Habit Theory in Health

Psychological research on habit formation suggests that making healthy behaviours habitual and breaking the habits underlying unhealthy behaviours can lead to sustainable changes in individuals' actions.

Habits, defined as actions triggered automatically by contextual cues, reduce dependence on conscious attention and motivational processes, making health-promoting actions more automatic and effortless. This is particularly relevant in public health, as it allows for the development of interventions that focus on creating and modifying habits to improve health outcomes. By understanding the psychology of habit formation, public health professionals can provide simple and sustainable behaviour change advice, ultimately contributing to the promotion of healthy living and the prevention of poor health. Additionally, behavioural science theory, including habit-based approaches, can help unify knowledge, predict behaviour, and guide the development of effective public health interventions, making it more likely for public health nursing efforts to succeed. Therefore, integrating habit-based theories into public health strategies can significantly enhance the effectiveness of health promotion and behaviour change initiatives.

Recommended Reading

Gardner, B., Rebar, A. L., & Lally, P. (2022). How does habit form? Guidelines for tracking real-world habit formation. Cogent psychology, 9(1), 2041277. https://doi.org/10.1080/23311908.2022.2041277 

Further Reading

Automatic versus controlled processing

• Hollands, G. J., Marteau, T. M., & Fletcher, P. C. (2016). Non-conscious processes in changing health-related behaviour: a conceptual analysis and framework. Health Psychology Review, 10(4), 381-394. https://doi.org/10.1080/17437199.2015.1138093

• Marteau, T. M., Hollands, G. J., & Fletcher, P. C. (2012). Changing human behavior to prevent disease: the importance of targeting automatic processes. Science, 337(6101), 1492-1495. https://doi.org/10.1126/science.1226918

Habits

• Gardner, B. (2015). A review and analysis of the use of ‘habit ’in understanding, predicting and influencing health-related behaviour. Health Psychology Review, 9(3), 277-295. https://doi.org/10.1080/17437199.2013.876238

• Gardner, B., Lally, P., & Wardle, J. (2012). Making health habitual: the psychology of ‘habit-formation’ and general practice. British Journal of General Practice, 62(605), 664-666. Gardner, B., Lally, P., & Wardle, J. (2012). Making health habitual: the psychology of ‘habit-formation' and general practice. British Journal of General Practice, 62(605), 664-666. https://doi.org/10.3399/bjgp12X659466

• Gardner, B., Arden, M. A., Brown, D., Eves, F. F., Green, J., Hamilton, K., ... & Lally, P. (2023). Developing habit-based health behaviour change interventions: Twenty-one questions to guide future research. Psychology & health, 38(4), 518-540. https://doi.org/10.1080/08870446.2021.2003362

• Orbell, S., & Verplanken, B. (2010). The automatic component of habit in health behavior: habit as cue-contingent automaticity. Health psychology, 29(4), 374. https://psycnet.apa.org/doi/10.1037/a0019596

• Wood, W., & Rünger, D. (2016). Psychology of habit. Annual Review of Psychology, 67, 289-314. https://doi.org/10.1146/annurev-psych-122414-033417

• Wood, W., & Neal, D. T. (2016). Healthy through habit: Interventions for initiating & maintaining health behavior change. Behavioral Science & Policy, 2(1), 71-83. https://doi.org/10.1177/237946151600200109

Implementation intentions

• Prestwich, A., Sheeran, P., Webb, T.L. & Gollwitzer, P.M. (2015). Implementation intentions. In M. Conner and P. Norman (eds.). Predicting and Changing Health Behaviour. Research and Practice with Social Cognition Models. Berkshire, England: Open University Press.

