Article

Experiences of habit formation: A qualitative study

Taylor & Francis
Psychology, Health & Medicine
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Abstract

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 revealed three themes: Strategies used to support initial engagement in a novel behaviour; development of behavioural automaticity; and selecting effective cues to support repeated behaviour. Results showed that behaviour change was initially experienced as cognitively effortful but as automaticity increased, enactment became easier. Habits were typically formed in work-based contexts. Weekends and vacations temporarily disrupted performance due to absence of associated cues, but habits were reinstated on return to work. Implications for theory and practice are discussed.

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... Furthermore, mindfulness and habit formation are often seen as opposites, with a habit defined as mindless behavior (Langer, 1989) and mindfulness as "paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" (Kabat-Zinn, 1994, p. 4). It is proposed in the literature that habit formation needs an expanded view that requires the mindfulness aspect in order to be better applied to the treatment of complex issues (Gardner, 2012;Harvey et al., 2022;Lally et al., 2011;Lally & Gardener, 2013;Robinson et al., 2022;Rothman et al., 2009). A comprehensive review of this literature across different disciplines shows that mindfulness involves deliberate and intentional focused reflection (Casey et al., 2022;Liu et al., 2021;Mitchell et al., 2021;Wong et al., 2022), which are elements that need to be incorporated into intervention that has the effective use of habit formation and automaticity (Ariyasinghe & Arachchige, 2020;Lewis et al., 2021). ...
... There is a consensus in the literature that including the science of habit formation and automaticity in the design and delivery of evidence-based therapies (EBT) for mental health challenges would appear to enhance their effectiveness (Fiorella, 2020;Harvey et al., 2022;Kazdin, 2018;Lally et al., 2011;Lally & Gardener, 2013;Robinson et al., 2022;Rothman et al., 2009). In patient care settings, the potential benefits of automating complex healthy habits are often overlooked due to the immediate effects of brief advice. ...
... Similarly, greater cognitive resources are needed during the initial phases of habit formation (Lally et al., 2011); therefore, gamma activity should be higher. As the habit becomes more automatic, maintenance demands decrease (Gardner & Lally, 2018;Wood & Neal, 2007), which could potentially result in a corresponding decrease in gamma activity. ...
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Within current mental healthcare practices, a reliable mechanism is needed for transitioning therapeutic interventions into long-term habit formation. While a sizeable body of literature on habit formation and automaticity looking at simple behaviors such as overall activity level and diet exists, few studies have investigated the complex behavior formation needed to instill new beneficial mental health habits. Additionally, limited research has looked at the neurophysiological or biological correlates of these mental processes and changes. Madhavan et al. (2015) proposed that, during active learning or recall, individuals exert more cognitive energy compared to information maintenance, resulting in heightened gamma activity. This new data demonstrates that gamma increases as learning is taking place then decreases once the behavior is learned (habituated), providing evidence of habit formation and automaticity and its nonlinear nature. The current pilot study seeks to contribute to the field’s developing knowledge of habit formation and automaticity as something that can be deliberately and mindfully learned, through a planned and guided approach over a specified time frame, to empower individuals to achieve lasting improvements in mental health challenges. Our research contributes practical strategies to improve interventions and achieve sustainable outcomes for the public health emergency in mental health.
... The "Ten Top Tips" (TTT) weight-loss intervention focused on a leaflet promoting habitual performance of simple dietary and physical activity behaviors (Beeken et al., 2012Lally, Chipperfield, & Wardle, 2008;Lally, Wardle, & Gardner, 2011). The leaflet included ten habit-based recommendations, advice about the importance of weight management, and a "tick-sheet" for monitoring adherence to each tip. ...
... Further support may be necessary where discontinuity is only temporary because later reexposure to cues may activate "dormant" habitual responses, prompting relapse into old behaviors (Gardner, 2015). For example, stress-cued habitual nail-biting may cease when relaxing on holiday but reemerge on returning home to everyday stressors (Lally et al., 2011). Where permanent discontinuation is unfeasible, habit inhibition or substitution may provide more sustainable options (Quinn et al., 2010). ...
... Qualitative interviews can assess, if not quantify, habit. People can reflect on the experience of behaviors becoming more or less familiar and routine over time and spontaneously use the language of habit (e.g., routine, automaticity) when doing so (Gardner, Sheals et al., 2014;Lally et al., 2011;Matei et al., 2015). ...
... Habits emerge with minimal prior thinking and persist as long as cues continue to be encountered (Lally et al., 2011). They are reinforced through associative and reward-learning mechanisms, and each associative repetition leads to small changes in the cognitive and neural mechanisms associated with procedural memory (Smith & Graybiel, 2016). ...
... The amount or frequency of repetition in the habit formation process remains unclear (Lally et al., 2011). However, some researchers (e.g., Lally et al., 2010;Lally et al., 2011;Lally & Gardner, 2013) have concluded that consistent repetition of behaviors increases habit strength. ...
... The amount or frequency of repetition in the habit formation process remains unclear (Lally et al., 2011). However, some researchers (e.g., Lally et al., 2010;Lally et al., 2011;Lally & Gardner, 2013) have concluded that consistent repetition of behaviors increases habit strength. As Rivers (1964, p. 35) states, "Habit strength is a function of how many of the stimuli produced by a response have this so-called reinforcing potential. ...
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Bu kitap, eğitim bilimleri ve öğretmen yetiştirme temel alanına özgü alt disiplin alanları ile ilgili çalışmaları bir araya getirerek, bilim insanlarının güncel araştırmalarını sunmayı amaçlamaktadır. Bu alanın akademisyenleri tarafından gelen yoğun talebi doğrultusunda oluşturduğumuz “Eğitim Bilimleri Araştırmaları” serimiz üç kitap ile tamamladık. Yeni serimize “Eğitimde Güncel Araştırmalar” adını verdik. Kitabımız, özellikle eğitim bilimleri ve öğretmen yetiştirme alanında araştırma yapmak isteyen akademisyenlere ilham kaynağı olmayı hedeflemektedir. Ayrıca, okurlar için faydalı bir kaynak olarak da kullanılabileceğini düşünüyoruz. Kitabın ortaya çıkmasında yazılarıyla katkı sunan yazarlara ve hazırlanmasında emeği geçen herkese teşekkür ederiz.
... Past studies took various approaches to study habit formation that improve physical health [15] [16]. Lally et al. [15] documented experiences of habit development in participants who enrolled on a weight loss intervention. ...
... Past studies took various approaches to study habit formation that improve physical health [15] [16]. Lally et al. [15] documented experiences of habit development in participants who enrolled on a weight loss intervention. Tobias [16] developed a social psychological model of habit development by studying the effect of memory aid in habit development and analyzing time-series data from a behavior-change campaigns. ...
... Both studies found insights regarding behavior change. Lally et al. [15] revealed that behavior change is initially experienced as effortful but automaticity increased, as the performance becomes easier. Moreover, Tobias [16] provided a new understanding on the role of memory to support the performance of repeated behaviors. ...
Conference Paper
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Cognitive Chrono-Ethnography (CCE) explores the qualitative nature of people's decision-making process through ethnographical field observation to identify human behaviors related to a daily activity. This paper shows how the results of previous CCE studies on habitual walking behavior possibly nudged people along the stages of the transtheoretical model. The interview results of 29 participants from past CCE studies showed that participants became more consciously aware of their appreciation for certain walking elements through either the one-on-one interview or the experience on an unfamiliar route. Moreover, the revealed walking motivations were matched to the six different stages of the transtheoretical model, assuming that people in the precontemplation and contemplation stages are motivated by exploration and a route plan, people in the preparation and action stages are motivated by the surrounding and social aspects, and people in the maintenance and termination stages are motivated by mental thinking, physical exercise, and a route plan.
... Self-monitoring has been shown to be beneficial in strengthening the formation of new habits (Carden and Wood 2018;Lally, Wardle, and Gardner 2011). Recognizing one's own behavioral outcomes can help determine whether the intended actions have been occurring continuously. ...
... Recognizing one's own behavioral outcomes can help determine whether the intended actions have been occurring continuously. This also assists the actor in identifying undesirable behaviors and making decisions about how to address these issues (Lally, Wardle, and Gardner 2011;Lally and Gardner 2013). Such selfmonitoring should be accompanied by positive feedback about the satisfaction gained from one's own behavioral changes. ...
... Design research frequently applies domain-specific instruction theories when it comes to designing an intervention (van den Akker et al. 2006). Based on our literature review, habit formation and NLB's strategies to promote reading habits (Gardner, Lally, and Wardle 2012;Lally and Gardner 2013;Lally, Wardle, and Gardner 2011;Rajaratnam 2013) were used to determine high-level conjectures. These domain-specific theories hypothetically act to support the reading habits of students. ...
Article
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Previous studies have primarily focused on improving research article reading skills, whereas reading habits are among the factors influencing students’ productive reading in higher education. This study aims to design an intervention to promote the research article reading habits of graduate students in Thailand. The study applies design research and uses the habit formation principle as a design theory. This research also applies user experience (UX) research to gather additional informative data to design the intervention in order to gain more effectiveness regarding an aspect of the participants’ effective behavior. The findings show that participants in the designed intervention can be divided into two groups: the novice and the experienced. The reading habits of both groups changed after participating in the intervention. Additional results provided important information for improving the design models so that they are appropriate for participants with varying characteristics.
... In the context of medication taking, both play a role. First, an intention to take a specific action must be formulated [14][15][16][17][18][19], e.g., a person should take one pill of metformin after breakfast. Next, to form the habit, the intention needs to turn into action [14,15], and that action needs to be repeated-the person starts taking one pill of metformin after breakfast and then continues to do so consistently for several weeks. ...
