Phillippa Lally

University of Surrey · School of Psychology

Purpose Physical activity is safe and feasible for individuals with metastatic cancer and may support symptom management. We investigated the extent to which individuals with metastatic cancer are meeting the World Health Organisation (WHO) moderate-vigorous physical activity (MVPA) guideline, factors associated with meeting the guideline, and perc...

Understanding the influence of habit on health behaviour, or the formation or disruption of health habits over time, requires reliable and valid measures of automaticity. The most used measure, the Self-Report Behavioural Automaticity Index (SRBAI; derived from the Self-Report Habit Index [SRHI]), comprises four items, which may be impractical in s...

BACKGROUND The APPROACH pilot study explored the feasibility and acceptability of an app (National Health Service [NHS] Active 10) with brief habit-based behavioural support calls and print materials intended to increase brisk walking in people diagnosed with cancer. OBJECTIVE Following UK Medical Research Council guidelines, this process evaluati...

Purpose This study explored perceived changes in health behaviours and body weight following a cancer diagnosis and investigated related sociodemographic and clinical characteristics. Methods Individuals living with and beyond breast, prostate, or colorectal cancer (N = 5835) completed the ‘Health and Lifestyle After Cancer Survey’ which explored...

This study aimed to examine whether psychological distress was cross-sectionally associated with meeting World Cancer Research Fund (WCRF) recommendations in people living with and beyond cancer. Participants were adults living with and beyond breast, prostate and colorectal cancer, participating in the baseline wave of the Advancing Survivorship a...

Habit change is often seen as key to successful long-term behaviour change. Making 'good' behaviours habitual-that is, ensuring a behaviour is prompted automatically on exposure to situational cues, based on cue-response associations learnt through context-consistent repetition-is portrayed as a mechanism for sustaining such behaviours over time. C...

Purpose: Physical activity is safe and feasible for individuals with metastatic cancer and may support symptom management. We investigated the extent to which individuals with metastatic cancer are meeting moderate-vigorous physical activity (MVPA) guidelines, factors associated with meeting guidelines, and perceptions about physical activity and r...

Introduction Increased moderate to vigorous physical activity (MVPA) can improve clinical and psychosocial outcomes for people living with and beyond cancer (LWBC). This study aimed to assess the feasibility and acceptability of trial procedures in a pilot randomised controlled trial (RCT) of a theory-driven app-based intervention with behavioural...

Objective Evidence shows that higher depressive symptoms are associated with mortality among people living with and beyond cancer (LWBC). However, prior studies have not accounted for a wider range of potential confounders, and no study has explored whether socioeconomic position (SEP) moderates the association. This study aimed to examine the asso...

Purpose This study aimed to examine whether psychological distress was cross-sectionally associated with meeting World Cancer Research Fund (WCRF) recommendations in people living with and beyond cancer. Methods Participants were adults living with and beyond breast, prostate and colorectal cancer, participating in the baseline wave of the Advancin...

Background A cancer diagnosis and its treatment may be an especially isolating experience. Despite evidence that positive health behaviours can improve outcomes for people living with and beyond cancer (LWBC), no studies have examined associations between loneliness and different health behaviours in this population. This study aimed to describe th...

Background Adults with intellectual disabilities (IDs) are susceptible to multiple health risk behaviours such as alcohol consumption, smoking, low physical activity, sedentary behaviour and poor diet. Lifestyle modification interventions can prevent or reduce negative health consequences caused by these behaviours. We aim to determine the effectiv...

Background Lifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances. Methods A realist evidence synthesis was conducted th...

Background Individuals living with and beyond cancer are at heightened risk of adverse psychological and social outcomes and experiences. In March 2020, the COVID-19 global pandemic presented a unique set of social circumstances with the potential to exacerbate the challenges faced by this population. The purpose of this study was to investigate th...