Cognitive bias modification

• Field, M., Werthmann, J., Franken, I., Hofmann, W., Hogarth, L., & Roefs, A. (2016). The role of attentional bias in obesity and addiction. Health Psychology, 35(8), 767. https://psycnet.apa.org/doi/10.1037/hea0000405

• Jones, A., Hardman, C. A., Lawrence, N., & Field, M. (2017). Cognitive training as a potential treatment for overweight and obesity: A critical review of the evidence: Proposal for special issue in appetite: Executive function training & eating behaviour. Appetite, 124, 50-67. https://doi.org/10.1016/j.appet.2017.05.032

Priming

• Papies, E. K. (2016). Health goal priming as a situated intervention tool: how to benefit from nonconscious motivational routes to health behaviour. Health Psychology Review, 10(4), 408-424.

• Custers, R., & Aarts, H. (2010). The unconscious will: How the pursuit of goals operates outside of conscious awareness. Science, 329(5987), 47-50.

Ease of behaviour

• Bucher, T., Collins, C., Rollo, M. E., McCaffrey, T. A., De Vlieger, N., Van der Bend, D., ... & Perez-Cueto, F. J. (2016). Nudging consumers towards healthier choices: a systematic review of positional influences on food choice. British Journal of Nutrition, 115(12), 2252-2263.

• Johnson, E.J. & Goldstein, D. (2003). Do defaults save lives? Science, 302, 1338-1339.

• Samuelson, W., & Zeckhauser, R. (1988). Status quo bias in decision making. Journal of Risk and Uncertainty, 1(1), 7-59.

The Self-report habit Index - https://psycnet.apa.org/doiLanding?doi=10.1037%2Ft03772-000

Physical Activity

• Hawlader, M. D. H., Mozid, N. E., Sharmin, S., Monju, I. H., Ahmed, S. B., Sarker, W., ... & Dalal, K. (2023). The art of forming habits: applying habit theory in changing physical activity behaviour. Journal of Public Health, 31(12), 2045-2057. https://doi.org/10.1007/s10389-022-01766-4

• Hagger, M. S. (2019). Habit and physical activity: Theoretical advances, practical implications, and agenda for future research. Psychology of Sport and Exercise, 42, 118-129. https://doi.org/10.1016/j.psychsport.2018.12.007

Weight Loss/Diet/Dietary Change

• Gardner, B., Richards, R., Lally, P., Rebar, A., Thwaite, T., & Beeken, R. J. (2021). Breaking habits or breaking habitual behaviours? Old habits as a neglected factor in weight loss maintenance. Appetite, 162, 105183. https://doi.org/10.1016/j.appet.2021.105183

• Rothman, A. J., Sheeran, P., & Wood, W. (2009). Reflective and automatic processes in the initiation and maintenance of dietary change. Annals of behavioral medicine, 38(suppl_1), s4-s17. https://doi.org/10.1007/s12160-009-9118-3

• Lin, P. Y., Wood, W., & Monterosso, J. (2016). Healthy eating habits protect against temptations. Appetite, 103, 432-440. https://doi.org/10.1016/j.appet.2015.11.011

• Mullan, B., Olivier, C., & Thøgersen‐Ntoumani, C. (2021). Mind the gap: Habit and self‐determined motivation predict health behaviours in middle‐aged and older adults. British Journal of Health Psychology, 26(4), 1095-1113. https://doi.org/10.1111/bjhp.12522

Hand Washing

• Aunger, R., Schmidt, W. P., Ranpura, A., Coombes, Y., Maina, P. M., Matiko, C. N., & Curtis, V. (2010). Three kinds of psychological determinants for hand-washing behaviour in Kenya. Social science & medicine, 70(3), 383-391. https://doi.org/10.1016/j.socscimed.2009.10.038

Medication

• Phillips, L. A., Leventhal, H., & Leventhal, EA (2013). Assessing theoretical predictors of long-term medication adherence: Patients' treatment-related beliefs, experiential feedback and habit development. Psychology & Health, 28(10), 1135-1151. 

Dental Hygiene

• Judah, G., Gardner, B., & Aunger, R. (2013). Forming a flossing habit: An exploratory study of the psychological determinants of habit formation. British journal of health psychology, 18(2), 338-353. https://doi.org/10.1111/j.2044-8287.2012.02086.x