A process-oriented measure of habit strength for moderate-to-vigorous physical activity

App-Based Physical Activity Intervention Among Women With Prior Hypertensive Pregnancy Disorder: A Randomized Clinical Trial

Importance

Insufficient moderate to vigorous physical activity (MVPA) is a risk factor for cardiovascular disease (CVD). Effective interventions are needed to bridge the intention-behavior gap and increase MVPA, especially among women with prior hypertensive pregnancy disorder (HPD).

Objective

To test the effectiveness of two 8-week app-based MVPA interventions (motivation and action) that were based on the integrated behavior change (IBC) model and used evidence-based behavior change techniques from behavioral sciences.

Design, Setting, and Participants

This randomized clinical trial (RCT) included women with prior HPD. A purpose-built app was tested from October 2021 to March 2022, with follow-up immediately after the intervention (week 9), 3 months later (week 21), and 12 months later (week 61). The study ended in May 2023. Data were analyzed from March 31, 2022, to June 9, 2024.

Intervention

All participants received a wearable fitness tracker and a purpose-built physical activity intervention app and were randomized to 1 of 3 groups (control, motivation, or action): The control group received information on CVD, MVPA, and HPD; the motivation group received the same information as well as motivational interviewing-based counseling; and the action group received the same information as well as behavior change techniques that targeted all processes in the IBC model (motivational, volitional, automatic): motivational interviewing-based counseling, action and coping planning, commitment, positive psychology, and mindfulness-based stress reduction.

Main Outcomes and Measures

The primary outcome was MVPA (in minutes per week). Treatment effects were estimated using available case ordinary least-squares regression.

Results

A total of 619 women participated in this study: 205 in the control group, 209 in the motivation group, and 205 in the action group. Their mean (SD) age was 38.9 (7.3) years; 386 of 577 participants (67%) had a bachelor's degree or more and 550 of 577 (95%) were living with a child or children. The mean (SD) weekly MVPA for all 3 groups went from a high baseline of 242 (190) minutes to 197 (208) minutes immediately post intervention. No significant postintervention treatment effects on MVPA were observed for the action group (week 9 treatment effect, -17 [95% CI, -58 to 23] min/wk) or the motivation group (week 9 treatment effect, -3 [95% CI, -58 to 51] min/wk), despite the action intervention positively influencing motivational and volitional processes. The app and intervention components were all evaluated positively by participants.

Conclusions and Relevance

In this clinical trial of 2 app-based MVPA interventions among 619 women with prior HPD, no treatment effects on MVPA were observed. Possible explanations include (1) the importance of automatic processes in determining MVPA and the absence of treatment effects on these processes and (2) the high baseline activity levels of control group participants, which may have given less room for the treatments to improve upon. These are important considerations for those designing future MVPA interventions and RCTs.

Trial Registration

Netherlands Trial Register Identifier: NL9329.

Predicting alcohol consumption: Application of an integrated social cognition model of intentions, habits, and cue consistency

Drinking alcohol in excess is associated with deleterious health outcomes, highlighting the need for research to identify potentially modifiable correlates of excessive alcohol consumption to target in behavioral interventions. The present two-wave prospective correlational study applied an integrated theoretical model that included theory of planned behavior constructs alongside habit, cue consistency, affective attitudes, and past behavior as predictors of two alcohol-related behaviors, drinking within safe limits and regular alcohol drinking, in separate samples of Australian undergraduate students (total N = 474). Structural equation models identified direct effects of habit, affective attitude, and subjective norms on intention for both behaviors. Habit at follow-up, cue consistency, and past behavior directly predicted behavior in both samples, whereas intention predicted behavior only for drinking within safe limits, and affective attitude only predicted behavior for regular drinking. Cue consistency moderated the effects of habit on behavior for both behaviors and moderated the effect of past behavior on regular drinking. Results corroborate past behavior and habit as key correlates of behavior and provide preliminary evidence of the importance of integrating cue consistency, a defining characteristic of habit, as a moderator of habit and past behavior effects an integrated theory test.

Contextual disruption and exercise: mapping changes to exercise routines and engagement during the COVID-19 pandemic

OBJECTIVE

This study examines the impact of COVID-19 restrictions on exercise routines and engagement in moderate-vigorous physical activity (MVPA).

DESIGN

Individuals (N = 397) who reported meeting recommended guidelines for MVPA prior to COVID-19 completed an online questionnaire during the United States' COVID-19 lockdowns in April/May 2020.

MAIN OUTCOME MEASURES

Participants reported their MVPA currently and before COVID-19, and answered questions about five contextual cues (e.g. time of day, interaction partners, type of workout, surrounding events, location of exercise) that characterized their exercise routines currently and before COVID-19.

RESULTS

Contextual cues were perceived as highly disrupted and less consistent during COVID-19 (vs. before) and these changes were associated with greater declines in MVPA. For each cue, distinct effects predicting MVPA declines also emerged for perceived disruption due to COVID-19 restrictions, perceived importance of cue in getting one to exercise, and cue consistency over time.

CONCLUSION

Building on prior research, COVID-19 restrictions affected the context in which people exercised, and changes in these contextual cues were related to declines in MVPA. Re-establishing consistency in certain cues (e.g. time of day) after a disruption may help to forestall declines in MVPA compared to others (e.g. type of workout).