Purpose The present work investigated dietary changes amongst individuals living with and beyond cancer (LWBC) from before to during the pandemic. To identify those at greatest risk of unhealthy changes, it was further examined whether patterns varied by sociodemographic, health-related, and COVID-19-related characteristics. Methods This longitudi...

Background: Greater physical activity is associated with improved outcomes in people living with and beyond cancer. However, most studies in exercise oncology use self-reported measures of physical activity. Few have explored agreement between self-reported and device-based measures of physical activity in people living with and beyond cancer. Thi...

Background Many individuals living with and beyond cancer (LWBC) have ongoing quality of life (QoL) issues, including fatigue. The World Cancer Research Fund (WCRF) provides health behaviour recommendations for people LWBC, and there is some evidence linking adherence to these with improved QoL. Methods Adults LWBC (specifically breast, colorectal...

Self-completed 24 h dietary recalls (24-HRs) are increasingly used for research and national dietary surveillance. It is unclear how difficulties with self-completion affect response rates and sample characteristics. This study identified factors associated with being unable to self-complete an online 24-HR but willing to do so with an interviewer....

Objectives: Interventions promoting habitual fruit consumption have the potential to bring about long-term behaviour change. Assessing the effectiveness of such interventions requires adequate habit and behaviour measures. Habits are based on learned context-behaviour associations , so measures that incorporate context should be more sensitive to e...

Purpose The present work investigated dietary changes among individuals living with and beyond cancer (LWBC) from before to during the pandemic. To identify those at greatest risk of unhealthy changes, it was further examined whether patterns varied with sociodemographic, health-related, and COVID-19-related characteristics. Methods This longitudi...

Purpose People living with and beyond cancer (LWBC) are advised to achieve a body mass index (BMI) within the healthy range (≥18.5 and <25). Not perceiving a need for weight change may be a barrier to achieving a healthy weight. This study aimed to explore factors associated with perceived need for weight change among people LWBC. Methods Adults di...

A vegan diet, which excludes all animal-derived products, has been associated with some improvements in health, while also conferring environmental benefits. Understanding the psychological determinants of successfully switching to a vegan diet will help to inform the design of interventions supporting long-term dietary change. Studies to date have...

Objective: This study aimed to qualitatively explore how partner support for health behaviours is perceived, received, and utilised in people living with and beyond cancer (LWBC). Methods: Semi-structured audio interviews were conducted with 24 participants, 15 men and 9 women, living with and beyond breast, prostate, and colorectal cancer. Indu...

Objective: The COVID-19 pandemic saw promotion of novel virus transmission-reduction behaviours, and discouragement of familiar transmission-conducive behaviours. Understanding changes in the automatic nature of such behaviours is important, because habitual behaviours may be more easily reactivated in future outbreaks and disrupting old habits ma...

Purpose Social support facilitated healthy behaviours in people living with and beyond cancer (LWBC) before the COVID-19 pandemic. Little is known about how social support impacted their health behaviours during the pandemic when social restrictions were imposed. The aim of this study was to qualitatively explore how social support was perceived to...

Purpose Positive health behaviours (sufficient exercise, healthy diet, limiting alcohol, and not smoking) can improve multiple outcomes after a cancer diagnosis. Observational studies suggest that health behaviours were negatively impacted for some but not all individuals living with and beyond cancer. The aim of this study was to qualitatively exp...

In 2015, Tesco Express convenience stores implemented a healthy checkouts initiative; products high in fat, salt or sugar were removed from in‐queue areas. We compare purchasing of less healthy foods before and after its introduction. Tesco provided store‐level sales data (n = 1151) for Express stores in England over two 8‐week periods, May–July 20...

Objectives Understanding changes in moderate to vigorous aerobic physical activity (MVPA) and muscle-strengthening activity (MSA) at the start of the COVID-19 pandemic and their correlates (socio-demographics, health characteristics, living and exercise conditions and pre-pandemic MVPA/MSA) can inform interventions. Design A cross-sectional analys...