... Next, to form the habit, the intention needs to turn into action [14,15], and that action needs to be repeated-the person starts taking one pill of metformin after breakfast and then continues to do so consistently for several weeks. The importance of intentions decreases as the behavior is repeated, and with time, the activity can be automatically completed without reconsidering its purpose [19]. Creating salient cues contributes to the activity consistency and reduces behavioral complexity, while giving extrinsic rewards might hinder the habit-formation process [12]. ...
... Creating salient cues contributes to the activity consistency and reduces behavioral complexity, while giving extrinsic rewards might hinder the habit-formation process [12]. Finally, the behavior must be maintained to become a habit and bring long-lasting change [12,[14][15][16][17][18][19]. Thus, behaviorists consider that a habit can be acquired through the repetition of behavior in the presence of contextual cues [12]. ...
Article
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Past research has demonstrated that older adults tend to use daily activities as cues to remember to take medications. However, they may still experience medication non-adherence because they did not select adequate contextual cues or face situations that interfere with their medication routines. This work addresses two research questions: (1) How does the association that older adults establish between their daily routines and their medication taking enable them to perform it consistently? (2) What problems do they face in associating daily routines with medication taking? For 30 days, using a mixed-methods approach, we collected quantitative and qualitative data from four participants aged 70–73 years old about their medication taking. We confirm that older adults who matched their medication regimens to their habitual routines obtained better results on time-based consistency measures. The main constraints for using daily routines as contextual cues were the insertion of medication taking into broad daily routines, the association of multiple daily routines with medication taking, the lack of strict daily routines, and the disruption of daily routines. We argue that the strategies proposed by the literature for forming medication-taking habits should support their formulation by measuring patients’ dosage patterns and generating logs of their daily activities.
... In order to do so, the results of the CCE study (5 & 6) should be used to confirm and refine the study parameters that are set as initial hypotheses of the behavior-selection shaping factors (7). The newly identified study parameters can then be used to also refine the set of descriptive personas (8). The goal of the refined set of personas is to compile the results of the CCE study and show what factors are valued by different groups of people with different walking behaviors, and how these influenced their walking experience. ...
... The goal of the refined set of personas is to compile the results of the CCE study and show what factors are valued by different groups of people with different walking behaviors, and how these influenced their walking experience. The steps from (4) to (8) can then be repeated in order to further refine and increase the accuracy of the set of descriptive personas. ...
... Past research has taken a variety of different approaches to study the development of a habit to improve physical health [8,13]. Lally et al. [8] documented experiences of habit development in 10 participants who enrolled on a weight loss intervention. ...
Conference Paper
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The motivations that people have during a walk are often unknown to the individual. Past research has attempted to discover more about the motivations that are valued by people during a walk, and found a potential relation between people's walking habit and their walking motivations. Therefore, to further reveal this relation, this research proposes the Cognitive Chrono-Ethnography (CCE) method to identify the factors of a walk that could contribute to the quality of a walking experience. As a result, the CCE method applied to this context can specify differences between people's action selection activities and make clear which factors of a walk could potentially develop a walking habit.
... These findings highlight the feasibility and positive outcomes of using technology-enabled interventions to reduce SB in older populations and emphasize the need to tailor future interventions to their age-specific relevance. In addition, habit formation theory [35] suggests that sedentary habits are unconscious decisions. Interrupting these ingrained patterns by making them conscious through regular prompts to get up and move more has been shown to be effective [31]. ...
... Interrupting these ingrained patterns by making them conscious through regular prompts to get up and move more has been shown to be effective [31]. Over time, these prompts should become redundant as the decision to stand up rather than sit down becomes an automatic and habitual action [35]. ...
Article
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This brief narrative review assesses how digital technologies—such as wearables, mobile health apps, and various digital tools such as computers, game consoles, tablets, smartphones, and extended reality systems—can influence sedentary and physical activity behaviors among community-dwelling older adults. Each section highlights the central role of these technologies in promoting active aging through increased motivation, engagement and customized experiences. It underlines the critical importance of functionality, usability and adaptability of devices and confirms the effectiveness of digital interventions in increasing physical activity and reducing sedentary behavior. The sustainable impact of these technologies needs to be further investigated, with a focus on adapting digital health strategies to the specific needs of older people. The research advocates an interdisciplinary approach and points out that such collaborations are essential for the development of accessible, effective and ethical solutions. This perspective emphasizes the potential of digital tools to improve the health and well-being of the aging population and recommends their strategic integration into health promotion and policy making.
... I found the structure of the program helpful because I thought: 'This is something so great [that] I'm going to continue with every day.' And then Christmas happened, and then the cold weather happened, and I have to confess I'm not doing it every day (45). ...
... Our qualitative data added to this and was consistent with the published literature highlighting habit formation as a factor that promoted continuation. [44][45][46] Limitations We acknowledge the following limitations to our study. First, as a fully online study with enrollment through the Canadian PBC Society, open to inclusion regardless of geographic location, we were unable to review medical charts. ...
Article
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Background and Aims: People with primary biliary cholangitis (PBC) experience high rates of mental distress and fatigue despite standard of care therapy. We aimed to assess the impact of an online mind-body intervention on these symptoms. Methods: This 12-week RCT used sequential mixed-methods evaluation. Alongside standard of care, participants with primary biliary cholangitis were randomized to receive weekly countdown emails, or the intervention consisting of (i) a weekly 20–30 minute-mind-body follow-along video, (ii) weekly 5–10-minute psychology-based “managing chronic disease skills videos,” and (iii) 10-minute telephone check-ins. The primary outcome was a change in the Hospital Anxiety and Depression Scale (HADS). Secondary outcomes evaluated changes in fatigue, perceived stress, resilience, and health-related quality of life. ANCOVA determined between-group differences. Results: Of the 87 randomized patients (control group: n = 44, intervention group: n = 43), the between-group HADS total score improved by 20.0% (95% CI 4.7, 35.2, p = 0.011). Significant improvements were seen in depression (25.8%), perceived stress (15.2%), and 2 primary biliary cholangitis-40 domains [emotional symptoms (16.3%) and social symptoms (11.8%)] with a mean satisfaction of 82/100. This corresponded with end-of-study qualitative findings. Although no improvements were observed in fatigue in the main analysis, a significant benefit was observed in the subgroup of intervention participants (20/36;56%) who completed the mind-body video routine at least 3 times per week. Conclusion: This intervention improved measures of mental wellness and quality of life with high satisfaction and reasonable adherence. Future studies could explore strategies to optimize adherence and target fatigue.
... Habits are formed through repeated performances of a behaviour over time in response to a particular cue (Lally and Gardner, 2013). Forming habits can be useful for behaviour change as the frequent performance of the behaviour over time can lead to the behaviour becoming more "automatic", whereby individuals eventually perform the behaviour without thinking (Lally et al., 2011). Consequently, behaviours are performed with more ease and frequency (Lally et al., 2011;Lally and Gardner, 2013). ...
... Forming habits can be useful for behaviour change as the frequent performance of the behaviour over time can lead to the behaviour becoming more "automatic", whereby individuals eventually perform the behaviour without thinking (Lally et al., 2011). Consequently, behaviours are performed with more ease and frequency (Lally et al., 2011;Lally and Gardner, 2013). Habit has been found to be important for a number of health behaviours, including physical activity (Rebar et al., 2016), medication adherence (Liddelow et al., 2021b) and eating behaviours (Evans et al., 2017). ...
Article
Purpose Safe food-handling media campaigns have been successful at improving some safe food-handling behaviours among consumers. However, little is known about whether specific mechanisms of change, such as habit and perceived risk, can improve the effectiveness of safe food-handling campaign materials. Consequently, this study aims to determine if habit and risk-based behaviour change techniques can improve the effectiveness of safe food-handling media campaign materials. Design/methodology/approach A prospective experimental design was used. Participants completed baseline measures of habit, perceived risk and behaviour before watching two short safe food-handling video advertisements. Participants were then randomly assigned to complete either a habit or a perceived risk-based behaviour change technique task. Two weeks later, participants completed the baseline measures again. A series of multivariate analyses of variance were conducted to determine differences over time between the two groups in relation to habit, perceived risk and behaviour. Findings Significant increases in habit ( p < 0.001), perceived risk ( p < 0.001) and behaviour ( p < 0.001) among all participants were found over the study period. However, there were no significant differences in these changes between participants who completed either task for the majority of the target behaviours and related constructs. This suggested that both habit and risk-based behaviour change techniques may help improve campaign materials; however, future research is needed to determine these effects in comparison to a non-active control group. Originality/value To the best of the authors’ knowledge, this is the first study to compare the use of two behaviour change techniques for improving safe food-handling health messaging materials. Future safe food-handling media campaigns would benefit from including habit and risk-based behaviour change techniques.
... A moderate positive correlation was found between the mechanism of action and beliefs of PA engagement in the control condition, r(31) = . 23. ...
... This intervention aimed to examine if the chatbot can be an effective tool to help people form new habits to do more PA. Results of the t-tests were in line with previous studies [21][22] [23] and the hypothesis that habit formation intervention lead to increased willingness to engage in more PA compared to the control conversation. Results were also in line with the predictions of the habit formation model proposed in [24]. ...
