Trait self-control as a determinant of health behavior: Recent advances on mechanisms and future directions for research.

We summarize theory and research testing a mechanistic explanation for the trait self-control-health behavior relationship. Specifically, social cognition constructs summarizing individuals' utility, normative, risk, and capacity beliefs with respect to future health behavior performance are proposed to mediate the self-control-health behavior relationship. The effect represents the informational function of self-control in decision making. We also specify a mechanism wherein trait self-control moderates the intention-behavior relationship such that 'good' self-control affords effective intention-to-action translation. Both effects have pervasive support in the extent literature. We propose ongoing meta-analyses expected to provide further robust support for these mechanistic effects and the need for research employing designs enabling better directional and causal inferences in the effects, including experimental or types of cross-lagged panel design.

A qualitative analysis of parents' beliefs about portable pool safety behaviours.

The aim of this study was to develop an in-depth understanding of the beliefs parents hold regarding portable pool safety behaviours using the theory of planned behaviour (TPB). Semi-structured interviews were conducted with parents (N = 15) of children aged 5 years and younger who owned a portable pool. Interviews examined three key safety behaviours: supervising within arms' reach, fencing portable pools deeper than 30 cm, and emptying and storing portable pools safely after use. Parents identified a range of advantages, disadvantages, normative influences, and facilitators and barriers towards the three behaviours. The identification of these salient behavioural, normative, and control beliefs enrich limited understandings of portable pool safety behaviours of parents with young children. Current findings fill a knowledge gap in portable pool safety and provide potential targets for messages to improve parents' behaviours for their young children around portable pools in the hope of preventing loss of life.

Predicting alcohol consumption: Application of an integrated social cognition model of intentions, habits, and cue consistency.

Drinking alcohol in excess is associated with deleterious health outcomes, highlighting the need for research to identify potentially modifiable correlates of excessive alcohol consumption to target in behavioral interventions. The present two-wave prospective correlational study applied an integrated theoretical model that included theory of planned behavior constructs alongside habit, cue consistency, affective attitudes, and past behavior as predictors of two alcohol-related behaviors, drinking within safe limits and regular alcohol drinking, in separate samples of Australian undergraduate students (total N = 474). Structural equation models identified direct effects of habit, affective attitude, and subjective norms on intention for both behaviors. Habit at follow-up, cue consistency, and past behavior directly predicted behavior in both samples, whereas intention predicted behavior only for drinking within safe limits, and affective attitude only predicted behavior for regular drinking. Cue consistency moderated the effects of habit on behavior for both behaviors and moderated the effect of past behavior on regular drinking. Results corroborate past behavior and habit as key correlates of behavior and provide preliminary evidence of the importance of integrating cue consistency, a defining characteristic of habit, as a moderator of habit and past behavior effects an integrated theory test.

An integrated dual process model in predicting e-cigarette use in undergraduate students.

The use of e-cigarette or vape devices is a growing concern on an international scale, given the devices' addictive nature and questions regarding their short- and long-term health impacts. Their use is especially an issue in young people, many of whom have little or no previous nicotine use experience. This study tested an integrated dual process model in 363 young Australian undergraduates where prospectively measured e-cigarette use was predicted by the psychological constructs of the theory of planned behavior, supplemented with risk perception, e-cigarette dependence, habit, and implicit attitude. Intention to use an e-cigarette was predicted by affective attitude, subjective norm, and e-cigarette dependance, but not instrumental attitude, perceived behavioral control, or risk perception. E-cigarette use was predicted by e-cigarette dependance, intention, habit, implicit attitude, and previous nicotine use, although perceived behavioral control did not directly predict behavior nor moderate the intention-behavior relationship. Current findings provide evidence for important psychological predictors of e-cigarette use, signposting potential intervention targets. Specifically, interventions may benefit from using strategies that tap affective or normative beliefs alongside automatic constructs and dependence, while focusing less on beliefs about the health impacts of e-cigarettes or control over using.

Auditing learner driver information about floodwaters: An environmental scan of government issued resources in Australia.

