Implementation Intention Group Research Articles

The effect of implementation intentions on event-, time-, and activity-based prospective memory in typically developing children

Prospective memory (PM) refers to the ability to remember and complete planned tasks in the future, which relies on working memory (WM) for encoding and maintaining the intention. Implementation intention is a useful strategy for improving PM function in adults. Yet the effect of implementation intentions in children, and whether factors such as age, gender, and WM capacity could modulate its effect remains unclear. In this study, we examined the effect of implementation intentions on PM in 154 children at 7–11 years of age. The standard group received standard instructions on PM task, whereas the implementation intention group received additional PM instruction, which comprised the “if . then .” format and guided visual imagery of the PM scenario. Participants completed the computer-based PM tasks (tapping into focal event-, time-, and activity-based PM) and the WM tests. The results showed that the two groups exhibited similar focal event-, time-, and activity-based PM performance. Although age and gender did not modulate the effect of implementation intentions on PM, WM capacity moderated the implementation intention effect on time-based PM. Specifically, higher WM capacity predicted higher implementation intention benefit. These findings suggest that children with higher WM capacity may have higher chance to benefit from the implementation intention strategy.

Prospective memory performance and its improvement in individuals with high schizotypal traits: Evidence from eye-tracking studies

ObjectiveThis study aimed to examine prospective memory (PM) performance and the potential effect of implementation intention on PM performance and the underlying mechanisms in individuals with high schizotypyal traits (HSTs) using eye-tracking paradigms. MethodsIn Experiment 1, 30 individuals with HSTs and 30 individuals with low schizotypal traits (LSTs) underwent a visual search task that involved PM cues, and participants’ eye movements were recorded. In Experiment 2, 50 individuals with HSTs were randomly assigned to the implementation intention group and typical instruction group. ResultsIn Experiment 1, individuals with HSTs had a lower PM accuracy and performed less PM cue monitoring (indicated by fewer total fixation counts on distractor words) than individuals with LSTs. In Experiment 2, implementation intention significantly improved PM accuracy and increased total fixation counts on distractor words in individuals with HSTs compared to the HST group with typical instruction. ConclusionsIndividuals with HSTs were impaired in PM and showed reduced cue monitoring compared to individuals with LSTs. Implementation intention improved PM performance and facilitated cue monitoring in individuals with HSTs. SignificanceOur findings indicate that cue monitoring may be an important process of intervention target for PM for individuals in the schizophrenia spectrum.

Validation of the most cost-effective nudge to promote workers’ regular self-weighing: a cluster randomized controlled trial

Regular self-weighing is useful in obesity prevention. The impact of nudge-based occupational self-weighing programs in the cluster randomized controlled trial was examined. The primary outcome was regular self-weighing after 6 months, which we used to compute cost-effectiveness. Participants were Japanese local government employees who underwent 1 h workshops after being assigned to one of the three nudge groups. Each group was designed according to the nudges’ Easy, Attractive, Social, Timely framework: quiz group (n = 26, attractive-type nudges), implementation intentions group (n = 25, social-type nudges), and growth mindset group (n = 25, timely type nudges). A reference group (n = 36, no nudges) was also formed. After 6 months, all three interventions were effective for regular self-weighing, with the growth mindset intervention (60.0%) being significantly more effective. The cost-effectiveness of the growth mindset group was 1.7 times and 1.3 times higher than that of the quiz group and the implementation intentions group, respectively. Findings from our study are expected to facilitate the use of nudges for health practitioners and employers, which in turn may promote obesity prevention.

“Short and Sweet”: A Randomized Controlled Initial Investigation of Brief Online Psychological Interventions With Endurance Athletes

There is potential in delivering brief, educational interventions online, particularly for recreational athletes. This initial investigation examined how two online interventions were perceived by endurance participants and how they affected outcomes of interest. After measuring self-efficacy, 142 people were randomized to one of three groups (self-talk, implementation intentions, and control) before an endurance event. Ninety-four completed postevent measures, which were self-efficacy, goal attainment, performance satisfaction, coping, stress appraisals, and social validity. The interventions involved approximately 10 min of initial engagement with online material. Perceptions of stress controllability were significantly higher in the implementation intention group compared with the control. There were no other statistically significant effects. Nevertheless, both intervention groups were satisfied with their interventions, found them useful, and were planning to continue using them. The findings demonstrate the feasibility and value of using brief, online psychological interventions, which may be timely in our changing profession, as COVID-19 has moved many interventions online.