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Conversational agents (CAs, aka chatbots) for behavioral interventions have great potential to improve patient engagement and provide solutions that can benefit human health. In this study, we examined the potential efficacy of chatbots in assisting with the resolution of specific barriers that people frequently encounter when doing behavioral interventions for the purpose of increasing physical activity (PA). To do this, six common barriers (i.e., things that stand in the way of increasing PA) were targeted (e.g., stress and fatigue), we adopted domain knowledge (i.e., psychological theories and behavioral change techniques) to design six interventions aimed at tackling each of these six barriers. These interventions were then incorporated into consultative conversations, which were subsequently integrated into a chatbot. A user study was conducted on non-clinical samples (n=77) where all participants were presented with three randomly but equally distributed chatbot interventions and a control condition. Each intervention conversation addressed a specific barrier to PA, while the control conversation did not address any barrier. The outcome variables were beliefs in PA engagement, attitudes toward the effectiveness of each intervention to resolve the barrier, and the overall chatbot experience. The results showed a significant increase in beliefs of PA engagement in most intervention groups compared to the control group, and positive attitudes toward the effectiveness of the interventions in reducing their respective barriers to PA, and positive chatbot experience. The results demonstrate that theory-grounded interventions delivered by chatbots can effectively help people overcome specific barriers to PA, thereby increasing their beliefs in PA engagement. These promising findings indicate that chatbot interventions can be an accessible and widely applicable solution for a larger population to promote PA.
... Self-help books and podcasts which discuss the formation of good habits abound. Meanwhile, Lally et al. (2011) demonstrate that "with repetition, the behaviors become more automatic and less effortful" (p. 487), which is an insight that can inspire people to attempt to incorporate new habits since they will become progressively easier. ...
... 487), which is an insight that can inspire people to attempt to incorporate new habits since they will become progressively easier. In addition, Lally et al. (2011) suggest that habit formation can be optimized if it is linked with other small habits. In my case, I decided to ride my bicycle to work rather than drive so that the time on my bike allowed me to contemplate the day ahead, which meant that I had to leave the house earlier and change my clothes at work. ...
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This paper examines the two most salient negative emotions experienced by two teachers during their first year at a private university in Japan. Both teachers kept a diary of their first year to uncover similarities and differences in their adjustment to their new work environment. The diary data revealed situations that brought about feelings of frustration and overwhelm. For teachers to better understand and support each other, encouragement to use reflective practice tools, such as teaching diaries, are needed at every stage of their careers.
... Context cues can be either external (e.g., seeing the coffee machine) or internal (e.g., feeling bored) (LaRose 2017). Once formed, these associations between behavior and context are so strong that they can survive an interruption (weekends, holidays); as soon as the context cue is encountered again, the behavioral response is activated (Lally, Wardle, and Gardner 2011). ...
... News media seek to steer users' behavior via such strategies as social media promotion (Bayer and LaRose 2018), push notifications (Wheatley and Ferrer-Conill 2021) and newsletters (Hendrickx, Donders, and Picone 2020). News users themselves can inhibit undesirable habits by introducing friction, e.g., via various digital detox strategies (Syvertsen, 2020), or stimulate formation of desirable habits through imposing deliberate strategies such as taking preparatory action and programming effective cues (Lally, Wardle, and Gardner 2011). "Stacking" refers to adding a desired behavior (on)to an existing habit (e.g., flossing after brushing teeth), and "swapping" refers to trading in an existing habit for the new desired behavior in the same context (e.g., switching to decaf coffee) (Wood 2019). ...
Article
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This article uses the notion of habit to explore how news users adopt a new subscription into their everyday routines, and identifies facilitators and obstacles helping or inhibiting this process. Sixty-eight participants received a three-week newspaper trial subscription and were interviewed about their experiences afterward. Facilitators of repeated use were concurrent rewards; embedment into existing routines; and visual reminders. Obstacles were lack of steady routines; strong existing habits; perceived effort; disillusionment; and accessibility. Findings point to the importance of visibility: participants – even those with positive initial experiences – tended to forget their subscription. Visual cues were needed to remind participants to read their subscription: app icons, open browser tabs, social media posts, push notifications, and the print newspaper. Proactive implementation of these cues suggests participants themselves were also aware of their propensity to forget the subscription. Existing (news) habits either helped anchor use of the subscription or blocked it by being automatically cued up by context features. Results also point to a mental hurdle: having to muster up the cognitive and motivational energy to start reading the news. Finally, findings suggest that concurrently experienced rewards may be more conducive to news habit formation than retrospectively experienced rewards.
... Practical strategies are believed to aid in the establishment of new healthy habits. One effective approach is to integrate novel habits with pre-existing ones, thereby creating a routine [2,13]. This entails linking a new habit to an existing one, simplifying integration into daily life. ...
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Background: Healthy lifestyles depend on forming crucial habits through the process of habit formation, emphasising the need to establish positive habits and break negative ones for lasting behaviour changes. This systematic review aims to explore the time required for developing health-related habits. Methods: Six databases (Scopus, PsychINFO, CINAHL, EMBASE, Medline and PubMed) were searched to identify experimental intervention studies assessing self-report habit or automaticity questionnaires (e.g., the self-report habit index (SRHI) or the self-report behavioural automaticity index (SRBAI)), or the duration to reach automaticity in health-related behaviours. Habit formation determinants were also evaluated. Meta-analysis was performed to assess the change in the SRHI or SRBAI habit scores between pre- and post-intervention, and the study quality was assessed using the PEDro scale. Results: A total of 20 studies involving 2601 participants (mean age range: 21.5–73.5 years) were included. Most studies had a high risk of bias rating (n = 11). Health behaviours included physical activity (n = 8), drinking water (n = 2), vitamin consumption (n = 1), flossing (n = 3), healthy diet (n = 8), microwaving a dishcloth (for foodborne disease reduction, n = 2) and sedentary behaviour reduction (n = 1). Four studies reported the median or mean times to reach habit formation, ranging from 59–66 days (median) and 106–154 days (means), with substantial individual variability (4–335 days). The meta-analysis showed significant improvements in habit scores pre- to post-intervention across different habits (standardised mean difference: 0.69, 95% CI: 0.49–0.88). Frequency, timing, type of habit, individual choice, affective judgements, behavioural regulation and preparatory habits significantly influence habit strength, with morning practices and self-selected habits generally exhibiting greater strength. Conclusions: Emerging evidence on health-related habit formation indicates that while habits can start forming within about two months, the time required varies significantly across individuals. A limitation of this meta-analysis is the relatively small number of studies included, with flossing and diet having the most evidence among the behaviours examined. Despite this, improvements in habit strength post-intervention are evident across various behaviours, suggesting that targeted interventions can be effective. Future research should aim to expand the evidence base with well-designed studies to better understand and enhance the process of establishing beneficial health habits.
... require minimal willpower or deliberate effort) [67]. Research shows that repetition of a behaviour in a consistent context enables it to acquire automaticity, and once automaticity is established, it is more resistant to extinction than deliberative (intentional) behaviours [68,69]. Habits are defined as 'psychological dispositions to repeat past behaviour' [70] and habit indicates "a process whereby exposure to a cue automatically triggers a non-conscious impulse to act due to the activation of a learned association between the cue and the action" [25,71]. ...
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Background The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG. Methods A previous habit-based intervention ‘Ten Top Tips for a Healthy Weight’ (10TT) was adapted and made suitable for pregnancy in line with the Medical Research Council’s (MRC) complex intervention development guidelines. It involved three key activities: (1) identifying the evidence base; (2) identifying appropriate theory; and, (3) modelling processes. A core element was integrating lived experience via personal and public involvement (PPI). Results The original 10TTs were adapted with PPI in line with current advice on nutrition and physical activity in pregnancy. New intervention materials were devised, including a leaflet and a logbook and app for self-monitoring to be delivered alongside a brief 1:1 conversation. Behaviour change techniques (BCTs) included in the new materials were coded using a number of behavioural taxonomies. An E-learning resource was created to help standardise the approach to delivery of the intervention and avoid stigmatising conversations. Conclusion Following MRC guidance for the development of complex interventions alongside significant PPI allowed for the adaption of 10TT habit-based weight management intervention into the ‘Healthy Habits in Pregnancy and Beyond’ (HHIPBe) intervention. The feasibility and acceptability of implementing this intervention in the antenatal setting will be explored in a feasibility randomised controlled trial. Trial Registration This study was registered on Clinical Trials as ‘Healthy Habits in Pregnancy and Beyond (HHIPBe)’ ClinicalTrials.gov Identifier: NCT04336878. The study was registered on 07/04/2020.
... The intervention will be based on behavioural theories, 58 including the socio-ecological model 59 and habit formation model. 60 The socio-ecological model emphasises the importance of taking into account factors that may ...
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Introduction Evidence suggests that sedentary behaviour (SB) and physical activity (PA) are important indicators of well-being and quality of life in older adults (OAs). However, OAs are the least active and highly sedentary of all the age groups. The present study intends to examine the feasibility of a wearable gadget to remind users to break sitting time (by standing up and moving more), coupled with a brief health coaching session, pamphlet and reminder messages to decrease SB and improve PA. Methods and analysis This study will employ a multi-methods approach that generates quantitative data from questionnaires and qualitative data from semi-structured interviews following OAs’ involvement in the study. This intervention will be informed by the socio-ecological model (SEM) and the habit formation model. The quantitative and qualitative data will be analysed separately and then integrated for interpretation and reporting, which will assist our knowledge of the feasibility of the programme. Ethics and dissemination Ethical approval for this study has been obtained from Swansea University (NM_ 2023 6667 6123). Informed consent will be obtained from participants. The findings of the study will be disseminated to the scientific community through conference presentations and scientific publications. The findings of the current study will determine the suitability of a future effectiveness trial. Trial registration number NCT06407557 .
... For example, the routine of handwashing may have been so embedded in a chefs' practice due to its multiple repetitive occurrences that it has become subconscious. If a routine is disrupted, then an individual experiences emotional unease which only disappears after a routine is reinstated (Lally et al., 2011). For instance, if there is no water in one kitchen tap, then a chef will try to find another one to follow a handwashing routine. ...
