Making health habitual: the psychology of ‘habit-formation’ and general practice
Open accessAbstract
The Secretary of State recently proposed that the NHS: ‘... take every opportunity to prevent poor health and promote healthy living by making the most of healthcare professionals’ contact with individual patients.’ 1 Patients trust health professionals as a source of advice on ‘lifestyle’ (that is, behaviour) change, and brief opportunistic advice can be effective.2 However, many health professionals shy away from giving advice on modifying behaviour because they find traditional behaviour change strategies time-consuming to explain and difficult for the patient to implement.2 Furthermore, even when patients successfully initiate the recommended changes, the gains are often transient3 because few of the traditional behaviour change strategies have built-in mechanisms for maintenance. Brief advice is usually based on advising patients on what to change and why (for example, reducing saturated fat intake to reduce the risk of heart attack). Psychologically, such advice is designed to engage conscious deliberative motivational processes, which Kahneman terms ‘slow’ or ‘System 2’ processes.4 However, the effects are typically short-lived because motivation and attention wane. Brief advice on how to change, engaging automatic (‘System 1’) processes, may offer a valuable alternative with potential for long-term impact. Opportunistic health behaviour advice must be easy for health professionals to give and easy for patients to implement to fit into routine health care. We propose that simple advice on how to make healthy actions into habits — externally-triggered automatic responses to frequently encountered contexts — offers a useful option in the behaviour change toolkit. Advice for creating habits is easy for clinicians to deliver and easy for patients to implement: repeat a chosen behaviour in the same context, until it becomes automatic and effortless. While often used as a synonym for frequent or customary behaviour in everyday parlance, within psychology, ‘habits’ are defined as actions that …
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Forming medication taking habits can reduce reliance on memory and help sustain behaviour change.
“Forming medication taking habits can reduce reliance on memory and help sustain behaviour change.39–42”
From Refining and optimising a behavioural intervention to support endocrine therapy adherence (ROSETA) in UK women with breast cancer: Protocol for a pilot fractional factorial trial (2023) · cites this paper as [41]
The Making Healthy Habits section says habits can persist with minimal effort or deliberation, and Habit Formation and Health suggests habit-formation advice can promote long-term behaviour change. The paper discusses diet and activity habits, not medication-taking specifically; it also does not explicitly address reliance on memory. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHabit-based advice is particularly useful in primary care, as it is less time consuming to explain and easier for patients to implement than traditional behaviour change strategies.
“Habit-based advice has been identified as particularly useful in primary care, as it is less time consuming to explain and easier for patients to implement than traditional behaviour change strategies.22”
From A brief intervention for weight control based on habit-formation theory delivered through primary care: results from a randomised controlled trial (2017) · cites this paper as [22]
Interventions targeting automatic actions have application where patients' level of engagement or motivation means that more traditional behavioural approaches with high demand for commitment achieve limited adherence.
“Interventions targeting automatic actions have application where patients’ level of engagement or motivation means that more traditional behavioural approaches with inherently high demand for commitment achieve limited adherence.22, 23”
From A brief intervention for weight control based on habit-formation theory delivered through primary care: results from a randomised controlled trial (2017) · cites this paper as [22]
Habit formation usually takes 2-3 months, and significant HbA1c changes require at least 3 months.
“This can be because habit formation usually takes 2-3 months [86], and significant HbA1c changes require at least 3 months [87].”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [86]
Implementing health-related behaviour change takes time and practice is important.
“Implementing health related behaviour change also takes time and with any skill, practice is important (Gardner et al., Citation2012).”
From The feasibility and acceptability of a single-session Acceptance and Commitment Therapy (ACT) intervention to support women self-reporting fear of childbirth in a first pregnancy. (2023) · cites this paper as Gardner et al., 2012
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Social Cognitive Theory: An Agentic Perspective
Bandura, A. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.1 · Cited by 15,510 · see citing works
Health benefits of physical activity: the evidence
Warburton, D. E. R. (2006) · Canadian Medical Association Journal · doi:10.1503/cmaj.051351 · Cited by 8,007 · see citing works
A perspective on judgment and choice: mapping bounded rationality.
Kahneman, D. (2003) · American Psychologist · doi:10.1037/0003-066x.58.9.697 · Cited by 5,540 · see citing works
The support of autonomy and the control of behavior.
Deci, E. L., & Ryan, R. M. (1987) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.53.6.1024 · Cited by 3,242 · see citing works
Systematic review and meta-analysis
Gillies, A. (2019) · CRC Press eBooks · doi:10.1201/9781315377315-19 · Cited by 2,659 · see citing works
The support of autonomy and the control of behavior.
Deci, E. L., & Ryan, R. M. (1987) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.53.6.1024 · Cited by 2,280 · see citing works
How are habits formed: modelling habit formation in the real world
Lally, P., van Jaarsveld, C. H. M., Potts, H. W. W., & Wardle, J. (2010) · European Journal of Social Psychology · doi:10.1002/ejsp.674 · Cited by 2,036 · see citing works
Self-citationPrinciples of Behavior. An Introduction to Behavior Theory
N., E., & Hull, C. L. (1943) · The Journal of Philosophy · doi:10.2307/2019960 · Cited by 1,731 · see citing works
A new look at habits and the habit-goal interface.
