# Behavior change techniques to reduce sedentary behavior and increase physical activity in people at risk for cardiovascular disease: a scoping review

## TL;DR

This review explores behavior change techniques to reduce sedentary behavior and increase physical activity in people at risk for cardiovascular disease.

## Contribution

The study categorizes interventions using the Behavior Change Techniques Taxonomy v1 to improve intervention effectiveness.

## Key findings

- Nineteen articles were included, covering various study types and identifying 11 categories of behavior change techniques.
- Previous studies lacked focus on the persistence of intervention effects and cardiovascular impacts of different physical activities.
- Future interventions should consider physical activity types, cultural backgrounds, and behavior change theories.

## Abstract

Most people at high risk of cardiovascular disease have high levels of sedentary behavior and little physical activity, which increases the incidence of cardiovascular disease. Although there have been many studies confirming the benefits of reducing sedentary behavior and increasing physical activity, the effectiveness and sustainability of the interventions have been limited. Behavior Change Techniques are the smallest unit of effect in the process of changing behavior. Behavior Change Techniques Taxonomy v1 is the first consensus-based interdisciplinary taxonomy of Behavior Change Techniques to date. This can help researchers identify effective components of behavior change interventions and transform general interventions into targeted interventions, and improve intervention effectiveness.

This scoping review aimed to identify and evaluate the behavior change interventions to reduce sedentary behavior and increase physical activity in people at high risk for cardiovascular disease and to improve the effectiveness of interventions.

We conducted a scoping review in accordance with the Arksey and O'Malley framework. Eleven databases were searched (BMJ Best Clinical Practice, UpToDate, Cochrane Library, EMBase, PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Database, VIP, Yimaitong Database) from inception through 20 July, 2025, following the scoping review methodology. We synthesized the interventions narratively using the Behavior Change Techniques Taxonomy v1.

Nineteen articles were ultimately included, including five guidelines, seven randomized controlled trials (RCTs), three cross-sectional studies, one quasi-experimental study, one qualitative study, one cohort study and one systematic review. Categorized according to the Behavior Change Techniques Taxonomy v1, it contains a total of eleven aspects, including goals and planning, feedback and monitoring, social support, shaping knowledge, natural consequences, comparison of behaviour, repetition and substitution, regulation, antecedents, identity, self-belief.

Previous studies did not cover the persistence of intervention effects, and there is still controversy regarding the cardiovascular effects of different physical activity types. In future, a more comprehensive approach should be adopted to intervene in behaviors, such as physical activity types, cultural backgrounds, and combined with behavior change theories and Behavior Change Techniques, to implement targeted interventions for behaviors.