Effectiveness of Adapted Behaviour Change Techniques for Adults with Learning Disabilities: A Comparative Study of Healthcare and Social Care Settings v1

Adults with learning disabilities (LD) experience significant health inequalities and often receive support across both healthcare and social care services. Behaviour Change Techniques (BCTs) are widely used to support health and wellbeing, yet there is limited evidence on how these techniques should be adapted for adults with LD, and whether their effectiveness differs across service contexts. This mixed‑methods study aims to evaluate the implementation, acceptability, and outcomes of adapted BCTs delivered within healthcare and social care services of the same organisation. Before data collection, a systematic literature review will be conducted to identify existing adapted BCTs, adaptation frameworks, and outcome measures. Findings will inform the intervention design, adaptation strategies, and measurement tools used in the study. The research comprises two parallel arms: (1) adapted BCTs delivered in healthcare services, and (2) adapted BCTs delivered in social care settings. Quantitative data will be collected at baseline, post‑intervention, and follow‑up to assess changes in target behaviours, engagement, quality of life, and staff confidence. Qualitative interviews and focus groups with adults with LD, carers, and staff will explore experiences of the intervention, accessibility, and contextual influences on implementation. A convergent mixed‑methods approach will integrate findings to identify similarities and differences between settings. Participants will include adults with LD who are receiving support from the organisation’s services. Consent processes will follow the Mental Capacity Act 2005, using accessible information, supported decision‑making, and consultee involvement where individuals lack capacity. Ethical considerations include safeguarding, minimising distress, and ensuring confidentiality and data protection. The study requires NHS Research Ethics Committee (REC) approval, Health Research Authority (HRA) approval, and organisational R&D governance approval. Where social care services fall under local authority or regulated provision, local social care research governance processes will also be followed. Findings will inform evidence‑based, person‑centred practice and provide practical recommendations for implementing adapted BCTs across health and social care services, with the aim of improving outcomes and reducing inequalities for adults with learning disabilities.