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Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease

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journal contribution
posted on 26.07.2021, 15:50 authored by Mara Pereira Guerreiro, Judith StrawbridgeJudith Strawbridge, Afonso Miguel Cavaco, Isa Brito Félix, Marta Moreira Marques, Cathal Cadogan

Background: Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies.

Methods: The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases.

Results: Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists' feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases.

Conclusions: A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.


Erasmus+ Programme of the European Union under the grant agreement no. 2019–1-PT01-KA203– 061389.



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Published Citation

Guerreiro MP, Strawbridge J, Cavaco AM, Félix IB, Marques MM, Cadogan C. Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease. BMC Med Educ. 2021;21(1):287.

Publication Date

20 May 2021

PubMed ID



  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Population Health and Health Services
  • Health Professions Education


BioMed Central


  • Published Version (Version of Record)