1. L. Alison Phillips, August 25, 2017
How Universal Should Techniques for Habit Formation Be? Consideration of Individual Differences and Behavior-Specific Factors
L. Alison Phillips, August 25, 2017

2. The Science of Habit Consensus on habit definition and measurement?
Largely (see Gardner, 2015)
Remaining questions for complex health behaviors
Definition and measurement necessary for intervention design and evaluation

3. Habits are learned, automatic responses with features1,2:
Activation by recurring context cues
Context stability (same time, same place)
Not goal-dependent; devaluing response outcomes
Rigid, chunked response
Automatic: non-conscious, uncontrollable, without awareness, unintentional
1Wood et al., 2014; 2Wood & Rünger, 2016

4. Here is a picture of the device I use to measure medication adherence
Here is a picture of the device I use to measure medication adherence. The bottle cap records the time the bottle is opened, so you can see if a patient takes his/her pill every day (or twice a day, whatever the regimen is) and if the timing is consistent across days.

5. 10pm
7pm
Reported Weak Habit
4pm
1pm
10am
7am
4am

6. Reported Strong Habit 10pm 7pm 4pm 1pm 10am 7am 4am
Although, a remaining Q about rewards…
7am
4am

7. What about exercise?

8. Habits are learned, automatic responses with features:
Activation by recurring stable, external context cues?

9. Here is a picture of the device I have used to measure physical activity, called the Fitbit.

10. Strong Habit Weak Habit High Physical Activity Low Physical Activity
We can sort of see exercise habit in physical activity data, but it’s not as easy as for medication adherence. Two of these people have reported strong exercise habits. Two have reported relatively weak exercise habits. For exercise, very few people have the same schedule every day of the week; therefore, if the cue is part of an existing daily routine, such as after work or after class, then the time of exercise will be similar across days from week to week but not from day to day within any one week. So harder to see and distinguish from random, effortful exercise.
Weak Habit

11. Habits are learned, automatic responses with features:
Activation by recurring stable, external context cues?
Weak evidence of rigid time and place
My data
Tappe & Glanz (2013)
External, time- and location-tied cues?
Internal/somatic? (e.g., when stressed; period of time)
Sequential? (e.g., “after last class”)
Generalized? (e.g., “before dinner”)

12. Habits are learned, automatic responses with features:
Not goal-dependent; devaluing response outcomes?

13. Exercise Habit Strength as a Function of Past Exercise Frequency and Intrinsic Motivation
From Gardner & Lally (2013)
β = 0.28***
β = 0.12*
β = -0.04

14. Initiators Maintainers Exercise Intention Intrinsic Motivation (+/-)
Exercise Frequency
Exercise Automaticity
Maintainers
Exercise Intention
Intrinsic Motivation (+/-)
Exercise Frequency
I published a paper recently with Eric Hekler showing that intrinsic rewards promote exercise frequency via automaticity, or habit strength, among those in a maintenance stage of change, showing the continued importance of rewards (but internal) for habitual engagement in exercise.
Exercise Automaticity
Phillips, L. A., Chamberland, P-E., Hekler, E. B., Abrams, J. A., & Eisenberg, M. H. (2016)

15. Habits are learned, automatic responses with features:
Not goal-dependent; devaluing response outcomes?
Not dependent on external goals or contexts…but internal rewards important for exercise

16. Habits are learned, automatic responses with features:
Rigid, chunked response?

17. Exercise Habit? Which Part?
After class, I run/walk briskly on the treadmill for about 30 to 40 minutes, then stretch for about 20 minutes. After that I do a workout for glutes for the length of a Beyonce song.

18. Exercise Instigation vs Execution
Figure from Gardner, Phillips, Judah (2016), BJHP
See Phillips & Gardner, 2016, Health Psychology

19. Habits are learned, automatic responses with features:
Rigid, chunked response?
Perhaps aiming for this (exercise execution habit) is not the best technique for behavior maintenance

20. Automaticity? Automaticity, not frequency of behavior Non-conscious?
Without awareness?
Uncontrollable?
Unintentional?
Different types of automaticity (Moors & DeHouwer, 2006)
Non-deliberative
Cognitively efficient
Physically efficient
Relatively easy
Default choice

21. Behavior-specific elements of habit… …Different processes and techniques of habit formation
Some behaviors (exercise!) require conscious awareness, energy, and time to perform
Some behaviors (taking meds!) do not have rewards

22. Now: Individual differences and an intervention study

24. Recent study
Intervention: education on behavioral goal + education on habit development + implementation intention
AM Cue
PM Cue
Control 1: education on behavioral goal only
Control 2: no specification of time for cue
Hypothesis:
Exercise habit: Matching diurnal preference with cue- timing will lead to strongest habit formation
Calcium supplementation habit: AM cue will lead to strongest habit formation, regardless of diurnal preference

25. Design & Method
2 (Chronotype: Morning-Type, Evening-Type) X 2 (Behavior: calcium supplementation, physical activity) X 4 (Cue-group: AM cue, PM cue, controls)
Participants
Women
No strong habits for physical activity or calcium supplementation
Equal morning-types and evening-types
Willing to engage in new health behavior for 1 month
5 measurements of constructs (intentions, habit strength, frequency, cue fidelity (4 time points))
Analysis…

28. Thank You Any Questions?
Acknowledgements:
Howard & Elaine Leventhal
Miriam Eisenberg
Eric Hekler
Kimberly More
Joshua Cohen
Benjamin Gardner
Edith Burns
Lisa McAndrew
Marcus, Caroline, Rebecca Credé
Wendy & Greg Phillips
Flickr/Mark Topper
L. Alison Phillips
Healthyhabitslab.org