L. Alison Phillips

L. Alison Phillips
Iowa State University | ISU · Department of Psychology

Ph.D.

About

89
Publications
38,779
Reads
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3,456
Citations
Introduction
I research patients' commonsense-model illness perceptions, adherence, and patient-provider communication, focusing on the processes of health-behavior development that occur after behavior initiation (after beliefs/perceptions are already favorable towards a particular treatment). I am also conducting research to help identify the mechanisms required for maintenance of complex behaviors such as exercise and dietary choice/preference. Can and how can they be "habits"?
Additional affiliations
August 2012 - August 2014
George Washington University
Position
  • Research Assistant
August 2014 - present
Iowa State University
Position
  • Professor (Assistant)

Publications

Publications (89)
Article
A healthy diet is a protective factor against a host of negative health outcomes. To maintain such a diet necessitates the consumption of at least 240 g of vegetables per day. However, most of the population fails to meet this threshold. Utilising a randomised controlled trial, the present study tested the effectiveness of a one‐off higher order ha...
Article
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Interventions often fail to achieve long‐term behavioral maintenance. Utilizing motivational and volitional strategies to promote behavioral maintenance factors may improve this. Using a full‐factorial experiment, we tested the effects of three intervention components (focused on intrinsic motivation and identity, exercise preparation habit, and ex...
Article
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Background Falls are the leading cause of injury related morbidity and mortality in older adults. Primary and secondary prevention strategies that address modifiable risk factors are critically important to reduce the number of falls and fall related injuries. A number of evidence-based fall prevention programs are available, but few offer potentia...
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Older adults face unique barriers and challenges related to physical activity (PA) participation. Motivational interviewing (MI) is a commonly used health coaching strategy to support behavior change that holds potential for older adults. Previous research on MI strategies has focused primarily on face-to-face delivery, limiting insights regarding...
Article
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Planning-based interventions are often used to help individuals form habits. Existing literature suggests a one-size-fits all approach to habit formation, but planning interventions may be optimized if tailored to individual differences and/or behavioral complexity. We test the hypothesis that planning to do a relatively complex behaviour (exercise...
Preprint
BACKGROUND Medication adherence, or how patients take their medication as prescribed, is a global public health issue. Improving medication-taking habit might be an effective way to improve medication adherence. However, habit is difficult to quantify, and conventional habit metrics are self-reported, with recognized limitations. Recently, several...
Article
Background Medication adherence, or how patients take their medication as prescribed, is suboptimal worldwide. Improving medication-taking habit might be an effective way to improve medication adherence. However, habit is difficult to quantify, and conventional habit metrics are self-reported, with recognized limitations. Recently, several objectiv...
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Objective: Prospect theory proposes that message framing differentially impacts the likelihood of engaging in health-related behaviors. Specifically, gain-framed messages that highlight the benefits of engaging in a behavior are more effective at promoting preventative behaviors than loss-framed messages highlighting the costs associated with a lac...
Article
Objective: Medically unexplained symptoms (MUS), such as chronic fatigue syndrome, irritable bowel syndrome, and Gulf War Illness (GWI), are difficult to treat. Concordance-shared understanding between patient and provider about illness causes, course, and treatment-is an essential component of high-quality care for people with MUS. This qualitativ...
Data
Anonymized pilot data for an intervention targeting exercise identity development
Article
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Habit strength for taking medication is associated with medication adherence. However, habit strength is typically measured via self-reports, which have limitations. Objective sensors may provide advantages to self-reports. To evaluate whether habit-strength metrics derived from objective sensor data (MEMS® Caps; AARDEX Group) are associated with s...
Article
Objectives: Exercise identity may promote exercise maintenance. However, less is known about factors that affect exercise identity. Whether descriptive social norms are potential intervention targets for identity development was evaluated. Design: A cross-sectional design using data from the Attitudes, Identities, and Individual Differences (AII...
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[This corrects the article DOI: 10.3389/fpsyg.2022.962150.].
Article
Poor-quality data has the potential to increase error variance, reduce statistical power and effect sizes, and produce Type I or Type II errors. Paying participants is one technique researchers may use in an attempt to obtain high-quality data. Accordingly, two secondary datasets were used to examine the relationship between participant payment and...
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Background Researchers are working to identify dynamic factors involved in the shift from behavioral initiation to maintenance—factors which may depend on behavioral complexity. We test hypotheses regarding changes in factors involved in behavioral initiation and maintenance and their relationships to behavioral frequency over time, for a simple (t...
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Introduction There are several widely used theories of health behavior change, which mostly utilize the social cognitive approach. These theories tend to posit that intention is a direct predictor of behavior, do not include automatic influences on behavior, and propose a one-size-fits-all theory for both initiators and maintainers. However, the in...
