Changing behaviour

Bringing about changes in modifiable behavioural risk factors is very difficult.

From a behavioural science perspective one reason why health messages are not making an impact is the habitual nature of human behaviour. A significant barrier to changing behavior is people’s pre-existing personal and lifestyle habits that render them resistant to change.

Although a minority of people will heed health advice and change their behaviour because it is good for them, others will have the intention to change, and understand the need to change but will nonetheless persist with their pre-existing behaviours.

This is not due to a lack of knowledge; most of us know what is healthy and what isn’t. And if we are not certain, there is an abundance of information available at the click of a button. So why do we find it difficult to make these changes even though we understand their importance?


Habit machines

Think about what you have done so far today. How often were you actually thinking about what you were doing? Were you mainly doing what you’ve done before? How much was habit? We aren’t in control of ourselves as much as we’d like to be. Most of the time we are not in control at all.[1]

We all have many habits. Some are useful and good for us, like washing our hands, brushing our teeth and putting on seat belts. Others aren’t so good, like repeatedly checking our phones, or eating unhealthy snacks while we watch tv. So how does our brain create these habits?

Habits are generally formed by repeating a behaviour until it has become more or less automatic.[2] By repeating behaviour in a consistent context, we forge a direct link in memory between the context and response.[3] Therefore, we learn to associate the behaviour triggered by that setting; this process is termed ‘context-dependent repetition’. This reinforces a mental context–behaviour association, such that alternative options become less accessible in memory.[4] Eventually, the mere perception of the context automatically triggers the responding behaviour.[5],[6]


Behavioural interventions

Interventions to change habits are most effective when they address the cuing of habit performance, either through inhibiting habit responses once activated or avoiding or altering exposure to the cues.[7] Nearly forty years of research at the University of Hertfordshire has resulted in new thinking in the area of behaviour change, led by Professor Ben (C) Fletcher, founder of FIT Science, and Professor Karen Pine, Professor of Developmental Psychology.[8] With this model of behaviour professor Fletcher and Pine created their Do Something Different behaviour change approach. Professor Fletcher and Pine collaborate with Onmi in the development of our behaviour change programme called “Flex”.

Figure 1: Do Something Different model of behaviour change.1

Flex sends out personalised Do’s – or micro behaviours – designed to encourage you to step out of your comfort zone and try new behaviours. Flex is Onmi’s new implementation of the Do Something Different approach that uses behavioural data to personalise the Do’s. The aim of the programme is to break the distal habits proposed to play a role in unhealthy behaviours. For example, in a programme about weight loss it means a Do is not necessarily activity or food related, but can also target the way you commute, shop, relax or socialise.


Do’s stimulate you to engage in novel activities that expand your behavioural repertoire.

Habits are often made up of a chain of actions and thoughts. This is important because one behaviour (or thought) automatically cues the next one in the chain. The bad habit will probably have started earlier than you think because the habit chain may be quite long. For example, you might always drive the same way home after work, you might pass the shop that triggers a thought about eating biscuits, you buy biscuits meaning to be good about when you eat them. Then you go home and turn on the tv and get a coffee. The eating of the biscuits that is likely then will have started with a habit chain going back many apparently independent decisions, such as which route to drive to get home. Do’s break the habit chains earlier than you might otherwise do. 

The Do’s work because they interrupt the sequence of conditioning; they change the small lifestyle behaviours that trigger the unhealthy habit chain and try to instigate a new chain of events.[9] Through experimenting with new behaviours, you might be better equipped to weaken your existing habits and also encounter new experiences that could challenge current thinking.[10]




References

[1] Do Something Different. (2015) The Architecture of a Habit

[2] Nilsen P, Roback K, Brostrom A et al. (2012) Creatures of habit: accounting for the role of habit in implementation research on clinical behaviour change. Implement Sci 7, 53. 

[3] Neal DT, Wood W & Quinn JM (2006) Habits-A repeat performance. Curr Dir Psychol Sci 15, 198–202. 

[4] Gardner B (2014) A review and analysis of the use of ‘habit’ in understanding, predicting and influencing health-related hebaiour. Health Psychol Rev 9, 277–295. 

[5] Neal DT, Wood W, Labrecque JS et al. (2012) How do habits guide behavior? Perceived and actual triggers of habits in daily life. J Exp Soc Psychol 48, 492–498.

[6] Quinn JA, Pascoe A, Wood W et al. (2009) Can’t control yourself? Monitor those bad habits. Pers Soc Psychol Bull 36, 499–511.

[7] Wood, W. & Neal, D. (2007). A new look at habits and the habit-goal interface. Psychological Review, Vol. 114, No. 4, 843–863

[8] https://dsd.me/healthcare/the-evidence/ [accessed 02-12-2019]

[9] Pine, K., 2014. Time to shift brain channels to bring about effective changes in health behaviour. Perspectives in public health134(1), p.16.

[10] Page, M.P., and Page, N.C. (2011). “HOT topics: habits, opportunities and thoughts in pro-environmental behaviour change,” in Going Green: The Psychology of Sustainability in the Workplace, ed. D. Bartlett (Leicester: The British Psychological Society),65–71. 

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