Background: Prompting employees to swap their usual lunches for lower-energy alternatives may help align energy intake with public health recommendations. We tested the effect of offering lower-energy swaps with and without physical activity calorie equivalent (PACE) information on the energy of lunches pre-ordered in an online hypothetical workpl...

Physical distancing remains an important initiative to curb COVID‐19 and virus transmission more broadly. This exploratory study investigated how physical distancing behaviour changed during the COVID‐19 pandemic and whether it was associated with identity with virus transmission avoidance and physical distancing habit strength. In a longitudinal,...

Background There are multiple health benefits from participating in physical activity after a cancer diagnosis, but many people living with and beyond cancer (LWBC) are not meeting physical activity guidelines. App-based interventions offer a promising platform for intervention delivery. This trial aims to pilot a theory-driven, app-based intervent...

Purpose Social support facilitated healthy behaviours in people living with and beyond cancer (LWBC) before the COVID-19 pandemic. Little is known about how social support impacted their health behaviours during the pandemic when social restrictions were imposed. The aim of this study was to qualitatively explore how social support impacted the hea...

Advances in understanding how habit forms can help people change their behaviour in ways that make them happier and healthier. Making behaviour habitual, such that people automatically act in associated contexts due to learned context-response associations, offers a mechanism for maintaining new, desirable behaviours even when conscious motivation...

Abstract Rationale: Translating research evidence into clinical practice to improve care involves healthcare professionals adopting new behaviours and changing or stopping their existing behaviours. However, changing healthcare professional behaviour can be difficult, particularly when it involves changing repetitive, ingrained ways of providing ca...

Background Dietary supplements (DSs) are not recommended for the prevention of cancer recurrence. Although DS use is common in individuals living with and beyond cancer, its associations with beliefs about reduced cancer recurrence risk and demographic and health behaviors are unclear. Methods Adults (18 years old or older) who had been diagnosed...

Objective Habitual behaviours are triggered automatically, with little conscious forethought. Theory suggests that making healthy behaviours habitual, and breaking the habits that underpin many ingrained unhealthy behaviours, promotes long-term behaviour change. This has prompted interest in incorporating habit formation and disruption strategies i...

Purpose: The present study aimed to quantify the level of sleep problems in 5835 breast, prostate, and colorectal cancer survivors, and explore a number of potential determinants of poor sleep quality in the present sample. BMI, diet, and physical activity were of particular interest as potential determinants. / Methods: Participants who completed...

Background Adults with learning disabilities have an increased disposition to unhealthy lifestyle behaviours which often occur simultaneously. Existing studies focus on complex interventions targeting unhealthy diet, physical inactivity, sedentary behaviour, smoking, and alcohol use to reduce health risks experienced. It is essential to understand...

Background There are multiple health benefits from participating in physical activity after a cancer diagnosis, but many people living with and beyond cancer (LWBC) are not meeting physical activity guidelines. App-based interventions offer a promising platform for intervention delivery. This trial aims to pilot a theory-driven, app-based intervent...

Background The aim was to pilot an adapted manualised weight management programme for persons with mild–moderate intellectual disabilities affected by overweight or obesity (‘Shape Up-LD’). Method Adults with intellectual disabilities were enrolled in a 6-month trial (3-month active intervention and 3-month follow-up) and were individually randomi...

THIS PAPER HAS NOW BEEN PUBLISHED and is open-access (incl available on ResearchGate). See doi 10.1080/23311908.2022.2041277. *** This paper proposes criteria for design, measurement, analysis and interpretation when tracking real-world habit formation and potential moderators of the effect of repetition on formation.

Maintaining weight loss requires long-term behaviour change. Theory and evidence around habitual behaviour - i.e., action triggered by impulses that are automatically activated upon exposure to cues, due to learned cue-action associations - can aid development of interventions to support weight loss maintenance. Specifically, weight loss is more li...