The relationship between exercise intention and behavior of Chinese college students: A moderated mediation model

Inconsistency between intention and behavior is very common in daily life. This study explored the intention-behavior relationship in exercise, focusing on the mediating effect of action planning and the moderating effects of habit strength and gender. For the purpose of providing theoretical reference for the implementation of intervention strategies in the volitional phase, a total of 489 college students (M-age = 20.61, 57.46% female) from Hubei Province, China, were recruited to complete the questionnaire at two time points. The findings showed that exercise intention could positively predict exercise behavior via the mediating effect of action planning, with the mediating effect accounting for 48.52% of the total effect. The predictive effect of action planning × habit strength interaction on exercise behavior was statistically significant. As individuals’ levels of habitual strength increased, so did the relationship between action plans and exercise behavior. The action planning-exercise behavior relationship was stronger in males than in females. In summary, action planning is a very important predictor of the post-intentional phase and has many advantages. For individuals whose exercise has become habitualized, forming a plan is not counterproductive and can still promote more exercise rather than in a mutually compensating manner.

Development and validation of a Japanese translation of the K-SF-42

In this study, we conducted the translation and validation of the K-SF-42 in Japan (Figueredo, 2017). The K-SF-42 is a new short form of the Arizona Life History Battery. We obtained empirical evidence that the original seven-factor structure could be applied to the Japanese translated version of K-SF-42 (K-SF-42-J). We also observed good internal consistency of the seven scales of K-SF-42-J. The multi-group confirmatory factor analysis findings suggest that the K-SF-42-J can be used in both sexes and diverse age groups. The K-SF-42-J scales showed similar correlates as the English original, with higher scores of other life history strategy measurement, trait emotional intelligence, well-being, and cultural and social resources in childhood. Use of the K-SF-42-J will allow researchers with Japanese speaking samples to integrate their findings with the existing life history strategy research literature. The brevity of the K-SF-42-J will be appealing to researchers who are concerned about taxing the time and motivation of their participants.

On the pitfalls of conceptualizing excessive physical exercise as an addictive disorder: Commentary on Dinardi et al. (2021)

This commentary challenges some of the proposals made in the opinion paper entitled "The expanded interactional model of exercise addiction" by Dinardi, Egorov, and Szabo (2021). We first question the usefulness of the (expanded) interactional model of exercise addiction to determine the psychological processes underlying distress and functional impairment in excessive physical exercise. We then consider the authors' use of the Self-Determination Theory to model exercise addiction, which risks the misclassification of strenuous, but adaptive, patterns of physical exercise as exercise addiction. We finally address broader concerns regarding the idea that maladaptive exercising could be conceptualized as an addictive disorder.

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.

Automaticity facets applied to screen-time sedentary behaviours and active commuting measured by accelerometers

Background: The time adults spend sitting in front of screens is a health risk factor. In contrast, walking and cycling to and from work, also known as active commuting, could promote physical activity and improve population health.

Objective: This study investigated automatic properties role in explaining active commuting and screen-based sedentary behaviours. The stable, daily conditions for carrying out active commuting and screen-based sedentary behaviour are most likely to develop automatic properties. These characteristics mean performing behaviours via external cues (i.e. lack of intentionality), with an unpleasant emotional experience of not carrying out a set routine (i.e. lack of controllability), and without paying much attention (i.e. efficiency).

Method: This article describes findings of a prospective and correlational study in which 128 people participated. First, participants responded to questions assessed using the Generic Multifaceted Automaticity Scale (GMAS), which measured the automatic properties of screen-based sedentary behaviour and active commuting. The following week, both behaviours were assessed by daily logs to document active commuting and screen-based sedentary behaviour events, and by an accelerometer, worn for seven days, as an objective criterion. Confirmatory factor analyses, bivariate correlations, and multiple linear regressions were computed for the associations between the GMAS scores and objective criterion measures of screen-based sedentary behaviours and active commuting.

Results: Automaticity facets displayed different relationships with screen-based sedentary behaviours and active commuting – people with higher lack of intentionality and lack of controllability for active commuting present higher levels of moderate physical activity. In contrast, the lack of controllability of screen-based sedentary behaviours was a significant predictor of sedentary screen time.

Conclusions: The multidimensional approach to automaticity could be useful in determining more precisely the features that need to be addressed to promote the adoption of active commuting and limit the time spent sitting in front of screens.

Cue Consistency Associated with Physical Activity Automaticity and Behavior

Physical activity is partly regulated by automatic processes such as habits (ie, well-learned responses to cues), but it remains unclear what cues trigger these processes. This study examined the relations of physical activity automaticity and behavior with the consistency of people, activity, routine, location, time, and mood cues present upon initiation of physical activity behavior. Australian adults (N = 1,244, 627 female, M age = 55 years) reported their physical activity automaticity, behavior, and the degree of consistency of these cues each time they start a physical activity behavior. Multiple regression models, which accounted for gender and age, revealed that more consistent routine and mood cues were linked to more physical activity automaticity; whereas more consistent time and people cues were linked to more physical activity behavior. Interventions may more effectively translate into long-lasting physical activity habits if they draw people's attention to the salient cues of time, people, routine, and mood.