Taking back control: dealing with impulsive processes in digital health behaviour change.

收回控制权：处理数字健康行为变化中的冲动过程。

• 批准号: ES/T009039/1
• 负责人: Samantha Van Beurden
• 金额: $ 12.49万
• 依托单位: UNIVERSITY OF EXETER
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FT009039%2F1
• 关键词: Taking; back; control; dealing; impulsive

Many of us value our health, yet we still behave in ways that undermines it. Poor diet, smoking, alcohol consumption, and lack of exercise can cause a large number of diseases such as cardiovascular disease, type 2 diabetes, and cancer. Successfully changing these behaviours can help prevent, and in some cases treat, such conditions (e.g., weight loss can result in Type 2 Diabetes remission) which would have a substantial impact on the UK and global economy. However, our behaviours are complex and influenced by biological, psychological, social and environmental factors. To be able to support behaviour change, a good understanding of the behaviour and the influences on it is crucial.Traditional methods of behaviour change have focused on informing about negative consequences of an unhealthy behaviour. These were meant to increase motivation and often also included educational components that provided instructions on which behaviours to perform and how. But, even when motivated, people still struggle to change their behaviour. Much of human behaviour is guided by impulsive, non-conscious processes that are triggered by situational cues, which means that in most instances we act without thinking. This helps us to be fast and efficient - we do not have to consciously think about every single thing we do all of the time. However, these processes can get in the way of successful behaviour change, leading to the relapse to and maintenance of unhealthy, but often psychologically-rewarding, automatic and habitual behaviours. Sometimes we are aware of the struggle or conflict between what has been triggered in-the-moment (e.g., desire to eat a piece of cake) and what we know we should be doing for our long-term goals (e.g., desire to manage our weight). The experience of such a struggle is often described as a temptation. More effective ways of supporting behaviour change would help people to manage these impulsive processes. Such approaches should provide support as and when required. During my PhD, I used the Intervention Mapping approach to help develop a smartphone app-based intervention (ImpulsePal) that is person-centred and informed by theory and research evidence. This digital intervention offers a variety of strategies including a brain training game (food inhibition training), location-based goal reminders, if-then planning, a mindfulness-based strategy, and an emergency button. Participants using the app in the feasibility trial lost more weight than those who did not use the app. Interviews with app users suggest that they valued having access to in-the-moment support. They also felt more aware of the influences on their eating behaviour, which prompted them to do something about it. Some also mentioned that their cravings changed in frequency and intensity over time and that therefore the need to use these strategies reduced over time.My goal is to pursue this avenue of research within academia. This fellowship would enhance my future applications for research funding and faculty positions in a number of ways. One study would help me to further explore the within-person changes in craving frequency and intensity mentioned in the interviews, and to link them to the strategies the individual had been using. This could help refine ImpulsePal to offer appropriate support at key times. This study would also help me to expand my research and analytical skill set. I would use the opportunity to explore various options for the full-scale evaluation of the ImpulsePal app, it's roll-out, and adaptation for application in other clinical areas (e.g., alcohol consumption). I will further use the Fellowship to build professional networks, disseminate my work more widely, enhance my subject-specific knowledge, and acquire additional research, teaching, and other academic skills. The aim is to strengthen as an independent researcher to be able to contribute more effectively to research in this area.

我们很多人都很重视自己的健康，但我们的行为方式仍然会损害健康。不良的饮食、吸烟、饮酒和缺乏锻炼会导致大量疾病，如心血管疾病、2型糖尿病和癌症。成功地改变这些行为可以帮助预防，并在某些情况下治疗此类疾病（例如，体重减轻可以导致2型糖尿病缓解），这将对英国和全球经济产生重大影响。然而，我们的行为是复杂的，受到生物、心理、社会和环境因素的影响。为了能够支持行为改变，很好地理解行为及其影响是至关重要的。改变行为的传统方法侧重于告知不健康行为的负面后果。这些都是为了增加动机，通常还包括教育成分，提供指导哪些行为应该执行以及如何执行。但是，即使受到激励，人们仍然很难改变自己的行为。人类的许多行为都是由冲动、无意识的过程引导的，这些过程是由情境线索触发的，这意味着在大多数情况下，我们的行为是不假思索的。这有助于我们快速高效——我们不必每时每刻都有意识地思考我们所做的每一件事。然而，这些过程可能会阻碍成功的行为改变，导致不健康的，但往往是心理上有益的，自动和习惯性的行为的复发和维持。有时，我们会意识到当下被触发的事情（例如，想吃一块蛋糕）和我们知道我们应该为我们的长期目标做的事情（例如，控制体重的愿望）之间的斗争或冲突。这种挣扎的经历常常被描述为一种诱惑。支持行为改变的更有效方法将帮助人们管理这些冲动过程。这种方法应在需要时提供支持。在我的博士学位期间，我使用干预映射方法来帮助开发一种基于智能手机应用程序的干预（脉冲），它以人为本，并由理论和研究证据提供信息。这种数字干预提供了各种各样的策略，包括大脑训练游戏（食物抑制训练）、基于位置的目标提醒、如果-然后计划、基于正念的策略和紧急按钮。在可行性试验中使用该应用程序的参与者比没有使用该应用程序的参与者减掉了更多的体重。对应用程序用户的采访表明，他们重视获得即时支持。他们也更加意识到自己的饮食行为受到了影响，这促使他们采取了一些措施。一些人还提到，他们的渴望随着时间的推移在频率和强度上发生了变化，因此使用这些策略的必要性随着时间的推移而减少。我的目标是在学术界进行这方面的研究。这项奖学金将在很多方面增强我未来申请研究基金和教职的能力。一项研究将帮助我进一步探索访谈中提到的渴望频率和强度的个人内部变化，并将它们与个人一直使用的策略联系起来。这有助于改进impulse，以便在关键时刻提供适当的支持。这项研究也将帮助我扩展我的研究和分析技能。我会利用这个机会对impulse app的全面评估、推出以及在其他临床领域（如酒精消费）的应用进行调整。我将进一步利用奖学金建立专业网络，更广泛地传播我的工作，提高我的专业知识，并获得更多的研究、教学和其他学术技能。其目的是加强作为一名独立研究人员能够更有效地为这一领域的研究作出贡献。

项目成果

White Paper: Open Digital Health - accelerating transparent and scalable health promotion and treatment

• DOI: 10.1080/17437199.2022.2046482
• 发表时间: 2022-03-11
• 期刊: HEALTH PSYCHOLOGY REVIEW
• 影响因子: 9.8
• 作者: Kwasnicka, Dominika;Keller, Jan;Sanderman, Robbert
• 通讯作者: Sanderman, Robbert

The BMJ Awards 2020: Stroke and cardiovascular team of the year.

2020 年 BMJ 奖：年度中风和心血管团队。

• DOI: 10.1136/bmj.m844
• 发表时间: 2020
• 期刊: BMJ (Clinical research ed.)
• 作者: Wise J