Habit formation and change

We meat again: a field study on the moderating role of location-specific consumer preferences in nudging vegetarian options

This field study set out to test whether consumers' history of making decisions in a particular choice context moderated the effectiveness of a nudge intervention to reduce meat consumption. In a Danish hospital canteen that served both staff members and visitors, a combination of nudges (Chef's recommendation sticker + prominent positioning) was implemented to promote vegetarian sandwiches. The sales of these sandwiches increased from 16.45% during the baseline period to 25.16% during the nudge intervention period. Most notably, this increase was caused by the visitors, who had weak location-bound preferences. Hospital staff members (who had strong location-bound preferences) were unaffected by the nudge in their choice. This is an important finding because the two consumer groups did not differ on their person-bound preferences for meat. It seems that behaviour change is best predicted by location-bound preferences, whereas the behaviour itself is best predicted by person-bound preferences. These findings can help organizations in estimating whether a nudge intervention has enough potential for behaviour change, or whether more directive policies are required.

Less smartphone and more physical activity for a better work satisfaction, motivation, work-life balance, and mental health: An experimental intervention study

Employees' work satisfaction and mental health are crucial for an organization's productivity. The current experimental study on employees (Ntotal = 278) from different professional sectors and workplaces in Germany investigated how to improve both by changes of daily non-work-related smartphone use time and physical activity time. For one week, the smartphone group (N = 73) reduced its daily smartphone use by one hour, the physical activity group (N = 69) increased its daily physical activity by 30 minutes, the combination group (N = 72) followed both interventions, the control group (N = 64) did not change its behavior. Online surveys assessed work-related and mental health-related variables at three measurement time points (baseline; post-intervention; two-week follow-up). The reduction of smartphone use time and the combination of both interventions increased work satisfaction, work motivation, work-life balance, and positive mental health significantly; experience of work overload and problematic smartphone use significantly decreased. All interventions decreased depressive symptoms and enhanced sense of control significantly. Following the present findings, a conscious and controlled reduction of non-work-related smartphone use time and its combination with more physical activity could improve employees' work satisfaction and mental health in the organizational context either as an addition to established training programs or as a separate time- and cost-efficient low threshold program.

Compulsive rituals in Obsessive-Compulsive Disorder - A qualitative exploration of thoughts, feelings and behavioral patterns

BACKGROUND AND OBJECTIVES

Rituals are common among healthy individuals and across cultures and often serve adaptive purposes. In individuals with obsessive-compulsive disorder (OCD), rituals become compulsive, time-consuming and distressing, and may lead to functional impairment. Previous research has examined the functions and characteristics of compulsive rituals, but there is paucity of in-depth, first-person reports about this topic.

METHOD

We used a qualitative approach to explore thoughts, feelings, and behavioral patterns that characterize OCD rituals. Ten individuals with OCD participated in a semi-structured interview that focused on their most prominent compulsive ritual. The interviews were subjected to a thematic analysis.

RESULTS

Eight themes emerged from the analysis and were organized in two main categories: Micro Level perspective, comprising triggers, attention, emotional changes, and stopping criteria; and Macro Level perspective, comprising feelings and perceptions, change over time, motives, and inhibitors. The findings shed light on the role of fixed rules and feelings of "completeness" in OCD rituals, the nature of emotional and attentional characteristics during rituals performance, and the evolution of compulsive rituals over time.

LIMITATIONS

This study used a qualitative approach based on a small number of participants, which limits the generalizability of the findings.

CONCLUSION

Our results, if replicated, may have clinical implications. The reported patterns of anxiety reduction during ritual performance may contribute to the fine-tuning of CBT for OCD. The findings concerning the nature of attention during ritual performance and the development of rituals over time may be important for understanding the mechanisms that maintain compulsive rituals.

Decision-making under stress: A psychological and neurobiological integrative model

Understanding the impact of stress on cognitive processes, particularly decision-making, is crucial as it underpins behaviors essential for survival. However, research in this domain has yielded disparate results, with inconsistencies evident across stress-induction paradigms and drug administration protocols designed to investigate specific stress pathways or neuromodulators. Building upon empirical studies, this research identifies a multifaceted matrix of variables contributing to the divergent findings. This matrix encompasses factors such as the temporal proximity between stressors and decision tasks, the nature of stressors and decision contexts, individual characteristics including psychobiological profiles and affective states at the time of decision-making and even cultural influences. In response to these complexities, we propose a comprehensive model that integrates these relevant factors and their intricate interplay to elucidate the mechanisms governing decision-making during stressful events. By synthesizing these insights, our model not only refines existing paradigms but also provides a framework for future study designs, offering avenues for theoretical advancements and translational developments in the field of stress's impact on cognitive functions. This research contributes to a deeper understanding of the nuanced relationship between stress and decision-making, ultimately advancing our knowledge of cognitive processes under challenging conditions.

The Specification of a Computational Model of Physical Activity Habit

The influence of habit on physical activity is computationally modeled as the aggregated influence of past behavioral choices a person makes in a given context. We hypothesize that the influence of habit on behavior can be enhanced through engagement of the target behavior in a particular context or weakened through engagement of alternative behaviors in that context.

What Happens When Payments End? Fostering Long-Term Behavior Change With Financial Incentives

Financial incentives are widely used to get people to adopt desirable behaviors. Many small landholders in developing countries, for example, receive multiyear payments to engage in conservation behaviors, and the hope is that they will continue to engage in these behaviors after the program ends. Although effective in the short term, financial incentives rarely lead to long-term behavior change because program participants tend to revert to their initial behaviors soon after the payments stop. In this article, we propose that four psychological constructs can be leveraged to increase the long-term effectiveness of financial-incentive programs: motivation, habit formation, social norms, and recursive processes. We review successful and unsuccessful behavior-change initiatives involving financial incentives in several domains: public health, education, sustainability, and conservation. We make concrete recommendations on how to implement the four above-mentioned constructs in field settings. Finally, we identify unresolved issues that future research might want to address to advance knowledge, promote theory development, and understand the psychological mechanisms that can be used to improve the effectiveness of incentive programs in the real world.

