"I know it's just pouring it from the tap, but it's not easy": Motivational processes that underlie water drinking

Representational shifts: increasing motivation for bottled water through simulation-enhancing advertisements

BACKGROUND

Despite its numerous health benefits, consumers' daily water consumption is below recommend levels while soft drink consumption remains high. Previous research has shown that the degree to which drinks are cognitively represented in terms of consumption and enjoyment (i.e., through simulations of consumption and reward) predicts desire and intake. Here, we examined whether simulation-enhancing advertisements that frame water in terms of consumption and reward change cognitive representations and increase motivation for a fictitious bottled water.

METHODS

In three pre-registered online experiments (Nexp1 = 984; Nexp2 = 786; Nexp3 = 907), UK participants viewed three advertisements that either highlighted the rewarding consumption experience of water (e.g., "Refresh all your senses with this smooth, cool water"; simulation-enhancing ads), the health consequences of drinking water (e.g., "This water takes care of your health"; health-focused ads), or control ads. We assessed cognitive representations of the bottled water with a semantic feature production task, and we coded the words used as consumption and reward features or positive long-term health consequences features. We assessed motivation through ratings of the attractiveness of the water (Exp. 1 only), desire to drink it, and willingness to pay for it (WTP).

RESULTS

In line with our hypotheses, participants represented the bottled water more in terms of consumption and reward after viewing simulation-enhancing advertisements, and more in terms of positive long-term health consequences after viewing health-focused advertisements. There was no direct effect of advertisement condition on motivation ratings. However, significant indirect effects showed that simulation-enhancing advertisements increased desire and WTP through the proportion of consumption and reward features, whereas health-focused advertisements increased motivation through an increase in the proportion of positive long-term health consequences features. The effects through consumption and reward were stronger.

CONCLUSIONS

These findings are consistent with research suggesting that the experience of immediate reward from drinking water underlies intake. Public health interventions should emphasize the enjoyment of drinking water, rather than the long-term health benefits.

Increased consumption despite fewer occasions: A longitudinal analysis of COVID-19 lockdown effects on soft drink consumption in England

We examined the impact of a COVID-19 lockdown in England on the frequency of consumption occasions and amount of soft drinks consumed. Beverage consumption is strongly associated with specific, often social, consumption situations (e.g., going out). We reasoned that lockdown would affect consumption behaviour because it removed typical soft drink consumption situations. Specifically, we hypothesised that soft drink consumption occasions and amount would be reduced during lockdown compared to before and after lockdown, especially in typical soft drink consumption situations. In two surveys (Dec. 2020 and May 2021) among the same participants (N = 211, N = 160; consuming soft drinks at least once/week), we assessed the frequency of soft drink and water consumption occasions before, during, and after the Nov./Dec. 2020 lockdown, across typical soft drink and water drinking situations. This presents a detailed picture of the situations in which participants drink soft drinks and water, and how this was affected by a lockdown. We also assessed the daily amount of soft drinks and water consumed in each period, and perceived habitualness of drinking soft drinks and water. As predicted, participants reported fewer occasions of drinking soft drinks during lockdown compared to before and after, especially in typical soft drink consumption situations. Unexpectedly, however, the daily amount of soft drinks consumed increased during lockdown, compared to before and after, especially among participants with stronger perceived habitualness of soft drink consumption. Exploratory analyses suggest that during lockdown, participants increased their soft drink consumption at home. Water consumption, on the other hand, was not systematically affected by the lockdown. These findings suggest that even if some typical consumption situations disappear, consumption may be hard to disrupt if the behaviour is rewarding.

Developing habit-based health behaviour change interventions: twenty-one questions to guide future research

OBJECTIVE

Habitual behaviours are triggered automatically, with little conscious forethought. Theory suggests that making healthy behaviours habitual, and breaking the habits that underpin many ingrained unhealthy behaviours, promotes long-term behaviour change. This has prompted interest in incorporating habit formation and disruption strategies into behaviour change interventions. Yet, notable research gaps limit understanding of how to harness habit to change real-world behaviours.

METHODS

Discussions among health psychology researchers and practitioners, at the 2019 European Health Psychology Society 'Synergy Expert Meeting', generated pertinent questions to guide further research into habit and health behaviour.

RESULTS

In line with the four topics discussed at the meeting, 21 questions were identified, concerning: how habit manifests in health behaviour (3 questions); how to form healthy habits (5 questions); how to break unhealthy habits (4 questions); and how to develop and evaluate habit-based behaviour change interventions (9 questions).

CONCLUSIONS

While our questions transcend research contexts, accumulating knowledge across studies of specific health behaviours, settings, and populations will build a broader understanding of habit change principles and how they may be embedded into interventions. We encourage researchers and practitioners to prioritise these questions, to further theory and evidence around how to create long-lasting health behaviour change.

