Hostname: page-component-5b777bbd6c-7mr9c Total loading time: 0 Render date: 2025-06-21T14:06:35.189Z Has data issue: false hasContentIssue false
  • English
  • Français

Behaviour change interventions: getting in touch with individual differences, values and emotions

Part of: 2019 DOHaD 11th World Congress

Published online by Cambridge University Press:  28 July 2020

Sofia Strömmer Open the ORCID record for Sofia Strömmer [Opens in a new window] ,
Wendy Lawrence ,
Sarah Shaw ,
Sara Correia Simao ,
Sarah Jenner ,
Millie Barrett ,
Christina Vogel Open the ORCID record for Christina Vogel [Opens in a new window] ,
Polly Hardy-Johnson ,
David Farrell  and
Kathryn Woods-Townsend
...Show all authors
Sofia Strömmer*
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Wendy Lawrence
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sarah Shaw
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sara Correia Simao
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Sarah Jenner
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
Millie Barrett
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Christina Vogel
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Polly Hardy-Johnson
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
David Farrell
Affiliation:
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Glasgow, UK
Kathryn Woods-Townsend
Affiliation:
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
Janis Baird
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Leanne Morrison
Affiliation:
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Centre for Clinical and Community Applications of Health Psychology, Southampton, UK School of Primary Care, Population Health and Medical Education, Southampton, UK
Deborah M. Sloboda
Affiliation:
Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada L8S 4K1
Hazel Inskip
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
Mary Barker
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
*
Address for correspondence: Sofia Strömmer, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, SouthamptonSO16 6YD, UK. Email: ss3@mrc.soton.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Systematic reviews and meta-analyses suggest that behaviour change interventions have modest effect sizes, struggle to demonstrate effect in the long term and that there is high heterogeneity between studies. Such interventions take huge effort to design and run for relatively small returns in terms of changes to behaviour.

So why do behaviour change interventions not work and how can we make them more effective? This article offers some ideas about what may underpin the failure of behaviour change interventions. We propose three main reasons that may explain why our current methods of conducting behaviour change interventions struggle to achieve the changes we expect: 1) our current model for testing the efficacy or effectiveness of interventions tends to a mean effect size. This ignores individual differences in response to interventions; 2) our interventions tend to assume that everyone values health in the way we do as health professionals; and 3) the great majority of our interventions focus on addressing cognitions as mechanisms of change. We appeal to people’s logic and rationality rather than recognising that much of what we do and how we behave, including our health behaviours, is governed as much by how we feel and how engaged we are emotionally as it is with what we plan and intend to do.

Drawing on our team’s experience of developing multiple interventions to promote and support health behaviour change with a variety of populations in different global contexts, this article explores strategies with potential to address these issues.

Keywords

Adolescentswomendiet and physical activitybehaviour changeinterventionsmotivation
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 6 , December 2020 , pp. 589 - 598
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with the International Society for Developmental Origins of Health and Disease