Wood, W., & Neal, D. T. (2007) · Psychological Review · doi:10.1037/0033-295x.114.4.843 · Cited by 1,470 · see citing works
Long-term maintenance of weight loss: Current status.
Jeffery, R. W., Epstein, L. H., Wilson, G. T., Drewnowski, A., Stunkard, A. J., & Wing, R. R. (2000) · Health Psychology · doi:10.1037/0278-6133.19.suppl1.5 · Cited by 1,093 · see citing works
Lally, P., & Gardner, B. (2013) · Health Psychology Review · doi:10.1080/17437199.2011.603640 · Cited by 901 · see citing works
Self-citationGardner, B., de Bruijn, G.-J., & Lally, P. (2011) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9282-0 · Cited by 574 · see citing works
Self-citationHow do habits guide behavior? Perceived and actual triggers of habits in daily life
Neal, D. T., Wood, W., Labrecque, J. S., & Lally, P. J. (2011) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2011.10.011 · Cited by 441 · see citing works
Self-citationHill, J. O. (2009) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26566 · Cited by 370 · see citing works
Reflective and Automatic Processes in the Initiation and Maintenance of Dietary Change
Rothman, A. J., Sheeran, P., & Wood, W. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9118-3 · Cited by 368 · see citing works
Experiences of habit formation: A qualitative study
Lally, P. J., Wardle, J., & Gardner, B. (2011) · Psychology Health & Medicine · doi:10.1080/13548506.2011.555774 · Cited by 277 · see citing works
Self-citationHealthy habits: efficacy of simple advice on weight control based on a habit-formation model
Lally, P., Chipperfield, A., & Wardle, J. (2008) · International Journal of Obesity · doi:10.1038/sj.ijo.0803771 · Cited by 250 · see citing works
Self-citationRobust habit learning in the absence of awareness and independent of the medial temporal lobe
Bayley, P. J., Frascino, J. C., & Squire, L. R. (2005) · Nature · doi:10.1038/nature03857 · Cited by 176 · see citing works
Gardner, B., & Lally, P. J. (2012) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9442-0 · Cited by 176 · see citing works
Self-citationBeeken, R. J., Croker, H., Morris, S., Leurent, B., Omar, R., Nazareth, I., & Wardle, J. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-667 · Cited by 83 · see citing works
Self-citationLawlor, D. A., Keen, S., & Neal, R. D. (2000) · PubMed · Cited by 71 · see citing works
Psychological, health and social predictors of emotional and social loneliness in older people
McKee, K., & Dahlberg, L. (2012) · Psychology and Health · Cited by 1 · see citing works
Habit-formation as a novel theoretical framework for dietary change in preschoolers
McGowan, L. J., Cooke, L., Croker, H. A., Wardle, J., & Gardner, B. (2012) · UCL Discovery (University College London) · Cited by 1 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [4]4. Kahneman D. A perspective on judgment and choice. Am Psychol 2003; 58(9): 697-720.
- [22]22. Maltz M. Psycho-cybernetics. New York, NY: Prentice Hall, 1960.
Cited by
Sorted by citations
2024 ESC Guidelines for the management of chronic coronary syndromes
Vrints, C. J., Andreotti, F., Koskinas, K. C., Rosselló, X., Adamo, M., Ainslie, J., BANNING, A. P., Budaj, A., Buechel, R. R., Chiariello, G. A., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae177 · Cited by 3,314 · see citing works
Sensitive periods of substance abuse: Early risk for the transition to dependence
Jordan, C. J., & Andersen, S. L. (2017) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2016.10.004 · Cited by 455 · see citing works
“, 2009), such that behaviors are initiated more or less “automatically” (Gardner et al., 2012).”
Action, actor, context, target, time (AACTT): a framework for specifying behaviour
Presseau, J., McCleary, N., Lorencatto, F., Patey, A. M., Grimshaw, J. M., & Francis, J. J. (2019) · Implementation Science · doi:10.1186/s13012-019-0951-x · Cited by 411 · see citing works
Deschasaux, M., Druesne‐Pecollo, N., Esseddik, Y., de Edelenyi, F. S., Allès, B., Andreeva, V. A., Baudry, J., Charreire, H., Deschamps, V., Egnell, M., et al. (2020) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqaa336 · Cited by 444 · see citing works
The Handbook of Behavior Change
Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N. E., & Lintunen, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318 · Cited by 420 · see citing works
Using Behavioral Science to help fight the Coronavirus
Lunn, P. D., Belton, C. A., Lavin, C., McGowan, F., Timmons, S., & Robertson, D. A. (2020) · Journal of Behavioral Public Administration · doi:10.30636/jbpa.31.147 · Cited by 285 · see citing works
Changing Behavior Using the Theory of Planned Behavior
Ajzen, I., & Schmidt, P. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.002 · Cited by 303 · see citing works
Miller, K. J., Shenhav, A., & Ludvig, E. A. (2019) · Psychological Review · doi:10.1037/rev0000120 · Cited by 280 · see citing works
“This prediction also provides a mechanistic underpinning for the repetition strategies that have shown to be effective at improving workplace and health-related performance through habit formation (Gardner, Lally, & Wardle, 2012; Lally et al., 2010; Wood & Rünger, 2016).”