Article
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Although many chefs have developed the habit to practice food waste management in the kitchen, so-called environmental habitus, little is known about how this habitual practice has formed and how/if it has evolved with time. This study combines practice theory and theory of habit formation to explore the (f)actors that have influenced the formation and evolvement of environmental habitus among chefs. Interpretive phenomenological analysis is used to examine the lived experiences of 18 senior chefs in Indonesia who have habitually engaged in food waste management. The study establishes the critical role of mothers in shaping personal outlook of chefs on the importance of food waste reduction. Senior chefs are key for reinforcing this outlook, but also for providing necessary competencies and tools for resourceful cooking. The study highlights family upbringing and on-the-job training as the critical (f)actors in the formation and evolvement of the habitual practice of food waste management among future chefs.
... Theories of habit formation suggest that automaticity of the new habitual behaviour might increase over the course of the study. This is because the participants acquired this behaviour anew and the automatization of a behaviour is supposed to increase with constant repetition (Gardner, 2015;Lally et al., 2010Lally et al., , 2011. Accordingly, we conducted a single-factor repeated measures analysis of variance with linear contrasts to analyse the time trend of automaticity. ...
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Habits facilitate automatic behaviours and are resource efficient. Habits at work may be beneficial because they conserve cognitive-attentional resources, thus fostering work engagement and goal progress. In a diary intervention study (2 daily assessments, 10 work days), we asked 72 employees to establish a new habit at work. Half of them additionally completed an intervention on the correct use of implementation intentions. All participants were given access to a follow-up survey. In multi-level analyses, automaticity of the new habitual behaviour predicted work engagement and goal progress at the day-level. Implementation intentions predicted frequency of the habitual behaviour and in turn increased automaticity of this behaviour. The effects of implementation intentions were still evident at follow-up. Contrary to expectations, the intervention did not increase participants' daily use of implementation intentions. The results indicate that implementation intentions might be used in everyday work to establish habits at work, thus increasing employees' efficiency and engagement.
... Second, the insignificant differences in daily walking between all four study groups over the four-week post-incentivization period suggest that the four-week incentivization period was likely too short for habits to form. In fact, prior research suggests that it takes roughly two to three months of adhering to an anchoring plan to successful form a habit (Duhigg, 2013;Lally et al., 2010Lally et al., , 2011. To address this, future interventions targeting physical activity habit formation should employ longer intervention periods to support participants' use of an anchoring plan for triggering physical activity. ...
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The purpose of this study was to: (1) compare the relative efficacy of different combinations of three behavioral intervention strategies (i.e., personalized reminders, financial incentives, and anchoring) for establishing physical activity habits using an mHealth app and (2) to examine the effects of these different combined interventions on intrinsic motivation for physical activity and daily walking habit strength. A four-arm randomized controlled trial was conducted in a sample of college students (N = 161) who had a self-reported personal wellness goal of increasing their physical activity. Receiving cue-contingent financial incentives (i.e., incentives conditional on performing physical activity within ± one hour of a prespecified physical activity cue) combined with anchoring resulted in the highest daily step counts and greatest odds of temporally consistent walking during both the four-week intervention and the full eight-week study period. Cue-contingent financial incentives were also more successful at increasing physical activity and maintaining these effects post-intervention than traditional non-cue-contingent incentives. There were no differences in intrinsic motivation or habit strength between study groups at any time point. Financial incentives, particularly cue-contingent incentives, can be effectively used to support the anchoring intervention strategy for establishing physical activity habits. Moreover, mHealth apps are a feasible method for delivering the combined intervention technique of financial incentives with anchoring.
... Due to the association, the habitual behavior is automatically and sometimes unconsciously activated (Aarts & Dijksterhuis, 2000) while alternative behaviors become less accessible (Danner et al., 2007). Often, the effort required to initiate the habitual behavior decreases over time and initiation becomes effortless (Lally et al., 2011). Even when intentions change, engagement in habitual behavior commonly persists (Adriaanse & Verhoeven, 2018). ...
Article
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Study habits drive a large portion of how university students study. Some of these habits are not effective in fostering academic achievement. To support students in breaking old, ineffective habits and forming new, effective study habits, an in-depth understanding of what students’ study habits look like and how they are both formed and broken is needed. Therefore, in this study, we explored these aspects among first-year university students in six focus group discussions (N = 29). Using a thematic analysis approach, we clustered the data in five themes: Goals Matter, Balancing Perceived Efficiency and Effectiveness when Studying, Navigating Student Life: from Structured Routines to Self-Regulation Challenges, the Quest for Effective Habits with Trying to Break Free From the Screen as subtheme, and the Motivation Roller Coaster. Findings suggest that students had different study habits depending on their goals. Students had quite accurate metacognitive knowledge about effective learning strategies for long-term learning, but often used other learning strategies they deemed most efficient in reaching their goals. Students indicated intentions to change, but did not prioritize change as their current habits enabled them to pass exams and change was not perceived as adding value. Fluctuations in motivation and transitioning to a self-regulated life hampered students’ intentions to form new and break old habits. Next to insights into factors affecting students’ behavioral change intentions, the findings suggest the importance of aligning assessment methods with life-long learning and supporting students in their long-term academic goal setting to prioritize study habits which target lasting learning to optimally foster their self-regulated learning.
... By using a bilingual format, 2 Pre-intervention surveys (oral health practices and perceptions of refugees section of the Sociodemographic and Oral Health Perceptions of Refugees survey and EOHL-BL40 survey in English) to determine long-term retention of knowledge of dental terms and to identify changes in patient perceptions of oral health and personal oral hygiene practices over the past two weeks. The two-week followup period was selected due to the fact that it takes at least 18 days for an individual to adopt a habit [29]. We wanted to give the participants enough time to get accustomed to brushing and flossing before we asked questions about oral health practices again. ...
Article
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Inadequate comprehension of healthcare information contributes to poor health outcomes. Ethnic minorities are one of the populations most affected by low health and oral health literacy (OHL). The hypothesis of the current study was that an oral health education program (OHEP) can improve the OHL, oral health awareness and behaviors of refugees. We also hypothesized that there will be a difference between OHL in English and native language in the Pre-intervention phase. Fifty-two adult refugees participated in an educational program that included a comprehensive and culturally sensitive PowerPoint presentation and hands-on learning activities on oral health topics. The study used a cross-sectional pre-post study design. Before the program (Pre-intervention group), participants completed 2 surveys: Sociodemographic Survey and Oral Health Perceptions of Refugees in a bilingual format, and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English, and in the participants’ native language. Immediately after an OHEP (Post-intervention group), participants completed the EOHL-BL40 survey in English only. Two weeks after OHEP (Follow-up intervention), participants completed again the Sociodemographic Survey and Oral Health Perceptions of Refugees and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English only. The mean percentage of words understood on Pre-intervention EOHL-BL40 survey were significantly higher in native languages (47.3% ±3.7%) compared with survey in English (15.3% ±1.2%, P < 0.001). Post-intervention scores, immediately after educational program, were higher (28.6% ±2.4%), P < 0.001) for survey in English compared with the Pre-intervention (15.3% ±1.2%). The follow-up (2 weeks later) scores (25.5% ±2.4) were slightly lower than Post-intervention but still significantly higher (P < 0.001) than Pre-intervention. Results for both Sociodemographic Survey and Oral Health Perceptions of Refugees surveys were similar: the OHEP positively affected oral health awareness and oral health behaviors. Results of the study suggested that OHEP may improve oral health literacy, oral health awareness, and personal oral hygiene practices of refugees.
... 15 Maintenance of behavioral changes can be considered a demanding cognitive task, at least before they have turned into automatized habits. 18,19 Any factor implying additional cognitive demands on an individual may thus hinder the process of maintenance. Stress is one such factor, and we have previously shown that perceived stress was related to increased disinhibition and hunger, which in turn were associated with less successful weight loss maintenance. ...
... We also observed less consistency in meditation frequency during the weekends and holidays. This is in line with the findings of Lally et al. [20], who explained that adhering to habit formation plans tends to be more difficult when daily activities are less structured. ...
Article
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Existing studies of technology supporting meditation habit formation mainly focus on mobile applications which support users via reminders. A potentially more effective source of motivation could be contextual cues provided by meaningful objects in meaningful locations. This longitudinal mixed-methods 8-week study explored the effectiveness of such an object, Prana, in supporting forming meditation habits among seven novice meditators. First, the Meditation Intentions Questionnaire-24 and the Determinants of Meditation Practice Inventory-Revised were administered. The self-report habit index (SrHI) was administered before and after the study. Prana recorded meditation session times, while daily diaries captured subjective experiences. At the end of the study, the system usability scale, the ten-item personality inventory, and the brief self-control scale were completed, followed by individual semi-structured interviews. We expected to find an increase in meditation frequency and temporal consistency, but the results failed to confirm this. Participants meditated for between 16% and 84% of the study. The frequency decreased with time for four, decreased with subsequent increase for two, and remained stable for one of them. Daily meditation experiences were positive, and the perceived difficulty to start meditating was low. No relevant correlation was found between the perceived difficulty in starting to meditate and meditation experience overall; the latter was only weakly associated with the likelihood of meditating the next day. While meditation became more habitual for six participants, positive scores on SrHI were rare. Despite the inconclusive results, this study provides valuable insights into challenges and benefits of using a meditation device, as well as potential methodological difficulties in studying habit formation with physical devices.