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Rose, T, Barker, M, Maria Jacob, C, et al. A systematic review of digital interventions for improving the diet and physical activity behaviors of adolescents. J Adolesc Health. 2017; 61, 669–677.CrossRefGoogle ScholarPubMed
Samdal, GB, Eide, GE, Barth, T, Williams, G, Meland, E. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta-regression analyses. Int J Behav Nutr Phys Act. 2017; 14, 42.CrossRefGoogle ScholarPubMed
Steinmetz, H, Knappstein, M, Ajzen, I, Schmidt, P, Kabst, R. How effective are behavior change interventions based on the theory of planned behavior? Zeitschrift für Psychologie. 2016; 224, 216–233.CrossRefGoogle Scholar
Reynolds, JP, Webb, TL, Benn, Y, Chang, BPI, Sheeran, P. Feeling bad about progress does not lead people want to change their health behaviour. Psychol Health. 2018; 33, 275–291.CrossRefGoogle Scholar
Baird, J, Barker, M, Harvey, NC, et al. Southampton PRegnancy Intervention for the Next Generation (SPRING): protocol for a randomised controlled trial. Trials. 2016; 17, 493.CrossRefGoogle ScholarPubMed
Lawrence, W, Black, C, Tinati, T, et al. Making every contact count: Longitudinal evaluation of the impact of training in behaviour change on the work of health and social care practitioners. J Health Psychol. 2016; 21, 138–151.CrossRefGoogle Scholar
Black, C, Lawrence, W, Cradock, S, et al. Healthy conversation skills: increasing competence and confidence in front-line staff. Public Health Nutr. 2014; 17, 700–707.CrossRefGoogle ScholarPubMed
Strömmer, S, Lawrence, W, Rose, T, et al. Improving recruitment to clinical trials during pregnancy: a mixed methods investigation. Soc Sci Med. 2018; 200: 73–82.CrossRefGoogle ScholarPubMed
Campbell, MK, Snowdon, C, Francis, D, et al. Recruitment to randomised trials: strategies for trial enrolment and participation study. The STEPS study. Health Technol Assessment. 2007; 11, 1–123.CrossRefGoogle Scholar
Morris, T, Strömmer, S, Vogel, C, et al. Improving pregnant women’s diet and physical activity behaviours: the emergent role of health identity. BMC Pregnancy and Childbirth. 2020; 20, 244.CrossRefGoogle ScholarPubMed
Rodriguez Rocha, NP, Kim, H. eHealth interventions for fruit and vegetable intake: a meta-analysis of effectiveness. Health Educ Behav. 2019; 46, 947–959.CrossRefGoogle ScholarPubMed
Gray, JM. The shift to personalised and population medicine. Lancet. 2013; 382, 200–201.CrossRefGoogle ScholarPubMed
Barker, M, Dombrowski, SU, Colbourn, T, et al. Intervention strategies to improve nutrition and health behaviours before conception. The Lancet. 2018; 391, 1853–1864.CrossRefGoogle ScholarPubMed
Heckhausen, J, Heckhausen, H, editors. Motivation and Action, 2008. Cambridge University Press, New York.CrossRefGoogle Scholar
Heckhausen, J. Developmental Regulation in Adulthood: Age-Normative and Sociostructural Constraints as Adaptive Challenges, 2006. Cambridge University Press.Google Scholar
Strommer, S, Shaw, S, Jenner, S, et al. How do we harness adolescent values in designing health behaviour change interventions? J Health Psychol. 2020; Under Review.Google Scholar
Strömmer, S, Barrett, M, Woods-Townsend, K, et al. Engaging adolescents in changing behaviour (EACH-B): study protocol for a cluster randomised controlled trial to improve diets and physical activity levels of adolescents. Trials. 2020; Under Review.Google Scholar
Ryan, RM, Deci, EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000; 55, 68.CrossRefGoogle ScholarPubMed
Ryan, RM, Deci, EL. Overview of self-determination theory: An organismic dialectical perspective. In . Handbook of self-determination research (eds. Deci, EL, Ryan, RM), 2002. Rochester: The University of Rochester Press.Google Scholar
Bay, JL, Vickers, MH, Mora, HA, Sloboda, DM, Morton, SM. Adolescents as agents of healthful change through scientific literacy development: a school-university partnership program in New Zealand. Int J STEM Educ. 2017; 4, 15.CrossRefGoogle ScholarPubMed
Weller, S, Hardy-Johnson, P, Strömmer, S, et al. ‘I should be disease free, healthy and be happy in whatever I do’: a cross-country analysis of drivers of adolescent diet and physical activity in different low- and middle-income contexts. Public Health Nutr. 2020 May 13.CrossRefGoogle Scholar
Ballantyne, R, Warren, A, Nobbs, K. The evolution of brand choice. J Brand Management. 2006; 13, 339–352.CrossRefGoogle Scholar
Strack, F, Deutsch, R. Reflective and impulsive determinants of social behavior. Pers Soc Psychol Rev. 2004; 8, 220–247.CrossRefGoogle ScholarPubMed
Bryan, CJ, Yeager, DS, Hinojosa, CP. A values-alignment intervention protects adolescents from the effects of food marketing. Nat Hum Behav. 2019; 3, 596–603.CrossRefGoogle ScholarPubMed
