Woodward, Amie ORCID: https://orcid.org/0000-0002-9579-4012 and Butler, Frances ORCID: https://orcid.org/0000-0001-6479-2922 (2026) Applying the Behaviour Change Wheel to design physical activity interventions for women undergoing the menopausal transition. Menopause. (In Press)

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Abstract

Objective
Physical activity (PA) is critical for mitigating cardiovascular disease risk during the menopausal transition, yet participation often declines during this life stage. This study applied the Behaviour Change Wheel (BCW), a comprehensive framework for designing evidence-based interventions, to identify determinants of PA and develop tailored strategies to support women in meeting UK PA guidelines.

Methods
We conducted a behavioural diagnosis by integrating primary data from three focus groups with perimenopausal and postmenopausal women (n=14, 51.5±2.2 years) and findings from six qualitative studies. Data were coded using the Theoretical Domains Framework and the COM-B model (Capability, Opportunity, Motivation-Behaviour). We then used the BCW to systematically select intervention functions, policy categories, and behaviour change techniques (BCTs) to address identified determinants.

Results
We identified 14 behavioural determinants across all COM-B domains. Interventions should address menopause-related physical capabilities and self-efficacy, caregiving identities that de-prioritise personal health, and anxiety regarding public exercise environments. Intervention functions including Training, Education, and Enablement can build confidence and skills, while Modelling and Persuasion can be used to elevate positive role models and reframe PA as health-promoting behaviour compatible with caregiving roles.

Conclusions
This study outlines a theory-informed intervention package that provides recommendations to support PA engagement during midlife. Recommendations include providing menopause-specific technical support for safe PA, creating inclusive, non-judgemental environments, and using BCTs like action planning and graded tasks to build sustainable habits. These findings offer an actionable foundation to develop future PA interventions that reflect the specific needs and lived experiences of women undergoing the menopausal transition.

Item Type:	Article
Status:	In Press
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
School/Department:	School of Science, Technology and Health
Institutes:	Institute for Health and Care Improvement
URI:	https://ray.yorksj.ac.uk/id/eprint/15488

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