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Promoting behaviour change

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Falko F Sniehotta
added a research item
Behaviour change techniques for healthy weight services to support families with children aged 4-11 years Changing behaviour in families 2 About Public Health England Public Health England exists to protect and improve the nation's health and wellbeing and reduce health inequalities. We do this through world-leading science, research, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct delivery organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific and delivery expertise and support. Public Health England Wellington House 133-155 Waterloo Road London SE1 8UG
Falko F Sniehotta
added a research item
This is a supplementary document to the PHE Guide to Delivering and Commissioning Tier 2 Adult Weight Management Services providing relevant, evidence-based behaviour change techniques recommended for inclusion in weight management services for weight loss and weight loss maintenance. The recommendations in this review are based on recommendations from NICE guidance PH49 (Behaviour change: individual approaches) and PH53 (Weight management: lifestyle services for overweight or obese adults) and evidence from large systematic reviews (Michie, Abraham, Wittington, et al, 2009; Dombrowski, Sniehotta, Avenell, et al, 2012; Dombrowski, Knittle, Avenell, 2014; Hartmann-Boyce, Jebb, Fletcher and Aveyard, 2015).
Thomas Llewelyn Webb
added 6 research items
Compensatory green beliefs (CGBs) reflect the idea that a pro-environmental behavior (e.g., recycling) can off-set the negative effects of an environmentally detrimental behavior (e.g., driving). It is thought that CGBs might help explain why people act in ways that appear to contradict their pro-environmental intentions, and inconsistently engage in pro-environmental behaviors. The present study sought to investigate the nature and use of CGBs. A series of interviews suggested that participants endorsed CGBs to (a) reduce feelings of guilt with respect to (the assumed or actual) negative environmental impact of their actions and (b) defend their green credentials in social situations. Participants also justified detrimental behaviors on the basis of higher loyalties (e.g., family’s needs), or the perceived difficulty of performing more pro-environmental actions. In addition to shedding light on how, when, and why people might hold and use CGBs, the research also provides new insight into how CGBs should be assessed.
Objective: When do people decide to do something about problematic health behaviours? Theoretical models and pragmatic considerations suggest that people should take action when they feel bad about their progress – in other words, when they experience negative progress-related affect. However, the impact of progress-related affect on goal striving has rarely been investigated. Design and Methods: Study 1 (N = 744) adopted a cross-sectional design and examined the extent to which measures of progress-related affect were correlated with intentions to take action. Study 2 (N = 409) investigated the impact of manipulating progress-related affect on intentions and behaviour in an experimental design. Results: Study 1 found that, while engaging in health behaviours had the expected affective consequences (e.g. people felt bad when they were not eating healthily, exercising regularly or limiting their alcohol consumption), it was feeling good rather than bad about progress that was associated with stronger intentions. Study 2 replicated these findings. Participants induced to feel good about their eating behaviour had marginally stronger intentions to eat healthily than participants led to feel bad about their eating behaviour. Conclusion: The findings have implications for interventions designed to promote changes in health behaviour, as well as theoretical frameworks for understanding self-regulation.
Objectives: The primary objective was to explore young people's risk appraisals of bowel cancer, including whether they had a coherent understanding of the protective effects of physical activity (PA). A secondary objective was to examine whether the illness risk representations (IRRs) framework could be used to understand beliefs underlying bowel cancer risk appraisals. Design: Qualitative. Methods: Framework analysis of semi-structured interviews with 19 people aged 14-17 years. Results: Participants judged their risk of getting bowel cancer as low. This was based on a lack of family history of cancer and their current lifestyle behaviours, which were viewed as having a protective effect, or because they planned on making change to their lifestyle in the future when disease risk became more relevant. Participants were not aware of, and struggled to understand, the link between PA and bowel cancer. They also lacked knowledge of the effects of, or treatments for, bowel cancer. Beliefs underlying judgements about the risk of bowel cancer fitted the IRR framework reasonably well. Conclusions: The present research suggests that interventions designed to increase PA with a view to reducing the risk of bowel cancer should aim to make the future risk of bowel cancer feel more tangible, help young people to understand the full range of consequences, explain how and why preventative behaviours such as PA are effective in reducing risk, and emphasize that the typical late presentation of symptoms, and therefore investigation by health care services, reduces treatability. Statement of contribution What is already known on this subject? Physical activity (PA) performed throughout the lifespan can have a protective effect on bowel cancer, but levels of PA are low among young people. Changing beliefs about the risk of getting bowel cancer may be a useful strategy in motivating PA. What does this study add? Increased understanding of how young people think about bowel cancer and the relationship between PA and cancer. Identification of strategies for increasing young adults' appraisals of the likelihood and severity of bowel cancer. Evidence to support the validity of illness risk representations framework.
