Reading : Hale and Hearty Policie, How Psychological Science Can Create and Maintain Healthy Habits (Rothman et al. 2015) Flashcards
Basic argument of the paper
Advancements in psychological science need to be used to guide health interventions in order for them to be effective.
Four strategies to guide interventions
a) focus on beliefs that motivate healthy action
(b) form intentions that are more likely to lead to healthy action
(c) disrupt the influence of prior unhealthy habits
(d) develop routines that lead to new healthy habits.
a) Strategies that motivate action
People generally are reluctant to recognize personal risks and are overconfident about their own invulnerability to health problems.
Avoid this tendency to minimize own vulnerability by… focusing health messages on impact to others
e.g. “Hand hygiene prevents you from catching diseases.” Specifically, when an appeal was altered to refer to “patients” instead of “you,” rates of hand washing increased by 10% and soap use increased by 45%.
a) Strategies That Motivate Action: implications for policy
-Policies to promote hand washing in health care facilities and eating establishments should emphasize the implications for patients and customers, respectively.
-Policies to promote precautionary behaviors such as wearing seat belts or bike helmets could remind parents of the consequences for their children.
b) Strategies that Aid the Translation of Intentions into Action : problem + why it occurs
-Even when people decide to take action to improve their health there is on average only a 50% chance that their intention will lead to action. –> how can this gap be bridged?
- Why might intent and actions differ? An intention is forgotten, the opportunity to take action passes, or confusion about how to act engenders paralysis. Initial efforts could be derailed by falling prey to temptations, distractions, fatigue or losing will power.
b) Strategies that Aid the Translation of Intentions into Action
Combat using if-then plans = “If (opportunity/obstacle) arises, then I will (respond in this way)!”
If/ then plans are particularly effective when people find themselves in situations that impact their ability to translate healthy intentions into action (e.g. limitations in self-control).
b) Strategies that Aid the Translation of Intentions into Action: implications for policy
-Policies should ensure that people can formulate if–then plans on documents such as doctor’s appointment letters.
-Policies should ensure that the provision of medication prescriptions or behavioral instructions include an opportunity to formulate an if–then plan.
c) Strategies to Disrupt Existing Habits: problem + why it occurs
It is hard to disrupt older habitual behavioural patterns with new healthier ones –> habits involve memory systems that are relatively separate from those that represent people’s goals and conscious intentions. Familiar contexts and routines can bring the old unwanted behaviours back.
c) Strategies to Disrupt Existing Habits: two approaches
One approach = capitalizing on context changes in people’s lives e.g. moving house. A shift in context reduces risk of old cues that will result in the unwanted habitual behaviour. Can also do this deliberately by modifying your microenvironment e.g. changing the visibility or arrangement of food choices.
A second approach involves policies that introduce behavioral friction to existing contexts that make it harder for people to follow their unhealthy habits e.g. ban of smoking in UK pubs (where people habitually smoke –> messes with the link between smoking and drinking). Same deal with having to ask for cigarettes at a counter instead of them being on the shelf.
c) Strategies to Disrupt Existing Habits –> Remove or bypass cues that trigger an old habit: policy implications
-Distribute public transportation information and free transit vouchers to people who have recently moved.
-Design buildings so that stairways are salient and encountered before elevators.
c) Strategies to Disrupt Existing Habits –> Create behavioral friction to impede the habitual response and encourage consideration of alternatives
-Ban display of products such as cigarettes in retail stores so that purchasers have to request them.
-Restaurants should provide healthy alternatives as the default option in “value meal” packages (e.g., apple slices instead of fries).
d) Strategies to Develop Routines That Create New Habits
Could involve repetition of the desired behaviour I a stable context e.g. taking a walk after dinner. Once this habit is formed, people can rely on the behaviour to protect them even when they are distracted/ will power is low e.g. during exam time.
Alternatively could piggy back onto another behaviour e.g. flossing directly after teeth brushing (something you have already established a routine for).
d) Strategies to Develop Routines That Create New Habits: implications for policy
-Elementary school curricula could include the regular performance of context-stable health behaviors (e.g., hand washing after using the restroom).
-Product labels as well as pharmacists can instruct patients how to piggyback medication onto existing daily routines.