BackgroundDigital Behaviour Change Interventions to Break and Form Habits
Pinder, C., Vermeulen, J., Cowan, B. R., & Beale, R. (2018) · ACM Transactions on Computer-Human Interaction · doi:10.1145/3196830 · Cited by 235 · see citing works
“The two main self-report measures for habits are Verplanken and Orbell’s 12-item SelfReport Habit Index (SRHI, (2003)) and the Self-Report Behavioural Automaticity Index (SRBAI, (Gardner et al. 2012)).”
BackgroundAdherence to Cardiovascular Medications: Lessons Learned and Future Directions
Kronish, I. M., & Ye, S. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2013.02.001 · Cited by 213 · see citing works
Exercise and Fitness in the Age of Social Distancing During the COVID-19 Pandemic
Nyenhuis, S. M., Greiwe, J. C., Zeiger, J. S., Nanda, A., & Cooke, A. (2020) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2020.04.039 · Cited by 213 · see citing works
Effectiveness of lifestyle health promotion interventions for nurses: a systematic review
Stanulewicz, N., Knox, E., Narayanasamy, M., Shivji, N., Khunti, K., & Blake, H. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010017 · Cited by 206 · see citing works
“, [213,214]), which may not be possible with interventions running on a one time per week basis.”
BackgroundMobile Health Applications to Promote Active and Healthy Ageing
Helbostad, J., Vereijken, B., Becker, C., Todd, C., Taraldsen, K., Pijnappels, M., Aminian, K., & Mellone, S. (2017) · Italian National Conference on Sensors · doi:10.3390/s17030622 · Cited by 186 · see citing works
“In the PreventIT project we use a number of psychological theories and techniques and map the behaviour change components using a taxonomy onto the requirements of the system so as to ensure that the most effective techniques are used to devise messages delivered to individuals based on profiles and goals [52].”
MethodMcGowan, L., Cooke, L. J., Gardner, B., Beeken, R. J., Croker, H., & Wardle, J. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.112.052159 · Cited by 160 · see citing works
Self-citationChanging Behavior Using the Model of Action Phases
Keller, L., Gollwitzer, P. M., & Sheeran, P. (2020) · The Handbook of Behavior Change · doi:10.1017/9781108677318.006 · Cited by 147 · see citing works
Beeken, R. J., Leurent, B., Vickerstaff, V, Wilson, R., Croker, H., Morris, S., Omar, R. Z., Nazareth, I., & Wardle, J. (2017) · International Journal of Obesity · doi:10.1038/ijo.2016.206 · Cited by 126 · see citing works
Self-citationHabitual exercise instigation (vs. execution) predicts healthy adults’ exercise frequency.
Phillips, L. A., & Gardner, B. (2015) · Health Psychology · doi:10.1037/hea0000249 · Cited by 131 · see citing works
Self-citationThe impact of an online stress intervention on burnout and teacher efficacy
Ansley, B. M., Houchins, D. E., Varjas, K., Roach, A. T., Patterson, D., & Hendrick, R. (2020) · Teaching and Teacher Education · doi:10.1016/j.tate.2020.103251 · Cited by 145 · see citing works
Matei, R., Thuné‐Boyle, I., Hamer, M., Iliffe, S., Fox, K. R., Jefferis, B. J. M. H., & Gardner, B. (2015) · BMC Public Health · doi:10.1186/s12889-015-1921-0 · Cited by 115 · see citing works
“Habit-formation advice is based on repeating a chosen behaviour in a setting until it becomes automatic [30].”
BackgroundMethodSelf-citationGardner, B., Sheals, K., Wardle, J., & McGowan, L. (2014) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-014-0135-7 · Cited by 182 · see citing works
“Habit theory generates propositions for purposive habit development [19].”
BackgroundSelf-citationChanging Behavior Using the Health Action Process Approach
Schwarzer, R., & Hamilton, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.007 · Cited by 107 · see citing works
The Importance of Creating Habits and Routine
Arlinghaus, K. R., & Johnston, C. A. (2018) · American Journal of Lifestyle Medicine · doi:10.1177/1559827618818044 · Cited by 107 · see citing works
Habit Formation and Behavior Change
Gardner, B., & Rebar, A. L. (2019) · Oxford University Press eBooks · doi:10.1093/obo/9780199828340-0232 · Cited by 107 · see citing works
Self-citationDevelopment and validation of the Self-Regulation of Eating Behaviour Questionnaire for adults
Kliemann, N., Beeken, R. J., Wardle, J., & Johnson, F. (2016) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0414-6 · Cited by 105 · see citing works
“On the other hand inhibiting ‘negative’ behaviours, such as avoidance of unhealthy foods, may require cognitivelymediated self-regulatory skills to be maintained [8, 54].”
BackgroundSelf-citationGillebaart, M., & Adriaanse, M. A. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00190 · Cited by 105 · see citing works
“Because of this automaticity, executing habitual behaviors does not require conscious intent or effort (Aarts et al., 1998; Gardner et al., 2012).”
BackgroundWhite, I., Smith, L., Aggio, D., Shankar, S., Begum, S., Matei, R., Fox, K. R., Hamer, M., Iliffe, S., Jefferis, B. J. M. H., et al. (2017) · Pilot and Feasibility Studies · doi:10.1186/s40814-017-0139-6 · Cited by 98 · see citing works
“Guidance on how to incorporate habit-formation techniques into brief advice is available [32, 56].”
