Using Implementation Science to Support Personal Goals and Resolutions
11-min read
Applying the Theoretical Domains Framework (TDF) to personal behavior change
In late 2023, during a TCI team meeting, we started joking around about some personal behavior changes we were working on and where we would map them to the Theoretical Domains Framework (TDF). We laughed about the change strategies we selected (spoiler alert: Julia picked audit and feedback, which is shocking given her feelings about this strategy). The conversation made us wonder if other people who are nerdy about implementation science, like us, might also find our behavior changes interesting, and if sharing them may encourage others to try using implementation science to implement their own goals and resolutions.
So, this month, instead of discussing a specific implementation science topic, five team members shared reflections about the barriers and facilitators (mapped to the Theoretical Domains Framework) for their personal behavior changes.
Some team members haven’t started making their change yet, while others have and are making progress. Two people selected the same behavior change (folding and putting away laundry) without realizing it, and while we debated asking one person to switch their behavior change, we thought it may be fascinating to see different reflections about the same behavior change.
Here is an overview of the five behavior changes:
Valentina is reducing her time spent on social media
Carrie and Alexis are both resolving to fold and put away laundry
Jonathan is working on communicating more directly
Julia is reducing her sitting time
We hope you find our behavior change reflections as fun and inspiring as we did.
Goal: Reduce time spent on social media
Team Member: Valentina
TDF barriers and facilitators
Behavior regulation
Memory, Attention, and Decision Processes
Goals
Emotions → My frustration is serving as a facilitator here
Change strategy
A reminder + restriction combination as a strategy (even though it doesn’t match the TDF)
I have used reminders in the past, such as setting up a notification system for when I pass X hours on X app. It would remind me that I had reached my limit, but I would always be ready for more. I then realized that my issue was not that I stayed on the app but that I opened it without realizing it. So, a reminder that X hours have passed wouldn't solve my issue; I needed something that forced me to evaluate my choice to open the app consciously – to make sure that's what I really wanted.
I downloaded an app called "One Sec" that works as an automation within your phone (the free version only allows me to use one app, so I decided to use it for Instagram).
Every time I try to open Instagram, it immediately restricts my use and presents a screen that says "Take a deep breath" which lasts 15 seconds.
After those 15 seconds, I am shown how many attempts of opening Instagram I had within the last 24 hours and when I last used it.
At the bottom of that screen is a button that says, "I don't want to open Instagram," and one below it that says, "Continue to Instagram."
If I press "I don't want to open Instagram," it will close the app.
If I press "Continue to Instagram," it will open the app.
Here are some of my stats since I downloaded the app (~mid/end of December):
In December, I had 101 attempts/week.
I have saved four hours/week (according to One Sec analytics).
My weekly usage average went down from ~9h to ~6h (according to Apple's Screen Time analytics). That means ~3 hours saved according to my phone (I suspect this is more accurate than One Sec analytics).
I only reached my one-hour limit twice.
I will continue to test this strategy, but so far, using One Sec to help restrict my usage has allowed me to consciously decide whether or not I want to open the application.
Goal: Fold and put away laundry
Team Member: Carrie
WHY: This year, I am resolving to put away the laundry. I can get the laundry cleaned and dry, and most of the time even folded, all within a day. But when it comes to taking that laundry and putting it into drawers (mine and my kids), I have a problem.
TDF Barriers and Facilitators
Goals and intentions
I want to (I do, I do want to)
Environmental context/Resources
I want to believe this is the main barrier; putting the kids’ laundry away is hard since I am usually with them (driving them somewhere or working during their waking hours). So, saying it’s the fact that they are in bed when I get it folded in the late evening means it’s not an individual barrier, I can change but an environmental problem. But really, that is not the whole context...
Memory, Attention, and Decision Processes
I often remember I need to put laundry away when I walk upstairs to put the kids to bed or when I walk upstairs to go to bed myself, and there it is…. the basket full of clothes. But I must admit, by this point, either my kids or I are so exhausted that putting the laundry away at that moment feels overwhelming.
