International Journal of Clinical Pharmacy

, Volume 38, Issue 5, pp 1027–1031 | Cite as

A change in behaviour: getting the balance right for research and policy

  • Maureen O’Sullivan
  • Cristín Ryan
  • Damian G. Downey
  • Carmel M. HughesEmail author


Behaviour change interventions offer clinical pharmacists many opportunities to optimise the use of medicines. ‘MINDSPACE’ is a framework used by a Government-affiliated organisation in the United Kingdom to communicate an approach to changing behaviour through policy. The Theoretical Domains Framework (TDF) organises constructs of psychological theories that are most relevant to behaviour change into 14 domains. Both frameworks offer a way of identifying what drives a change in behaviour, providing a target for an intervention. This article aims to compare and contrast MINDSPACE and the TDF, and serves to inform pharmacy practitioners about the potential strengths and weaknesses of using either framework in a clinical pharmacy context. It appears that neither framework can deliver evidence-based interventions that can be developed and implemented with the pace demanded by policy and practice-based settings. A collaborative approach would ensure timely development of acceptable behaviour change interventions that are grounded in evidence.


Behaviour change interventions Behaviour change theory MINDSPACE Theoretical Domains Framework (TDF) 




Conflicts of interest



  1. 1.
    Marteau T, Dieppe P, Foy R, Kinmonth A, Schneiderman N. Behavioural medicine: changing our behaviour. BMJ. 2006;332:437–8.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:37.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Haynes RB. Determinants of compliance: the disease and the mechanics of treatment. Baltimore: Johns Hopkins University Press; 1979.Google Scholar
  4. 4.
    Rand CS. Measuring adherence with therapy for chronic diseases: implications for the treatment of heterozygous familial hypercholesterolemia. Am J Cardiol. 1993;72:68D–74D.CrossRefPubMedGoogle Scholar
  5. 5.
    World Health Organisation. Adherence to long-term therapies. Evidence for action. 2003. Accessed 29 June 2016.
  6. 6.
    Institute for Government. MINDSPACE. Influencing behaviour through public policy. 2010. Accessed 29 June 2016.
  7. 7.
    King D, Jabbar A, Charani E, Bicknell C, Wu Z, Miller G, et al. Redesigning the ‘choice architecture’ of hospital prescription charts: a mixed methods study incorporating in situ simulation testing. BMJ Open. 2014. doi: 10.1136/bmjope-2014-005473.Google Scholar
  8. 8.
    Thaler RH, Sunstein CR. Nudge: improving decisions about health, wealth and happiness. London: Penguin Books; 2009.Google Scholar
  9. 9.
    Samson A, editors. The Behavioral Economics Guide 2014 (with a foreword by George Loewenstein and Rory Sutherland). 1st ed. 2014. Accessed 29 June 2016.
  10. 10.
    Marteau TM, Ogilive D, Roland M, Suhrcke M, Kelly MP. Judging nudging: can nudging improve population health? BMJ. 2011;342:d228.CrossRefPubMedGoogle Scholar
  11. 11.
    Dolan P, Hallsworth M, Halpern D, King D, Metcalfe R, Vlaev I. Influencing behaviour: the mindspace way. J Econ Psychol. 2012;33(1):264–77.CrossRefGoogle Scholar
  12. 12.
    Hales D, Attawell K, Hayman J, Khan N, On behalf of the United States Agency for International Development and Department for International Development. PSI Zimbabwe assessment report. 2004. Accessed 29 June 2016.
  13. 13.
    Michie S, West R. Behaviour change theory and evidence: a presentation to Government. Health Psychol Rev. 2013;7:1–22.CrossRefGoogle Scholar
  14. 14.
    French SD, McKenzie JE, O’Connor DA, Grimshaw JM, Mortimer D, Francis JJ, et al. Evaluation of a theory-informed implementation intervention for the management of acute low back pain in general medical practice: the IMPLEMENT cluster randomised trial. PLoS One. 2013. doi: 10.1371/journal.pone.0065471.Google Scholar
  15. 15.
    French SD, Green SE, O’Connor DA, McKenzie JE, Francis JJ, Michie S, et al. Developing theory informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. 2012;7:38.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Michie S, Johnson M, Abraham C, Lawton R, Parker D, Walker A, On behalf of the “Psychological Theory” group. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14:26–33.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Phillips CJ, Marshall AP, Chaves NJ, et al. Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study. J Multidiscip Healthc. 2015;8:139–46.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Maureen O’Sullivan
    • 1
  • Cristín Ryan
    • 2
  • Damian G. Downey
    • 3
  • Carmel M. Hughes
    • 1
    Email author
  1. 1.School of PharmacyQueen’s University BelfastBelfastUK
  2. 2.School of PharmacyRoyal College of Surgeons in IrelandDublinIreland
  3. 3.Belfast City HospitalBelfast Health and Social Care TrustBelfastUK

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