Can forming Implementation Intentions Support Behaviour Change in Populations of People with Mental Health Difficulties?

Abstract

Thesis Abstract Implementation intentions (IIs) are tools that support behaviour change techniques by helping people turn their intentions into action. Due to health access inequality, people with mental health difficulties have increased risk of premature mortality. Forming IIs alongside clinical practice may support behaviour change in this population. The systematic review updated and offered critique of the previous meta-analysis published in this area. Twenty-four studies from 21 papers were included in the meta analysis. Effect sizes ranged from -0.63 to 4.1, with an average medium effect of 0.69 [0.14-1.24]. Across studies, goal setting and II interventions had a significant effect compared to control conditions. Quantifying heterogeneity demonstrated substantial heterogeneity (I^2 = 81%). Methodological quality was rated as “weak” across studies. The quantitative empirical study evaluated the feasibility and acceptability of using a Volitional Help-Sheet to help service users in adult inpatient mental health services to form IIs to reduce sedentary behaviour. Participants randomised to the experimental arm were asked to complete a Volitional Help-Sheet and form IIs. Participants randomised to the control arm were exposed to the same information but not asked to form IIs. Feasibility and acceptability could not be demonstrated. Barriers to recruitment were discussed. The qualitative empirical study conducted semi-structured interviews with staff working within inpatient mental health settings to understand their experience of research both during and pre-dating the Covid-19 pandemic, aiming to understand barriers and enablers of research within these settings. Eleven members of staff were interviewed. Interview transcripts were analysed using Thematic Analysis. Five superordinate themes were identified: “Conflicting agendas and the service user experience”, “Value placed on research” “Whose role it is?”, “The "prism of covid" compounded, not caused”, “Understanding and working with complexity”, and “A wealth of knowledge - what helps?”. Recommendations for future research in inpatient mental health settings are outlined. This critical analysis considered II and behaviour change research, offering critique and reflection on the themes highlighted in the three preceding papers.

Date of Award	31 Dec 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Christopher Arden Armitage (Supervisor)