BackgroundSelf-citationAsbjørnsen, R. A., Wentzel, J., Smedsrød, M. L., Hjelmesæth, J., Clark, M. M., Solberg Nes, L., & Van Gemert-Pijnen, J. E. W. C. (2020) · Journal of Medical Internet Research · doi:10.2196/22598 · Cited by 84 · see citing works
“Habit formation can be integrated into eHealth interventions to support the formation of new and lasting habits and might be a missing link in the effort to address the challenges related to weight loss maintenance [7,10,14,15,22,115-121].”
BackgroundVasudevan, A., & Ford, E. M. (2021) · Prevention Science · doi:10.1007/s11121-021-01328-2 · Cited by 92 · see citing works
“Training habit and confidence with weights or machines is built over time and early intervention and commencement of strength training is beneficial for developing and maintaining muscle mass, strength and bone density in adult women throughout life (Gardner et al. 2012).”
BackgroundIs self-weighing an effective tool for weight loss: a systematic literature review and meta-analysis
Madigan, C. D., Daley, A., Lewis, A. L., Aveyard, P. N., & Jolly, K. B. (2015) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-015-0267-4 · Cited by 91 · see citing works
Patton, D., Cadogan, C. A., Ryan, C. A., Francis, J., Gormley, G., Passmore, P., Kerse, N. M., & Hughes, C. M. (2017) · Health Expectations · doi:10.1111/hex.12595 · Cited by 91 · see citing works
Fournier, M., d’Arripe-Longueville, F., & Radel, R. (2016) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.12730 · Cited by 88 · see citing works
“The SRBAI is a self-report measure of experienced automaticity, and these authors discussed the validity of using such a declarative measure to capture an automatic response.”
BackgroundMethodInfluentialDigital training for building resilience: systematic review, meta-analysis, and meta-regression
Ang, W. H. D., Chew, H. S. J., Dong, J., Yi, H., Mahendren, R., & Lau, Y. (2022) · Stress and Health · doi:10.1002/smi.3154 · Cited by 83 · see citing works
“This habit‐forming process would require time ranging from 21 to 66 days could offer an explanation why the improvement was only detected at the follow‐up (Gardner et al., 2012; Lally & Gardner, 2013).”
BackgroundGardner, B., Thuné‐Boyle, I., Iliffe, S., Fox, K. R., Jefferis, B. J. M. H., Hamer, M., Tyler, N., & Wardle, J. (2014) · Trials · doi:10.1186/1745-6215-15-368 · Cited by 83 · see citing works
“Repetition in the early stages is best facilitated where the individual is intrinsically motivated (that is, pursues behaviour for its personal value, rather than to satisfy external demands) [39,40], where target behaviours are manageable and realistic [41], and where people actively monitor their progress [37].”
BackgroundMethodInfluentialSelf-citationHow does habit form? Guidelines for tracking real-world habit formation
Gardner, B., Rebar, A. L., & Lally, P. J. (2022) · Cogent Psychology · doi:10.1080/23311908.2022.2041277 · Cited by 87 · see citing works
“The SRHI has however been criticised on the basis that, while self-identity is often associated with habit, it is not a necessary component of habit (Gardner et al., 2012), and cannot be expected to develop in concert with habit.”
BackgroundSelf-citationMichael, I., Ramsøy, T. Z., Balakrishnan, M. S., & Kotsi, F. (2019) · Journal of Islamic marketing · doi:10.1108/jima-09-2017-0098 · Cited by 82 · see citing works
“In the behavioural economics literature, these have been referred to as System 1 and System 2, respectively (Gardner et al., 2012).”
González, D. S., Rojo‐Pérez, F., Rodríguez, V. R., & Fernández‐Mayoralas, G. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17228305 · Cited by 81 · see citing works
“In this respect, changes in the attitudes of older participants may involve many months of daily repetition to establish a habit [98]; however, the predominance of interventions implemented for a short period of time (20 h) or on a sporadic basis (once a week or less frequently) have limited their potential positive e…”
BackgroundFeil, K., Allion, S., Weyland, S., & Jekauc, D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.626750 · Cited by 85 · see citing works
“autonomy-supportive coaching style, individualized exercise prescriptions, pamphlet on PA, calendar (Gardner et al., 2012), 15min phone interview every 2 weeks, SMS cues every day before PA session (2) supervised PA group: 2 supervised sessions and 1 autonomous session per week Habit: SRBAI PA: IPAQ Mixed model: Diffe…”
MethodPretty, J., & Barton, J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17217769 · Cited by 81 · see citing works
Mueller, M., Schorle, S., Vach, K., Hartmann, A., Zeeck, A., & Schlueter, N. (2022) · PLoS ONE · doi:10.1371/journal.pone.0264306 · Cited by 85 · see citing works
mHealth self-care interventions: managing symptoms following breast cancer treatment
Fu, M. R., Axelrod, D., Guth, A. A., Rampertaap, K., El-Shammaa, N., Hiotis, K. L., Scagliola, J., Yu, G., & Wang, Y. (2016) · mHealth · doi:10.21037/mhealth.2016.07.03 · Cited by 77 · see citing works
Głąbska, D., Skolmowska, D., & Guzek, D. (2020) · Sustainability · doi:10.3390/su12124930 · Cited by 76 · see citing works
“Moreover, hand hygiene behaviors may become lifelong habits [22], so the process of forming them should be conducted before adulthood [23].”
