Feasibility of a behavioral automaticity intervention among African Americans at risk for metabolic syndrome

Abstract

Background: Targeting habit-development (behavioral automaticity) as part of healthy lifestyle behavior change interventions may improve the adoption and maintenance of healthful behaviors. Few studies, however, have evaluated the feasibility of using a habit-development approach to foster the adoption of recommended physical activity and dietary behaviors. We report quantitative and qualitative data from a feasibility study evaluating a habit-formation intervention to foster healthy dietary and physical activity habits among middle aged African Americans with metabolic syndrome.

Methods: Using a non-comparative design we evaluated the feasibility an 8-week, hybrid format (telecoaching and face-to-face sessions), habit-focused intervention targeting the development of healthful dietary and physical activity habit development among 24 African Americans aged 40 and older with metabolic syndrome recruited from the emergency department - a setting where individuals in under-resourced communities often go for primary care. We administered behavioral automaticity measures tailored to participants' self-selected habits biweekly during the intervention and collected clinical outcomes of systolic blood pressure, weight, waist circumference, and BMI at baseline week 20.

Results: Participant attrition from the program was high (~ 50%). Despite high levels of attrition, 92% of intervention completers were extremely satisfied with the program. Intervention completers also experienced gains in behavioral automaticity for both dietary and physical activity habits. Overall, higher levels of adherence were associated with higher positive gains in automaticity with the statistical significance of the associations being more pronounced for physical activity habit plans relative to dietary habit plans.

Conclusions: Our preliminary data support a habit-development approach for fostering the adoption of healthful dietary and physical activity habits. However, in this pilot study high rates of attrition were seen, suggesting that strategies to improve retention and participant engagement should be included in future studies, particularly when targeting African American emergency department patients.

Trial registration: ClinicalTrials.gov ID: NCT03370419 Registered 12/11/2017, retrospectively registered.

Keywords: Behavioral automaticity; Emergency department; Habits; Health behavior; Metabolic syndrome.

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained from the Wayne State University Institutional review Board prior to initiating the study. All participants involved in study activities had provided their written informed consent to participate.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1

Sequence of habit development

Fig. 2

Mean adherence and gains in automaticity by diet and physical activity modalities

Fig. 3

Associations between adherence and gains in automaticity by diet and physical activity modalities

Fig. 4

Associations between text frequencies and adherence and gains in automaticity by diet and PA modalitie

Fig. 5

Trial flow