Thomas Llewelyn Webb
added 2 research items
Introduction Both theoretical and empirical evidence suggests that time perspective is likely to influence self-regulatory processes and outcomes. Despite the theoretical and practical significance of such relations, the relationship between time perspective and self-regulatory processes and outcomes across different measures, samples and life domains, including health, has yet to be explored. Methods and analysis The proposed review will develop a taxonomy for classifying measures according to the self-regulatory process, ability or outcome that they are likely to reflect. Electronic scientific databases will be searched, along with relevant conference abstract booklets and citation lists. Additionally, a call for unpublished data will be submitted to relevant bodies. To be eligible for inclusion, studies must include a measure of time perspective and a measure of at least one self-regulatory process, ability and/ or outcome. Eligibility will not be restricted by publication date, language, type of sample or setting. The bivariate correlations will be extracted (or calculated) and submitted to a random-effects meta-analysis. The sample-weighted average effect size, heterogeneity, risk of bias and publication bias will be calculated, and the effects of categorical and continuous moderator variables on the effect sizes will be determined. Ethics and dissemination The proposed meta-analysis will synthesise previously conducted research; thus, ethical approval is not required. The findings will be submitted for publication in an international peer-reviewed journal and reported as part of the first author’s PhD thesis. The findings will also be disseminated to the research community and, where appropriate, to other interested parties through presentations at relevant academic and non-academic conferences.
Objective: To evaluate an intervention programme based on the Health Action Process Approach and designed to increase the intake of fruit and vegetables (F&V) among Iranian adolescents aged 13 to 18. Design: A randomised controlled trial with three arms examined the short- (1 month) and long-term (6 months) effects of the intervention. There were two intervention groups (one included adolescents only [A group; n = 510]; the second included mothers and adolescents [M + A group; n = 462]) and a control group (n = 483). All participants were recruited from schools. Main outcome measures: Social cognitions, self-regulatory processes and F&V intake. Results: The intervention led to an increase in F&V intake for adolescents in the short and long terms. Adolescents in the M + A group increased their F& V intake more than adolescents in the A group. Outcome expectancies, self-monitoring, intentions, action and coping planning, perceived social support and behavioural automaticity mediated the effect of the intervention on F&V intake. Conclusion: The theory-based intervention led to an increase in F&V intake and promoted more positive social cognitions and self-regulatory processes among Iranian adolescents. The findings also provide evidence that involving mothers in an intervention can confer additional benefit.
Thomas Llewelyn Webb
added 13 research items
Can self-control be improved through practice? Several studies have found that repeated practice of tasks involving self-control improves performance on other tasks relevant to self-control. However, in many of these studies, improvements after training could be attributable to methodological factors (e.g., passive control conditions). Moreover, the extent to which the effects of training transfer to real-life settings is not yet clear. In the present research, participants (N 174) completed a 6-week training program of either cognitive or behavioral self-control tasks. We then tested the effects of practice on a range of measures of self-control, including lab-based and real-world tasks. Training was compared with both active and no-contact control conditions. Despite high levels of adherence to the training tasks, there was no effect of training on any measure of self-control. Trained participants did not, for example, show reduced ego depletion effects, become better at overcoming their habits, or report exerting more self-control in everyday life. Moderation analyses found no evidence that training was effective only among particular groups of participants. Bayesian analyses suggested that the data was more consistent with a null effect of training on self-control than with previous estimates of the effect of practice. The implication is that training self-control through repeated practice does not result in generalized improvements in self-control.
Background Many online interventions designed to promote health behaviors combine multiple behavior change techniques (BCTs), adopt different modes of delivery (MoD) (eg, text messages), and range in how usable they are. Research is therefore needed to examine the impact of these features on the effectiveness of online interventions. Objective This study applies Classification and Regression Trees (CART) analysis to meta-analytic data, in order to identify synergistic effects of BCTs, MoDs, and usability factors. Methods We analyzed data from Webb et al. This review included effect sizes from 52 online interventions targeting a variety of health behaviors and coded the use of 40 BCTs and 11 MoDs. Our research also developed a taxonomy for coding the usability of interventions. Meta-CART analyses were performed using the BCTs and MoDs as predictors and using treatment success (ie, effect size) as the outcome. ResultsFactors related to usability of the interventions influenced their efficacy. Specifically, subgroup analyses indicated that more efficient interventions (interventions that take little time to understand and use) are more likely to be effective than less efficient interventions. Meta-CART identified one synergistic effect: Interventions that included barrier identification/ problem solving and provided rewards for behavior change reported an average effect size that was smaller (ḡ=0.23, 95% CI 0.08-0.44) than interventions that used other combinations of techniques (ḡ=0.43, 95% CI 0.27-0.59). No synergistic effects were found for MoDs or for MoDs combined with BCTs. Conclusions Interventions that take little time to understand and use were more effective than those that require more time. Few specific combinations of BCTs that contribute to the effectiveness of online interventions were found. Furthermore, no synergistic effects between BCTs and MoDs were found, even though MoDs had strong effects when analyzed univariately in the original study.
Visualizing behavior from a third-person (vs. first-person) perspective can produce stronger motivation to enact the behavior. However, the effects of perspective on health behaviors have been mixed. Hypothesizing that the difficulty of the visualized behavior might moderate the effect of perspective, two experiments manipulated the difficulty of the visualized behaviors (fruit/vegetable consumption; exercise) plus perspective and subsequently measured motivation (Experiments 1 and 2) and behavior (Experiment 2). In both experiments, the third-person perspective produced stronger motivation to perform the easier, but not the more difficult, behavior. This effect extended to behavior in Experiment 2. Under certain conditions, encouraging people to visualize behavior from a third-person perspective could represent a useful and cost-effective means of promoting health behavior change.