BackgroundHabit Formation in Wearable Activity Tracker Use Among Older Adults: Qualitative Study
Peng, W., Li, L., Kononova, A. G., Cotten, S. R., Kamp, K., & Bowen, M. (2020) · JMIR mhealth and uhealth · doi:10.2196/22488 · Cited by 76 · see citing works
“The third phase of habit formation is the stability phase in which the behavior persists over time with minimal effort and deliberation [34].”
BackgroundMethodInfluentialHubbard, G., Kyle, R. G., Neal, R. D., Marmarà, V., Wang, Z., & Dombrowski, S. U. (2018) · BMC Public Health · doi:10.1186/s12889-018-5570-y · Cited by 76 · see citing works
“Learning to conduct SSE during adolescence may increase the chances of this important health behaviour becoming habitual [38] during adulthood when skin cancer incidence is higher.”
BackgroundFlaherty, S. J., McCarthy, M. B., Collins, A., & McAuliffe, F. M. (2017) · Public Health Nutrition · doi:10.1017/s1368980017002889 · Cited by 76 · see citing works
“Future interventions should address both routine and habitual elements of food purchasing behaviour to improve the potential to achieve sustained behaviour change (20 – 22) .”
BackgroundPromoting Physical Activity Through Conversational Agents: Mixed Methods Systematic Review
Luo, T. C., Aguilera, A., Lyles, C. R., & Figueroa, C. A. (2021) · Journal of Medical Internet Research · doi:10.2196/25486 · Cited by 68 · see citing works
“…change theories Bickmore et al [31], Kramer et al [38] Behavior change theory (broad) [51] Piao et al [41], Vainio et al [44] Habit formation model [52] Fadhil et al [34] Health action process approach [53] Bickmore et al [30,31], Olafsson et al [40], Sillice et al [42] Transtheoretical model [54]…”
Global implementation of PrEP for HIV prevention: setting expectations for impact
Pyra, M. N., Haberer, J. E., Hasen, N., Reed, J. B., Mugo, N., & Baeten, J. M. (2019) · Journal of the International AIDS Society · doi:10.1002/jia2.25370 · Cited by 74 · see citing works
“For individuals, risk should be considered in terms of periods or seasons, not days or weeks [45]; thus, we suggest an expectation of six months of use, while not a perfect fit for all PrEP users, might be useful for programme evaluation and good habit development [46].”
BackgroundPretty, J., Rogerson, M., & Barton, J. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14070706 · Cited by 77 · see citing works
“Repeated behaviours in consistent settings proceed more efficiently, and are strengthened through association between situation (environmental cues) and action [100,101].”
BackgroundSingh, B., Murphy, A., Maher, C., & Smith, A. E. (2024) · Healthcare · doi:10.3390/healthcare12232488 · Cited by 98 · see citing works
Gardner, B., Rebar, A. L., & Lally, P. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.041 · Cited by 69 · see citing works
Self-citationDeterminants of hand hygiene compliance among nurses in US hospitals: A formative research study
Sands, M., & Aunger, R. V. (2020) · PLoS ONE · doi:10.1371/journal.pone.0230573 · Cited by 72 · see citing works
“[32, 33] Habitual actions are triggered in response to contextual cues associated with their performance: for example, automatically putting on a seatbelt (action) after getting into the car (contextual cue) or washing hands (action) after using the toilet (contextual cue).[34] Habit strength is a continuum.”
BackgroundEvaluating the Evidence on Sitting, Smoking, and Health: Is Sitting Really the New Smoking?
Vallance, J. K., Gardiner, P. A., Lynch, B. M., D’Silva, A., Boyle, T., Taylor, L., Johnson, S. T., Buman, M. P., & Owen, N. G. (2018) · American Journal of Public Health · doi:10.2105/ajph.2018.304649 · Cited by 69 · see citing works
Montoya, J. L., Jankowski, C. M., O’Brien, K. K., Webel, A. R., Oursler, K. K., Henry, B. L., Moore, D. J., & Erlandson, K. M. (2019) · AIDS · doi:10.1097/qad.0000000000002137 · Cited by 67 · see citing works
Habit-based workplace physical activity intervention: a pilot study
Hamilton, K., Fraser, E., & Hannan, T. E. (2019) · Occupational Medicine · doi:10.1093/occmed/kqz119 · Cited by 66 · see citing works
A holistic approach to healthy ageing: how can people live longer, healthier lives?
Calder, P. C., Carding, S. R., Christopher, G., Kuh, D. J., Langley‐Evans, S. C., & McNulty, H. (2018) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12566 · Cited by 67 · see citing works
“An interesting alternative is to make any behaviour change a habit, one that fits into a person’s normal routine ((86,87)).”