INTRODUCTION: Vehicles driving, or being swept, into floodwaters is a leading cause of flood-related death. Establishing safe behaviors among learner drivers may reduce risk throughout their driving lifetime. METHODS: An environmental scan of publicly available government issued learner and driver handbooks across the eight Australian jurisdictions was conducted to identify information provided regarding floodwaters. Search terms included 'flood,' 'rain,' 'water,' and 'wet.' A visual audit of flood-related signage was also conducted. RESULTS: Twelve documents, across eight jurisdictions, were analyzed. Four jurisdictions' documents provided no information on flooding. Of the four jurisdictions that provided information, content varied. This included highlighting risks and discouraging entering floodwaters in a vehicle, including penalties associated with travel on closed roads, to advising depth and current checks if crossing a flooded roadway, with recommendations based on vehicle size (preference given to bigger vehicles, i.e., 4wds). Information on flood-related signage was found in one jurisdiction. DISCUSSION: Learner and driver handbooks represent a missed opportunity to provide flood safety information. Currently, information is not provided in all jurisdictions, despite flood-related vehicle drowning deaths of drivers and passengers being a national issue. Where information is presented, it is limited, often lacks practical guidance on how to assess water depth, current, and road base stability, and could better use evidence regarding the psychological factors underpinning, and behavioral prompts for performing, or avoiding, risky driving behavior during floods. CONCLUSIONS: The provision and content of information in learner driver and driver handbooks must be improved, particularly within the context of increasing flooding and extreme weather associated with the effects of climate change. PRACTICAL APPLICATIONS: We encourage all jurisdictions to provide practical information that draws on evidence-based risk factors and empirically established psychological factors for behavioral change to help establish safe driver behaviors around floods in the formative years of learning to drive.

The influence of life transitions on Danish adults' physical activity beliefs and behaviour: A qualitative study.

Using a qualitative design, we explored how life transitions influence Danish adults' physical activity beliefs and behaviour adopting the Theory of Planned Behaviour as a guiding framework. Life story interviews with 42 participants revealed 6 salient life transition periods which affected physical activity behaviour, either in a disruptive way resulting in decreased activity levels or in a facilitative manner, providing opportunities for increased activity engagement. The identified life transition periods uniquely influenced individuals' attitudes, subjective norms and perceived behavioural control (PBC) beliefs, thus affecting motivations toward physical activity. Specifically, starting primary school or a career, forming a romantic relationship, and having a child primarily shaped subjective norm and PBC, while leaving home was especially influential on PBC and retirement on attitudes and PBC. Consistent themes across the transition periods included time constraints and opportunities to be active, supportive social contexts, access to facilities and having a need to be active.

Testing the Effect of Cue Consistency on the Past Behavior-Habit-Physical Activity Relationship.

Behavior performed in the presence of consistent cues is a core element for successful habit development, with the repeated presence of consistent cues facilitating the activation of automatic responses in future. Yet, little is known about the effects of different cue types on habit. Using a two-wave prospective PLS-SEM model with a sample of 68 undergraduate students, we assessed the mediating effects of habit on the past-behavior-to-physical-activity relationship, and how the mediating effects of habit were moderated by the consistent presence of different forms of cues. Habit mediated the effects of past behavior on physical activity, with a significantly stronger mediating effect of habit in those reporting undertaking physical activity at the same time of day, doing the same activity, and in the same mood. Consistent place, people, and part of routine did not moderate the effects of habit. The results provide formative evidence for a key assertion of the habit theory that consistent contextual and internal cues are a cornerstone of habitual development and action, but they also indicate the importance of examining different forms of cues and their impact on the formation and enaction of habits as some cues may be more relevant than others.

Identifying key beliefs underlying QR code check-in and compliance behaviours in the COVID-19 pandemic.

ISSUE ADDRESSED: The implementation of quick response (QR) code check-in compliance behaviour during the COVID-19 pandemic featured in infection control strategies in several global jurisdictions, but was of particular interest in the Australian context, where it became mandated on a nationwide scale. We aimed to identify the salient beliefs people hold toward complying with the QR code check-in using a Theory of Planned Behaviour belief-based framework. METHODS: An elicitation study using open-ended questions (Queensland; N = 93, Mage = 4.77 years, SD = 13.62 and Victoria; N = 76, Mage = 44.92 years, SD = 11.63) and a prospective correlational study using a two-wave online survey (Queensland; N = 290, Mage = 38.99, 46.6% female and Victoria; N = 290, Mage = 38.27, 53.4% female) were conducted. RESULTS: Qualitative data were coded through an iterative content analysis, while quantitative data were analysed using linear multiple regression. Behavioural, normative and control beliefs were associated with intention and behaviour in both samples. Variation in beliefs across the states also were observed. CONCLUSIONS: Across both samples, beliefs in positive outcomes consistently exhibited stronger associations with both intention and behaviour than the reported negative outcomes. Distinct differences emerged between the two samples in terms of regression effects. SO WHAT?: Results indicate individual experience may affect the beliefs which guide behaviour, supporting the potential efficacy of health promotion campaigns tapping into context specific beliefs and experiences if QR code check-in is to be implemented as an infection control measure in future.