Finding effective ways to increase acceptance of lower-energy swaps offered for snacks and non-alcoholic drinks may reduce population energy intake. We examined whether incrementally increasing the tangibility of information accompanying swaps offered increased their acceptance. UK adults (n=3,481) selected a sweet snack, a savoury snack, and a dri...

Objectives: Understanding changes in moderate to vigorous aerobic physical activity (MVPA) and strength training (MSA) from before to after (pre-/post-) the onset of the Covid-19 pandemic in the UK (first lockdown) and their correlates can inform interventions. Methods: Cross-sectional analysis of retrospective and concurrent data on MVPA/MSA pre-...

Objectives: Habit formation has been identified as one of the key determinants of behaviour change. To initiate habit formation, self-regulation interventions can support individuals to form a cue-behaviour plan and to repeatedly enact the plan in the same context. This randomized controlled trial aimed to model habit formation of an everyday nutr...

Online systems that allow employees to pre-order their lunch may help reduce energy intake. We investigated the acceptability of a pre-ordering website for a workplace canteen that prompts customers to swap to lower-energy swaps and the factors influencing swap acceptance. Employees (n = 30) placed a hypothetical lunch order through a pre-ordering...

Objectives: In the last decade, there has been a rapid expansion of physical activity (PA) promotion programmes and interventions targeting people living with and beyond cancer (LWBC). The impact that these initiatives have on long-term maintenance of PA remains under-researched. This study sought to explore the experiences of participants in orde...

Habitual behaviours are elicited when a familiar context activates cue-behaviour associations that have been learned through previous performance. A core hypothesis within habit theory is that, by virtue of its automaticity, habit weakens the impact of intention on action, such that in facilitating conditions, action will be guided more by habit th...

Adapting a food frequency questionnaire to assess dietary intake of people living with and beyond cancer - Volume 79 Issue OCE1 - S. Esser, R. Conway, M. Michalopoulou, V. Ireland, P. Lally, R. Beeken, A. Fisher, H. Croker

Use of online dietary recalls to assess adherence to dietary guidelines in people living with and beyond cancer: feasibility and process requirements for ASCOT - Volume 79 Issue OCE1 - R. Conway, S. Esser, M. Michalopoulou, V. Ireland, P. Lally, R. Beeken, A. Fisher, H. Croker

Purpose The purpose of this study was to understand breast, prostate and colorectal cancer clinical nurse specialists’ (CNSs) perspectives on physical activity (PA) promotion and the role of smartphone apps to support PA promotion in cancer care. Methods CNSs working in breast, prostate or colorectal cancer were recruited via advertisements distri...

Health psychology is witnessing a resurgence of interest in the concept of habit (Verplanken, 2018). Habit can be defined as a process whereby a cue automatically triggers an impulse to act, based on cue–action associations learned through repeated performance; habitual behaviour refers to action generated by this process (Gardner, 2015). Habit imp...

Hagger (2019) offers an insightful synthesis of recent theoretical and empirical developments in understanding of habit and its relevance to physical activity. This commentary extends coverage of one such advance, namely the distinction between two manifestations of habit in physical activity: habitually ‘deciding’ to engage in activity (i.e. habit...

Habitual actions are elicited automatically in associated settings, bypassing conscious motivation. This has prompted interest in habit formation as a mechanism for sustaining behaviour change when conscious motivation erodes. Promoting habit depends on understanding how habit develops. This chapter reviews theory and evidence around the habit form...

The Secretary of State recently proposed that the NHS: ‘... take every opportunity to prevent poor health and promote healthy living by making the most of healthcare professionals’ contact with individual patients.’ 1 Patients trust health professionals as a source of advice on ‘lifestyle’ (that is, behaviour) change, and brief opportunistic advi...