A Theory of Transitions Influencing Diabetes Self-management Among Emerging Adults With Type 1 Diabetes

Emerging adults with type 1 diabetes are experiencing numerous transitions, potentially affecting diabetes self-management. For example, when transitioning to college, these emerging adults may experience changes in their daily routines and usual reminders or triggers for habitual behavior such as checking blood glucose levels. In turn, these emerging adults may omit checking glucose levels, impacting decisional and adaptational diabetes self-management behavior associated with their insulin dose or bolus. Thus, we propose a theory on transitions influencing daily routines, diabetes self-management habitual behavior triggers, and, in turn, diabetes self-management habitual and decisional/adaptational behaviors for emerging adults with type 1 diabetes.

A machine-learning assisted review of the use of habit formation in medication adherence interventions for long-term conditions

Adherence to medication in long-term conditions is around 50%. The key components of successful interventions to improve medication adherence remain unclear, particularly when examined over prolonged follow-up periods. Behaviour change theories are increasingly interested in the utility of habit formation for the maintenance of health behaviour change, but there is no documentation on how habit has been conceptualised in the medication adherence intervention literature, or what effect the key technique identified in habit formation theory (context dependent repetition) has in these studies. To examine this, a machine-learning assisted review was conducted. Searches of MEDLINE, EMBASE and PSYCInfo and the reference list of a comprehensive systematic review of medication adherence interventions yielded 5973 articles. Machine learning-assisted title and abstract screening identified 15 independent RCTs published between 1976 and 2021, including 18 intervention comparisons of interest. Key findings indicate that conceptualisations of habit in the medication adherence literature are varied and behaviour change technique coding identified only six studies which explicitly described using habit formation. Future work should aim to develop this evidence base, drawing on contemporary habit theory and with explicit demonstration of what techniques have been used to promote habit formation.

Characterizing Human Habits in the Lab

Habits pose a fundamental puzzle for those aiming to understand human behavior. They pervade our everyday lives and dominate some forms of psychopathology but are extremely hard to elicit in the lab. In this Registered Report, we developed novel experimental paradigms grounded in computational models, which suggest that habit strength should be proportional to the frequency of behavior and, in contrast to previous research, independent of value. Specifically, we manipulated how often participants performed responses in two tasks varying action repetition without, or separately from, variations in value. Moreover, we asked how this frequency-based habitization related to value-based operationalizations of habit and self-reported propensities for habitual behavior in real life. We find that choice frequency during training increases habit strength at test and that this form of habit shows little relation to value-based operationalizations of habit. Our findings empirically ground a novel perspective on the constituents of habits and suggest that habits may arise in the absence of external reinforcement. We further find no evidence for an overlap between different experimental approaches to measuring habits and no associations with self-reported real-life habits. Thus, our findings call for a rigorous reassessment of our understanding and measurement of human habitual behavior in the lab.

Investigating hope in oral health promotion for adolescents: an exploratory study based on observations at the dental clinic

Introduction

Maintaining well-being is crucial, especially in challenging conditions, considering the common public health issue of dental caries. Within the context of adolescent oral health, this research explores the techniques employed by dental professionals to potentially foster hope -a positive manner that promotes well-being- in adolescents during consultations, opening a window into the realm of patient engagement and well-being.

Materials and methods

Data were collected through observations conducted at public dental clinics in Norway, with the participation of three dental professionals and four adolescents between the ages of 12 and 15 years. The data were analyzed using thematic analysis. Practices were observed from dental professionals in their interactions with adolescents, which align with features of hope.

Result

Three core themes were identified: (1) bonding strategies; (2) verbal and non-verbal strategies for creating positive relationships; and (3) adolescents' empowerment in dental consultations.

Conclusion

Although a new concept within oral health promotion, it seems that dental professionals in this study were observed to be facilitating hope in adolescents when they were providing their dental care. Consideration should be given to the potential for future approaches to be developed for use in dental consultations to facilitate hope strategically. While these approaches are likely to contribute to improving patient-centredness, consideration is needed of challenges and barriers to their implementation.

Can the Cans: Determinants of Container Deposit Behavior before and after Introduction of a Container Refund Scheme

OBJECTIVE

Container deposit schemes are often hailed as a useful avenue to increase consumer recycling rates. Yet, there is little research investigating within-person changes in people's beliefs and behavior following the implementation of these schemes, or tests of the mechanisms by which such change has occurred.

METHODS

The current study fills this knowledge gap and assessed container recycling behavior and habits as well as the social cognition factors of attitudes, subjective norms, perceived behavioral control, and intentions in a sample of 90 Queenslanders before the implementation of the container deposit scheme and one and three months post-implementation.

RESULTS

Analysis of variance indicated more frequent recycling behavior following the implementation of the scheme, as well as stronger habits, intentions, and perceived behavioral control.

CONCLUSIONS

Such a concomitant change in behavior, beliefs, and habits provides support for behavior change theory, while also flagging potential targets for strategies that can be paired with container deposit schemes to enhance their efficacy and uptake.

Adjusting to the COVID-19 outbreak in the United States: The impact of disruptions on habits and changes in health behaviors

The COVID-19 pandemic provides a naturalistic test of whether pandemic-related disruptions weaken habits and undermine behavior stability. We hypothesized that better capacity to effortfully guide behavior (self-regulation) would buffer this effect and be associated with behavior stability and development of new habits to accomplish daily behaviors. A cross-sectional study of 416 MTurk workers recruited in April 2020 (Mage = 34.60, SD = 11.51) indicated that pandemic-related disruptions generally exceeded people's capacity to effortfully modify their behavior. Self-regulation related to the development of new habits and to lower likelihood that work productivity decreased. Self-regulation also protected against the effect of disruption on the likelihood that substance use increased. Besides these associations, self-regulation was largely unrelated to health-related behaviors and, in some instances, associated with poorer outcomes. These findings underscore the need to appreciate the impact of contextual disruptions in interpreting and promoting change in health-related behaviors.