Article
Background: Beliefs about type 2 diabetes (T2D) medications predict treatment adherence; yet, factors that influence these beliefs are poorly understood. Further, prior studies reduce the complex interplay between beliefs about treatment necessity and medication-related concerns to a single dimension by using a difference score. This study examined...
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Behavioural theories, predictions, and interventions should be relevant to complex, real-world health behaviours and conditions. Habit theory and habit formation interventions show promise for predicting and promoting, respectively, longer-term behaviour change and maintenance than has been attained with theories and interventions focused only on d...
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Individuals experiencing body dissatisfaction have poorer health outcomes in part due to engaging in less physical activity. Body appreciation is protective of health behaviors and proposed to be conceptually different from body dissatisfaction. Two studies evaluated whether body appreciation and dissatisfaction represented two distinct dimensions,...
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Research has pointed to the potential of extended reality (XR), including virtual, mixed, and augmented reality, for broadly impactful benefits, including learning, physical activity and health, and psychosocial aspects such as increased empathy and reduced loneliness. More research is needed to evaluate the outcomes of XR in new populations of use...
Article
Recruitment of insufficiently active individuals into exercise interventions is difficult due to many different barriers, including motivational barriers and negative body image. The present study provided an initial conceptual test of whether self‐affirmation can help increase recruitment of insufficiently active women to an exercise intervention....
Article
Objective: Medically unexplained symptoms (MUS) are prevalent among veteran and non-veteran populations. Current biopsychosocial theory implicates a multitude of factors in MUS development and perpetuation. The current study tests whether physical symptom attribution to MUS is associated with perceived symptom severity and bothersomeness and there...
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Background Transdisciplinary translational science applies interdisciplinary approaches to the generation of novel concepts, theories and methods involving collaborations among academic and non-academic partners, in order to advance the translation of science into broader community practice. Objective This paper introduces a special issue on trans...
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Objective In response to COVID-19, we conducted a rapid review of risk communication interventions to mitigate risk from viruses to determine if such interventions are efficacious. Methods We searched for risk communication interventions in four databases: Medline, PsycInfo, the ProQuest Coronavirus Research Database, and CENTRAL. The search produ...
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This introduction to the special issue outlines key ways that behavioral medicine researchers can accelerate their science. The authors highlight the 2020 Society of Behavioral Medicine's annual meeting plenary sessions, that fit this theme.
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A visioning initiative among members of SBM has identified new areas of investigations, such as behavioral medicine’s need to address climate change, gun violence and science communication. These areas emerged along-side traditional areas of behavioral medicine such as decreasing health inequity and integrating behavioral medicine into health care...
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We describe the cognitive processes, illness‐specific prototypes, and deep‐level schemata (acute/episodic/chronic) that generate the mental representations (illness and treatment representations) guiding people's selection, performance, and evaluation of medically prescribed treatments or self‐selected actions to prevent and control illness threats...
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Background Many of our daily behaviors are habitual, occurring automatically in response to learned contextual cues, and with minimal need for cognitive and self-regulatory resources. Behavioral habit strength predicts adherence to actions, including to medications. The time of day (morning vs. evening) may influence adherence and habit strength to...
Article
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Background Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the...
Article
Introjected regulation has been inconsistently linked to physical activity, which may be due to it being an umbrella construct for different types of introjected regulation that have the potential to be differentially related to behavior. We evaluated (1) whether self-oriented approach, self-oriented avoidance, other-oriented approach, and other-or...
Article
Medically unexplained symptoms (MUS) are common among veterans and are difficult to treat. Optimal treatment entails continued care from providers, yet this care may be influenced negatively by nonconcordance between veterans’ and providers’ views of MUS. We surveyed 243 veterans with MUS and evaluated the degree of nonconcordance perceived by vete...
Article
Medically unexplained symptoms and/or syndromes (MUS) affect the health of 20% to 30% of patients seen in primary care. Optimally, treatment for these patients requires an interdisciplinary team consisting of both primary care and mental health providers. We propose that counseling psychologists may develop expertise to improve the care of patients...
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Little is known about what predicts student service members' and veterans' (SSM/V) adjustment to college. In qualitative research, SSM/V report feeling they do not belong and are misunderstood by college communities, a phenomenon that counseling psychologists call cultural incongruity. The goal of the current study was to quantitatively examine the...
Article
Physical activity-or lack thereof-is one behaviour that may help explain why individuals who are dissatisfied with their bodies experience poor health outcomes. Objective: The purpose of the present study was to examine the mediating role of behavioural regulations (i.e., autonomous and controlled) in the relation between body dissatisfaction and...