BackgroundEllingson, L. D., Lansing, J. E., DeShaw, K. J., Peyer, K. L., Bai, Y., Pérez, M., Phillips, L. A., & Welk, G. J. (2019) · JMIR mhealth and uhealth · doi:10.2196/10988 · Cited by 64 · see citing works
“Though evidence has demonstrated that the development of habits can be involved in adoption and adherence to PA behaviors [18-21], studies, to date, have not specifically used habit theory to understand or promote PA along with activity tracker usage.”
BackgroundThe Role of Behavioral Science in Personalized Multimodal Prehabilitation in Cancer
Grimmett, C., Bradbury, K. J., Dalton, S. O., Fecher‐Jones, I., Hoedjes, M., Varkonyi-Sepp, J., & Short, C. E. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.634223 · Cited by 63 · see citing works
“Incorporating strategies to promote habit formation could also help to achieve longer-term outcomes (Gardner et al., 2012).”
BackgroundHightow‐Weidman, L., & Bauermeister, J. A. (2020) · mHealth · doi:10.21037/mhealth.2019.10.01 · Cited by 64 · see citing works
“For example, we hypothesized that within an adherence app such as AllyQuest, the medication tracking component would need to be used daily, for about two to three months to ensure habit formation (24,25).”
LI, L. C., Sayre, E. C., Xie, H., Falck, R. S., Best, J. R., Liu-Ambrose, T. Y. L., Grewal, N., Hoens, A. M., Noonan, G., & Feehan, L. M. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.8514 · Cited by 63 · see citing works
“It should be noted that sedentary behavior is linked to individuals’ habitual routines [48-51].”
BackgroundPfeifer, D., Rešetar, J., Kljusurić, J. G., Krbavčić, I. P., Bender, D. V., Rodríguez‐Pérez, C., Ruiz‐López, M. D., & Šatalić, Z. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.617721 · Cited by 62 · see citing works
“While the motivation for introducing new lifestyle behaviors, such as cooking more and meal planning, resides in the fear of getting infected, this might be a trigger for habit formation (54, 55).”
BackgroundChanging Behavior Using Social Cognitive Theory
Łuszczyńska, A., & Schwarzer, R. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.003 · Cited by 71 · see citing works
Patient-Reported Compliance in older age patients with chronic heart failure
Jankowska‐Polańska, B., Świątoniowska-Lonc, N., Sławuta, A., Krówczyńska, D., Dudek, K. D., & Mazur, G. J. (2020) · PLoS ONE · doi:10.1371/journal.pone.0231076 · Cited by 60 · see citing works
“0–15 0–15 0–15 0–14 0–15 0–15 Overall adherence level 13 [9; 17] 13 [9; 17] 0.”
Wright, A., Stone, K. J., Martinelli, L., Fryer, S. M., Smith, G., Lambrick, D., Stoner, L. R., Jobson, S., & Faulkner, J. (2020) · Clinical Rehabilitation · doi:10.1177/0269215520984133 · Cited by 58 · see citing works
“Homebased settings may also be efficacious as patients could use such devices more frequently in a familiar context(10) contributing to the formation of habits leading to long-term behavior change.(11) Further research is needed to investigate the feasibility, efficacy and application of over-ground robotic-assisted g…”
BackgroundClarke, J. L., Kipping, R., Chambers, S., Willis, K. J., Taylor, H., Brophy, R., Hannam, K. J., Simpson, S. A., & Langford, R. M. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-051497 · Cited by 58 · see citing works
Blair, C. K., Harding, E., Wiggins, C. L., Kang, H., Schwartz, M., Tarnower, A. C., Du, R., & Kinney, A. Y. (2021) · JMIR Cancer · doi:10.2196/18819 · Cited by 56 · see citing works
“Research suggests that, given the automaticity of sedentary behavior, different and more effortful strategies are required to break existing habits compared with forming new habits [95-97].”
BackgroundMüller, A. M., BLANDFORD, A. E., & Yardley, L. (2017) · mHealth · doi:10.21037/mhealth.2017.08.05 · Cited by 58 · see citing works
“It is likely that reducing sitting time in a step-by-step manner is more acceptable (73,74).”
BackgroundStorm, V., Dörenkämper, J., Reinwand, D. A., Wienert, J., de Vries, H., & Lippke, S. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5147 · Cited by 56 · see citing works
“Habituation of the healthy behavior may be the final phase in the health behavior change chain, whereby the behavior has stabilized and its strength has plateaued [14].”
Vogel, C., Crozier, S., Penn-Newman, D., Ball, K., Moon, G., Lord, J. L., Cooper, C. C., & Baird, J. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003729 · Cited by 55 · see citing works
Govender, R., Wood, C. E., Taylor, S. A., Smith, C. H., Barratt, H., & Gardner, B. (2017) · Dysphagia · doi:10.1007/s00455-017-9799-x · Cited by 51 · see citing works
“The advantage of exercises becoming habitual is that they are more likely to be maintained over time, as they become less reliant on motivation and other cognitive processes such as conscious memory [39].”