The Willpower Paradox: Possible and Impossible Conceptions of Self-Control

Self-control denotes the ability to override current desires to render behavior consistent with long-term goals. A key assumption is that self-control is required when short-term desires are transiently stronger (more preferred) than long-term goals and people would yield to temptation without exerting self-control. We argue that this widely shared conception of self-control raises a fundamental yet rarely discussed conceptual paradox: How is it possible that a person most strongly desires to perform a behavior (e.g., eat chocolate) and at the same time desires to recruit self-control to prevent themselves from doing it? A detailed analysis reveals that three common assumptions about self-control cannot be true simultaneously. To avoid the paradox, any coherent theory of self-control must abandon either the assumption (a) that recruitment of self-control is an intentional process, or (b) that humans are unitary agents, or (c) that self-control consists in overriding the currently strongest desire. We propose a taxonomy of different kinds of self-control processes that helps organize current theories according to which of these assumptions they abandon. We conclude by outlining unresolved questions and future research perspectives raised by different conceptions of self-control and discuss implications for the question of whether self-control can be considered rational.

Portrayal of oral hygiene and risk behaviours in animated movies

Background

Behaviours depicted in movies and TV shows can significantly affect one's behaviour. Children are particularly susceptible to these effects as their habits are still forming. Oral hygiene behaviours play a crucial role in preventing or slowing down the progression of dental diseases, which are among the most common yet preventable diseases in the world. Therefore, it is important to understand if popular movies include oral hygiene behaviours or risk-related behaviours, which can in effect influence children's behaviour.

Aim

The aim of this study is to review the top grossing animated movies of all time to record and collect on screen portrayals of oral hygiene practices and risk behaviours related to oral health.

Methodology

Top 30 highest grossing animated feature films (over 40 min duration) were coded using a structured coding instrument to capture oral hygiene and risk-related behaviours related to oral health. Two coders performed coding using the standardised instrument.

Results

Overall, 93% of behaviours were coded as a risk behaviour, with 7% coded as positive oral hygiene behaviour. Within the risk behaviour category, the majority (74%) were based around the consumption of sugar with risk behaviour occurring in 23 out of 30 movies (76%), while oral hygiene practices occurred in 6 out of 30 movies (20%); one movie depicted neither oral hygiene nor oral health risk behaviours. About 53% of behaviours were purely visual, 10% verbal, and 37% a combination of verbal and visual. Anthropomorphic characters and movie settings resulted in more behaviours related to oral health, either hygiene or mainly risk behaviours, depicted.

Conclusion

Despite their importance in shaping habits and attitudes, animated movies portrayed a significant number of risk behaviours related to oral health with depiction of beneficial behaviours remaining limited. Consideration should be given on how to best portray behaviours that promote and enhance optimal oral hygiene behaviours to achieve and sustain better oral health for children.

Nursing students' attitudes, behaviour, and knowledge toward smoking cessation: Results from a descriptive survey at a regional university

BACKGROUND

Smoking is the largest single cause of lifestyle-related preventable morbidity and mortality. Nurses form the largest cohort of health professionals and are strategically placed to implement smoking cessation interventions. However their capacity is underutilised, particularly in rural and remote areas in countries such as Australia where the incidence of smoking in is higher than average and access to healthcare is limited. One strategy to address the underutilisation of nurses in smoking cessation interventions is to include training in the university/college nursing curriculum. To effectively implement this training, it is vital to have an in-depth knowledge of student nurses' attitudes towards smoking including the role of healthcare professionals in smoking cessation, their smoking behaviour and that of their peers, and knowledge regarding smoking cessation techniques and resources.

OBJECTIVES

Investigate nursing students' attitudes, behaviour, and knowledge towards smoking cessation, determine the impact of demographics and educational experienced on these, and develop recommendations for future research and educational practice.

DESIGN

Descriptive survey.

PARTICIPANTS

Non-probability sample of undergraduate nursing students (n = 247) from a regional Australian university.

RESULTS

Significantly more participants had tried smoking cigarettes than had not (p = 0.026). There were no significant relationships between gender and smoking (p = 0.169) or e-cigarette use (p = 0.200), but a significant relationship was found between age and smoking status where older participants (48-57 years) were more likely to smoke (p < 0.001). Most participants (70 %) were supportive of public health measures to reduce cigarette smoking but felt that they lacked specific knowledge to assist their patients to cease smoking.

CONCLUSIONS

Within education there needs to be an emphasis on the central role that nurses play in smoking cessation with a greater focus on training nursing students about smoking cessation strategies and resources. There is also a need to ensure that students know it falls within their duty of care to address smoking cessation with patients.

Mindfulness Meditation App Abandonment During the COVID-19 Pandemic: An Observational Study

Objectives

Mindfulness meditation apps are used by millions of adults in the USA to improve mental health. However, many new app subscribers quickly abandon their use. The purpose of this study was to determine the behavioral, demographic, and socioeconomic factors associated with the abandonment of meditation apps during the COVID-19 pandemic.

Method

A survey was distributed to subscribers of a popular meditation app, Calm, at the start of the COVID-19 pandemic in March 2020 that assessed meditation app behavior and meditation habit strength, as well as demographic and socioeconomic information. App usage data were also collected from the start of each participant's subscription until May 2021. A total of 3275 respondents were included in the analyses. Participants were divided into three cohorts according to their subscription start date: (1) long-term subscribers (> 1 year before pandemic start), (2) pre-pandemic subscribers (< 4 months before pandemic start), and (3) pandemic subscribers (joined during the pandemic).

Results

Meditating after an existing routine was associated with a lower risk of app abandonment for pre-pandemic subscribers (hazard ratio = 0.607, 95% CI: 0.422, 0.874; p = 0.007) and for pandemic subscribers (hazard ratio = 0.434, 95% CI: 0.285, 0.66; p < 0.001). Additionally, meditating "whenever I can" was associated with lower risk of abandonment among pandemic subscribers (hazard ratio = 0.437, 95% CI: 0.271, 0.706; p < 0.001), and no behavioral factors were significant predictors of app abandonment among the long-term subscribers.

Conclusions

These results show that combining meditation with an existing daily routine was a commonly utilized strategy for promoting persistent meditation app use during the COVID-19 pandemic for many subscribers. This finding supports existing evidence that pairing new behaviors with an existing routine is an effective method for establishing new health habits.

Preregistration

This study is not pre-registered.