... (63) Alguns estudos que avaliam a curva da mudança de hábitos versus o tempo afirmam que um hábito demora cerca de 66 dias a ser enraizado e automatizado, sendo que ao fim de 21 dias (período crítico) é quando poderá acontecer uma quebra de motivação o que irá comprometer todo o processo de mudança de hábitos. (64)(65)(66)(67) Assim, o que parece ajudar a promover a mudança de comportamento é, por um lado a forma como o conhecimento é fornecido e adquirido, e por outro a existência de acompanhamento ao longo do tempo. (68) Presentemente as informações sobre mudança de comportamento em saúde oral, na sua maioria, incluem instruções sobre dieta e hábitos de higiene oral focados no paciente, transmitidas em ambiente clínico, no seguimento de consultas e/ou tratamentos. ...
Thesis
To study young adults' perception about the use of apps as complement for oral health and to verify whether the apps Dentalcluj Brush Assistant and Brush DJ have an influence on oral health indices. Two studies were conducted. The first study, cross-sectional and descriptive, applied a questionnaire to portuguese individuals aged between 18 and 20 years old. The questionnaire collected information about the perception of the use of apps related to oral health. The second study was experimental and longitudinal and included undergraduate dental prosthesis students. Three groups were formed: control; with access to the Brush DJ app; and with access to the Dentalcluj Brush Assistant app. Data were collected using a questionnaire and intraoral examination. The questionnaire collected information about the perception of the use of the apps. The intraoral examination evaluated the Bleeding on Probing Index (BOP) and Oral Hygiene Index-Simplified (OHI-S) at three moments with an interval of fifteen days between them.
... This strengthening occurs when the behavior, prompted by a specific context, is consistently and repeatedly performed (Verplanken et al. 1999;Wood et al. 2009;Lally et al. 2013), allowing to strengthen the mental association established in the implementation intention. Once the habit is strengthened, the cognitive effort required to act decreases, and the habit becomes second nature (Lally et al. 2011). Alternatives (staying on the bus) become less accessible (Danner et al. 2007(Danner et al. , 2008. ...
Conference Paper
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Interventions for noncommunicable diseases (NCDSs) often require changing behaviors. In this regard, habitual behaviors (i.e., habits) are positively evaluated to foster behavioral changes. Forming habits is challenging but can be supported digitally. This paper reviews the requirements of forming habits and investigates how these requirements are implemented in habit apps. Based on the results, design principles are discussed for digital therapeutics. In contrast to con- ventional apps, digital therapeutics have a medical purpose and can be prescribed for the time it needs for a habit to form. The results reveal that conventional apps try to bind the user and ignore the state where the habit needs to be strengthened by decreasing technology use. In this regard, digital therapeutics reveal potential in supporting the formation of habits to prevent and treat NCDs.
... Importantly, habits have been shown to persist despite declining motivation or distractions (Galla & Duckworth, 2015;Gardner, Lally, & Wardle, 2012;Neal et al., 2013). One commonly used habit formation strategy is to pair the desired behavior to an existing daily routine, called "anchoring" (Gardner, Lally, & Wardle, 2012;Lally et al., 2011;Lally & Gardner, 2013). For example, "After I get dressed and wash my face in the morning, I will practice meditation for 10 minutes." ...
Article
Mobile app-based meditation is an effective self-care solution for depression, but limited evidence exists for the long-term benefits among autistic adults, who are at increased risk of experiencing depression. The primary goal of this study was to examine the feasibility and effectiveness of incorporating habit training into an app-based meditation intervention to maintain reductions in depressive symptoms among autistic adults. Participants were randomized to an App Only (who only received access to the meditation app), App + Habit Training (who received the meditation app and instructions for anchoring their app-based meditation to an existing routine), or a waitlist control group. All participants completed questionnaires at baseline, post-intervention, and 6 months post-intervention, and responded to SMS ecological momentary assessments regarding their meditation practice during the 8-week intervention and an 8-week follow-up period. The results show that the App + Habit Training group reported significantly more days with meditation per week during and after the intervention ( p < 0.05) and also experienced a larger decrease in depression symptoms post-intervention and 6 months later ( p < 0.05) relative to the control group. These findings demonstrate that app-based meditation habits are an effective self-care solution for autistic adults with depression, and anchoring is a promising strategy for establishing other healthy habits among autistic adults. Lay Abstract Existing research has identified an increased risk of depression among autistic adults, which can negatively impact their adaptive functioning abilities and socioeconomic outcomes. Mobile app-based meditation is a feasible, accessible, and effective self-care solution for depression among neurotypical adults, but there is limited evidence for the long-term benefits of app-based meditation among autistic adults. Habits are a key behavioral strategy for maintaining behavior change, and anchoring is one effective habit formation intervention that has yet to be tested among autistic adults. This study demonstrates that it is both feasible and effective to integrate the anchoring habit formation strategy into an app-based meditation intervention for establishing meditation habits among autistic adults. In addition, the study shows that app-based meditation habits were successful at maintaining reductions in depressive symptoms over 6 months. These results demonstrate the power of anchoring-based habit formation interventions for establishing healthy habits among autistic adults, which offers a promising behavioral intervention technique for establishing other healthy habits among autistic adults. The study also shows that app-based meditation habits are an effective long-term self-care solution for managing depressive symptoms among autistic adults that should be used by mental health providers and policymakers. Future research should test this combined anchoring and app-based meditation intervention technique among larger samples of autistic adults and over longer durations to better understand the mechanisms underlying the success of this intervention.
... It sometimes takes conscious effort to build up a good habit. Habit formation is the process by which a behaviour, through regular repetition, becomes automatic or habitual (Lally et al., 2011). For a behaviour to be automated, regular repeating of the behaviour in a particular sequence over a period of time is assured of such behaviour becomes automatic and part of the individual (Wood & Neal, 2016). ...
Article
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The prevalence rate of gambling and social networking in the university setting interferes with students’ study habit dimensions. Thus, this study seeks to determine the dimensions of study habits exhibited by university students in Ghana, precisely the University of Cape Coast. The study adopted the descriptive survey design with a sample size of 351. The Study Habits Inventory (SHI) was adapted to determine the dimensions of students’ study habits. The inventory recorded a Cronbach’s Alpha coefficient (r) of .97. From the findings, it was evident that most students had satisfactory study habits in all five dimensions (Allotment of time, concentration, consultation, procedure in studying and reading and library use). Hence, it was inferred from the findings that the satisfactory study habits of students were because they did not have a very well-planned and organised study time. To this, it was recommended that, since one’s study habits can be interfered with by gambling and social life activities, the Study Habit Unit, in collaboration with the department academic counsellors, hall counsellors and a recommended “Gaming Research Unit” of the university should intermittently run an open forum where students can test their study habit dimensions and be acquainted so as to seek counsel or improvement where necessary
... The formation of a habit is initially rapid, plateauing over time as the habit is formed [33,34]. Although there is individual variation in the timescale in which a behavior becomes habitual, habit formation tends to occur most notably within the first 2 weeks of attempting to change the behavior [33,35,36]. This highlights the need for support in the early phases of a behavior change intervention aimed at supporting habit formation [31,34]. ...
Article
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Background: Adjuvant endocrine therapy (AET) reduces breast cancer recurrence and mortality in women with early-stage breast cancer. Unintentional nonadherence to AET is common (eg, forgetting to take medication). Forming habits surrounding medication taking could reduce reliance on memory and improve AET adherence. SMS text messaging interventions may offer a low-cost approach for promoting medication-taking habits. To optimize the likely effectiveness of such SMS text messages, the content should be developed using a transparent approach to ensure fidelity to relevant psychological theory and with user input to increase acceptability. Objective: This study aimed to develop a pool of brief SMS text messages promoting habit formation to support AET adherence, which are acceptable to women with breast cancer and show fidelity to theory-based behavior change techniques (BCTs). Methods: According to published literature, we selected 6 BCTs derived from the habit formation model: action planning, habit formation, restructuring the physical environment, adding objects to the environment, prompts/cues, and self-monitoring of behavior. In study 1, behavior change experts (n=10) created messages, each based on 1 of the 6 BCTs, in a web-based workshop and rated the fidelity of the messages to the intended BCT. In study 2, women with experience of taking AET discussed the acceptability of the messages in a focus group (n=5), and the messages were refined following this. In study 3, women with breast cancer rated the acceptability of each message in a web-based survey (n=60). In study 4, additional behavior change experts rated the fidelity of the remaining messages to the intended BCT in a web-based survey (n=12). Finally, a consultant pharmacist reviewed a selection of messages to ensure that they did not contradict general medical advice. Results: In study 1, 189 messages were created targeting the 6 BCTs. In total, 92 messages were removed because they were repetitious, unsuitable, or >160 characters, and 3 were removed because of low fidelity (scoring <5.5/10 on a fidelity rating scale). Following study 2, we removed 13 messages considered unacceptable to our target population. In study 3, all remaining messages scored above the midpoint on an acceptability scale (1-5); therefore, no messages were removed (mean 3.9/5, SD 0.9). Following study 4, we removed 13 messages owing to low fidelity (scoring <5.5/10 on a fidelity rating scale). All the remaining messages showed fidelity to the intended BCTs (mean 7.9/10, SD 1.3). Following the pharmacist review, 2 messages were removed, and 3 were amended. Conclusions: We developed a pool of 66 brief SMS text messages targeting habit formation BCTs to support AET adherence. These showed acceptability to women with breast cancer and fidelity to the intended BCTs. The delivery of the messages will be further evaluated to assess their effect on medication adherence.
... To measure habitual use as a successful behavioral change outcome, we adopted 3 items from UTAUT2 [44]. Because after reviewing 2 qualitative studies evaluating habit formation outcomes [46,47], we found they asked the same questions, such as whether participants felt that their use of devices had become a habit and if the behavioral changes were programmed into their routines. To ensure the validity and reliability of measurement items, we adopted translated items from peer-reviewed Korean studies that used identical models and similar subjects. ...