BackgroundSelf-citationUnderstanding responses to climate change
Gifford, R., Lacroix, K., & Chen, A. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-813130-5.00006-0 · Cited by 54 · see citing works
Cleo, G., Glasziou, P., Beller, E., Isenring, E., & Thomas, R. (2019) · International Journal of Obesity · doi:10.1038/s41366-018-0067-4 · Cited by 53 · see citing works
Warner, L. M., & French, D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.032 · Cited by 53 · see citing works
Nutrition knowledge, attitudes, and self-regulation as predictors of overweight and obesity
Balani, R., Herrington, H., Bryant, E., Lucas, C., & Kim, S. C. (2019) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000169 · Cited by 54 · see citing works
Vladimirova, K., Henninger, C. E., Joyner-Martinez, C., Iran, S., Diddi, S., Durrani, M., Iyer, K. V., Jestratijevic, I. M., McCormick, H., Niinimäki, K., et al. (2022) · Cleaner and Responsible Consumption · doi:10.1016/j.clrc.2022.100056 · Cited by 51 · see citing works
“Gardner et al. (2012) state the dif fi culty with breaking habits lies in the fact that they are formed over a longer period.”
Changing Behavior Using Ecological Models
Salmon, J., Hesketh, K. D., Arundell, L., Downing, K. L., & Biddle, S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.017 · Cited by 51 · see citing works
Social cognition theories and behavior change in COVID-19: A conceptual review
Hagger, M. S., & Hamilton, K. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104095 · Cited by 50 · see citing works
Scheerman, J. F. M., van Meijel, B., van Empelen, P., Kramer, G. J. C., Verrips, G. H. W., Pakpour, A. H., van den Braak, M. C. T., & van Loveren, C. (2018) · BMC Oral Health · doi:10.1186/s12903-018-0475-9 · Cited by 51 · see citing works
“As habit-formation takes an average of 66 days [47], we expect that the 84 days of exposure to the intervention will be long enough to guarantee a long-term behavior change.”
BackgroundNudging healthier food choices in a cafeteria setting: A sequential multi-intervention field study
Bauer, J. M., Bietz, S., Rauber, J., & Reisch, L. A. (2021) · Appetite · doi:10.1016/j.appet.2021.105106 · Cited by 50 · see citing works
Hlynsson, J. I., & Carlbring, P. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1259997 · Cited by 46 · see citing works
“Furthermore, although more frequent measurements might initially seem burdensome for participants, research on habit formation indicates that higher frequency of a behavior enhances its automaticity (Gardner et al., 2012; McCloskey and Johnson, 2019).”
BackgroundBauza, V., Sclar, G. D., Bisoyi, A., Majorin, F., Ghugey, A., & Clasen, T. (2021) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.21-0087 · Cited by 45 · see citing works
“achieving sustained handwashing behavior change.(15,16) The longevity of these changes also 356 suggests that improved handwashing habits might remain after the pandemic subsides, which 357 could potentially lead to reduced disease transmission for other respiratory and fecal-oral 358 diseases, as was observed in Mexi…”
BackgroundDevelopment of Tooth Brushing Recommendations Through Professional Consensus
Glenny, A., Walsh, T., Iwasaki, M., Kateeb, E. T., Braga, M. M., Riley, P., & Melo, P. (2023) · International Dental Journal · doi:10.1016/j.identj.2023.10.018 · Cited by 45 · see citing works
“61,62,63 The ability to brush effectively will differ from one child to another, and so the appropriate age to stop supervised tooth brushing should be determined by the child’s parent or carer.”
BackgroundUsing Facebook in a Healthy Lifestyle Intervention: Feasibility and Preliminary Efficacy
Ling, J., Robbins, L. B., Zhang, N., Kerver, J. M., Lyons, H., Wieber, N., & Zhang, M. (2018) · Western Journal of Nursing Research · doi:10.1177/0193945918756870 · Cited by 45 · see citing works
Changing Behavior Using Self-Determination Theory
Hagger, M. S., Hankonen, N. E., Chatzisarantis, N. L. D., & Ryan, R. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.008 · Cited by 49 · see citing works
Frei, A. L., Radtke, T., Lana, K. D., Brun, P., Sigrist, T., Spielmanns, M., Beyer, S., Riegler, T. F., Büsching, G., Spielmanns, S., et al. (2022) · CHEST Journal · doi:10.1016/j.chest.2022.07.026 · Cited by 48 · see citing works
Bonvicini, L., Pingani, I., Venturelli, F., Patrignani, N., Bassi, M. C., Broccoli, S., Ferrari, F., Gallelli, T., Panza, C., Vicentini, M., et al. (2022) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2022.101940 · Cited by 43 · see citing works
“, 2020) intervention was framed in a social ecological perspective and was theoretically informed also by drawing on constructs derived from Habit Theory (Gardner et al., 2012) and Behavioural Choice.”