Leveraging collective action and environmental literacy to address complex sustainability challenges

Developing and enhancing societal capacity to understand, debate elements of, and take actionable steps toward a sustainable future at a scale beyond the individual are critical when addressing sustainability challenges such as climate change, resource scarcity, biodiversity loss, and zoonotic disease. Although mounting evidence exists for how to facilitate individual action to address sustainability challenges, there is less understanding of how to foster collective action in this realm. To support research and practice promoting collective action to address sustainability issues, we define the term "collective environmental literacy" by delineating four key potent aspects: scale, dynamic processes, shared resources, and synergy. Building on existing collective constructs and thought, we highlight areas where researchers, practitioners, and policymakers can support individuals and communities as they come together to identify, develop, and implement solutions to wicked problems. We close by discussing limitations of this work and future directions in studying collective environmental literacy.

Individual differences in environmental wellbeing and pro-environmental behaviors explained by self-control

Climate change is an increasing problem, with more extreme weather conditions and rising temperatures. To fulfill the temperature goals of the Paris agreement a societal change is needed, a change that requires a shift of lifestyle from all of us. If we want to change our behaviors to more sustainable ones, we need to sacrifice substantial things today to improve a future, which often seems distant and abstract. People with high level of self-control have been shown to have a better ability to visualize future events, which makes self-control an interesting trait to look at in relation to pro-environmental behavior. The aim of this study was to examine how self-control correlates with environmental well-being and environmental behavior. An internet-based survey was sent to a representative Swedish sample (n = 602). The respondents were asked to fill out a newly developed scale measuring their anxiety and security regarding environmental matters (environmental wellbeing), as well as indicate how often they engage in six different pro-environmental behaviors (e.g., turning lights off when leaving the room). Additionally, data on the respondents' gender, age, political orientation, and self-control was collected. Our results suggest a positive correlation between self-control and environmental wellbeing and a weaker, but still positive, correlation between self-control and some pro-environmental behaviors. Additionally, respondents who identified themselves as politically left had lower environmental wellbeing, while men had higher environmental wellbeing, but behaved less environmentally friendly. Thus, our results suggest that political orientation was a better predictor of sound environmental behavior than subjective self-control was.

Digital Strategies for Screen Time Reduction: A Randomized Field Experiment

Many consumers nowadays wish to reduce their smartphone usage in the hope of improving productivity and well-being. We conducted a pre-registered field experiment (N = 112) over a period of several weeks to test the effectiveness of two widely available digital strategies for screen time reduction. The effectiveness of a design friction intervention (i.e., activating grayscale mode) was compared with a goal-setting intervention (i.e., self-commitment to time limits) and a control condition (i.e., self-monitoring). The design friction intervention led to an immediate, significant reduction of objectively measured screen time compared with the control condition. Conversely, the goal-setting intervention led to a smaller and more gradual screen time reduction. In contrast to the popular belief that reducing screen time has broad benefits, we found no immediate causal effect of reducing usage on subjective well-being and academic performance.

Habit and Routine Interventions with Emerging Adults with Diabetes: An Integrative Review

Although theoretical and empirical writings on habits and routines are a promising body of science to guide interventions, little is known about such interventions among emerging adults with type 1 diabetes. Thus, an integrative review was conducted to describe interventions in relation to habits and routines, their influence on outcomes, and users' perspectives. A medical librarian conducted a search. Teams screened titles, abstracts, and articles based upon predefined criteria. Evidence from the final 11 articles was synthesized. A minority of investigators explicitly articulated habits and routines theoretical underpinnings as part of the interventions. However, text messaging or feedback via technology used in other interventions could be implicitly linked to habits and routines. For the most part, these interventions positively influenced diabetes self-management-related behaviors and health outcomes. In general, the interventions were perceived positively by users. Future research is advocated using habit and routine theoretical underpinnings to guide interventions.

Habit formation in context: Context‐specific and context‐free measures for tracking fruit consumption habit formation and behaviour

OBJECTIVES

Interventions promoting habitual fruit consumption have the potential to bring about long-term behaviour change. Assessing the effectiveness of such interventions requires adequate habit and behaviour measures. Habits are based on learned context-behaviour associations, so measures that incorporate context should be more sensitive to expected habit and behaviour changes than context-free measures. This study compared context-specific and context-free measures of fruit consumption habit and behaviour following a 3-week habit formation intervention.

DESIGN

Prospective online study (n = 58).

METHODS

Behaviour frequency was assessed across five timepoints, retrospectively (Time 1 [T1], T5) or via daily diary data (uploaded weekly at T2, T3 and T4). Habit strength was assessed before (T1) and immediately after the intervention (T4), and again 2 weeks later (T5). Analyses of variance were run, with time and context specificity as within-subject factors, and habit and behaviour frequency as dependent measures.

RESULTS

An interaction between time and context specificity was found in both analyses (habit: F(2,114) = 12.848, p < .001, part.η²  = .184; behaviour: F(2,114) = 6.714, p = .002, part.η²  = .105). Expected habit formation patterns 5 weeks post-baseline were only detected by the context-specific habit measure. Likewise, increased behaviour frequency was only found when the target context was specified (p's < .001).

CONCLUSIONS

Assessments of purposeful dietary habit and behaviour change attempts should incorporate context-specific measurement.

The art of forming habits: applying habit theory in changing physical activity behaviour

Background

Habits are obtained as a consequence of cue-contingent behavioural repetition. Context cues stimulate strong habits without an individual contemplating that action has been initiated. Because of its health-enhancing effects, making physical activity a part of one’s life is essential. This study examined the associations of physical activity (PA) behaviours with PA habits and the role of autonomous motivation in developing PA habits.

Methods

This study used a cross-sectional design. A structured questionnaire was implemented through emails to 226 university students, where PA levels, habits and autonomous motivation were self-reported.

Results

Binary logistic regression identified age groups, gender and participants who were trying to lose weight as the significant predictors in meeting physical activity guidelines. Path analysis showed that moderate-intensity physical activity (β = 0.045, CI = 0.069–0.248) and strength training exercises (β = 0.133, CI = 0.148–0.674) were significantly associated with PA habits (p < 0.01). Autonomous motivation was directly associated with PA habits (β = 0.062, CI = [0.295–0.541], p < 0.01) and was also significantly related to moderate-intensity physical activity (β = 0.243, CI = [0.078–0.266], p < 0.01) and strength training exercises (β = 0.202, CI = [0.033–0.594], p < 0.05).

Conclusions

The emphasis on experiment-based logic and interest in habit formation in the research community is extensive. As the college years offer an excellent opportunity to establish healthy behavioural interventions, encouraging students in regular PA and exhibiting an autonomous motivation towards PA may be necessary.