Article
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Background Prevention of the risk factors for metabolic syndrome (MetS) in middle-aged individuals is an important public health issue. Technology-mediated interventions, such as wearable health devices, can aid in lifestyle modification, but they require habitual use to sustain healthy behavior. However, the underlying mechanisms and predictors of habitual use of wearable health devices among middle-aged individuals remain unclear. Objective We investigated the predictors of habitual use of wearable health devices among middle-aged individuals with risk factors for MetS. Methods We proposed a combined theoretical model based on the health belief model, the Unified Technology of Acceptance and Use of Technology 2, and perceived risk. We conducted a web-based survey of 300 middle-aged individuals with MetS between September 3 and 7, 2021. We validated the model using structural equation modeling. ResultsThe model explained 86.6% of the variance in the habitual use of wearable health devices. The goodness-of-fit indices revealed that the proposed model has a desirable fit with the data. Performance expectancy was the core variable explaining the habitual use of wearable devices. The direct effect of the performance expectancy on habitual use of wearable devices was greater (β=.537, P
... Examples include washing one's face and brushing one's teeth automatically after waking up every morning or always going home along the same route after work. These habits develop unconsciously, and it is possible to perform many actions automatically, without conscious control[29]. The automatic nerve signal transmission and conscious primacy hypothesis proposes that when the same actions are repeated many times in a particular environment, the neural connections are strengthened and produce networks between the neurons receiving stimuli and producing actions. ...
... To facilitate daily practice, strategies such as intention [47,48] and repeated behavior in the same context/situation were used [49] in addition to self-observation and verbal persuasion [50]. A training manual describing the nature, duration, and sequence of each activity was developed by researchers to ensure the consistency of the intervention. ...
Article
Objective: Quality of life of people living with HIV is strongly affected by sleep problems, fatigue, pain, anxiety, and depression symptoms. This study set out to evaluate the effects of autogenic training (AT) on quality of life and symptoms within this population. Methods: A mixed method randomized controlled trial was conducted. Participants were randomly assigned to either the AT group (n = 32) or the control group (CG) (n = 31). Quality of life and symptoms were measured in both groups three times: prior to intervention (T0), immediately after intervention (T3), and three months after intervention (T6). Fourteen individual interviews were conducted. Results: Results show a significant improvement in social and mental dimensions of quality of life for the two groups at T6. They also show a significant improvement in sleep for AT participants at T3. Qualitative results are consistent with quantitative ones. Conclusion: AT seems to improve sleep quality and could improve some dimensions of quality of life and other symptoms among people living with HIV. Further studies are needed to confirm these results. Trial registration number: NCT01901016.
... Replacing specific high calorie foods is likely to be straight-forward to implement and intuitive but new habits do require repeated conscious effort before becoming automatic [27]. ...
Article
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Weight loss maintenance can be difficult and ultimately unsuccessful, due to psychological, behavioural, social, and physiological influences. The present study investigated three strategies with the potential to improve weight maintenance success: daily weighing, missing an occasional meal, habitually changing high energy foods. The principal aim was to gain an understanding of attitudes to these strategies in participants who had recent experience of weight loss attempts, with or without maintenance. This was a qualitative study involving semi-structured interviews, with 20 participants aged 18–67 (twelve females), analysed using thematic analysis. Most participants disliked daily weighing and missing an occasional meal for long-term maintenance and were concerned about potential negative effects on mental health. All participants had experience of habitual changes to high energy foods and regarded this strategy as obvious and straightforward. Replacement of high energy foods was favoured over elimination. Participants preferred strategies that felt flexible, “normal” and intuitive and disliked those that were thought to have a negative impact on mental health. Further investigation is needed on whether concerns regarding mental health are well founded and, if not, how the strategies can be made more acceptable and useful.
... One of the main reasons for nonadherence in an SMS trial was cited as forgetting at weekends due to a change of routine [85,138]. Messages sent twice weekly could support medication taking in the change of routine at weekends [139]. The SMS messages will then reduce to weekly reminders for 6 weeks, as medication taking should become sufficiently habitual to persist despite a reduction in support. ...
Article
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Background Adjuvant endocrine therapy (AET) reduces the risk of breast cancer recurrence and mortality. However, up to three-quarters of women with breast cancer do not take AET as prescribed. Existing interventions to support adherence to AET have largely been unsuccessful, and have not focused on the most salient barriers to adherence. This paper describes the process of developing four theory-based intervention components to support adherence to AET. Our aim is to provide an exemplar of intervention development using Intervention Mapping (IM) with guidance from the Multiphase Optimisation Strategy (MOST). Methods Iterative development followed the six-stage IM framework with stakeholder involvement. Stage 1 involved a literature review of barriers to adherence and existing interventions, which informed the intervention objectives outlined in Stage 2. Stage 3 identified relevant theoretical considerations and practical strategies for supporting adherence. Stage 4 used information from Stages 1-3 to develop the intervention components. Stages 1-4 informed a conceptual model for the intervention package. Stages 5 and 6 detailed implementation considerations and evaluation plans for the intervention package, respectively. Results The final intervention package comprised four individual intervention components: Short Message Service to encourage habitual behaviours surrounding medication taking; an information leaflet to target unhelpful beliefs about AET; remotely delivered Acceptance and Commitment Therapy-based guided self-help to reduce psychological distress; and a website to support self-management of AET side-effects. Considerations for implementation within the NHS, including cost, timing and mode of delivery were outlined, with explanation as to how using MOST can aid this. We detail our plans for the final stage of IM which involve feasibility testing. This involved planning an external exploratory pilot trial using a 2⁴⁻¹ fractional factorial design, and a process evaluation to assess acceptability and fidelity of intervention components. Conclusions We have described a systematic and logical approach for developing a theoretically informed intervention package to support medication adherence in women with breast cancer using AET. Further research to optimise the intervention package, guided by MOST, has the potential to lead to more effective, efficient and scalable interventions.
... Repeating an action regularly in the presence of the cue serves to reinforce mental cue-action associations that are stored in memory. As habit forms, the reliance on conscious cognitive control to initiate action is alleviated, and the action becomes a more automatic response to the associated cues (Lally et al., 2011). Habit increases the likelihood of future behavioural frequency such that encountering the cue prompts the action non-consciously, even amidst competing goals or lapses in motivation and concentration (Hagger & Rebar, 2020). ...
Article
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, multinational study with fortnightly repeated‐assessments, associations and moderation effects were considered for both overall (person‐level means) and occasion‐specific deviations in habit and identity. Participants (N = 586, M age = 42, 79% female) self‐reported physical distancing behavioural frequency, physical distancing habit strength, and identity with avoiding virus transmission. Physical distancing followed a cubic trajectory, with initial high engagement decreasing rapidly before increasing again near study end. Physical distancing was associated with both overall and occasion‐specific virus transmission avoidant identity and physical distancing habit strength. People with strong virus transmission avoidant identity engaged in physical distancing frequently regardless of fluctuations in habit strength. However, for those with weaker virus transmission avoidant identity, physical distancing was strongly aligned with fluctuations in habit strength. To enhance engagement in physical distancing, public health messaging might fruitfully target greater or more salient virus‐transmission avoidance identity and stronger physical distancing habit.
... This study is an initial effort towards bridging this gap in the literature by exploring how purchasing behaviours evolved before, during, and after a COVID-19 lockdown in Italy. More explicitly, this study intends to examine both the marked trend of consumers to make online purchases during the Covid-19 pandemic in Italy and verify, according with habit formation process, based on the repetition of an action, proposed by various researchers (Beeken et al., 2017;Fleig et al., 2016;Lally et al., 2011;Mullan et al., 2014;White et al., 2017), whether shopping online has become a new habit. In particular Lally et al., in 2010, showed that development of an individual's habits can be depict by an asymptotic curve with a constant increase over time up to a final plateau, achieved at a median of 66 days after the start of testing, sheer length of lockdown in Italy. ...
Book
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The topic of self-care is currently a big trend that acts as a protective factor in many difficult life situations. The realization and internalization of self-care is very desirable in some phases of life. University studies are considered one of the most challenging life stages. Studying at a college/university brings with it big life changes: a new circle of people; new types of study load; establishing partnership relations; becoming independent. Self-care gives students the opportunity to establish order in their lives, how to slow down and think about the meaning of things, how to keep themselves cool. The goal of the textbook is to help students understand what self-care is about, what it can be helpful for, and how to implement it. It offers a variety of demonstrations, examples and worksheets for your first contact with self-care.
Chapter
Prevalence of poor dietary habits is a significant contributor to various health issues. Bad eating choices are ingrained in the intuitive and impulsive mode of thinking (System 1) and efforts to promote health information primarily target the analytical mode of thinking (System 2). How can healthy dietary habits consumption decisions be taken so that the same decisions are made when system 1 kicks in? Studies show that when behavior is habitual it occurs automatically and persists irrespective of the achievement of the goal. This chapter therefore advocates an approach to facilitate change of habit through the cue response mechanism. Various factors that influence habit formation - attitude, strength of motivation to form new habit, inhibitory control, reward salience, strength of conditioned responses (i.e. old habitual behavior) and influence of surroundings and peers are taken into consideration and strategies drawn leading to longevity of the habit formed. This provides a promising avenue for developing interventions to form healthy eating habits.
