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      Non-conscious processes in changing health-related behaviour: a conceptual analysis and framework

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          ABSTRACT

          Much of the global burden of non-communicable disease is caused by unhealthy behaviours that individuals enact even when informed of their health-harming consequences. A key insight is that these behaviours are not predominantly driven by deliberative conscious decisions, but occur directly in response to environmental cues and without necessary representation of their consequences. Consequently, interventions that target non-conscious rather than conscious processes to change health behaviour may have significant potential, but this important premise remains largely untested. This is in part due to the lack of a practicable conceptual framework that can be applied to better describe and assess these interventions. We propose a framework for describing or categorising interventions to change health behaviour by the degree to which their effects may be considered non-conscious. Potential practical issues with applying such a framework are discussed, as are the implications for further research to inform the testing and development of interventions. A pragmatic means of conceptualising interventions targeted at non-conscious processes is a necessary prelude to testing the potency of such interventions. This can ultimately inform the development of interventions with the potential to shape healthier behaviours across populations.

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          Most cited references 50

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          The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions.

          CONSORT guidelines call for precise reporting of behavior change interventions: we need rigorous methods of characterizing active content of interventions with precision and specificity. The objective of this study is to develop an extensive, consensually agreed hierarchically structured taxonomy of techniques [behavior change techniques (BCTs)] used in behavior change interventions. In a Delphi-type exercise, 14 experts rated labels and definitions of 124 BCTs from six published classification systems. Another 18 experts grouped BCTs according to similarity of active ingredients in an open-sort task. Inter-rater agreement amongst six researchers coding 85 intervention descriptions by BCTs was assessed. This resulted in 93 BCTs clustered into 16 groups. Of the 26 BCTs occurring at least five times, 23 had adjusted kappas of 0.60 or above. "BCT taxonomy v1," an extensive taxonomy of 93 consensually agreed, distinct BCTs, offers a step change as a method for specifying interventions, but we anticipate further development and evaluation based on international, interdisciplinary consensus.
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            Reflective and impulsive determinants of social behavior.

            This article describes a 2-systems model that explains social behavior as a joint function of reflective and impulsive processes. In particular, it is assumed that social behavior is controlled by 2 interacting systems that follow different operating principles. The reflective system generates behavioral decisions that are based on knowledge about facts and values, whereas the impulsive system elicits behavior through associative links and motivational orientations. The proposed model describes how the 2 systems interact at various stages of processing, and how their outputs may determine behavior in a synergistic or antagonistic fashion. It extends previous models by integrating motivational components that allow more precise predictions of behavior. The implications of this reflective-impulsive model are applied to various phenomena from social psychology and beyond. Extending previous dual-process accounts, this model is not limited to specific domains of mental functioning and attempts to integrate cognitive, motivational, and behavioral mechanisms.
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              Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence.

              Numerous theories in social and health psychology assume that intentions cause behaviors. However, most tests of the intention- behavior relation involve correlational studies that preclude causal inferences. In order to determine whether changes in behavioral intention engender behavior change, participants should be assigned randomly to a treatment that significantly increases the strength of respective intentions relative to a control condition, and differences in subsequent behavior should be compared. The present research obtained 47 experimental tests of intention-behavior relations that satisfied these criteria. Meta-analysis showed that a medium-to-large change in intention (d = 0.66) leads to a small-to-medium change in behavior (d = 0.36). The review also identified several conceptual factors, methodological features, and intervention characteristics that moderate intention-behavior consistency.
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                Author and article information

                Journal
                Health Psychol Rev
                Health Psychol Rev
                RHPR
                rhpr20
                Health Psychology Review
                Routledge
                1743-7199
                1743-7202
                1 October 2016
                16 February 2016
                : 10
                : 4
                : 381-394
                Affiliations
                [ a ]Behaviour and Health Research Unit, University of Cambridge , Cambridge, UK
                [ b ]Department of Psychiatry, University of Cambridge , Cambridge, UK
                Author notes
                [CONTACT ] Gareth J. Hollands gareth.hollands@ 123456medschl.cam.ac.uk

                Supplemental material for this article can be accessed at 10.1080/17437199.2015.1138093.

                1138093
                10.1080/17437199.2015.1138093
                5214381
                26745243
                © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Counts
                Figures: 2, Tables: 0, Equations: 0, References: 50, Pages: 14
                Product
                Funding
                Funded by: UK Department of Health Policy Research Programme
                Award ID: 107/0001
                Categories
                Article
                Special Section on Non-Consious Processes in Health Psychology

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