examining the evidence of successful interventions based ... · 1. keep to your meal routine (helps...
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Leeds Institute of
Health Sciences
Examining the evidence of successful
interventions based on habit theory
Rebecca Beeken, PhD
Yorkshire Cancer Research
University Academic Fellow
Habits
Habit development
• Habits are (relatively)
automatically triggered
actions
• Formed through
repetition in a consistent
context = ↑ automaticity
• Can be used to help
individuals ‘learn’ healthy
lifestyle behaviours
Lally et al, Eur J Soc Psychol, 2009
66 days
(18-254 days)
Habit-based interventions
• Require less engagement or motivation
• Less time-consuming to explain
• Easier to implement
• Promotes long-term maintenance
Ten Top Tips
• Leaflet based on habit theory
• Info about what habits are
and how to form (incl
planning and monitoring)
• Monitoring charts
• Info re self-weighing
http://www.weightconcern.org.uk/node/11
Ten Top Tips
1. Keep to your meal routine (helps develop habits)
2. Focus on your food (helps to avoid slips)
3. Look at the labels (helps lower calorie choices)
4. Go reduced fat (-200 kcal)
5. Walk off the weight (-100 to 200 kcal)
6. Pack a healthy snack (-100 kcal)
7. Caution with your portions (-100 kcal)
8. Up on your feet (-100 kcal)
9. Think about your drinks (-150 kcal)
10. Don’t forget your 5 a day (-50 Kcal)
Total calorie deficit = 800-900 kcal
Small-scale study in a volunteer population (Lally et al, 2008)
Design
A two-arm, individually-randomised, controlled trial in adults with obesity in primary
care (n=537), comparing weight loss in patients receiving a simple weight control
intervention based on habit formation theory (10TT) vs. ‘usual care’
Primary Outcome
Change in body weight over 3 months
Ten Top Tips
Subgroup analyses
• No difference in intervention effect
for gender, age and baseline BMI
• The intervention appears more
effective for least deprived
participants (effect of the
intervention increasing -0.035kg
for each increase in deprivation
centile, 95%CI=[-0.06,-0.01],
p=0.007).
Ten Top Tips in Australia
Cleo G. et al. 2018; International Journal of Obesity
Mean weight
loss = 5.7kg
67% ≥5%
Design
A two-arm, cluster-randomised, controlled trial in parents of children aged 2–6 y (n =
126) from 6 children’s centres in London, comparing feeding behaviours in parents
receiving training on habit formation for 3 feeding behaviours vs. a no treatment
control
Primary Outcome
Parental habit strength for each behaviour
University College London
Poppets Healthy Habits! Poppets Healthy Habits!
University College London
Poppets Healthy Habits! Poppets Healthy Habits!
University College London
Poppets Healthy Habits!
• Behaviours
targeted:
• Fruit and veg
• Healthy snacks
• Healthy drinks
Adjusted post-intervention mean (±SD) parental automaticity scores
for the 3 targeted feeding behaviors
McGowan et al. Am J
Clin Nutr 2013;98:769-
777
Adjusted post-intervention mean (±SD) food intakes of children in the control and
intervention groups.
Laura McGowan et al. Am J Clin Nutr 2013;98:769-777
Evidence of successful interventions
based on habit theory?
• Some evidence of success
– Number of benefits
– Modest changes
– Not for everyone?
– Long-term maintenance?
• Promoting engagement?
– Digital formats?
– Role of healthcare professionals
– Support/ accountability
– Delivery at the population level?
• Habit breaking?
Acknowledgments
• All our participants and collaborators
• Dr Helen Croker
• Dr Pippa Lally
• Dr Laura McGowan
• Dr Nathalie Kliemann
• Dr Abi Fisher
• Dr Gina Cleo
• Professor Jane Wardle
(1960-2015)
Leeds Institute of
Health Sciences
Questions?
Thank you for listening
@DrBeccaBeeken