Improving Health of People With Multiple Sclerosis From a Multicenter Randomized Controlled Study in Parallel Groups: Preliminary Results on the Efficacy of a Mindfulness Intervention and Intention Implementation Associated With a Physical Activity Program.

Objectives: The objective of this study is to investigate the efficacy of psychological Interventions – Mindfulness or Implementation Intention – associated with a Physical Activity program, delivered via internet, in reducing Multiple Sclerosis symptoms.Method: Thirty-five adults were randomly assigned to one of the three groups: a Mindfulness-Based Intervention group (N = 12), Implementation Intention group (N = 11), and a Control Group (N = 12). All the groups received the same Physical Activity program. The Mindfulness condition group received daily training in the form of pre-recorded sessions while the Implementation group elaborated their specific plans once a week. Mobility, fatigue, and the impact of the disease on the patient’s life were measured. Two measurement times are carried out in pre-post intervention, at baseline and after eight weeks.Results: Overall, after 8 weeks intervention, results show that there was a significant increase in Walking distance in the three groups. In addition, the within-group analysis showed a statistically significant improvement between pre and post intervention on the physical component of the Disease Impact scale in the Implementation Intention group (p = 0.023) with large effect size, in the Mindfulness-Based Intervention group (p = 0.008) with a medium effect size and in the control group (p = 0.028) with small effect size. In the Implementation Intention group, all physical, psychosocial and cognitive Fatigue Impact subscales scores decreased significantly (p = 0.022, p = 0.023, and p = 0.012, respectively) and the physical component was statistically and negatively correlated (r = −0.745; p = 0.008) when Implementation Intention group practice a mild to moderate physical activity. In the Mindfulness-Based Intervention group, the physical component (MFIS) showed a statistically significant improvement (p = 0.028) but no correlation with moderate-to-vigorous physical activity (MVPA); the control group outcomes did not reveal any significant change.Conclusion: The results of this study are very encouraging and show the feasibility of Mindfulness interventions associated with physical activity to improve the health of people with MS. Further study should assess Mindfulness interventions tailored to MS condition and using both hedonic and eudemonic measures of happiness.

The impact of using implementation intentions as task instructions on prospective memory performance after stroke

ABSTRACT Prospective Memory (PM), the ability to remember to carry out intentions in the future, is often impaired after stroke. Little is known about rehabilitation of PM post-stroke with literature limited by small sample sizes and reliance on self-reported memory performance. Implementation intentions may make prospective remembering more automatic and follow a simple if–then structure (if X occurs, then I will do Y), focusing on the cue rather than the task. We aimed to investigate the effect of implementation intentions on PM post-stroke. Twenty-eight individuals with stroke and 27 controls were randomly allocated to a standard instruction or implementation intention condition and completed an assessment battery over two sessions. Implementation intention instructions were provided for PM tasks on the Delayed Message Task, Lexical Decision Prospective Memory Task (LDPMT), and the Virtual Reality Prospective Memory Shopping Task. The implementation intention groups performed better on all PM tasks compared to the standard instruction group, but no results reached statistical significance, likely due to the small sample size. In addition, the implementation intentions group monitored the time significantly more on the LDPMT than those in the standard instruction group.