Preprint
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Background The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG. Methods A previous habit-based intervention ‘Ten Top Tips for a Healthy Weight’ (10TT) was adapted and made suitable for pregnancy in line with the Medical Research Council’s (MRC) complex intervention development guidelines. It involved three key activities: 1) identifying the evidence base; 2) identifying appropriate theory; and, 3) modelling processes. A core element was integrating lived experience via personal and public involvement (PPI). Results The original 10TTs were adapted with PPI in line with current advice on nutrition and physical activity in pregnancy. New intervention materials were devised, including a leaflet and a logbook and app for self-monitoring to be delivered alongside a brief 1:1 conversation. Behaviour change techniques (BCTs) included in the new materials were coded using a number of behavioural taxonomies. An E-learning resource was created to help standardise the approach to delivery of the intervention and avoid stigmatising conversations. Conclusion Following MRC guidance for the development of complex interventions alongside significant PPI allowed for the successful adaption of 10TT habit-based weight management intervention into the ‘Healthy Habits in Pregnancy and Beyond’ (HHIPBe) intervention. The feasibility and acceptability of implementing this intervention in the antenatal setting will be explored in a feasibility randomised controlled trial. Trial Registration This study was registered on Clinical Trials as ‘Healthy Habits in Pregnancy and Beyond (HHIPBe)’ ClinicalTrials.gov Identifier: NCT04336878. The study was registered on 07/04/2020.
Article
Active travel can contribute to multiple health benefits in youth. Previous research has identified several factors influencing travel behavior. This study investigates how adolescents process these factors during their decision-making process on travel mode choice. Semi-structured interviews were conducted with 13 adolescents (11–14 years) and analysed using deductive–inductive thematic analysis. Four themes were generated from which the decision-making process on mode choice was conceptualized according to adolescents. The step-by-step process in which travel mode options were gradually reduced, was dependent on the context (Theme 1), the perceived availability of travel mode choice options, which was influenced by factors beyond the individual’s perceived control (Theme 2), and on adolescents’ pros/cons assessment to identify the most convenient option. Adolescents’ habitually used travel mode influenced the decision at several stages throughout the process (Theme 4). To promote healthy travel behaviors, interventions should consider contextual circumstances, balance between enabling autonomous choices and promoting advantages of active travel modes, address individual travel modes and include practices that foster conscious processing of decision-making.
Article
Background Persons with primary biliary cholangitis (PBC) experience significantly higher rates of mental distress and impaired health related quality of life (HrQoL) than the general population. Given limited evidence, but a high need, our primary aim was to assess feasibility and acceptability of a 12-week, online, mind–body wellness program in people with PBC. Methods This was a single-group, sequential mixed-methods, pre-post feasibility, and acceptability study. Core program components included follow-along movement, meditation and breathwork videos, and cognitive behavioural therapy informed activities. This was supplemented by weekly phone check-ins. Feasibility was assessed by recruitment, adherence, and retention. The pre-post exploratory efficacy assessment included surveys for fatigue, perceived stress, anxiety, depression, HrQoL, and resilience. A qualitative descriptive approach with semi-structured interviews evaluated study experiences. Results Thirty-two participants were recruited within 30 days and 29 (91%) were retained to end-of-study. Of these, 25 (86%) adhered to carrying out the mind–body practice at least 2–3 days per week. Feedback supported acceptability (satisfaction score 90%). Significant improvements were observed in fatigue (13%, p = 0.004), anxiety (30%, p = 0.005), depression (28%, p = 0.004), and five PBC-40 domains (itch, fatigue, cognitive, emotional, general symptoms). Qualitative interviews revealed improved stress management, better coping, and a more positive mindset. Fatigue and self-sabotaging thoughts were cited as barriers to participation. Conclusions These findings suggest that a 12-week online mind–body intervention is feasible and acceptable in patients with PBC. After iterative refinement, a randomized controlled trial will be designed using this feedback.
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Evidence shows that people with strong physical activity habits tend to engage in more physical activity than those with weaker habits, but little is known about how habit influences specific types of physical activity. This study aimed to test whether mean level of habit strength and magnitude of the habit strength – behaviour association differed as a function of physical activity modality. Participants (N = 120; M age = 25 years, 75% female) who reported engaging in organised sport separately reported their habit strength for organised sport and leisure time physical activity as well as the time they spent engaging in these physical activity behaviours. Means comparisons and multilevel modelling revealed that people had significantly stronger habit for organised sport than for leisure time physical activity. Crucially, no significant difference was found in the magnitude of the sport-habit and leisure-habit link. Post-hoc analyses revealed that habit was stronger for team sport compared to individual sport, but that there was no significant difference in sport-habit association between team and individual sports. Research should therefore focus on identifying the characteristics of team sports-based activity that are particularly conducive to habit formation as a precursor to developing interventions to promote performance of leisure time activity in a way that would attain such characteristics.
Chapter
The external environment in which people are trying to change behavior can include many things, all of which can impact their ability to change. Rather than going through each and every possible factor, in Chaps. 9, 10, and 11 we are going to look at three approaches to creating a supportive environment for change. And the first of these is the structure created by the science of how to build, break and change habits.
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Background: Chronic (ie, long-term) elevated stress is associated with a number of mental and physical health conditions. Mindfulness meditation mobile apps are a promising tool for stress self-management that can overcome several barriers associated with in-person interventions; however, to date, poor app-based intervention adherence has limited the efficacy of these mobile health tools. Anchoring, or pairing, a new behavior with an existing routine has been shown to effectively establish habits that are maintained over time, but this strategy typically only works for those with high initial motivation and has yet to be tested for maintaining meditation with a mobile app. Objective: This study will test novel combinations of behavioral economics-based incentives with the anchoring strategy for establishing and maintaining adherence to an effective dose of meditation with a mobile app. Methods: This 16-week study will use a 5-arm, parallel, partially blinded (participants only), randomized controlled design. We will implement a fractional factorial study design that varies the use of self-monitoring messages and financial incentives to support participants' use of their personalized anchoring strategy for maintaining adherence to a ≥10 minute-per-day meditation prescription during an 8-week intervention period, followed by an 8-week postintervention observation period. Specifically, we will vary the use of self-monitoring messages of either the target behavior (ie, meditation tracking) or the outcome associated with the target behavior (ie, mood symptom tracking). We will also vary the use of financial incentives conditional on either meditation at any time of day or meditation performed at approximately the same time of day as participants' personalized anchors. Results: Continuous meditation app use data will be used to measure weekly meditation adherence over the 16-week study period as a binary variable equal to 1 if participants complete ≥10 minutes of meditation for ≥4 days per week and 0 otherwise. We will measure weekly anchoring plan adherence as a binary variable equal to 1 if participants complete ≥10 minutes of meditation within +1 or -1 hour of the timing of their chosen anchor on ≥4 days per week and 0 otherwise. In addition to these primary measures of meditation and anchoring plan adherence, we will also assess the secondary measures of stress, anxiety, posttraumatic stress disorder, sleep disturbance, and meditation app habit strength at baseline, week 8, and week 16. Conclusions: This study will fill an important gap in the mobile health literature by testing novel intervention approaches for establishing and maintaining adherence to app-based mindfulness meditation. If successful, this study will identify an accessible and scalable stress self-management intervention that can help combat stress in the United States. Trial registration: ClinicalTrials.gov NCT05217602; https://clinicaltrials.gov/ct2/show/NCT05217602. International registered report identifier (irrid): DERR1-10.2196/39930.
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Handwashing with soap (HWWS) has been estimated to have the potential to prevent 35% of the 704,880 deaths per year caused by diarrhoeal infectious diseases (UN Millennium Project, 2018), its wider risk reduction influence subsequently accentuated in times of COVID-19. However, this depends on place specific risk communication that leads to behaviour change, particularly amongst children in economically poor neighbourhoods. A study centred on five schools in the informal settlement of Kawangware, Nairobi found that puppetry, shadow shows and school model making produced effective risk communication and engagement spaces. Increased HWWS occurred when children designed, owned, and were able to apply risk communication.
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This study investigates a popular theory of tourist motivation – the travel career pattern – and contrasts it against an alternative explanation – that childhood travel habits repeat throughout life. The key distinction is that the travel career pattern predicts change, whereas habit predicts repetition. This study tests competing hypotheses, using self-reported childhood and adulthood travel experiences, behaviours and motivations. Results point to childhood travel behaviour repeating as adult travel behaviour, supporting the key role of habit as a driver of travel behaviour. These findings represent a paradigm shift in our theoretical understanding of determinants of travel behaviour, which implies that habits could be used as leverage points for behavioural change in tourism.
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This textbook offers an excellent introduction to the variety of research methods used within the fields of clinical and health psychology. The book provides a detailed, yet concise, explanation of both qualitative and quantitative approaches and draws upon case-study examples to illustrate how these can be used in a variety of health-care settings, with special relevance to clinical disorders, disease prevention and health promotion. Research Methods for Clinical and Health Psychology fulfils the demand for a textbook explaining how qualitative and quantitative methods can be used explicitly in a health psychology context. It will be invaluable reading for clinical and health psychology students, trainees and practitioners, as well as those in nursing, medical and other healthcare departments taking an advanced psychology option.
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Health-compromising behaviors such as physical inactivity and poor dietary habits are difficult to change. Most social-cognitive theories assume that an individual's intention to change is the best direct predictor of actual change. But people often do not behave in accordance with their intentions. This discrepancy between intention and behavior is due to several reasons. For example, unforeseen barriers could emerge, or people might give in to temptations. Therefore, intention needs to be supplemented by other, more proximal factors that might compromise or facilitate the translation of intentions into action. Some of these postintentional factors have been identified, such as perceived self-efficacy and strategic planning. They help to bridge the intention-behavior gap. The Health Action Process Approach (HAPA) suggests a distinction between (a) preintentional motivation processes that lead to a behavioral intention, and (b) postintentional volition processes that lead to the actual health behavior. In this article, seven studies are reported that examine the role of volitional mediators in the initiation and adherence to five health behaviors: physical exercise, breast self-examination, seat belt use, dietary behaviors, and dental flossing. The general aim is to examine the applicability of the HAPA and its universality by replicating it across different health behaviors, based on various measures, time spans, and samples from different countries.
