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Background: Recent empirical research and theoretical models acknowledge that impulsive processes, can often undermine peoples’ attempts to lose weight despite currently available and effective support (Chapter 2). Aim: To develop, deliver, and evaluate an impulse management intervention to support weight loss in adults. Methods: A systematic review was conducted to identify available impulse management techniques for influencing eating behaviour (Chapter 3). Intervention Mapping was used to develop the intervention (Chapter 4) which drew on various sources including the findings from the systematic review, stakeholder consultations, existing guidance, and qualitative interviews. A two-arm randomised controlled feasibility trial (Chapter 5), with nested mixed-methods process evaluation and two cycles of intervention delivery and data collection (Chapter 6), was conducted. This assessed the feasibility and acceptability of, and informed refinements to, both the intervention and trial procedures in preparation for a full-scale effectiveness evaluation. Weight was measured as the proposed primary outcome for a full-scale trial at baseline, one-month, and three-months of follow-up, app usage data were collected at both follow-up time points, and semi-structured interviews were conducted at one-month with a subsample of intervention group participants only. Results: The systematic review critically appraised and synthesised evidence on 17 identified techniques which were categorised as Impulse-focused or Reflective techniques. Promising changes in eating behaviour and craving were found for the techniques of visuospatial loading, physical activity, and implementation intentions. Intervention Mapping resulted in development of a novel smartphone app-based intervention (ImpulsePal) aimed to reduce unhealthy snacking, overeating, and alcoholic and sugary drink consumption using impulse management techniques identified in the systematic review. Eighty-eight adults with a Body Mass Index of ≥25kg/m2 and wishing to lose weight, were recruited and randomised in a 2:1 ratio to use ImpulsePal (n=58) or to a waiting list control (n=30) group. Data were available for 74 participants (84%) at one-month and 67 (76%) at three months. Exploratory analyses suggest that the ImpulsePal group (n=43) lost 1.03kg (95% CI 0.33 to 1.74) more than controls (n=26) at one-month, and 1.01kg (95% CI -0.45 to 2.47) more at three months. Participants reported high satisfaction with the intervention and trial procedures. The process evaluation suggests that ImpulsePal and the impulse management techniques are feasible to deliver and acceptable to users. Interviews with twenty-two participants suggest that they valued having access to in-the-moment support, felt more aware of their own eating behaviour and influences on it, and felt an increased ability to resist temptations. Conclusions: This work has developed a novel, theory- and evidence-informed, person-centred app which showed potential to improve impulse management, promote healthier eating, and support weight loss. ImpulsePal is acceptable to overweight and obese adults who want to lose weight and is now ready for evaluation in a full-scale trial. The thesis discusses theoretical, methodological, and practical implications for the future development, evaluation, and implementation of digital behaviour change interventions.

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Environmental sustainability has received increasing attention in both scientific and public life over the past 40 years. Almost all problems are the result of the behaviour of people. Hence, successful solutions to environmental problems must be social as well as technological. Psychology has offered a variety of theoretical approaches to understanding environmentally sustainable behaviour (ESB), including rationaleconomic, social dilemmas, attitude and behavioural models. A related psychological literature also exists regarding the ways in which ESBs may be promoted most effectively in the community. The early chapters of this thesis provide a critical review of the major theoretical approaches in psychology to understanding ESB, as well as the ways in which the psychological literature has conceptualised applied intervention programs to promote ESB. It is suggested that a more holistic framework for conceptualising ESB is required which allows for the integration of the strengths of the variety of current approaches, and which also helps to understand their potential limitations. As such, a social-ecological framework is detailed that draws upon principles from both social and ecological psychology and has as its central tenet that ESBs should be conceptualised as the result of the ways in which members of a community interact with their environments. In particular, it is argued that people’s ESBs will be influenced by the extent to which they perceive particular environmentally relevant objects as ‘affording’ (Gibson, 1979) negative impact on the natural environment. Two field experiments were conducted (a pilot and a larger main study) which aimed to apply the social-ecological framework to the promotion of water and energy consumption within a local community in the city of Perth, Western Australia. The results of both field experiments showed significant reductions in water consumption as a result of the installation around the home of labels that aimed to attune residents to the water consumption affordances of various appliances. The same effects were not, however, obtained from energy consumption labels. In light of these differential effects upon water and energy consumption, a third, qualitative, study was conducted to examine the potential differences in residents’ representations of these two resources and the ways in which residents constructed the use of these resources in their talk. A series of in-depth interviews was conducted with a sample of residents who had taken part in the main field experiment. These were analysed from the perspectives of social representations theory (Moscovici, 1984) and discursive psychology (Edwards & Potter, 1992; Potter & Wetherell, 1987). This analysis revealed important differences in the ways in which these two resources were constructed. It also showed the ways in which community members were able to position themselves as responsible ‘users’, rather than ‘wasters’ of resources, the importance of justice and equity in residents’ resources discourse, and the ways in which ‘truth’ in the environmental domain is constructed and ascribed to certain groups. The results of the field experiments and qualitative study together suggest that whilst attuning residents to the environmental impact affordances of relevant objects in their homes does affect their ESBs, this process can not be separated from the influence of the social environment in which these behaviours are embedded. It is also argued that such social environmental influences may be best understood in terms of the linguistic devices that members of a particular society have at their disposal to explain and legitimate their behaviour. The major conclusion of the thesis is that attempts to investigate and promote environmentally sustainable behaviour should utilise multiple understandings from the social sciences, rather than remaining wedded to any one particular theoretical or methodological approach. The social-ecological framework that has guided the theoretical and practical work contained in this thesis represents an attempt at such integration. The implications of the findings for public policy efforts to promote ESB are also discussed.

