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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 …
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“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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]
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“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]
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“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]
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“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
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Metadata
- 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 › Pro-Environmental Behavior and Attitudes
- 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
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