Identifying disrupted biological factors and patient-tailored interventions for chronic fatigue in adolescents and young adults with Q-Fever Fatigue Syndrome, Chronic Fatigue Syndrome and Juvenile Idiopathic Arthritis (QFS-study): study protocol for a randomized controlled trial with single-subject experimental case series design

Background

Chronic fatigue with a debilitating effect on daily life is a frequently reported symptom among adolescents and young adults with a history of Q-fever infection (QFS). Persisting fatigue after infection may have a biological origin with psychological and social factors contributing to the disease phenotype. This is consistent with the biopsychosocial framework, which considers fatigue to be the result of a complex interaction between biological, psychological, and social factors. In line, similar manifestations of chronic fatigue are observed in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and juvenile idiopathic arthritis (JIA). Cognitive behavioral therapy is often recommended as treatment for chronic fatigue, considering its effectiveness on the group level. However, not everybody benefits on the individual level. More treatment success at the individual level might be achieved with patient-tailored treatments that incorporate the biopsychosocial framework.

Methods

In addition to biological assessments of blood, stool, saliva, and hair, the QFS-study consists of a randomized controlled trial (RCT) in which a single-subject experimental case series (N=1) design will be implemented using Experience Sampling Methodology in fatigued adolescents and young adults with QFS, CFS/ME, and JIA (aged 12–29). With the RCT design, the effectiveness of patient-tailored PROfeel lifestyle advices will be compared against generic dietary advices in reducing fatigue severity at the group level. Pre-post analyses will be conducted to determine relevance of intervention order. By means of the N=1 design, effectiveness of both advices will be measured at the individual level.

Discussion

The QFS-study is a comprehensive study exploring disrupted biological factors and patient-tailored lifestyle advices as intervention in adolescent and young adults with QFS and similar manifestations of chronic fatigue. Practical or operational issues are expected during the study, but can be overcome through innovative study design, statistical approaches, and recruitment strategies. Ultimately, the study aims to contribute to biological research and (personalized) treatment in QFS and similar manifestations of chronic fatigue.

Trial registration

Trial NL8789. Registered July 21, 2020.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06620-2.

Inhibitory control hinders habit change

Our habits constantly influence the environment, often in negative ways that amplify global environmental and health risks. Hence, change is urgent. To facilitate habit change, inhibiting unwanted behaviors appears to be a natural human reaction. Here, we use a novel experimental design to test how inhibitory control affects two key components of changing (rewiring) habit-like behaviors in healthy humans: the acquisition of new habit-like behavior and the simultaneous unlearning of an old one. We found that, while the new behavior was acquired, the old behavior persisted and coexisted with the new. Critically, inhibition hindered both overcoming the old behavior and establishing the new one. Our findings highlight that suppressing unwanted behaviors is not only ineffective but may even further strengthen them. Meanwhile, actively engaging in a preferred behavior appears indispensable for its successful acquisition. Our design could be used to uncover how new approaches affect the cognitive basis of changing habit-like behaviors.

Tailoring Can Improve Consumers’ Hygienic Food-Handling Behavior to Reduce the Transmission Risk of Antimicrobial-Resistant Bacteria through Food

Antimicrobial-resistant (AMR) bacteria spread via food to humans and can seriously impair infection treatment. Hygienic food handling is an effective measure to avoid the transmission of bacteria. Therefore, we tested three types of interventions (tailored, generic, and no intervention) for their effectiveness in improving consumers’ hygienic food handling against the spread of antimicrobial-resistant bacteria through foods in a longitudinal randomized control trial. We based the determinants of hygienic food-handling behavior on the Health Action Process Approach (HAPA). The tailored intervention raised self-reported hygienic food handling, self-efficacy, and perceived likelihood of risk compared to no intervention. Moreover, interventions yielded different effects for participants with high vs. low intentions to improve their food-handling behavior. However, there were no differences between the tailored and generic interventions. More research is needed to find out whether including other behavior change techniques in the tailored intervention may increase the effect of tailoring.

When Reflection Hurts: The Effect of Cognitive Processing Types on Organizational Adaptation to Discontinuous Change

Technological breakthroughs, institutional disruptions, and natural disasters often alter the course of organizations and entire industries. Such discontinuous changes threaten organizations’ survival by affecting the value of the knowledge accumulated in routines and capabilities. Although it is widely acknowledged that managerial cognition is a critical antecedent of organizational responses to discontinuous change, the role of type 1 (intuitive) and type 2 (reflective) processing in the adaptation of shared patterns of behavior, that is, routines, remains understudied. Drawing on dual-process theory, we propose that particular features of type 1 processing render this approach superior to type 2 processing, especially in highly ambiguous environments in which information is limited and difficult to verify. We tested our hypotheses in a longitudinal experiment linking individual-level factors with organizational-level practices of routine adaptation. Experienced managers, paired in 80 groups, developed routines in a first round of a simulation game; in a second round, we then introduced a discontinuous change making previous routines obsolete in order to observe how they adapted. The data show that priming type 1 processing facilitates organizational adaptation more than type 2 processing by providing faster, more routinized, efficiently coordinated, and optimal responses. In addition, type 1 appears to be more functional in highly ambiguous environments, whereas type 1 and type 2 processes yield similar levels of performance under low levels of ambiguity. Overall, our study advances the understanding of the nondeliberative dimension of organizational adaptation to discontinuous change.

Role-Aware Information Spread in Online Social Networks

Understanding the complex process of information spread in online social networks (OSNs) enables the efficient maximization/minimization of the spread of useful/harmful information. Users assume various roles based on their behaviors while engaging with information in these OSNs. Recent reviews on information spread in OSNs have focused on algorithms and challenges for modeling the local node-to-node cascading paths of viral information. However, they neglected to analyze non-viral information with low reach size that can also spread globally beyond OSN edges (links) via non-neighbors through, for example, pushed information via content recommendation algorithms. Previous reviews have also not fully considered user roles in the spread of information. To address these gaps, we: (i) provide a comprehensive survey of the latest studies on role-aware information spread in OSNs, also addressing the different temporal spreading patterns of viral and non-viral information; (ii) survey modeling approaches that consider structural, non-structural, and hybrid features, and provide a taxonomy of these approaches; (iii) review software platforms for the analysis and visualization of role-aware information spread in OSNs; and (iv) describe how information spread models enable useful applications in OSNs such as detecting influential users. We conclude by highlighting future research directions for studying information spread in OSNs, accounting for dynamic user roles.