Can a simple plan change a complex behavior? Implementation intentions in the context of water drinking

Underhydration has significant adverse physical and mental health effects, yet many people drink too little water. Implementation intentions have been found to effectively promote many health behaviors, but little is known about the processes underlying their effects in naturalistic settings, and whether they could improve water drinking. This mixed-methods study assessed the impact and potential underlying processes of using implementation intentions to increase self-reported water intake over a five-day follow-up. Ninety-five participants (Mage = 39, SD = 12) received an educational quiz to increase their water drinking motivation before being randomly assigned to the control or intervention group. Participants also completed a qualitative survey that assessed the processes underlying their attempts to increase water intake. Quantitative results suggested that most participants increased their average daily water intake regardless of group. Qualitative results indicated that implementation intention participants struggled with remembering and the perceived effort of preparation and drinking behaviors, which reduced the effect of planning on behavior. This study provides essential theoretical and methodological considerations for researchers studying implementation intentions, as the effects and mechanisms of implementation intentions in real-life situations may be more complex than previously assumed. For example, the results suggest that implementation intentions did not automatize remembering and performing the behavior in ways the current literature theorizes. Other kinds of interventions may be needed to improve the complex daily-life behaviour of water drinking.

Drinking water behavior and willingness to use filters by middle-aged and elderly residents in rural areas: A cross-sectional study in Tengchong, China

Access to safe drinking water is critical to health and development issues, and residents' drinking behavior reflects their awareness of health and water hygiene. Random sampling and face-to-face questionnaires were used to investigate the drinking water behavior, sanitation and perceptions of drinking water among middle-aged and elderly residents in Tengchong, southwest Yunnan from July 1 to July 28, 2021. Differences between groups were assessed using the Chi-square test and t-test. Two binary logistic regression analyses were conducted to explore the influencing factors of drinking unboiled tap water and willingness to use filters. Results show that 35% of residents drink unboiled tap water, and 29.8% of respondents indicated a willingness to use filters. The model results showed a strong correlation between 60 and 79 years old (OR: 0.510, 95% CI: 0.303-0.858), 80 and above years old (OR: 0.118, 95% CI: 0.038-0.365), drinking water at a regular interval (OR: 0.397, 95% CI: 0.257-0.612), wanting to gain knowledge about drinking water (OR: 0.198, 95% CI: 0.099-0.395), Perceived health risks (PHR) (OR: 0.847, 95% CI: 0.771-0.929), having kidney stones (OR: 2.975, 95% CI: 1.708-5.253) and drinking unboiled tap water (p < 0.05). 60-79 years old (OR: 0.446, 95% CI: 0.244-0.815), 80 and above years old (OR: 0.228, 95% CI: 0.064-0.812), water storage (OR: 0.088, 95% CI: 0.026-0.300), middle school and above (OR: 2.238, 95% CI: 1.289-3.883), household water treatment (HWT) (OR: 33.704, 95% CI: 9.726-116.791), Perceived health risks (PHR) (OR:1.106, 95% CI: 1.009-1.213), water authority satisfaction (WAT) (OR:0.857, 95% CI: 0.769-0.956) and willingness to use filters were correlated (p < 0.05). Our findings suggested that a certain proportion of permanent middle-aged and elderly residents in rural areas still drink unboiled tap water, and residents are less willing to use filters. Residents' perception of drinking water can reflect residents' drinking water behavior and willingness to a certain extent. It is recommended that the government and Centers for Disease Control (CDC) should strengthen relevant measures such as knowledge popularization and health education, and regulate the water use behavior of middle-aged and elderly residents. Promote safe, economical and effective household water filtration facilities to ensure public health safety.

Current Hydration Habits: The Disregarded Factor for the Development of Renal and Cardiometabolic Diseases

Improper hydration habits are commonly disregarded as a risk factor for the development of chronic diseases. Consuming an intake of water below recommendations (underhydration) in addition to the substitution of sugar-sweetened beverages (SSB) for water are habits deeply ingrained in several countries. This behavior is due to voluntary and involuntary dehydration; and because young children are exposed to SSB, the preference for a sweet taste is profoundly implanted in the brain. Underhydration and SSB intake lead to mild hyperosmolarity, which stimulates biologic processes, such as the stimulation of vasopressin and the polyol-fructose pathway, which restore osmolarity to normal but at the expense of the continued activation of these biological systems. Unfortunately, chronic activation of the vasopressin and polyol-fructose pathways has been shown to mediate many diseases, such as obesity, diabetes, metabolic syndrome, chronic kidney disease, and cardiovascular disease. It is therefore urgent that we encourage educational and promotional campaigns that promote the evaluation of personal hydration status, a greater intake of potable water, and a reduction or complete halting of the drinking of SSB.