Yeager, DS, Dahl, RE, Dweck, CS. Why interventions to influence adolescent behavior often fail but could succeed. Perspect Psychol Sci. 2018; 13, 101–122.CrossRefGoogle ScholarPubMed
Kimiecik, J, Horn, T, Newman, TJ, Kimiecik, CM. Moving adolescents for a lifetime of physical activity: shifting to interventions aligned with the third health revolution. Health Psychol Rev. 2019; 1–8.CrossRefGoogle Scholar
Lawton, R, Conner, M, McEachan, R. Desire or reason: predicting health behaviors from affective and cognitive attitudes. Health Psychol. 2009; 28, 56.CrossRefGoogle ScholarPubMed
Fredrickson, BL, Joiner, T. Reflections on positive emotions and upward spirals. Perspect Psychol Sci. 2018; 13, 194–199.CrossRefGoogle ScholarPubMed
Watson, JB. Psychology as the behaviorist views it. Psychol Rev. 1913; 20, 158.CrossRefGoogle Scholar
Seligman, ME, Csikszentmihalyi, M. Positive psychology: An introduction. In Flow and the foundations of positive psychology, 2014. Springer. p. 279–298.Google Scholar
Van Cappellen, P, Rice, EL, Catalino, LI, Fredrickson, BL. Positive affective processes underlie positive health behaviour change. Psychol Health. 2017, 1–21.CrossRefGoogle Scholar
Kiviniemi, MT, Duangdao, KM. Affective associations mediate the influence of cost–benefit beliefs on fruit and vegetable consumption. Appetite. 2009; 52, 771–775.CrossRefGoogle ScholarPubMed
Kiviniemi, MT, Voss-Humke, AM, Seifert, AL. How do I feel about the behavior? The interplay of affective associations with behaviors and cognitive beliefs as influences on physical activity behavior. Health Psychol. 2007; 26, 152.CrossRefGoogle ScholarPubMed
Rhodes, RE, Kates, A. Can the affective response to exercise predict future motives and physical activity behavior? A systematic review of published evidence. Ann Behav Med. 2015; 49, 715–731.CrossRefGoogle ScholarPubMed
Dubé, E, Laberge, C, Guay, M, Bramadat, P, Roy, R, Bettinger, JA. Vaccine hesitancy: an overview. Hum Vaccin Immunother. 2013; 9, 1763–1773.CrossRefGoogle ScholarPubMed
Van Rensburg, W, Head, BW. Climate change scepticism: reconsidering how to respond to core criticisms of climate science and policy. Sage Open. 2017; 7, 2158244017748983.CrossRefGoogle Scholar
Dunning, D. The Dunning–Kruger effect: On being ignorant of one’s own ignorance. Advances in experimental social psychology, 2011. 44: Elsevier. p. 247–296.Google Scholar
Motta, M, Callaghan, T, Sylvester, S. Knowing less but presuming more: Dunning-Kruger effects and the endorsement of anti-vaccine policy attitudes. Soc Sci Med. 2018; 211, 274–281.CrossRefGoogle ScholarPubMed
Smith, PJ, Humiston, SG, Marcuse, EK, et al. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model. Public Health Reports. 2011; 126(2_suppl), 135–146.CrossRefGoogle ScholarPubMed
Dubé, E, Bettinger, J, Halperin, B, et al. Determinants of parents’ decision to vaccinate their children against rotavirus: results of a longitudinal study. Health Educ Res. 2012; 27, 1069–1080.CrossRefGoogle ScholarPubMed
Kata, A. A postmodern Pandora’s box: anti-vaccination misinformation on the Internet. Vaccine. 2010; 28, 1709–1716.CrossRefGoogle ScholarPubMed
Diethelm, P, McKee, M. Denialism: what is it and how should scientists respond? Eur J Public Health. 2009; 19, 2–4.CrossRefGoogle ScholarPubMed
Betsch, C, Renkewitz, F, Betsch, T, Ulshöfer, C. The influence of vaccine-critical websites on perceiving vaccination risks. J Health Psychol. 2010; 15, 446–455.CrossRefGoogle ScholarPubMed
Fancourt, D, Finn, S. What is the evidence on the role of the arts in improving health and well-being. A scoping review Copenhagen, 2019. WHO Regional Office for Europe.Google Scholar
Fenn, C. Arts in England: Attendance, participation and attitudes in 2003, 2004. Arts council of England.Google Scholar
Kennett, CE. Participation in a creative arts project can foster hope in a hospice day centre. Palliative Med. 2000; 14, 419–425.CrossRefGoogle Scholar
Jones, K. A biographic researcher in pursuit of an aesthetic: The use of arts-based (re) presentations in “performative” dissemination of life stories. Qual Sociol Rev. 2006; 2, 66–85.Google Scholar
Barraket, DJ. Putting People in the Picture? The role of the arts in social inclusion. Social Policy Working Paper No. 4, 2005; pp. 1–19.Google Scholar
Kelemen, M, Hamilton, L. The role of creative methods in re-defining the impact agenda. CASIC Working Paper Series No. 1, 2015; pp. 1–29.Google Scholar
Anderson, J, Ruggeri, K, Steemers, K, Huppert, F. Lively social space, well-being activity, and urban design: findings from a low-cost community-led public space intervention. Environ Behav. 2017; 49, 685–716.CrossRefGoogle Scholar