Social cognition correlates of self-management behaviors in patients with familial hypercholesterolemia (FH): A meta-analytic review.

OBJECTIVE: Familial Hypercholesterolemia (FH) is an inherited disorder leading to increased risk of premature atherosclerotic cardiovascular disease. This risk can be ameliorated through adherence to pharmacological treatment and salient lifestyle behaviors (e.g., physical activity participation, healthy eating). Identifying theory-based, modifiable determinants of these behaviors may inform behavioral interventions promoting participation in FH self-management behaviors. We aimed to identify the belief-based social cognition constructs uniquely associated with intentions to perform, and actual participation in, FH self-management behaviors in the extant research. METHOD: A systematic database search identified studies (k = 9, N = 1394) reporting relations between social cognition theory constructs and intention toward, or actual participation in, self-management behaviors in FH patients. As no studies examining prospectively-measured behaviors were identified, we tested relations among social cognition constructs, intentions, and past FH-self-management behavior using random effects multi-level meta-analysis and meta-analytic structural equation modelling. RESULTS: We found non-zero averaged correlations among the key social cognition constructs (attitudes, norms, risk perceptions, self-efficacy), intentions, and past behavior. A meta-analytic structural equation model indicated non-zero averaged direct effects of attitudes, norms, self-efficacy, and past behavior on FH self-management behavioral intentions. There were also non-zero averaged indirect effects of past behavior on intentions mediated by the social cognition constructs. CONCLUSION: Findings provide evidence to support the proposed model and highlight the importance of personal, normative, and capacity related beliefs and past experience as unique correlates of intentions to perform FH self-management behaviors. The model may signal potential constructs that could be targeted in behavioral interventions to promote participation in FH self-management behaviors.

Social cognition, personality and social-political correlates of health behaviors: Application of an integrated theoretical model.

OBJECTIVE: Dispositional, intra-personal constructs such as personality traits and generalized beliefs are consistently related to health behaviors, but relatively few studies have tested the theory-based mechanisms by which these constructs relate to health behaviors and compared them across behavior type. In the current study we tested an integrated theoretical model in which belief-based social cognition constructs (attitudes, subjective norms, perceived behavioral control) were proposed to mediate effects of personality traits (conscientiousness, extroversion) and socio-political beliefs (political beliefs, locus of control, free will beliefs) on participation in three health-related behaviors: physical activity, COVID-19 vaccination, and sugar-sweetened beverage restriction. METHODS: Proposed integrated model effects were tested in a five-week prospective correlational study. Finnish residents completed measures of personality, socio-political, and social cognition constructs with respect to physical activity participation (N = 557), COVID-19 vaccination uptake (N = 1,115), and sugar-sweetened beverage restriction (N = 558) and self-reported their behavior at follow-up. RESULTS: Structural equation models revealed direct effects of intention on behavior, and of social-cognition constructs on intention, across all behaviors. We also found indirect effects of political beliefs on behavior mediated by social cognition constructs and intentions for COVID-19 vaccination and sugar-sweetened beverage restriction behaviors, indirect effects of conscientiousness on behavior mediated by social cognition constructs and intentions for physical activity and sugar-sweetened beverage restriction behaviors, and indirect effects of health locus of control on behavior mediated by social cognition constructs and intentions for physical activity behavior. Finally, we found a negative total effect of populist beliefs on behavior for COVID-19 vaccination behavior. CONCLUSION: Findings contribute to an evidence base for the effects of dispositional and social cognition constructs of health behaviors, point to a possible mechanism by which these generalized constructs relate to health behavior, and outline how the pattern of effects varies across the different behaviors.

Exploring environmental cues to instigate physical movement in the workplace.

Background: With the increase of sedentary jobs and the health risks associated with a sedentary lifestyle, finding novel methods to increase physical activity should be a priority. Environmental cues within the workplace can serve as cues to action for initiating light physical activity. Aim: To qualitatively explore the environmental cues that can instigate light physical activity within an office workplace context. Identification of these cues can inform behaviour change programmes designed to promote habitual physical movement within the workplace. Method: Purposive sampling was used to recruit full-time sedentary office workers who self-report as having a highly sedentary job. Interviews followed a semi-structured design and thematic analysis was used to explore environmental cues within commercial, home, and mixed office settings. Results: Forty-three office workers were interviewed, 16 from a commercial office, 12 from a home office, and 15 with a flexible work arrangement whereby they worked from both a commercial and home office. The findings of this study indicate that across all three groups the main instigator of movement was influenced by office layout (e.g. getting up for beverages and taking bathroom breaks), social environment (e.g. informal and formal meetings), and taking active breaks, both job-related (e.g. printing and filing) and non-job-related (e.g. household chores). Conclusions: These findings provide valuable insight for behaviour change programmes utilising environmental cues to inform habit-based interventions designed to instigate movement within the workplace.