From ability to behavior: A scenario-based assessment of health competence predicts daily health behaviors

Recent findings have suggested that we can gain new insights into health decision-making and behavior through the use of a scenario-based approach to health competence (HC). The present research sought to investigate whether and how such individual differences would matter in the conduct of daily life, within two daily diary studies (N = 260). In Study 1, participants receiving higher HC scores were more active in dealing with daily stressors or problems; by contrast, low-HC individuals were more prone to impulsive and antisocial behaviors. Based on these promising results, the Study 2 protocol was a more extensive one. Participants who received higher HC scores thought about their health more often and engaged in diverse healthy behaviors more frequently. Conversely, low-HC individuals were prone to risky and unhealthy daily behaviors. In total, the findings provide key evidence in favor of a new approach to HC and its behavioral manifestations.

Synthesizing the effects of mental simulation on behavior change: Systematic review and multilevel meta-analysis

Mental simulation of future scenarios is hypothesized to affect future behavior, but a large and inconsistent literature means it is unclear whether, and under what conditions, mental simulation can change people's behavior. A meta-analysis was conducted to synthesize the effects of mental simulation on behavior and examine under what conditions mental simulation works best. An inclusive systematic database search identified 123 (N = 5,685) effect sizes comparing mental simulation to a control group. After applying a multilevel random effects model, a statistically-reliable positive effect of Hedges' g = 0.49, 95% CI [0.37; 0.62] was found, which was significantly different than zero. Using a taxonomy to identify different subtypes of mental simulation (along two dimensions, class [process, performance, outcome] and purpose [whether an inferior, standard, superior version of that behavior is simulated]), it was found that superior simulations garnered more reliable beneficial effects than inferior simulations. These findings have implications for integrating theories of how mental simulations change behavior, how mental simulations are classified, and may help guide professionals seeking evidence-based and cost-effective methods of changing behavior.

Using Theories of Behavior Change to Develop Interventions for Healthy Aging

Healthy aging requires people to adopt and maintain beneficial behaviors in all stages of the life span. Supporting behavior change, including via the motivation to make and maintain those changes, is therefore important for the promotion of healthy aging. The aim of this overview is to introduce theoretical frameworks from the psychology of motivation that lend themselves to the development of effective interventions promoting behavior change conducive to healthy aging. We discuss theoretical frameworks referring to the determinants, properties, and functionality of goals aimed at behavior change, and consider the implications of the various theories for designing interventions to support healthy aging. We first consider theories that focus on beliefs and attitudes as determinants of goals, then we address theories that focus on the structure and content as important properties of goals, and, finally, we examine theories drawing on conscious and nonconscious processes underlying the functionality of these goals. We will present if-then planning and mental contrasting, as well as nudging and boosting, that is, novel strategies of behavior change that support the creation of scalable interventions for healthy aging across the life span. Against this background, new perspectives emerge for modern, state-of-the-art, and individually tailored interventions with the aim of enhancing older people's healthy living.

Applying the Science of Habit Formation to Evidence-Based Psychological Treatments for Mental Illness

Habits affect nearly every aspect of our physical and mental health. Although the science of habit formation has long been of interest to psychological scientists across disciplines, we propose that applications to clinical psychological science have been insufficiently explored. In particular, evidence-based psychological treatments (EBPTs) are interventions targeting psychological processes that cause and/or maintain mental illness and that have been developed and evaluated scientifically. An implicit goal of EBPTs is to disrupt unwanted habits and develop desired habits. However, there has been insufficient attention given to habit-formation principles, theories, and measures in the development and delivery of EBTPs. Herein we consider whether outcomes following an EBPT would greatly improve if the basic science of habit formation were more fully leveraged. We distill six ingredients that are central to habit formation and demonstrate how these ingredients are relevant to EBPTs. We highlight practice points and an agenda for future research. We propose that there is an urgent need for research to guide the application of the science of habit formation and disruption to the complex "real-life" habits that are the essence of EBPTs.

Improving Equine Welfare through Human Habit Formation

This paper explores the potential for interventions to develop pro-animal welfare habitual behaviours (PAWHBs) in people to improve the lives of animals. Human behavioural research indicates that opportunities exist to deliver lasting change through developing positive habitual behaviours. The routine nature of many equine care and management practices lends itself to habit formation and maintenance. This proof-of-concept paper aims to evaluate a theory-based intervention of developing and maintaining a PAWHB in people caring for equines. Qualitative research methods were used. A 30 day PAWHB intervention (PAWHBInt) of providing enrichment to an equine by scratching them in a consistent context linked to an existing routine behaviour was undertaken. Participants (n = 9) then engaged in semi-structured interviews that were analysed using thematic analysis, where the participants self-reported the outcomes they observed during the intervention. The study findings suggest that the PAWHBInt had a positive impact on human behaviour and habit formation. The research helps to address the dearth of evidence regarding the application of habit theory to equine welfare interventions and emphasised linking a desired new behaviour to an existing routine behaviour when developing PAWHBs. The research also highlights the role of mutual benefit for human and equine, and emotion in providing feedback and potential reward, supporting the link to the cue-routine-reward principle of habit theory.

Does alcohol-related desire thinking predict in-the-moment drinking behaviours?

Desire thinking (voluntary thinking involving a perseverative focusing on desired target-related memories, images, and information), is an important factor in the experience of drinking urges and cravings. Research has not examined the relationship between desire thinking, behavioural intention and the implementation of that behaviour into action, nor how one's past repeated behaviour in situ (expressed as habit) may moderate these relationships. We employed an ad libitum drinking paradigm to provide indirect measures of in-the-moment drinking behaviours (amount poured [mls] and amount consumed [mls]) in a group of eighty-eight self-defined social drinkers immediately after measuring self-reported drinking habit, drinking-related desire thinking, and general drinking behaviour. Results confirmed the predicted positive relationship between desire thinking and in-the-moment drinking behaviour with the effects increasing as a function of rising drinking habit strength. We also observed a dissociation between desire thinking components (verbal perseveration and imaginal prefiguration) in the moderating effects of habit strength on drinking behaviour. For imaginal prefiguration (thoughts related to construction of mental images of a desired target or of its context for consumption) a direct effect on drinking behaviours was shown. In comparison, the effect for verbal perseveration (repetitive self-talk regarding the need to achieve a desired target) was not shown to independently predict drinking-related behaviour but was significantly moderated by increasing drinking-related habit strength. Future work should formulate the nature of this moderating influence on perseverative goal-directed thinking.