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Background: The mutual maintenance model proposes that post-traumatic stress disorder (PTSD) symptoms and chronic physical symptoms have a bi-directional temporal relationship. Despite widespread support for this model, there are relatively few empirical tests of the model and these have primarily examined patients with a traumatic physical injury....
Article
Objective: Habit-formation interventions may help individuals initiate and maintain behaviour change. This paper proposes and empirically tests the idea that it is possible for individuals to form ‘higher-order habits’, or behaviours that can be executed in more than one way, and still be habitual. Design: Participants (N = 82) were healthy adults...
Article
Body dissatisfaction is linked to poor physical health, even after actual markers of health have been controlled for. This link is likely due to body dissatisfaction influencing health behaviors-more specifically , cardiovascular exercise. Modifiable reasons for this link have yet to be determined. We conducted a prospective study to evaluate wheth...
Article
Widely cited literature assumes habits to be: (1) specific and rigid behavioral responses; (2) in response to location- and timing-stable, external contexts, (3) goal-independent, and (4) enacted without conscious awareness. Hagger (2019) recently reviewed this literature as it applies to the physical activity domain. The purpose of this article is...
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Background While widely used and endorsed, there is limited evidence supporting the benefits of activity trackers for increasing physical activity; these devices may be more effective when combined with additional strategies that promote sustained behavior change like motivational interviewing (MI) and habit development. Objective This study aims...
Article
Consistent with the common-sense model of self-regulation, illness representations are considered the key to improving health outcomes for medically unexplained symptoms and illnesses (MUS). Which illness representations are related to outcomes and how they are related is not well understood. In response, we conducted a meta-analysis of the relatio...
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Research on the Commonsense Self-Regulation Model (CS-SRM) has emphasized reflective/conscious perceptual processes regarding illness threat (beliefs about symptoms, consequences, timeline and curability) in predicting and changing coping behaviours. Understanding of illness self-regulation and avenues for intervention might be enriched by consider...
Preprint
BACKGROUND While widely used and endorsed, there is limited evidence supporting the benefits of activity trackers for increasing physical activity; these devices may be more effective when combined with additional strategies that promote sustained behavior change like motivational interviewing (MI) and habit development. OBJECTIVE This study aims...
Article
Background: The Necessity-Concerns Framework (NCF) is a multidimensional theory describing the relationship between patients' positive and negative evaluations of their medication which interplay to influence adherence. Most studies evaluating the NCF have failed to account for the multidimensional nature of the theory, placing the separate dimens...
Article
Self-determination theory (SDT) is used to predict individual differences in goal-directed behavior. A fundamental tenet of SDT is that autonomously regulated behavior is more likely to be engaged in and sustained than externally controlled behavior. Unidimensional treatment of regulation is suboptimal. The current study utilizes a multidimensional...
Article
The literature on the impact of expansive poses on biological and psychological variables is characterized by discrepant findings. These discrepant findings may, in part, be a function of differences in how data were analyzed. In this article, we use multiverse analysis to examine whether the findings reported in the original paper by Carney, Cuddy...
Article
Objectives: Medically unexplained symptoms (MUS) are common, with particularly high rates observed in military veterans. Effective patient-provider-communication is thought to be a key aspect of care; however there have been few empirical studies on the association between communication and outcomes for patients with MUS. We evaluate whether discu...
Article
Objective: E-diaries and accelerometers promise more objective, real-time measurements of health behavior. However, social-psychological theory suggests that using electronic behavioral monitoring may influence rather than just record physical activity (PA), especially when a device is novel. Design: Participants (n=146) were randomly assigned t...
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Non-adherence to health behaviors required for chronic illness self-management is pervasive. Advancing health-behavior theory to include behavioral initiation and maintenance factors, including reflective (e.g., belief- and feedback-based) and automatic (e.g., habit-based) mechanisms of adherence to different treatment-related behaviors could impro...
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The Common-Sense Model of Self-Regulation (the “Common-Sense Model”, CSM) is a widely used theoretical framework that explicates the processes by which patients become aware of a health threat, navigate affective responses to the threat, formulate perceptions of the threat and potential treatment actions, create action plans for addressing the thre...
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Background Diurnal preference (and chronotype more generally) has been implicated in exercise behavior, but this relation has not been examined using objective exercise measurements nor have potential psychosocial mediators been examined. Furthermore, time-of-day often moderates diurnal preference’s influence on outcomes, and it is unknown whether...
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Purpose. Regular exercise is thought to involve both reflective (e.g., intention) and automatic (e.g., habit) mechanisms. Intrinsic motivation is a reflective factor in exercise initiation; we propose that the experience of intrinsic exercise rewards (enjoyment; stress reduction) may come to function as a factor in exercise automaticity, or habit,...
