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. 2024 Nov 20;25(1):782.
doi: 10.1186/s13063-024-08599-4.

Integrating habit science and learning theory to promote maintenance of behavior change: does adding text messages to a habit-based sleep health intervention (HABITs) improve outcomes for eveningness chronotype young adults? Study protocol for a randomized controlled trial

Marlen Diaz  1 , Estephania Ovalle Patino  1 , Sophia Oliver  1 , Sondra S Tiab  1 , Nena Salazar  1 , Jiyoung Song  1 , Lu Dong  2 , Laurel D Sarfan  1   3 , Eli S Susman  1 , Emma R Agnew  1 , Benjamin Gardner  4 , Allison G Harvey  5
Affiliations

Integrating habit science and learning theory to promote maintenance of behavior change: does adding text messages to a habit-based sleep health intervention (HABITs) improve outcomes for eveningness chronotype young adults? Study protocol for a randomized controlled trial

Marlen Diaz et al. Trials. .

Abstract

Background: Eveningness chronotype-the tendency for later sleep and wake times-arises from a confluence of psychosocial, behavioral, and biological factors. With the onset and progression of puberty, many young people develop an eveningness chronotype, which remains prevalent through the transition into adulthood. Eveningness has been associated with increased risk for poorer health. While eveningness is modifiable, maintaining the necessary behavior changes can be challenging. The science on habits demonstrates that habit formation is a key mechanism for maintaining behavior change over time. Learning theory offers schedules of reinforcement that also hold promise for enhancing the maintenance of behavior change. The present study will evaluate the Habit-based Sleep Health Intervention (HABITs)-which combines the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) with the science of habits-and a text message intervention informed by learning theory to attempt to sustainably modify the contributors to eveningness among young adults (18-30 years of age).

Methods: Participants (N = 160) will be randomly allocated to HABITs and HABITs + Texts. Both interventions include HABITs which involves three 50-min sessions followed by six 30-min sessions. Alongside the latter six sessions, HABITs + Texts will concurrently receive the text message intervention. Aims 1-3 will compare HABITs + Texts to HABITs on improvements in the outcomes of (1) utilization of sleep health behaviors and habit formation, (2) sleep and circadian functioning, and (3) functioning in five health-relevant domains, in the short (post-treatment) and longer (6-month and 12-month follow-up) term. Exploratory analysis will (1) compare HABITs and HABITs + Texts on (a) if sleep health behavior habit formation mediates the effects of intervention on improvement in outcomes and (b) if intervention effects are moderated by select variables, and (2) to evaluate if HABITs (regardless of the text message intervention) is associated with an improvement in outcomes in the short and longer term.

Discussion: This study has the potential to advance knowledge on (1) the value of leveraging the science of habits and learning theory in behavior change interventions, (2) the use of a low-cost and efficient intervention for habit formation and maintenance, (3) interventions that address eveningness chronotype, and (4) processes related to behavior change during emerging adulthood.

Trial registration: Clinicaltrials.gov NCT05167695. Registered on December 22, 2021.

Keywords: Circadian; Habits; Health; Intervention; Sleep; Text message; Transdiagnostic.

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Conflict of interest statement

Declarations Ethics approval and consent to participate The Committee for the Protection of Human Subjects at the University of California, Berkeley approved this study (2021–06-14409). Written informed consent is obtained from all participants. Consent for publication Model consent forms are available upon request. Competing interests AGH, MD, LDS, and LD have received National Institutes of Health funding. AGH has received book royalties from Guilford Press and Oxford University Press. ESS has received research support from the National Science Foundation, the Mind and Life Institute, and the Greater Good Science Center at the University of California, Berkeley.

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