A Web-Based Physical Activity Promotion Intervention for Inactive Parent-Child Dyads: Protocol for a Randomized Controlled Trial.

BACKGROUND: Low levels of physical activity are associated with numerous adverse health outcomes, yet sedentary lifestyles are common among both children and adults. Physical activity levels tend to decline steeply among children aged between 8 and 12 years, even though children's behavioral patterns are largely governed by familial structures. Similarly, parents' activity levels have been generally reported as lower than those of nonparents of comparable age. For this reason, family-based physical activity promotion interventions are a potentially valuable and relatively underresearched method for mitigating physical activity declines as children develop into adolescents and for increasing physical activity in parents. OBJECTIVE: This study aims to assess the efficacy, feasibility, and acceptability of a novel theory-based web-based physical activity promotion intervention among parent-child dyads in Finland who do not meet physical activity recommendations at baseline. METHODS: Participants (target N=254) will be recruited from the general population using a panel company and advertisements on social media and randomly assigned to either an immediate intervention group or a waitlist control group. The intervention consists of 4 web-based group workshops over the course of 10 weeks, web-based tasks and resources, and a social support chat group. Data on physical activity behavior and constructs from the integrated behavior change model will be collected through self-report surveys assessing physical activity, autonomy support, autonomous motivation, attitude, subjective norm, perceived behavioral control, intention, self-monitoring, habit, and accelerometer measurements at baseline, post intervention, and 3 months post intervention. Exit interviews with participants will assess the feasibility and acceptability of the intervention procedures. RESULTS: This study will reveal whether the intervention changes leisure-time physical activity among intervention participants relative to the control group and will examine the intervention's effects on important theoretical predictors of physical activity. It will also yield data that can be used to refine intervention materials and inform further implementation. Trial recruitment commenced in September 2023, and data collection should be completed by December 2024. CONCLUSIONS: The planned intervention has potential implications for both theory and practice. Practically, the use of an entirely web-based intervention may have scalable future uses for improving physical activity in 2 key populations, while also potentially informing on the value of dyadic, family-based strategies for encouraging an active lifestyle as an alternative to strategies that target either parents or children independently. Further, by assessing change in psychological constructs alongside potential change in behavior, the intervention also allows for important tests of theory regarding which constructs are most linked to favorable behavior change outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT06070038; https://clinicaltrials.gov/study/NCT06070038. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55960.

Can the Cans: Determinants of Container Deposit Behavior before and after Introduction of a Container Refund Scheme.

OBJECTIVE: Container deposit schemes are often hailed as a useful avenue to increase consumer recycling rates. Yet, there is little research investigating within-person changes in people's beliefs and behavior following the implementation of these schemes, or tests of the mechanisms by which such change has occurred. METHODS: The current study fills this knowledge gap and assessed container recycling behavior and habits as well as the social cognition factors of attitudes, subjective norms, perceived behavioral control, and intentions in a sample of 90 Queenslanders before the implementation of the container deposit scheme and one and three months post-implementation. RESULTS: Analysis of variance indicated more frequent recycling behavior following the implementation of the scheme, as well as stronger habits, intentions, and perceived behavioral control. CONCLUSIONS: Such a concomitant change in behavior, beliefs, and habits provides support for behavior change theory, while also flagging potential targets for strategies that can be paired with container deposit schemes to enhance their efficacy and uptake.

Testing the moderative role of automatic-reflective affect divergence in predicting physical activity.

Dual process theories postulate that behaviour is the product of two distinct cognitive systems, the automatic and reflective, and that congruence/divergence between the two types of cognitions can influence the predictive strength of either system on behaviour. However, the congruence/divergence hypothesis has yet to experience strong empirical support. The aim of this study was to test a novel dual process model to determine the moderating effect of affect divergence on the relationship between automatic affective evaluations-affective judgements, and physical activity. A sample of 315 university students recruited from an undergraduate research pool completed the Affective Misattribution Procedure and Affective Exercise Experiences Questionnaire, followed by a measure of physical activity behaviour one week later. A path analysis revealed a significant moderation effect such that the predictive strength of affective judgements was stronger when participants' automatic affective evaluations and affective judgements were congruent. Findings support current dual process theory and contributes to calls for more interventions, such as evaluative conditioning that target automatic processes alongside consciously held beliefs.

