What strategies are effective for behavior change?

From the Guidelines

Effective behavior change requires a multifaceted approach that combines clear goals, consistent habits, and supportive environments, with the most effective strategies including specific, proximal, shared goals, self-monitoring, scheduled follow-up, regular feedback, self-efficacy, motivational interviewing, family and peer support, and multi-component approaches 1. To achieve successful behavior change, it is essential to set specific, measurable, achievable, relevant, and time-bound (SMART) goals, breaking them down into smaller, manageable steps to prevent overwhelm and create momentum. Establishing triggers or cues in the environment that prompt the desired behavior, such as placing exercise clothes beside the bed for morning workouts, can also be helpful. Tracking progress daily using a simple method like a habit tracker app or journal can maintain accountability and motivation. Some key strategies for behavior change include:

• Setting specific, proximal, shared goals in collaboration with the patient
• Establishing a strategy for self-monitoring, such as a dietary or physical activity diary or web-based or mobile applications
• Scheduling regular follow-up to assess success, reinforce progress, and set new goals as necessary
• Providing feedback on progress toward goals, including using in-person, telephone, and/or electronic feedback
• Increasing the patient's perception that they can successfully change their behavior through self-efficacy
• Using motivational interviewing when patients are resistant or ambivalent about behavior change
• Arranging long-term support from family, friends, or peers for behavior change
• Combining two or more of the above strategies into the behavior change efforts, as multifaceted interventions have been found to be highly effective in changing behavior, with overall success rates exceeding 70% 1. The science behind successful behavior change involves neuroplasticity, where the brain physically rewires with repetition, making new behaviors automatic over time, typically requiring 66 days of consistency 1. Social support significantly increases success rates, so sharing goals with others or finding an accountability partner can be beneficial. Finally, focusing on identity-based change by adopting language that reinforces the new self-concept, such as "I am a runner" rather than "I'm trying to run more," can align self-perception with desired behaviors.

From the Research

Effective Strategies for Behavior Change

Several strategies have been identified as effective for behavior change, including:

• Goal setting: Setting specific, achievable goals can help individuals identify behaviors to change and develop plans to achieve those changes 2, 3
• Action planning: Breaking down goals into smaller, actionable steps can help individuals put their plans into action 2
• Considering key goal characteristics: Characteristics such as approach vs avoidance goals, performance vs mastery goals, and level of difficulty can impact the effectiveness of goal setting 2
• Public goal setting: Setting goals publicly, rather than privately, can increase motivation and accountability 3
• Group goals: Setting goals as part of a group can provide social support and increase motivation 3
• External monitoring: Having others monitor progress without providing feedback can increase motivation and accountability 3
• Face-to-face delivery: Delivering interventions in person, rather than remotely, can increase effectiveness 3
• Motivation and reward mechanisms: Understanding the underlying motivation and reward mechanisms that drive behavior change can help identify effective strategies for initiation and maintenance of behavior change 4
• Integration of individual- and system-level interventions: Combining individual-level interventions with system-level interventions can optimize population-level behavior change 5
• Experimental medicine approach: Using an experimental medicine approach to identify and validate targets of change and discover effective techniques for engaging those targets can help accelerate progress in health behavior change research 6

Key Considerations for Behavior Change

When developing strategies for behavior change, it is important to consider the following:

• The role of motivation and reward processes in driving behavior change 4
• The importance of identifying and validating targets of change 6
• The need for systematic studies to identify effective techniques for engaging targets of change 6
• The potential benefits of integrating individual- and system-level interventions 5
• The importance of considering key goal characteristics, such as approach vs avoidance goals and level of difficulty 2