Introduction Globally stroke remains the leading cause of adult disability. An aging population and a reduction in stroke case fatality has led to an increasing number of people living with stroke i.e. stroke survivors. The ability to perform important day-to-day activities, such as walking and housework, is frequently impaired in stroke survivors. Therefore, it has become essential to address the long-term needs of stroke survivors, prompting focussed research on life after stroke. A reduction in physical fitness after stroke may contribute to stroke related disability. It is possible to improve physical fitness by regular, structured physical activity. Improving physical fitness after stroke and increasing physical activity are aspects of life after stroke that are increasingly being researched. Although the evidence base for the benefits of physical fitness training is growing, research has indicated that benefits gained are not always maintained at follow-up. To facilitate the uptake and maintenance of physical activity after stroke, it is essential to understand why many stroke survivors do not undertake regular physical activity. Understanding this difficult concept will enable the tailoring of behaviour change interventions to promote and maintain physical activity after stroke. However, there has been limited work in developing theory driven behaviour change interventions to increase physical activity in stroke survivors. Therefore, the aim of this thesis was to develop and test a behaviour change intervention to increase physical activity after stroke. Methods In order to address the above aim, six interlinking studies were conducted within the development and feasibility stages of the MRC framework for the development of complex interventions. A systematic review (study one) examined barriers and facilitators to physical activity perceived by stroke survivors. This study showed a lack of literature in this area, and that the already published studies had limited generalisability to the UK stroke population. Therefore, it was deemed appropriate to conduct a qualitative study (study two) to examine the perceived barriers and facilitators to physical activity in the local stroke population. Both studies one and two highlighted the influence of self-efficacy towards increasing physical activity. As part of earlier work conducted prior to this PhD, there was previously unanalysed data on perceived barriers and facilitators to physical activity after stroke. These quantitative data encompassed specific questions exploring self-efficacy and intention to physical activity post stroke. In light of the evidence it was deemed necessary to analyse these data (study three). It was envisaged that the behaviour change intervention would incorporate a feedback device, so participants could clearly see how much daily physical activity they were undertaking. An opportunity arose to collaborate with a team at Newcastle University who had developed an accelerometer that incorporated an immediate feedback screen. Therefore, a device validation study was conducted as study four. Results from studies one to four were combined, with the use of the Theoretical Domains Framework, and the behaviour change intervention was developed. Two uncontrolled pilot studies (studies five and six) were conducted to determine the feasibility and acceptability of the behaviour change intervention to the stroke population. Results The systematic review included six articles, providing data on 174 stroke survivors. Commonly reported barriers were environmental factors, health concerns and stroke impairments. Commonly reported facilitators were social support and the need to be able to perform daily tasks. Qualitative interviews were conducted with 13 stroke survivors, at which point data saturation was reached. The most commonly reported TDF domains were ‘beliefs about capabilities’, ‘environmental context and resources’ and ‘social influence’. The quantitative study provided data from 50 stroke survivors. Intention and self-efficacy were high, with self-efficacy graded as either 4 or 5 (highly confident) on a five-point scale by [34 (68%)] participants, whilst 42 (84%) participants “strongly agreed” or “agreed” that they intended to increase their walking after their stroke. Ten participants were recruited to validate the new accelerometer. Mean time since stroke was 29 days (SD =27.9 days). The 10 participants walked a mean distance of 245 meters (SD=129m) and their mean walking speed was 0.79ms-1 (SD=0.34ms-1). The Culture Lab were unable to develop the accelerometer in the necessary time frame and therefore no accelerometer was available for trialling the behaviour change intervention. Therefore, pedometers were used to record step count during the behaviour change intervention. A total of four participants took part in the 12 week behaviour change intervention, over two study periods. All participants managed to increase their step counts during this time. The studies had problems both with recruitment and retention of participants. These issues have been discussed. Conclusions This work has enhanced the understanding of the barriers and facilitators perceived by stroke survivors to increase physical activity. This work has allowed the development of a theoretically driven, complex behaviour change intervention that was successfully trialled with a small group of stroke survivors. Areas of further research have been discussed.

