Implementation intentions as an acceptable health behaviour change strategy? Insights from people with lower socio‐economic position in think‐aloud interviews

British Journal of Health Psychology, vol. 31, pp. e70090

Abstract

OBJECTIVES: Implementation intentions are simple action plans that may help people with lower socio-economic position (SEP) to navigate their behaviour in environments that undermine their healthy intentions. Implementation intentions hold potential in being a relatively simple, but remarkably effective behaviour change technique. However, it remains unclear whether such a micro-intervention fits the daily realities, needs and skills of lower SEP groups. We aimed to explore how adults with lower SEP (1) perceive (generating) implementation intentions for changing their health behaviour, and (2) independently generate implementation intentions. METHODS: Adults living in lower SEP neighbourhoods (n = 15) participated in semi-structured interviews. Participants were instructed to think aloud while independently generating an implementation intention following written instructions. Interview data were thematically analysed, and the plans were evaluated. RESULTS: Participants perceived health as a central value in life, which translated into high readiness for health behaviour change. Implementation intentions were perceived as helpful and motivating because they provide structure, support small, doable steps and stimulate conscious decisions and reflections. Participants expressed strong motivation to use implementation intentions in daily life. However, although participants expressed that generating their plan was pleasant and easy, guidance was frequently requested and provided during plan formation. Besides, generated plans often lacked the essential if-then structure and concreteness. CONCLUSIONS: Implementation intentions appear acceptable and appealing as a behaviour change strategy for adults with lower SEP. However, independent formation of well-structured, actionable plans is challenging. Guided support is needed to ensure successful use of implementation intentions in lower SEP populations.

Authors 5

1. Loes van den Bekerom corresponding Aachen

   Leiden University Medical Center

   Affiliation as printed

   Health Campus the Hague/Department of Public Health and Primary Care Leiden University Medical Center The Hague/Leiden the Netherlands

2. Laurens C. van Gestel Aachen Health

   Leiden University

   Affiliation as printed

   Health, Medical and Neuropsychology Unit Leiden University Leiden the Netherlands

3. Satu Koivusaari Aachen Health

   Leiden University

   Affiliation as printed

   Health, Medical and Neuropsychology Unit Leiden University Leiden the Netherlands

4. Jet Bussemaker Aachen Institute of Public Administration

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Health Campus the Hague/Department of Public Health and Primary Care Leiden University Medical Center The Hague/Leiden the Netherlands

   The Institute of Public Administration, Leiden University Leiden the Netherlands

5. Marieke A. Adriaanse Aachen Health

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Health Campus the Hague/Department of Public Health and Primary Care Leiden University Medical Center The Hague/Leiden the Netherlands

   Health, Medical and Neuropsychology Unit Leiden University Leiden the Netherlands