Background The twelve-item Self-Report Habit Index (SRHI) is the most popular measure of energy-balance related habits. This measure characterises habit by automatic activation, behavioural frequency, and relevance to self-identity. Previous empirical research suggests that the SRHI may be abbreviated with no losses in reliability or predictive uti...

Table S2b. Primary datasets: Descriptives and intercorrelations (Datasets 3 and 4).

Figure S1. Results of systematic search strategy and screening procedure.

Table S2a. Primary datasets: Descriptives and intercorrelations (Datasets 1 and 2).

Table S1. Secondary datasets: Study characteristics, reliabilities, and habit-behaviour and SRHI-SRBAI correlations.

References for Supplementary Material [51-79].

Habit formation is thought to aid maintenance of physical activity, but little research is available into determinants of habit strength aside from repeated performance. Previous work has shown that intrinsically motivated physical activity, underpinned by inherent satisfaction derived from activity, is more likely to be sustained. We explored whet...

Objective: Misperception of social norms may result in normalising unhealthy behaviours. The present study tested the hypothesis that parents overestimate both the frequency of unhealthy snacking in pre-school children other than their own (descriptive norms) and its acceptability to other parents (injunctive norms). Design: A cross-sectional, s...

What are the psychological mechanisms that trigger habits in daily life? Two studies reveal that strong habits are influenced by context cues associated with past performance (e.g., locations) but are relatively unaffected by current goals. Specifically, performance contexts—but not goals—automatically triggered strongly habitual behaviors in memor...

Repeated action can lead to the formation of habits and identification as 'the kind of person' that performs the behaviour. This has led to the suggestion that identity-relevance is a facet of habit. This study explores conceptual overlap between habit and identity, and examines where the two constructs fit into an extended Theory of Planned Behavi...

We hypothesized that adolescents misperceive social norms for food consumption, and aimed to test this, and examine associations between perceived norms and dietary behaviours. School pupils (n=264) in the UK, aged 16-19 years, completed a questionnaire about their own attitudes to, and intake of, fruits and vegetables, unhealthy snacks and sugar-s...

Habit formation is an important goal for behaviour change interventions because habitual behaviours are elicited automatically and are therefore likely to be maintained. This study documented experiences of habit development in 10 participants enrolled on a weight loss intervention explicitly based on habit-formation principles. Thematic analysis r...

Health behaviour models typically neglect habitual action. The Self-Report Habit Index (SRHI) permits synthesis of evidence of the influence of habit on behaviour. The purpose of this study is to review evidence around mean habit strength, habit-behaviour correlations, and habit x intention interactions, from applications of the SRHI to dietary, ph...

Habits are automatic behavioural responses to environmental cues, thought to develop through repetition of behaviour in consistent contexts. When habit is strong, deliberate intentions have been shown to have a reduced influence on behaviour. The habit concept may provide a mechanism for establishing new behaviours, and so healthy habit formation i...

To investigate the process of habit formation in everyday life, 96 volunteers chose an eating, drinking or activity behaviour to carry out daily in the same context (for example 'after breakfast') for 12 weeks. They completed the self-report habit index (SRHI) each day and recorded whether they carried out the behaviour. The majority (82) of partic...

To evaluate the efficacy of a simple weight loss intervention, based on principles of habit formation. An exploratory trial in which overweight and obese adults were randomized either to a habit-based intervention condition (with two subgroups given weekly vs monthly weighing; n=33, n=36) or to a waiting-list control condition (n=35) over 8 weeks....

With obesity rates rising steadily in most parts of the world, there is considerable interest in novel weight loss interventions. This thesis tests the utility of habit formation theory for designing behaviour change advice for weight loss. Central to models of habit operation is the idea that habits develop through repetition of the behaviour in c...

Abstract Across four studies, we compared people’s inferences about the causes of their habits with the actual mechanisms,that guide habit performance. Suggesting that people believe that the actions they perform frequently are diagnostic oftheir motivating dispositions, habit strength for various behaviors was consistentlyassociated with stronger...