MethodWong, D. K., Pike, K. E., Stolwyk, R. J., Allott, K., Ponsford, J. L., McKay, A., Longley, W. A., Bosboom, P. R., Hodge, M. A., Kinsella, G., et al. (2023) · Neuropsychology Review · doi:10.1007/s11065-023-09624-0 · Cited by 42 · see citing works
Role of habit in treatment adherence among adults with cystic fibrosis
Hoo, Z. H., Gardner, B., Arden, M. A., Waterhouse, S., Walters, S. J., Campbell, M. J., Hind, D., Maguire, C., Dewar, J. C., & Wildman, M. J. (2018) · Thorax · doi:10.1136/thoraxjnl-2017-211453 · Cited by 39 · see citing works
Self-citationPlanning and Implementation Intention Interventions
Rhodes, R. E., Grant, S. J., & de Bruijn, G. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.039 · Cited by 41 · see citing works
Attitudes and Persuasive Communication Interventions
Hamilton, K., & Johnson, B. T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.031 · Cited by 40 · see citing works
Changing Behavior Using Habit Theory
Orbell, S., & Verplanken, B. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.013 · Cited by 39 · see citing works
Changing Behavior: A Theory- and Evidence-Based Approach
Hagger, M. S., Cameron, L. D., Hamilton, K., Hankonen, N. E., & Lintunen, T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.001 · Cited by 39 · see citing works
Alslaity, A., Chan, G., & Orji, R. (2023) · Frontiers in Artificial Intelligence · doi:10.3389/frai.2023.1125191 · Cited by 38 · see citing works
“, using the app to manage a disease like diabetes) (Gardner et al., 2012), supporting calm breathing (Oyebode et al.”
MethodBeeken, R. J., Croker, H. A., Heinrich, M., Smith, L., Williams, K., Hackshaw, A. K., Hines, J. E. W., Machesney, M., Madhavan, K., Cavanagh, S., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011646 · Cited by 37 · see citing works
“There has therefore been increasing interest in the application of habit theory within the healthcare context.(28) Providing individuals with advice on how to try and form habits for specific health behaviours (ie, by integrating simple actions into their existing routines, and associating the new action with a specif…”
BackgroundSelf-citationTarrant, M., Haslam, C., Carter, M., Calitri, R., & Haslam, S. A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.044 · Cited by 37 · see citing works
Bajalan, A., Bui, T., Salvadori, G., Marques, D., Schumacher, A., Rõsing, C. K., Dahle, U. R., Petersen, F. C., Ricomini-Filho, A. P., Nicolau, B. F., et al. (2022) · Antimicrobial Resistance and Infection Control · doi:10.1186/s13756-022-01192-x · Cited by 36 · see citing works
“However, facilitating healthy habits as early as possible while students are shaping their behavior is a relevant strategy to promote prudent and evidence-based antimicrobial prescription practices [42, 43].”
BackgroundHand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic
Oh, J., Lee, M., Lee, H., Yang, H., Park, J., Rahmati, M., Koyanagi, A., Smith, L., Fond, G. B., Boyer, L., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.49249 · Cited by 36 · see citing works
Could habits hold the key to weight loss maintenance? A narrative review
Cleo, G., Isenring, E. A., Thomas, R., & Glasziou, P. (2017) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12456 · Cited by 36 · see citing works
“Every time they subsequently snack in response to getting home, this link strengths, to the point that getting home prompts them to eat a snack automatically; a habit has been formed ((23)).”
BackgroundMethodInfluentialCarter, S. E., Draijer, R., Maxwell, J. D., Morris, A. S., Pedersen, S., Graves, L., Thijssen, D. H. J., & Hopkins, N. D. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238942 · Cited by 38 · see citing works
“and is based on the habit formation theory [11,19].”
BackgroundEvans, H. E. L., Galvao, D. A., Forbes, C. C., Girard, D., Vandelanotte, C., Newton, R. U., Vincent, A. D., Wittert, G., Kichenadasse, G., Chambers, S. K., et al. (2021) · Cancers · doi:10.3390/cancers13235925 · Cited by 35 · see citing works
“Barrier self-efficacy (9 items) [51], outcome expectations (8 items) [52], motivation type (19 items) [53], social support (2 items) [51], intentions (4 items) [54], behavioural capability (3 items) [39] and habit formation (4 items) [31] were all assessed at baseline and follow-up.”
BackgroundChanging Behavior Using Integrated Theories
Hagger, M. S., & Hamilton, K. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108677318.015 · Cited by 39 · see citing works
Jones, T. L., Edbrooke, L., Rawstorn, J. C., Hayes, S. C., Maddison, R., Denehy, L., & Short, C. E. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-08040-7 · Cited by 37 · see citing works
“Firstly, habits should be small and achievable to promote successful achievement and subsequent increases in self-efficacy and competences, which may encourage further behaviour change while avoiding feelings of failure [23].”
BackgroundInfluential
- Authors
- Gardner, B., Lally, P., & Wardle, J.
- Affiliations
- University College London (GB)
- Venue
- British Journal of General Practice
- Published
- 2012-12
- Volume
- 62
- Issue
- 605
- Pages
- 664-666
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC3505409
- OpenAlex
- W1987192180
- Cited by
- 591
- References
- 22
- Citations by year
- 2026: 63 · 2025: 57 · 2024: 61 · 2023: 51 · 2022: 58 · 2021: 61 · 2020: 92 · 2019: 47 · 2018: 37 · 2017: 23 · 2016: 23 · 2015: 8 · 2014: 4 · 2013: 6
- FWCI
- 8.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Cancer Research UK (14133)
- Medical Research Council (MR/J000396/1)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Physical Sciences › Environmental Science › Management, Monitoring, Policy and Law › Environmental Education and Sustainability
- Keywords
- habit formation, health behavior change, general practice, automatism, maintenance of behaviour change, lifestyle advice, health promotion
- MeSH terms
- Counseling, Habits, Health Promotion, Humans, Motivation, Health Behavior, Risk Reduction Behavior, General Practice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