Changing Hearts and Plates: The Effect of Animal-Advocacy Pamphlets on Meat Consumption

Social movements have driven large shifts in public attitudes and values, from anti-slavery to marriage equality. A central component of these movements is moral persuasion. We conduct a randomized-controlled trial of pro-vegan animal-welfare pamphlets at a college campus. We observe the effect on meat consumption using an individual-level panel data set of approximately 200,000 meals. Our baseline regression results, spanning two academic years, indicate that the pamphlet had no statistically significant long-term aggregate effects. However, as we disaggregate by gender and time, we find small statistically significant effects within the semester of the intervention: a 2.4 percentage-point reduction in poultry and fish for men and a 1.6 percentage-point reduction in beef for women. The effects disappear after 2 months. We merge food purchase data with survey responses to examine mechanisms. Those participants who (i) self-identified as vegetarian, (ii) reported thinking more about the treatment of animals or (iii) expressed a willingness to make big lifestyle changes reduced meat consumption during the semester of the intervention. Though we find significant effects on some subsamples in the short term, we can reject all but small treatment effects in the aggregate.

Cooking at Home and Adherence to the Mediterranean Diet During the COVID-19 Confinement: The Experience From the Croatian COVIDiet Study

Introduction: The primary aims of this study were to evaluate the changes in dietary behavior among the Croatian adult population during the COVID-19 outbreak and to explore the impact of confinement on cooking habits. Methods: The study was based on results from COVIDiet_Int cross-sectional study-a part of COVIDiet project (NCT04449731). A self-administered online questionnaire was used to assess the frequency of food consumption, eating habits, and sociodemographic information. A total number of 4,281 participants (80.5% females and 19.4% males) completed the questionnaire. Results: The Mediterranean Diet Adherence Screener (MEDAS) score before the confinement was 5.02 ± 1.97, while during the confinement, the MEDAS score increased to 5.85 ± 2.04. Participants who had higher adherence to the Mediterranean diet (MedDiet) during the confinement were mostly females (88.8%), aged between 20 and 50 years, with the highest level of education (66.3%) and normal BMI (70.6%). The majority of participants maintained their dietary behavior as it was before COVID-19 confinement, while 36.9% decreased their physical activity. Participants with higher MEDAS score were more eager to increase their physical activity. Additionally, higher median values of MEDAS score were noted for participants with body mass index values below 24.9 kg/m2 (6.0 vs. 5.0 for participants with BMI above 25 kg/m2). Participants in all residence places increased their cooking frequency during the confinement (53.8%), which was associated with an increase in vegetables, legumes, as well as fish and seafood consumption. Conclusions: According to our findings, Croatian adults exhibited medium adherence to the MedDiet during the COVID-19 confinement. The results suggest that cooking frequency could be positively associated with overall dietary quality, which is of utmost importance in these demanding times.

Assessing information security behaviour: a self-determination theory perspective

Purpose

This paper outlines the development of a validated questionnaire for assessing information security behaviour. The purpose of this paper is to present data from the questionnaire validation process and the quantitative study results.

Design/methodology/approach

Data obtained through a quantitative survey (N = 263) at a South African university were used to validate the questionnaire.

Findings

Exploratory factor analysis produced 11 factors. Cronbach’s alpha for the 11 factors were all above 0.7, suggesting that the questionnaire is valid and reliable. The responses show that autonomy questions received positive perception, followed by competence questions and lastly relatedness questions. The correlation analysis results show that there was a statistically significant relationship between competence factors and autonomy factors. There was a partial significant relationship between autonomy and relatedness factors, and between competence and relatedness factors. The study results suggest that competence and autonomy could be more important than relatedness in fostering information security behaviour among employees.

Research limitations/implications

This study used a convenience sampling, a cross-sectional design, and was carried out in a single organisation. This could pose limitations when generalising the study results. Future studies could use random sampling and consider other universities for further validation.

Practical implications

Universities can use the questionnaire to identify developmental areas to improve information security from a behaviour perspective.

Originality/value

This paper provides a research instrument for assessing information security behaviour from the perspective of the self-determination theory.

A Systematic Review Examining the Relationship Between Habit and Physical Activity Behavior in Longitudinal Studies

Purpose: To explain physical activity behavior, social-cognitive theories were most commonly used in the past. Besides conscious processes, the approach of dual processes additionally incorporates non-conscious regulatory processes into physical activity behavior theories. Habits are one of various non-conscious variables that can influence behavior and thus play an important role in terms of behavior change. The aim of this review was to examine the relationship between habit strength and physical activity behavior in longitudinal studies.

Methods: According to the PRISMA guidelines, a systematic search was conducted in three databases. Only peer-reviewed articles using a longitudinal study design were included. Both, habit and physical activity were measured at least once, and habit was related to physical activity behavior. Study quality was evaluated by assessment tools of the NHLBI.

Results: Of 3.382 identified publications between 2016 and 2019, fifteen studies with different study designs were included. Most studies supported that positive correlations between habit and physical activity exist. Some positive direct and indirect effects of habit on physical activity were detected and only a minority of studies showed the influence of physical activity on habit strength. Studies differentiating between instigation and execution habit found positive correlations and revealed instigation habit as a stronger predictor of physical activity. The quality of studies was rated as reasonable using assessment tools of the NHLBI.

Conclusion: This review revealed a bidirectional relationship between habit and physical activity. Whether habit predicts physical activity or vice versa is still unclear. The observation of habit influencing physical activity may be most appropriate in studies fostering physical activity maintenance while the influence of physical activity on habit may be reasonable in experimental studies with physical activity as intervention content to form a habit. Future investigations should differentiate between habit formation and physical activity maintenance studies depending on the research objective. Long-term study designs addressing the complexity of habitual behavior would be beneficial for establishing cue-behavior associations for the formation of habits. Furthermore, studies should differentiate between instigation and execution habit in order to investigate the influence of both variables on physical activity behavior independently.