The influence of ‘deliberate’ implementation intention on medical students’ risk decision task outcomes

ABSTRACT Implementation intention is a kind of behaviour choice strategy in which individuals adopt specific and definite behaviour patterns to achieve behavioural goals. The standard form is ‘if something happens, then I will do something’. Previous studies have shown that implementation intention strategy is a fast and effective mental skill with notable advantages. However, adding the requirement of ‘deliberate’ to the implementation plan will increase the probability of decision adjustment to a certain extent. In this study, the classic Balloon Analogue Risk Task (BART) was selected as the evaluation index of risk decision-making, and the ‘deliberate’ implementation intention was adopted to explore the impact of this behavioural strategy on risk selection. The recruited medical students were divided into two groups: the implementation intention group (n = 37) and the control group (n = 34). The baseline assessment for the BART was performed by all participants, and the intensive training of ‘deliberate’ implementation intention to ‘make as much money as possible’ was conducted before the post-test decision-making after one week. The adjusted BART (adj BART) value and AvgIncome were significantly higher than those at baseline in the implementation intention group(adj BART value: baseline 12.63 ± 2.90, post-test: 14.78 ± 2.66, F = 15.978, p < 0.001, η 2 = 0.307; AvgIncome: baseline 12.43 ± 2.56, post-test 15.00 ± 2.57, F = 20.953, p < 0.001, η 2 = 0.368). The mixed-model ANOVAs showed that there was a significant interaction between test time and group (adj BART value: F = 4.859, p = 0.031, η 2 = 0.066; AvgIncome: F = 4.261, p = 0.043, η 2 = 0.058). Conclusion: The implementation of ‘deliberate’ intention can help medical students make more rational judgements in risk decision-making tasks, avoid over conservative behaviour and obtain more benefits.

The relationship of personality and behavior change in a physical activity intervention: The role of conscientiousness and healthy neuroticism

This study examined the role of personality traits in a 5-week physical activity intervention study for working adults. We tested whether personality traits predicted individual differences in change in daily steps over time. Fifty-two participants ages 35 to 69 (Mage = 49.71, SD = 8.64) wore a Fitbit Zip step counter for 35 days and completed a personality questionnaire. Participants were randomly assigned to either an implementation intention group or a control group. Both groups wore a Fitbit and had the goal to increase their daily steps. For the present study, the sample was collapsed across groups. Higher conscientiousness was associated with greater increases in daily steps. Also, individuals with healthy neuroticism, the combination of higher neuroticism and higher conscientiousness, showed greater increases in daily steps. The findings highlight that the efficacy of physical activity interventions may depend on personality traits. Intervention outcomes may be improved if personality is taken into account when designing the programs.

Implementation intentions for weight loss in college students with overweight and obesity: a proof-of-concept randomized controlled trial.

One in three college students have overweight or obesity and are in need of brief, simple weight loss interventions. Implementation intentions, a strategy that connects a goal-aligned behavior to a cue, facilitate goal attainment of health behaviors but have not been applied as a standalone treatment for weight loss. The purpose of this study was to examine the efficacy of an implementation intention weight loss intervention in college students. In this three-arm, proof-of-concept, randomized controlled trial, college students with overweight/obesity (N = 95) were randomized to one of three conditions: an implementation intention group (IMP), an enhanced implementation intention group (IMP+) that included text message reminders and fluency training (i.e., training for speed and accuracy), and a control goal intention group (GOL) for 4 weeks. Participants completed anthropometric and self-report assessments pretreatment and posttreatment and experience-sampling assessments during the study to assess how implementation intentions contribute to behavior change. Across the sample, IMP and IMP+ groups reported significantly more goal-congruent behaviors than the GOL group. However, no between-condition differences emerged for weight and diet outcomes. Across conditions, students lost a statistically significant amount of weight, improved diet quality, and reduced caloric intake (ps < .05). Setting implementation intentions was associated with increased behaviors consistent with weight loss goals. Moreover, participants in all groups lost a statistically significant amount of weight. Incorporating implementation intentions into weight loss interventions, and testing the efficacy of this approach on weight loss over a longer duration, may be beneficial for college students with overweight/obesity.

Implementation intentions improve exercise self-efficacy and exercise behavior regardless of task difficulty

Previous scholars have demonstrated that implementation intentions have positive effects on exercise self-efficacy and exercise behaviors; however, others have found little evidence to support these results. Task difficulty has been deemed a key factor that may contribute to these discrepant findings. Therefore, we examined the effects of implementation intentions on exercise self-efficacy and exercise behavior under different task difficulty conditions. High school students (N = 90; 48 young women and 42 young men) were randomly assigned to 3 groups to receive different kinds of intervention (i.e., control group, goal intentions group, and implementation intentions group) and then were asked to hold the Navasana yoga posture under either high-difficulty or low-difficulty conditions. The results lend support to the assumption that implementation intentions help improve exercise self-efficacy and exercise behavior among high school students. The effects of implementation intentions were robust and independent of task difficulty.