Promoting regular parental supervised toothbrushing: An additive intervention design adopting the Health Action Process Approach.

The study aimed to test the efficacy of the core elements of the Health Action Process Approach (HAPA) in an intervention among parents to promote regular supervised toothbrushing of preschool-aged children. The pre-registered study (https://osf.io/fyzh3/) tested the effects of an intervention employing information provision, behavioural instruction, implementation intention and mental imagery techniques, adopting a randomised controlled design in a sample of Australian parents of preschoolers (N = 254). The intervention used an additive design with four conditions-education, self-efficacy, planning and action control-progressively layered to show the cumulative impact of incorporating self-efficacy, planning and action control strategies with a foundational education component. The intervention was delivered online, and participants completed self-report measures of parental supervised toothbrushing and HAPA-based social cognition constructs pre-intervention and 4 weeks post-intervention. Although no significant intervention effects on behaviour were observed, mixed-model analyses of variance (ANOVAs) revealed an increase in intention and task self-efficacy within the action control condition and an increase in action planning in both the action control and planning conditions from pre-intervention to follow-up. Despite no anticipated changes in behaviour, these findings endorse the use of theory- and evidence-based behaviour change strategies to inspire change in HAPA-based determinants of parental supervised toothbrushing: intention, action planning and task self-efficacy.

Using an integrated social cognition model to identify the determinants of QR code check-in compliance behaviors in the COVID-19 pandemic.

In Australia, checking in while entering venues was a legal requirement during the COVID-19 pandemic to track potential infection sites. This two-wave correlational study used an integrated theory of planned behavior model including moral norms, anticipated regret, and habit to predict check-in compliance in a sample of 181 Victorians (Mean Age = 41.88, 56.4% female) and 162 Queenslanders (Mean Age = 43.26, 47.5% female). Habit and intention predicted behavior, while perceived behavioral control did not. Intention was predicted by baseline habit, attitude, subjective norm, and moral norm in the Victorian sample, while only baseline habit and moral norm predicted intention in the Queensland sample. This study has potential implications for reviewing previous strategies and for future pandemic preparedness, both by identifying the drivers of infection control compliance, and through the discussion of how differences in effects between states may be linked to each state's experience of the pandemic (e.g. infection rates, lockdown length).

Single-session intervention on growth mindset on negative emotions for university student mental health (U-SIGMA): a protocol of two-armed randomized controlled trial.

BACKGROUND: The university years are a developmentally crucial phase and a peak period for the onset of mental disorders. The beliefs about the changeability of negative emotion may play an important role in help-seeking. The brief digital growth mindset intervention is potentially scalable and acceptable to enhance adaptive coping and help-seeking for mental health needs in university students. We adapted the Single-session Intervention on Growth Mindset for adolescents (SIGMA) to be applied in university students (U-SIGMA). This protocol introduces a two-armed waitlist randomized controlled trial study to examine the effectiveness and acceptability of U-SIGMA in promoting help-seeking among university students in the Greater Bay Area. METHODS: University students (N = 250, ages 18-25) from universities in the Greater Bay Area will be randomized to either the brief digital growth mindset intervention group or the waitlist control group. Participants will report on the mindsets of negative emotions, perceived control over anxiety, attitude toward help-seeking, physical activity, hopelessness, psychological well-being, depression, anxiety, and perceived stress at baseline and the 2-week and 8-week follow-ups through web-based surveys. A 30-min digital intervention will be implemented in the intervention group, with a pre- and post-intervention survey collecting intervention feedback, while the control group will receive the link for intervention after 8 weeks. DISCUSSION: This protocol introduces the implementation plan of U-SIMGA in multi-cities of the Greater Bay Area. The findings are expected to help provide pioneer evidence for the effectiveness and acceptability of the brief digital intervention for university students in the Chinese context and beyond and contribute to the development of accessible and effective prevention and early intervention for university students' mental health. TRIAL REGISTRATION: HKU Clinical Trials Registry: HKUCTR-3012; Registered 14 April 2023.  http://www.hkuctr.com/Study/Show/7a3ffbc0e03f4d1eac0525450fc5187e .

A non-randomised feasibility study of a mHealth follow-up program in bariatric surgery.

