Examining the evidence of successful interventions based ... · 1. Keep to your meal routine (helps develop habits) 2. Focus on your food (helps to avoid slips) 3. Look at the labels

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

[email protected]

@DrBeccaBeeken