Emotions
I hate putting clothes away. I have no idea why, but it’s just one of those things that I don’t like to do.
Change Strategies
One option is to focus on environmental restructuring. Reallocate time management so laundry can be put away while the kids are awake (for example, redistribute tasks like doing the dishes until after bedtime and putting laundry away during waking hours)
Maybe I need to put the basket in a place I will remember it at a time before walking up the stairs to bed (for example, on the dining room table). This may be successful, primarily because if I don’t get it put away before breakfast, one of my kiddos will start unfolding the laundry basket and get jam or cereal on everything…which means I’ll need to re-wash it all.
Alternatively, I could provide an incentive. Can I pay one of my kids more allowance, so it becomes their chore? Or what can I swap with my husband so he will take on this task? (Please note, this could be mapped to environmental context/resources – Environmental restructuring – revise professional roles (i.e., make it someone else’s job).
I will likely try incentivizing as my first strategy (see note about emotions and how I hate putting clothes away) but may resort to restructuring the environment by February. I will keep you updated on how many loads of laundry I have to rewash because of jam hands before the restructuring of the environment works!
Goal: Fold and put away laundry
Team Member: Alexis
WHY: The ever-present overflowing laundry basket of clean clothes that typically sits beside my bed is a constant eye-sore, taking up valuable floor space and is a nagging presence in my brain. Every time I look at it – I think, “Just sit down and put it away. It’ll take you a few minutes, and you’ll feel so much better, and bonus – you won’t have to go digging through it when you need something inside it.” … but I rarely do—slowly driving myself a little crazy as I repeat this week in and week out.
TDF Barriers and Facilitators
Intention (I plan to) and Goals (I want to)
I plan to do it every week, and I honestly want to put it away. Yet every week, without fail I put the laundry in the basket and put it down in a central area where I have to see it and pass it no matter where I’m walking on the main floor. I tell myself that I will fold it all and put it away as soon as I’m finished with whatever else I’m doing, but then I don’t.
Behavior Regulation (habits)
My first issue is also the biggest one – building any new habit is hard for many, but building a new habit with ADHD and the executive dysfunction that comes with it can sometimes feel nearly impossible. I’ve tried plenty of things to help – calendar reminders, apps, daily/weekly paper planners, but I usually ignore them – telling myself I’ll remember to do it later or I forget to use the app entirely.
Emotions
My second issue is that I hate folding and putting away laundry. I find it tedious and annoying (why are there always so many socks?!) I’d rather do just about anything else, even though I know I’ll hate it more when I can’t find a specific item of clothing and have to go digging through the basket.
Change Strategies
I started with Educating – My diagnosis is still relatively new to me so until I could understand the challenges of building new habits with ADHD – I wasn’t going to be able to make any new habit genuinely stick. In this process, I learned something crucial – people with ADHD are constantly in search of dopamine (the neurotransmitter that acts on areas of the brain to give you feelings of pleasure, satisfaction, and motivation) so to build and sustain a new habit successfully – we need to be able to pair it with something that helps give us that dopamine.
Incentivizing and Modeling - The most popular suggestion that I kept coming across in my research was body doubling (do the task with someone either while you do the task together or they do their own task to help keep each other focused and reduce potential distractions either in person, over FaceTime or using an app like dubbii: the body doubling app) paired with an incentive so that when you complete the task, you get a reward (i.e., motivate yourself by dangling that dopamine boost!)
While I have yet to try body-doubling, I’ve started incentivizing myself in a few ways. First, I started using an App called Amazing Marvin (Marvin has fun features like confetti when you complete a task, the ability to earn points for hidden features and more). I’ve also started rewarding myself with dedicated reading time – so if it takes me 30 minutes to fold and put it all away, then when I’m done, I give myself 30 minutes to read with no distractions, no guilt, and no frustration nagging at my brain meaning it’s 30 minutes of pure dopamine!
