title: Putting habit into practice, and practice into habit: a process evaluation and exploration of the acceptability of a habit-based dietary behaviour change intervention.
abstract: BACKGROUND
  Forming 'habit' - defined as a learned process that generates automatic responses to contextual cues - has been suggested as a mechanism for behaviour maintenance, but few studies have applied habit theory to behaviour change. This study used process evaluation data, taken from a randomised controlled trial of a healthy child-feeding intervention for parents previously shown to be effective, to explore the applicability to dietary behaviour change of predictions and recommendations drawn from habit theory. The intervention supported parents in pursuing child-feeding habit goals in three domains (giving fruit and vegetables, water, healthy snacks), over four fortnightly home visits. We explored whether (a) the habit-formation model was acceptable to participants, (b) better-specified habit-formation goals yielded greater habit gains, and (c) habit gains were sustained (d) even when subsequent, new habit goals were pursued.
  
  
  METHODS
  Qualitative and quantitative data were taken from 57 parents randomised to the intervention arm, and so analyses presented here used a pre-post intervention design. Thematic analysis of post-intervention qualitative interviews evaluated acceptability, and self-reported habit goals were content-analysed. ANOVAs explored changes in habit strength, recorded at home visits and one- and two-month follow-ups, across time and goals.
  
  
  RESULTS
  Participants understood and engaged positively with the habit-formation approach. Although many seemingly poorly-specified habit goals were set, goal characteristics had minimal impact on habit strength, which were achieved within two weeks for all behaviours (p's < .001), and were maintained or had increased further by the final follow-up.
  
  
  CONCLUSIONS
  The habit-formation model appears to be an acceptable and fruitful basis for dietary behaviour change.
authors.affiliation: Health Behaviour Research Centre, University College London, Gower Street, London, UK. b.gardner@ucl.ac.uk.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gardner
authors.forename: Kate
authors.initials: K
authors.lastname: Sheals
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.forename: Laura
authors.initials: L
authors.lastname: McGowan
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D058870:Food, Organic; D005638:Fruit; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D010865:Pilot Projects; D062410:Snacks; D012959:Socioeconomic Factors; D014675:Vegetables; D055815:Young Adult