Neural correlates of the effect of implementation intention on prospective memory.

Prospective memory (PM) refers to the ability to remember to do something in the future. Implementation intention refers to a self-regulatory strategy in the form of "If …, then …" planning that can improve PM performance. However, the neural basis of the effect of implementation intention on PM remains unclear, as do the phases of PM that are affected by implementation intention. This study aimed to address these issues. Healthy participants were randomly assigned to the implementation intention (n = 18) and typical instruction (n = 20) conditions. All of them underwent functional magnetic resonance imaging (fMRI) scanning when performing a PM task, which differentiated encoding, maintenance, and execution phases. Results demonstrated that participants in the implementation intention group showed different brain activations compared to participants in the typical instruction group. During the encoding phase, the implementation intention group showed increased activations in the inferior frontal gyrus (BA 10) and supramarginal gyrus (BA 40) compared to the typical instruction group; during the maintenance phase, the typical instruction group showed stronger activations in the inferior frontal gyrus (BA 46) than the implementation intention group; during the execution phase, the typical instruction group showed increased activations in the precentral gyrus (BA 6) and middle frontal gyrus (BA 8) than the implementation intention group. These results demonstrated the neural correlates of implementation intention on PM in different phases, and support the conclusion of our previous review based on fMRI evidence that implementation intention's improvement of PM performance is not fully automatic.

Pilot randomized trial of a volitional help sheet‐based tool to increase leisure time physical activity in breast cancer survivors

To develop and test a volitional help sheet-based tool to improve physical activity in breast cancer survivors compared to a standard self-generated implementation intention intervention. Pilot randomized trial conducted online over 3months. Participants were randomized to an online volitional help sheet (n=50) or implementation intention (n=51) intervention. Measures were taken at baseline, 1 and 3months. The main outcome measure was moderate-strenuous leisure timephysical activity. Secondary outcomes were health-related quality of life and mood. Participants exposed to the volitional help sheet and implementation intention interventions showed similar effects after 1month, with both groups reporting a significant increase in moderate-strenuous physical activity. After 3months, the initial increase in physical activity was maintained by the volitional help sheet group, but not the implementation intention group. Improvements were also found for negative affect and emotional quality of life. While both interventions show promise in promoting physical activity in breast cancer survivors, the volitional help sheet may be more effective for facilitating lasting change and emotional well-being. Findings suggest that the volitional help sheet may have potential to offer a cost-effective contribution to consumer-led tertiary preventive health. Future research should test these initial findings in a definitive trial. Statement of contribution What is already known on this subject? Physical activity is important for optimizing health in breast cancer survivors. Despite this, physical activity in this cohort remains low. Theory-based strategies are needed to help breast cancer survivors independently manage and maintain regular physical activity over the long term. What does this study add? Online planning interventions can improve physical activity in breast cancer survivors. Volitional help sheets, but not implementation intentions, show sustained effects for 3months. The intervention shows promise as a potential low-cost addition to long-term survivorship care plans.

To drink or to drink less? Distinguishing between effects of implementation intentions on decisions to drink and how much to drink in treatment-seeking individuals with alcohol use disorder

IntroductionFor many people with alcohol use disorders, alcohol drinking is a highly ingrained and automatized behavior with negative long-term health consequences. Implementation intentions, a behavioral intervention that links high-risk drinking situations with alternative, healthier responses, provide a means to intervene on habitual drinking behaviors. Here, a pilot treatment using implementation intentions was assessed with remote assessments and treatment prompts. MethodsTreatment-seeking individuals with alcohol use disorder between the ages of 18 and 65 were recruited from the community from October 2014 to November 2016. Participants (N=35) were quasi-randomly assigned to complete either active (n=18) or control (n=17) two-week implementation intention interventions. Active implementation intentions linked high-risk situations with alternative responses whereas the control condition selected situations and responses but did not link these together. Daily ecological momentary interventions of participant-tailored implementation intentions were delivered via text message. Alcohol consumption was assessed once daily with self-reported ecological momentary assessments (EMAs) of drinks consumed the previous day and thrice daily remotely submitted breathalyzer samples to assess reliability of self-reports. ResultsOn drinking days (80% of days), the active implementation intentions group reduced alcohol consumption during the intervention period compared to the control condition; however the difference between consumption was not observed at one-month follow-up. DiscussionThe implementation intention intervention was associated with a 1.09 drink per day decrease in alcohol consumption on drinking days compared to a decrease of 0.29 drinks per day in the control condition. Future studies may combine implementation intentions with other treatments to help individuals to reduce alcohol consumption.