Goal: Communicate more directly
Team Member: Jonathan
WHY: I strive to communicate diplomatically and be respectful of other people’s feelings, but I think that sometimes leads to unnecessarily wordy communications both orally and in writing and can even make the message less clear.
Barriers and Facilitators
Goals:
I want to do this. Intentions: I plan to do this.
Reinforcing behavior / Identity:
I think that over time, this behavior has been reinforced. I have sometimes needed to manage difficult situations or de-escalate a conflict in personal or professional settings, and using a tactful and diplomatic approach has resulted in positive outcomes. Over time, I have been congratulated or received some recognition from other people (e.g., in a group of friends or a team) and have been relied upon in similar situations in the future. But I think this has created a reinforcement loop that is not necessarily positive. I think I also like to integrate into my identity those aspects of communicating diplomatically and being able to navigate sensitive situations.
Beliefs about consequences / Emotions:
Logically, it seems clear to me that most communicative situations are not as high stakes, but I have nevertheless developed a belief that more direct communications might upset people around me and that being overly careful is a better approach.
Change Strategies
I have just started to reflect on potential strategies, but I haven’t yet planned them in detail nor fully reflected on how they map to intervention functions. Some initial ideas are:
I need to challenge my beliefs so that I use a more direct communication style unless the situation calls for a more diplomatic approach. Experiencing positive outcomes using a more direct communication style could help address barriers related to beliefs about consequences.
I could identify a role model who can communicate diplomatically and use a more direct communication style than myself.
Aiming to reduce the length of my communications, probably in a gamified way. This might be easier in written materials if I set up a sound system to track length.
I may also need to remind myself to try using a more direct communication style, maybe prompting me randomly a few times during the week, as otherwise, I think it would be easy to default to the more indirect style that I have become accustomed to.
Goal: Spend less than 40% of waking hours sitting
Team member: Julia
WHY: After learning about the “sitting epidemic” and being inspired by my husband, who virtually never sits, I decided that I could make this change to see health benefits (or maybe more importantly, to prevent health consequences).
Barriers and facilitators
Intentions and beliefs about consequences:
I started with a tremendous facilitator. I was very motivated to make this change. A series of contextual factors based on the health of several people around me inspired me to make this change immediately.
Knowledge
My first issue was not having a good understanding of my current sitting-to-standing/walking ratio. I didn’t even make the goal concrete until I had more data. So, the first barrier was a knowledge issue – what was I currently doing?
Behavior regulation
Many people discussed reminders as a strategy (e.g., an app that reminds you to stand once an hour) but remembering was not a barrier for me. I had more issues with changing my routine (e.g., standing instead of sitting to answer emails).
Reinforcement
Once I started, I experienced another facilitator almost immediately – it wasn’t as complicated as I expected to reduce my sitting time. I loved seeing improvements day by day and week by week.
Emotions
After a few weeks of tracking, I realized that I became very demotivated when I had less control over sitting and standing. For example, when I travelled, had many meetings, or attended holiday events where everyone was sitting, I stopped tracking because I didn’t want to see my terrible numbers for that day. I was essentially avoiding the negative data (which fascinatingly is one of the big issues with audit and feedback).
Change Strategies
Since I was very motivated and knowledge of my current practice was my primary barrier, I selected audit and feedback as my primary change strategy. I couldn’t find an app to do it automatically, so I used a time-tracking app (Toggl) to track 4 things manually: sitting, standing, walking/exercising, and lying down. As I got more data, I realized I was spending about 75% of my waking hours sitting, so I set a goal to get it below 40%.
At first, this strategy served to address my knowledge barriers, but it quickly became a way to positively reinforce my behavior.
I’m now two months into this behavior change, and I’m happy to share a screenshot of my sitting vs standing vs walking (any level of exercise above walking) over the past week.
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