, Amber Featherstone, Tara McCready, Stephen Jan, Clara Chow, Bruce Neal, Francesc Xavier Gómez-Olivé, Nokuzola Myakayaka, Chodziwadziwa Kabudula, Felix Limbani, Nkosinathi Masilela, Margaret Thorogoo, Anthony Rodgers, Patel Stephen Jan, Rohina Joshi, Stephen MacMahon, Pallab Maulik, Antonio Bernabe-Ortiz, J. Jaime Miranda, Vilarmina Ponce-Lucero, Sylvester Kimaiyo, Claire Kofler, Mulugeta Gebregziabher, Stephanie Warth, Salina Waddy, Amir Attaran, Sanni Yaya, Edward Mills, Katherine Muldoon, Anniza de Villiers, Amber Featherstone, Jamie Forrest, Robert Kalyesubula, Julius Kamwesiga, Paul Camacho Lopez, Jean Claude Tayari, Patricio Lopez, Juan Lopez Casas, Martin McKee, Ariffin Omar Zainal, Salim Yusuf, Norman Campbell, Kajiru Kilonzo, Peter Liu, Marion Marr, Sheldon Tobe, Xiangxian Feng, Jianhui Yuan, Feng He, Graham MacGregor, Xian Li, Yangfeng Wu, Lijing Yan, Ching Ping Lin, Jing Zhang, Jun Ma, Yuan Ma, Haijun Wang, Caryl Nowson, Marj Moodie, Kartik Kalyanram, Kamakshi Kartik, Thout Sudhir, Roger Evans, Simin Arabshahi, Ajay Mahal, Stephane Heritier, Brian Oldenburg, Michaela Riddell, Velandai Srikanth, Oduru Suresh, Kavumpurathu Thankappan, Sathish Thirunavukkarasu, Ravi Varma, Nihal Thomas, Gari Clifford, Dorairaj Prabhakaran, Simon Thom, Anand Krishnan, K. Srinath Reddy, Sarah Faletoese, Merina Ieremia, Jimaima Schultz, Junior Siitia, Wendy Snowdon, Arti Pillay, Arleen Sukhu, Christina Ulberg, Satupaitea Viali, Robert H. Gilman, Katherine Sacksteder, Kingsley Apusiga, Richard Cooper, Michael Ntim, Cynthia Binanay, Gerald Bloomfield, Eric Velazquez, Allison DeLong, Joseph Hogan, Eric Finkelstein, Valentin Fuster, Tom Inui, Martin Were, Diana Menya, Violet Naanyu, Jackson Rotich, Federico Augustovski, Jing Chen, Jing Chemg, Jacquelyn Dolan, Jiang He, Katherine Mills, Lizheng Shi, Larry Webber, Marie Krousel-Wood, Rosana Poggio, Adolfo Rubinstein, Rufus Akinyemi, Oyedunni Arulogun, Mayowa Owolabi, Samantha Hurst, Ezinne Uvere

Research output: Contribution to journalArticlepeer-review


Background: The Global Alliance for Chronic Diseases comprises the majority of the world's public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst vulnerable populations in high-income countries. In its inaugural research call, 15 projects were funded, focussing on lowering blood pressure-related disease burden. In this study, we describe a reflexive mapping exercise to identify the behaviour change strategies undertaken in each of these projects. Methods: Using the Behaviour Change Wheel framework, each team rated the capability, opportunity and motivation of the various actors who were integral to each project (e.g. community members, non-physician health workers and doctors in projects focussed on service delivery). Teams then mapped the interventions they were implementing and determined the principal policy categories in which those interventions were operating. Guidance was provided on the use of Behaviour Change Wheel to support consistency in responses across teams. Ratings were iteratively discussed and refined at several group meetings. Results: There was marked variation in the perceived capabilities, opportunities and motivation of the various actors who were being targeted for behaviour change strategies. Despite this variation, there was a high degree of synergy in interventions functions with most teams utilising complex interventions involving education, training, enablement, environmental restructuring and persuasion oriented strategies. Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation. Conclusions: The large variation in preparedness to change behaviour amongst the principal actors across these projects suggests that the interventions themselves will be variably taken up, despite the similarity in approaches taken. The findings highlight the importance of contextual factors in driving success and failure of research programmes. Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.

Original languageEnglish (US)
Article number158
JournalImplementation Science
Issue number1
StatePublished - Nov 9 2015


  • Behaviour change theory
  • Collaborative research
  • Hypertension
  • Implementation science
  • Low- and middle-income countries

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics
  • Public Health, Environmental and Occupational Health


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