Spatiotemporal brain dynamics supporting the immediate automatization of inhibitory control by implementation intentions

While cognitive interventions aiming at reinforcing intentional executive control of unwanted response showed only modest effects on impulse control disorders, the establishment of fast automatic, stimulus-driven inhibition of responses to specific events with implementation intention self-regulation strategies has proven to be an effective remediation approach. However, the neurocognitive mechanisms underlying implementation intentions remain largely unresolved. We addressed this question by comparing electrical neuroimaging analyses of event-related potentials recorded during a Go/NoGo task between groups of healthy participants receiving either standard or implementation intentions instructions on the inhibition stimuli. Inhibition performance improvements with implementation intentions were associated with a Group by Stimulus interaction 200–250 ms post-stimulus onset driven by a selective decrease in response to the inhibition stimuli within the left superior temporal gyrus, the right precuneus and the right temporo-parietal junction. We further observed that the implementation intentions group showed already at the beginning of the task the pattern of task-related functional activity reached after practice in the group having received standard instructions. We interpret our results in terms of an immediate establishment of an automatic, bottom-up form of inhibitory control by implementation intentions, supported by stimulus-driven retrieval of verbally encoded stimulus-response mapping rules, which in turn triggered inhibitory processes.

The role of the built environment in a randomized controlled trial to increase physical activity among men with prostate cancer: the PROMOTE trial.

The purpose of the study was to examine the association between the built environment and physical activity (PA) in prostate cancer survivors (PCS), as well as whether built environment factors (walkability, count of sports complexes) were effect modifiers of a PA intervention. Our study included 165 PCS residing in Edmonton, Alberta, from the PROMOTE trial. The PROMOTE trial was a randomized controlled trial of a behaviour change intervention to increase PA and quality of life in PCS. In the PROMOTE trial, 423 PCS were randomly assigned to a standard physical activity recommendation, self-administered implementation intention, or telephone-assisted implementation intention group. PA and quality of life outcomes were assessed at baseline, 1, and 3months. To explore the role of the built environment, this study examined walkability and count of sport complexes. Linear regression analyses revealed that the self-administered intervention group had an increase in self-reported PA minutes/week (β=133.4, 95% CI=-18.9 to 285.6); however, none of the built environment variables were found to be significantly associated with PA. The logistic regression showed that the self-administered intervention group had a significantly greater likelihood of meeting the PA guidelines (OR=2.1, 95% CI=0.9 to 4.9), though no built environment variables were associated with PA levels. Our findings suggest that the built environment was not associated with PA and was not an effect modifier in a PA behaviour change intervention for PCS. Further research is needed before clear conclusions can be generated ( ClinicalTrials.gov number NCT01410656).