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We argue that habit is a psychological construct, rather than simply past behavioral frequency. In 4 studies, a 12-item index of habit strength (the Self-Report Habit Index, SRHI) was developed on the basis of features of habit; that is, a history of repetition, automaticity (lack of control and awareness, efficiency), and expressing identity. High internal and test-retest reliabilities were found. The SRHI correlated strongly with past behavioral frequency and the response frequency measure of habit (Verplanken, Aarts, van Knippenberg, & van Knippenberg, 1994). The index discriminated between behaviors varying in frequency, and also between daily vs. weekly habits. The SRHI may be useful as a dependent variable, or to determine or monitor habit strength without measuring behavioral frequency.
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The habit discontinuity hypothesis states that when a context change disrupts individuals’ habits, a window opens in which behavior is more likely to be deliberately considered. The self-activation hypothesis states that when values incorporated in the self-concept are activated, these are more likely to guide behavior. Combining these two hypotheses, it was predicted that context change enhances the likelihood that important values are considered and guide behavior. This prediction was tested in the domain of travel mode choices among university employees who had recently moved versus had not recently moved residence. As was anticipated, participants who had recently moved and were environmentally concerned used the car less frequently for commuting to work. This was found not only when compared to those who were low on environmental concern (which would be a trivial finding), but also to those who were environmentally concerned but had not recently moved. The effects were controlled for a range of background variables. The results support the notion that context change can activate important values that guide the process of negotiating sustainable behaviors.
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Intervention strategies for promoting long-term weight loss are examined empirically and conceptually. Weight control research over the last 20 years has dramatically improved short-term treatment efficacy but has been less successful in improving long-term success. Interventions in preadolescent children show greater long-term efficacy than in adults. Extending treatment length and putting more emphasis on energy expenditure have modestly improved long-term weight loss in adults. Fresh ideas are needed to push the field forward. Suggested research priorities are patient retention, natural history, assessment of intake and expenditure, obesity phenotypes, adolescence at a critical period, behavioral preference-reinforcement value, physical activity and social support, better linkage of new conceptual models to behavioral treatments, and the interface between pharmacological and behavioral methods.
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Several theoretical views of automaticity are discussed. Most of these suggest that automaticity should be diagnosed by looking at the presence of features such as unintentional, uncontrolled/uncontrollable, goal independent, autonomous, purely stimulus driven, unconscious, efficient, and fast. Contemporary views further suggest that these features should be investigated separately. The authors examine whether features of automaticity can be disentangled on a conceptual level, because only then is the separate investigation of them worth the effort. They conclude that the conceptual analysis of features is to a large extent feasible. Not all researchers agree with this position, however. The authors show that assumptions of overlap among features are determined by the other researchers' views of automaticity and by the models they endorse for information processing in general.
Thesis
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 consistent contexts (Context Dependent Repetition CDR), but the process itself has attracted little research attention, and it has never been used as a basis for interventions. This thesis used CDR as the basis of a weight loss intervention and also examined the process of habit development for diet and activity behaviours. Study 1 was an eight week pilot study with ten participants who were given simple advice on developing diet and exercise habits associated with weight loss. Post-intervention interviews found evidence that some behaviours had acquired 'automaticity' - the hallmark of habits - and weight data showed an average 3kg weight loss. Study 2 extended the evaluation of the intervention in a randomised controlled trial of the habit-based advice compared with a no-treatment control group, incorporating standardised measures of automaticity. The results showed significantly greater weight loss in the intervention group, which was maintained over follow up. The recommended behaviours also became increasingly automatic. Study 3 tracked changes in automaticity over three months as volunteers repeated one eating or activity behaviour in a consistent context on a daily basis. The results showed that advice on CDR is sufficient to promote habit formation and supported the prediction that an asymptotic curve of increasing automaticity reflects a generalised habit-formation process. The average length of time to reach an asymptote was 70 days. This research has contributed to the understanding of habit formation and shown that it may be a useful foundation for simple, easily disseminable, weight loss interventions.
Book
While there are many books on retrospective memory, or remembering past events, Prospective Memory: An Overview and Synthesis of an Emerging Field is the first authored text to provide a straightforward and integrated foundation to the scientific study of memory for actions to be performed in the future. Authors Mark A. McDaniel and Gilles O. Einstein present an accessible overview and synthesis of the theoretical and empirical work in this emerging field.
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Interventions to change everyday behaviors often attempt to change people’s beliefs and intentions. As the authors explain, these interventions are unlikely to be an effective means to change behaviors that people have repeated into habits. Successful habit change interventions involve disrupting the environmental factors that automatically cue habit performance. The authors propose two potential habit change interventions. “Downstream-plus” interventions provide informational input at points when habits are vulnerable to change, such as when people are undergoing naturally occurring changes in performance environments for many everyday actions (e.g., moving households, changing jobs). “Upstream” interventions occur before habit performance and disrupt old environmental cues and establish new ones. Policy interventions can be oriented not only to the change of established habits but also to the acquisition and maintenance of new behaviors through the formation of new habits.
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Habits are response dispositions that are activated automatically by the context cues that co-occurred with responses during past performance. Experience-sampling diary studies indicate that much of everyday action is characterized by habitual repetition. We consider various mechanisms that could underlie the habitual control of action, and we conclude that direct cuing and motivated contexts best account for the characteristic features of habit responding—in particular, for the rigid repetition of action that can be initiated without intention and that runs to completion with minimal conscious control. We explain the utility of contemporary habit research for issues central to psychology, especially for behavior prediction, behavior change, and self-regulation.
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Prospective memory situations involve forming intentions and then realizing those intentions at some appropriate time in the future. An interesting feature of most prospective remembering is that recollection of the intended action occurs without an explicit request to attempt retrieval, and we present two views on how this type of remembering can be accomplished. One could strategically monitor the environment for the presence of the target event, or one could rely on anticipated environmental conditions more or less automatically reinstating the intended action. We present data supporting both views and argue that people use multiple approaches for solving the problem of retrieving an intention (prospective memory) after a delay. Moreover, we suggest that the extent to which prospective remembering is supported by relatively automatic processes (versus strategic resource-demanding monitoring) and the probability with which prospective memory is likely to be successful when relying on automatic processes varies as a function of the characteristics of the prospective memory task, target cue, ongoing task, and individual. We argue that the complexity of the empirical findings can best be understood by appealing to this multiprocess view of prospective memory. Copyright © 2000 John Wiley & Sons, Ltd.
Article
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 participants provided sufficient data for analysis, and increases in automaticity (calculated with a sub-set of SRHI items) were examined over the study period. Nonlinear regressions fitted an asymptotic curve to each individual's automaticity scores over the 84 days. The model fitted for 62 individuals, of whom 39 showed a good fit. Performing the behaviour more consistently was associated with better model fit. The time it took participants to reach 95% of their asymptote of automaticity ranged from 18 to 254 days; indicating considerable variation in how long it takes people to reach their limit of automaticity and highlighting that it can take a very long time. Missing one opportunity to perform the behaviour did not materially affect the habit formation process. With repetition of a behaviour in a consistent context, automaticity increases following an asymptotic curve which can be modelled at the individual level.
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Purpose and Methods This paper examines the social cognitive processes that regulate people's eating behavior. Specifically, we examine how eating behavior can be regulated by reflective, deliberative processes as well as automatic and habitual processes. Moreover, we consider how these processes operate when people are not only initiating a change in behavior but also maintaining the behavior over time. Results and Discussion Decomposing action control and behavior change into a 2 (reflective, automatic) × 2 (initiation, maintenance) matrix offers a useful way of conceptualizing the various determinants of eating behavior and suggests that different intervention strategies will be needed to target particular processes during respective phases of behavior change. The matrix also helps to identify key areas of intervention development that deserve attention.
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Intervention strategies that can produce successful rates of long-term behavior change have proven elusive and indicate the need for new approaches to this vexing problem. However, the development of new intervention strategies is constrained by our current conceptualization of behavioral maintenance. This article reviews how the dominant models of health behavior change have operationalized the psychological processes that guide the initiation and maintenance of a new pattern of behavior. In light of this review, an alternative framework is proposed based on the premise that the decision criteria that lead people to initiate a change in their behavior are different from those that lead them to maintain that behavior. Decisions regarding behavioral initiation are predicted to depend on favorable expectations regarding future outcomes, whereas decisions regarding behavioral maintenance are predicted to depend on perceived satisfaction with received outcomes. The implications of this framework for behavioral interventions are addressed.
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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. Intervention participants were followed up for 8 months. A total of 104 adults (35 men, 69 women) with an average BMI of 30.9 kg m(-2). Intervention participants were given a leaflet containing advice on habit formation and simple recommendations for eating and activity behaviours promoting negative energy balance, together with a self-monitoring checklist. Weight change over 8 weeks in the intervention condition compared with the control condition and weight loss maintenance over 32 weeks in the intervention condition. At 8 weeks, people in the intervention condition had lost significantly more weight (mean=2.0 kg) than those in the control condition (0.4 kg), with no difference between weekly and monthly weighing subgroups. At 32 weeks, those who remained in the study had lost an average of 3.8 kg, with 54% losing 5% or more of their body weight. An intention-to-treat analysis (based on last-observation-carried-forward) reduced this to 2.6 kg, with 26% achieving a 5% weight loss. This easily disseminable, low-cost, simple intervention produced clinically significant weight loss. In limited resource settings it has potential as a tool for obesity management.