BACKGROUND: Behavioural support via mobile health (mHealth) is emerging. This study aimed to assess the feasibility, acceptability, cost, and potential effect on weight of a mHealth follow-up program in bariatric surgery. METHODS: This was a non-randomised feasibility study describing intervention development and proof in the concept of a mHealth follow-up program in bariatric surgery. The study compares a prospective cohort with a historical control group and was conducted in a tertiary bariatric surgery service in Australia. The intervention group included individuals who had bariatric surgery (2019-2021) and owned a smart device, and the historical control group received usual postoperative care (2018). The intervention involved usual care plus codesigned biweekly text messages, monthly email newsletters, and online resources/videos over a 6-month period. The primary outcome measures included feasibility (via recruitment and retention rate), acceptability (via mixed methods), marginal costs, and weight 12 months postoperatively. Quantitative analysis was performed, including descriptive statistics and inferential and regression analysis. Multivariate linear regression and mixed-effects models were undertaken to test the potential intervention effect. Qualitative analysis was performed using inductive content analysis. RESULTS: The study included 176 participants (n = 129 historical control, n = 47 intervention group; mean age 56 years). Of the 50 eligible patients, 48 consented to participate (96% recruitment rate). One participant opted out of the mHealth program entirely without disclosing their reason (98% retention rate). The survey response rate was low (n = 16/47, 34%). Participants agreed/strongly agreed that text messages supported new behaviours (n = 13/15, 87%); however, few agreed/strongly agreed that the messages motivated goal setting and self-monitoring (n = 8/15, 53%), dietary change (n = 6/15, 40%), or physical activity (n = 5/15, 33%). Interviews generated four main themes (n = 12): 'motivators and expectations', 'preferences and relevance', 'reinforced information", and 'wanting social support'. The intervention reinforced information, email newsletters were lengthy/challenging to read, and text messages were favoured, yet tailoring was recommended. The intervention cost AUD 11.04 per person. The mean 12-month weight was 86 ± 16 kg and 90 ± 16 kg (intervention and historical control) with no statistically significant difference. Intervention recipients enrolled at 3 months postoperatively demonstrated a statistically significant difference in 12-month weight (p = 0.014). CONCLUSION: Although this study observed high rates of recruitment and retention, findings should be considered with caution as mHealth may have been embraced more by the intervention cohort as a result of the 2019 coronavirus pandemic. Of the various digital strategies developed and tested, the text message approach was the most acceptable; however, future intervention iterations could be strengthened through tailoring information when possible. The use of email newsletters and online resources/videos requires further testing of effectiveness to determine their value for continued use in bariatric surgery services.

Evaluation of an implementation intentions intervention for managing university student stress.

University students consistently report high levels of stress, which has been associated with a range of adverse outcomes. Promoting adaptive coping behaviours, such as problem-focused coping for managing university stress, is therefore a timely area of investigation. Current coping intervention approaches target reasoned cognitive processes; however, recent research has suggested that automatic processes are more strongly associated with problem-focused coping behaviour. The current study examined the effect of an implementation intentions intervention, a technique that can support behaviour to be performed automatically by facilitating continued repetition of a plan, on problem-focused coping behaviour under stress and stress-related outcomes. Following a pilot study (N = 21), a preregistered randomized controlled trial was conducted with university students (N = 154) using an online survey. Participants completed baseline measures of problem-focused coping behaviour, behavioural automaticity, behavioural intentions, action planning, perceived stress, procrastination, and psychological wellbeing; before receiving the intervention or control condition stimuli, and then at a 2-week follow-up. Behavioural intention and action planning were also measured immediately post-intervention. The intervention had a significant medium-sized effect on action planning for problem-focused coping, but no other significant effects were detected. Exploratory assessment of plan quality revealed medium-sized correlations between plan quality and changes in problem-focused coping behaviour. Findings indicate that implementation intentions may be a promising approach for increasing planning for the use of problem-focused coping. Indicators of plan quality found to be associated with changes in problem-focused coping provide valuable avenues for intervention optimisation in future research.

Optimizing behavior change through integration of individual- and system-level intervention approaches.

We contend that individual-level ("i-frame") intervention strategies can be appropriately integrated with system-level ("s-frame") strategies to optimize population-level behavior change. We outline instances of effective "i-frame" interventions, and how coordinated, integrated, well-resourced interventions that encompass components at both levels, and has organizational and user-group support, may optimize sustained behavior change intervention efforts, and allay practices that undermine "s-frame" components.