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The Commonsense Model of Self-Regulation (CSM) has a history of over 50 years as a theoretical framework that explicates the processes by which individuals form cognitive, affective, and behavioral representations of health threats. This article summarizes the major components of individuals' "commonsense models", the underlying assumptions of the...
Article
Objectives: 'Habit' is a process whereby situational cues generate behaviour automatically, via activation of learned cue-behaviour associations. This article presents a conceptual and empirical rationale for distinguishing between two manifestations of habit in health behaviour, triggering selection and initiation of an action ('habitual instigat...
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Many Veterans returning from service in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) experience chronic pain. What is not known is whether for some OIF/OEF Veterans this pain is part of a larger condition of diffuse multisystem symptoms consistent with chronic multisymptom illness (CMI). We use data from a prospective longitudinal s...
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Habit is thought to be conducive to health behavior maintenance, because habits prompt behavior with minimal cognitive resources. The precise role of habit in determining complex behavioral sequences, such as exercise, has been underresearched. It is possible that the habit process may initiate a behavioral sequence (instigation habit) or that, aft...
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Abstract Cognitive beliefs and affective responses to illness and to treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains-specifically, affective-illness, cognitive-illness, affective-treatment, and cognitive-treatment-for predicting strok...
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Patients' medication-related concerns and necessity-beliefs predict adherence. Evaluation of the potentially complex interplay of these two dimensions has been limited because of methods that reduce them to a single dimension (difference scores). We use polynomial regression to assess the multidimensional effect of stroke-event survivors' medicatio...
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Perceptions that stress causes and stress-reduction controls hypertension have been associated with poorer blood pressure (BP) control in hypertension populations. The current study investigated these "stress-model perceptions" in stroke survivors regarding prevention of recurrent stroke and the influence of these perceptions on patients' stroke ri...
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Patient non-adherence to medication is a pervasive problem that contributes to poor patient health and high healthcare costs. Basic research and interventions have focused thus far on behaviour initiation factors, such as patients' illness and treatment beliefs. This paper proposes two processes that occur after behaviour initiation that are theori...
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Background: Even though medications can greatly reduce the risk of recurrent stroke, medication adherence is suboptimal in stroke survivors. Objective: To identify key barriers to medication adherence in a predominantly low-income, minority group of stroke and transient ischemic attack (TIA) survivors. Design: Cross-sectional study. Participa...
Article
This study assessed the role of behavior enjoyableness in development of long‐term behavior. First, as expected from the literature on attitude and behavior change (Ajzen, 1991; Ryan & Deci, 2000), initial enjoyableness of a behavior predicted how successful participants were in performing the behavior in the short term (i.e., the time until they f...
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Researchers in behavioral medicine are using methods to study the effect of congruence between two predictors (e.g., patient and provider preferences for patient-decision making) on outcomes (e.g., patient satisfaction and adherence) that may compromise the validity of their results and conclusions. The current paper reviews the methods used in beh...
Article
ABSTRACT The development of consistent health behaviors is important for chronic illness prevention and management. The current study experimentally compared two strategies-a personal-rule and a deliberation strategy-designed to help participants consistently perform their intended behaviors over a 7-week period in a real-world setting. Although th...
Chapter
This chapter systematically reviews recent research on the prevalence and correlates of indoor tanning. We review the literature on the extent to which indoor tanning facilities are accessible to individuals in various geographic regions in the United States and internationally. Documenting the prevalence and accessibility of indoor tanning provide...
Article
Interventions that address patients' illness and treatment representations have improved patient adherence and outcomes when administered by psychologists and/or health educators and focused on a single chronic illness. The current study assesses the potential feasibility/effectiveness of an intervention based on the common-sense self-regulation mo...
Article
Physicians are inaccurate in predicting non-adherence in patients, a problem that interferes with physicians': (1) appropriate prescribing decisions and (2) effective prevention/intervention of non-adherence. The purpose of the current study is to investigate potential reasons for the poor accuracy of physicians' adherence-predictions and condition...
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This review of the current status of theoretically based behavioral research for chronic illness management makes the following points: (a) Behavioral interventions have demonstrated effectiveness for improving health outcomes using biomedical indicators, (b) current interventions are too costly and time consuming to be used in clinical and communi...

Questions

Question (1)
Question
Are patients made aware of being classified as having "medically unexplained symptoms/syndrome"? This matters to me, because I want to ask patients about their perceptions of their medically unexplained symptoms by referring to them as such.

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