Are Interventions Theory-Based? Development of a Theory Coding Scheme

Objective: Interventions are increasingly described as theory-based; however, the basis for this is often not clear. Advancing behavioral science requires a good understanding of how interventions are informed by, and test, theory. This study aims to develop a reliable method for assessing the extent to which behavioral interventions are theory-based. Design: The reliability, usability, and comprehensiveness of an initial coding scheme were improved in 13 iterative stages on the basis of its application to 29 papers, from a systematic review of interventions to promote physical activity and healthy eating. Results: The final Theory Coding Scheme contained 19 items, each with satisfactory interrater reliabilities, coding whether a theory or model was mentioned, how theories were used in intervention design, how intervention evaluations tested theory, and the implications of the results for future theory development. Conclusion: The Theory Coding Scheme is an important methodological innovation, providing a research tool to reliably describe the theoretical base of interventions, inform evidence syntheses within literature reviews and meta-analyses, and stimulate the use of empirical data for theory development.