Developing ecological momentary intervention content for relapse prevention

For many people with alcohol use disorders, alcohol drinking is a highly ingrained and automatized behavior with negative long-term health consequences. Implementation intentions, a behavioral intervention that links high-risk drinking situations with alternative, healthier responses, provide a means to intervene on habitual drinking behaviors. Here, a pilot treatment using implementation intentions was assessed with remote assessments and treatment prompts.Treatment-seeking individuals with alcohol use disorder between the ages of 18 and 65 were recruited from the community from October 2014 to November 2016. Participants (N = 35) were quasi-randomly assigned to complete either active (n = 18) or control (n = 17) two-week implementation intention interventions. Active implementation intentions linked high-risk situations with alternative responses whereas the control condition selected situations and responses but did not link these together. Daily ecological momentary interventions of participant-tailored implementation intentions were delivered via text message. Alcohol consumption was assessed once daily with self-reported ecological momentary assessments (EMAs) of drinks consumed the previous day and thrice daily remotely submitted breathalyzer samples to assess reliability of self-reports.On drinking days (80% of days), the active implementation intentions group reduced alcohol consumption during the intervention period compared to the control condition; however the difference between consumption was not observed at one-month follow-up.The implementation intention intervention was associated with a 1.09 drink per day decrease in alcohol consumption on drinking days compared to a decrease of 0.29 drinks per day in the control condition. Future studies may combine implementation intentions with other treatments to help individuals to reduce alcohol consumption.

The implications of counterfactual mind-sets for the functioning of implementation intentions

Two experiments explored how counterfactual mind-sets interact with implementation intentions and affect their flexibility. Participants engaged in a subtractive mind-set, an additive mind-set, or a control condition and were subsequently given either goal intentions or implementation intentions that facilitated cue detection (Experiment 1) or the goal-directed response (Experiment 2). Dependent variables were the number of targets specified in the intentions and the legitimate alternatives to the targets (flexibility measure). In Experiment 1, the implementation intention (versus goal intention) group were better at detecting specified cues, but worse on alternatives, regardless of mind-set. In Experiment 2, an interaction emerged. For both specified and alternative responses, the subtractive mind-set paired with an implementation intention versus goal intention performed better. This pattern was reversed for additive mind-set conditions. Hence, how counterfactual mind-sets affect the flexibility of planning is dependent on the particular mind-set used and the specific operations of plan.

Randomized Controlled Trial of a Behavior Change Intervention to Increase Physical Activity and Quality of Life in Prostate Cancer Survivors

Physical activity improves health in prostate cancer survivors; however, participation rates are low. This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors. Prostate cancer survivors (N = 423) were randomly assigned to a standard physical activity recommendation, a self-administered implementation intention, or a telephone-assisted implementation intention. Physical activity and quality of life were assessed at baseline, 1, and 3 months. Analyses of covariance using multiple imputation showed that physical activity at 1 month increased by 86 min/week in the standard physical activity recommendation group compared with 168 min/week in the self-administered implementation intention group (P = 0.023) and 105 min/week in the telephone-assisted implementation intention group (P = 0.35). A self-administered implementation intention intervention resulted in a meaningful short-term increase in physical activity. Supplementation with additional intervention strategies and more frequent intervention may improve longer-term exercise.

Self-efficacy and implementation intentions-based interventions on fruit and vegetable intake among adults: impact at 12-month follow-up

This study tested the effect of theory-based interventions designed to increase fruit and vegetable intake (FVI). Adults (n = 291) were randomized into four groups: implementation intentions (II) group; self-efficacy (SE) group; combination of implementation intentions and self-efficacy (II+SE) group; and a control group receiving written information on nutrition. They were reassessed at 1, 3, 6 and 12 month follow-up. This study found that short interventions such as SE and II+SE can achieve significant differences in FVI at six-month follow-up compared to the control group. However, this effect was not maintained at 12-month follow-up. Practitioners should add materials or follow up meetings to ensure maintenance of behavioral change.

An experimental assessment of the influence of exercise versus social implementation intentions on physical activity during and following pulmonary rehabilitation

Techniques to increase physical activity among pulmonary rehabilitation patients outside of the rehabilitation context are warranted. Implementation intentions are a strategy used to initiate goal-directed behaviour, and have been found to be useful in other populations. This study compared the long-term effects of exercise and social implementation intentions interventions on objectively measured physical activity in 40 pulmonary rehabilitation patients randomly assigned to condition. Repeated measures ANOVAs found that those in the exercise implementation intentions group took more steps (p=.007) at the end of pulmonary rehabilitation than those in the social implementation intentions group. Improvements attained by the exercise group during the intervention were not maintained 6-months following rehabilitation. Implementation intentions targeting physical activity appear to have positive short term effects on physical activity, although the long term effects are less consistent. This may be due in part to methods used to assess physical activity behaviour.