Association of habits, triggers, glycaemic control, routines, stress and impulse control among emerging adults with type 1 diabetes

AIM

Glycaemic control is known to be poor among emerging adults with type 1 diabetes, but the reasons for this are poorly understood. Examination of diabetes self-management-related habits, triggers and daily routines within the context of impulse control and perceived daily stress may provide increased understanding of glycaemic control during this transitional period. This study examined associations among checking blood glucose (CBG) habits, eating a meal (EAM) habits and glycaemic control within the context of CBG triggers, daily routines, impulse control and perceived daily stress, in emerging adults with type 1 diabetes.

METHODS

A cross-sectional convenience sample of 100 emerging adults with type 1 diabetes was recruited from an outpatient diabetes care clinic for this age group. Participants self-reported frequency of CBG and EAM habits, CBG triggers, daily routines, perceived daily stress and impulse control. Glycaemic control values were obtained from medical records. Path analysis was performed.

RESULTS

Better glycaemic control was positively and significantly associated with greater frequency of CBG and EAM habits. CBG habits were positively and significantly associated with CBG triggers and EAM habits. EAM habits were positively and significantly associated with daily routines.

CONCLUSIONS

We suggest interventional research targeting CBG and EAM habits and daily routines to examine the impact on diabetes self-management and glycaemic control.

The skill of self-control

Researchers often claim that self-control is a skill. It is also often stated that self-control exertions are intentional actions. However, no account has yet been proposed of the skillful agency that makes self-control exertion possible, so our understanding of self-control remains incomplete. Here I propose the skill model of self-control, which accounts for skillful agency by tackling the guidance problem: how can agents transform their abstract and coarse-grained intentions into the highly context-sensitive, fine-grained control processes required to select, revise and correct strategies during self-control exertion? The skill model borrows conceptual tools from 'hierarchical models' recently developed in the context of motor skills, and asserts that self-control crucially involves the ability to manage the implementation and monitoring of regulatory strategies as the self-control exercise unfolds. Skilled agents are able do this by means of flexible practical reasoning: a fast, context-sensitive type of deliberation that incorporates non-propositional representations (including feedback signals about strategy implementation, such as the feeling of mental effort) into the formation and revision of the mixed-format intentions that structure self-control exertion. The literatures on implementation intentions and motivation framing offer corroborating evidence for the theory. As a surprising result, the skill of self-control that allows agents to overcome the contrary motivations they experience is self-effacing: instead of continuously honing this skill, expert agents replace it with a different one, which minimizes or prevents contrary motivations from arising in the first place. Thus, the more expert you are at self-control, the less likely you are to use it.

Resisting, Recognizing, and Returning: A Three-Component Model and Review of Persistence in Episodic Goals

According to prior work, persistent goal pursuit is a continuous process where persisting is a matter of resisting the urge to give up. In everyday goals, however, persistence is often episodic, and its causes are more complex. People pause and resume pursuit many times. Whether people persist reflects more than will power and motivation, it also reflects the other goals they pursue, their resources, and the attentional demands of daily life. People can fail to persist not just because they gave up, but also because they failed to act. We propose a general model of persistence that accommodates the complexity of episodic goals. We argue that persistent goal pursuit is a function of three processes: resisting the urge to give up, recognizing opportunities for pursuit, and returning to pursuit. The broad factors that help and hurt persistence can be organized within these components. These components can also explain the mechanisms of four effective strategies for persistence: removing distractions, using reminders, using implementation intentions, and forming habits. The recognizing-resisting-returning model integrates and improves on extant theories of persistence and goal pursuit and is consistent with empirical work from laboratory and naturalistic settings.

Examining five pathways on how self-control is associated with emotion regulation and affective well-being in daily life

OBJECTIVE

Self-control is positively connected to well-being, but less is known about what, on the mechanistic level, explains this association. We hypothesized five pathways how this connection could be explained by emotion regulation, that is, by facilitating (a) strategy effectiveness, (b), adaptive strategy selection, (c) situation selection, (d) strategy variability, or (e) social sharing.

METHOD

To explore these pathways, we integrated two ambulatory assessment data sets (N = 250 participants, N = 22,796 observations) that included assessments of participants' emotions and their emotion regulation efforts.

RESULTS

We found that self-control was positively associated with affective well-being. Moreover, momentary but not trait self-control was associated with favoring adaptive and interpersonal strategy selection and less emotion regulation in general as well as with increased variability across strategies. However, these emotion regulation facets could not sufficiently explain the association between self-control and affective well-being.

CONCLUSIONS

Our main conclusion is that emotion regulation is not a mediator of the strong relation between self-control and affective well-being. Instead, we found evidence for the affective benefits of employing ways of emotion regulation that are less taxing mentally, which we discuss in light of current knowledge about self-control and emotion regulation.

Promotion of Healthy Lifestyles to Teenagers with Mobile Devices: A Case Study in Portugal

Educating teenagers about nutrition and promoting active lifestyles is essential in reducing the long-term health risks and one idea to achieve this is by using mobile applications. Previous studies showed that the existing mobile applications have similar functionalities, such as intervention with questionnaires, and the use of gamification techniques to improve interactiveness. However, unlike our study, some studies are not validated and verified by healthcare professionals. Additionally, this study intends to promote the interaction between the teenagers and the medical communities. In this study, we analyze the benefits of the proposed mobile application, which features monitoring of physical activity, daily tips and curiosities, questionnaires, and gamification through earning points. Most of the teenagers were satisfied with the physical activity monitoring and found the tips, curiosities, and weekly questionnaires useful. The study started with 26 teenagers from two schools in the center of Portugal that would use the mobile application for five weeks. Still, at the end of the study, only 7 teenagers finalized the study. The decreasing number of teenagers in the study was affected by the lack of social interaction caused by the pandemic situation. During the period, the mobile application would engage the users with notifications on nutrition and physical activity, challenges concerning the number of steps and calories they would have to spend, and questionnaires related to the curiosities and suggestions from the previous week. We used Fisher’s test to investigate the relationship between the assessment obtained in the responses to the questionnaires, and the adoption of healthier eating and sports practices. In summary, participants were satisfied with the mobile application and experienced some improvements in diet and habits.