What is the role of target activation in facilitating behaviour change?

From the Guidelines

Target activation plays a crucial role in facilitating behavior change by leveraging the brain's ability to form neural pathways through repetition and association, and it is most effectively implemented by setting specific, proximal, shared goals, self-monitoring, and providing regular feedback, as evidenced by the comprehensive review in Circulation 1. To effectively implement target activation, first clearly define the exact behavior you want to change, making it specific, measurable, and realistic. Break down complex behaviors into smaller, manageable actions that can be easily tracked and accomplished. Create environmental cues or triggers that prompt the desired behavior, such as placing a water bottle on your desk to encourage hydration or setting phone reminders for medication adherence.

Key Strategies for Target Activation

• Set specific, proximal goals in collaboration with the patient, including a personalized plan to achieve the goals 1
• Establish a strategy for self-monitoring, such as a dietary or physical activity diary or web-based or mobile applications 1
• Schedule regular follow-up to assess success, reinforce progress, and set new goals as necessary 1
• Provide feedback on progress toward goals, including using in-person, telephone, and/or electronic feedback 1
• Increase the patient's perception that they can successfully change their behavior through strategies such as mastery experiences, vicarious experience, physiological feedback, and verbal persuasion 1 By focusing attention on specific behaviors rather than vague goals, you activate the prefrontal cortex's executive functions, making behavior change more conscious and deliberate. This approach also reduces cognitive load by addressing one behavior at a time, preventing willpower depletion. For maximum effectiveness, combine target activation with positive reinforcement by rewarding yourself when you successfully perform the target behavior, which strengthens the neural pathways associated with the new behavior through dopamine release.

Additional Considerations

• Motivational interviewing can be used when patients are resistant or ambivalent about behavior change 1
• Arrange long-term support from family, friends, or peers for behavior change 1
• Combine two or more of the above strategies into the behavior change efforts for a multi-component approach 1

From the Research

Role of Target Activation in Facilitating Behaviour Change

• Target activation plays a crucial role in facilitating behaviour change by increasing the accessibility of behaviour-related thoughts, feelings, and goals 2
• Intervention strategies that operate by heightening the accessibility of relevant targets, such as nudges, cue-reminders, goal priming, the question-behavior effect, and if-then planning, are effective in generating health behaviour change 2
• The Activation Vs. Change Principle (AVCP) provides a theoretically grounded and parsimonious means of distinguishing among intervention strategies, and can aid interventionists in deciding which strategies to deploy and how to combine them in behavioural trials 2

Behavioural Activation Techniques

• Behavioural activation (BA) is a treatment approach that emphasizes helping individuals become more active in ways that are meaningful to them, and has been designated as a well-established, validated treatment for depression 3
• BA techniques, such as activity monitoring and scheduling, can help individuals recover self-efficacy and promote healthy behaviour according to individual values 4, 5
• BA may be easy to apply in clinical practice and effective for chronic cases or patients in a convalescent stage, and can be provided in an early stage of treatment, followed by cognitive reconstruction in a latter stage 4

Mechanisms of Change

• The purported mechanism of change underlying BA treatment lies in increasing activation, which in turn increases contact with positive reinforcement, thereby reversing the cycle of depression 3
• BA modifies function of reward-related networks in the brain, and these changes are associated with clinical improvement 3
• The effectiveness of BA accrues from heightened accessibility of relevant targets, and can be enhanced by combining different strategies in behavioural trials 2, 6