Music is often heralded as a means of bringing people together or celebrating diversity and therefore it is also often assumed that music can be a beneficial tool in conflict transformation settings. Despite this widespread belief there is little empirical evidence to support this notion. Indeed, there is more evidence that suggests the opposite; music can increase solidarity within one group but that very process strengthens the borders between what is accepted as in-group or out-group. It is this strengthening of identity borders that can lead to outright conflict if certain other social conditions prevail. One question remains, why is the belief in the power of music so widespread when there is evidence that demonstrates potential negative outcomes? In order to address that question, it is useful to observe that music continues to be used in community projects and within NGOs as a means to bond groups in social conflict despite the lack evidence to support their actions. The belief in the positive power of music has influenced behaviour so that musical activity is included in peace work. Indeed, belief can be seen as a prime motivator of behaviour in most sectors of the world, much more so than hard evidence. This thesis is an exploration of the social processes that occur in musical experiences that affect memory, identity and emotions and how they affect understanding and belief which in turn affects group behaviour. The research is inter-disciplinary, drawing on music sociology, social movements, cultural studies, ethno-musicology and conflict theory, and data was collected using qualitative methods (ethnographic interviewing, action research, observation/participation, grounded theory). The fieldwork was conducted with an inter-religious choir in Sarajevo, Bosnia-Herzegovina, and a comparative study conducted with a world-music community choir in London, UK.

Albert Einstein believed “we can't solve problems by using the same kind of thinking we used when we created them.” This quote, in my opinion, is particularly relevant for the academic literature that examines individual energy use. I believe that we have historically taken a categorized approach towards looking at individual energy use. Instead of thinking about multiple behaviours widely, we tend to look at individual behaviours deeply - focusing on electricity use, gas use, or travel behaviour in isolation instead of examining them simultaneously. For this reason, this thesis explores if and how an intervention aimed at one energy behaviour may influence or have untargeted effects on other energy behaviours across household energy use and personal travel behaviour from an interdisciplinary research perspective. The relevant literature is reviewed and an innovative methodology is devised to answer the research questions. By examining quantitative and qualitative data, the thesis evaluates the targeted and untargeted effects of an electricity display study across household energy and travel behaviours, assesses the influence that social and technical experiences with the display may have on behaviour, and explores how individuals conceptualize their energy usage to better understand untargeted effects. The findings indicate that 1) in a sample of 19 participants, 15 had untargeted effects in gas and 4 had untargeted effects in gas and travel, 2) the combined effect of social and technical experiences with the display can explain why an untargeted effect did or did not take place, and 3) participants perceived household energy as a resource but perceived travel as a means to move from one place to another. These findings lead to the development of a novel contribution of this research, known as the tangential effect. Contributions to theory and policy, an assessment of the methodological approach, and future research areas are given.

Obesity rates are growing at an alarming rate and new solutions are urgently needed (WHO, 2010). This thesis aimed to explore the potential to translate some of the lessons learnt from the UK’s successful tobacco control approach to combating obesity, using Self Determination Theory (SDT, Ryan & Deci, 2000) as a theoretical framework to explore the mechanisms of policy level factors influence on individual motivation. This was explored in three studies using a mixed methods approach. Qualitative Study 1 aimed to explore people’s experiences of tobacco control and obesity policies. The results suggest that current tobacco and obesity policy climates are perceived as controlling and are not perceived as motivating for behaviour change. Study 2 tested the hypothesis generated in Study 1, that exaggerated images (i.e. morbidly obese figures) accompanying articles about the health risks of being overweight would prevent overweight people from identifying with these risks. The results demonstrated there was no effect on identification with the message, however such images cause individuals to visually underestimate the level of obesity associated with health risks. Study 3 pilot tested a campaign-style intervention which was translated from the tobacco domain. It involved a snack-swapping intervention designed to help people to increase their fruit and vegetables intake while supporting their autonomous motivation, and aiming to provide an online environment to normalise this aspect of healthy eating. Participants had higher intake of fruit and vegetables as a results of taking part in the intervention, however their intake of unhealthy snacks was not reduced. Applying SDT as a theoretical approach was useful as a means of understanding people’s responses to legislation, however the results emphasized challenges in implementing strategies which aim to create autonomy supportive climate at public policy level. New insights for policy development stemming from the three empirical studies have been outlined.

This research sought to develop and test a health behaviour change intervention for overweight and inactive UK adults, aged 35-74 years, using the concept of an evolutionary mismatch to frame health information. The mismatch concept posits that human culture has evolved too rapidly for biological evolution to keep up, meaning the human body is poorly adapted to cope with the modern environment, predisposing us to chronic disorders. The first study explored whether using the mismatch concept to frame health information would be acceptable and engaging to target users. Mismatch-based text and graphic resources were shown to participants in semi-structured interviews. They had good acceptability, generated interest and seemed to provide a meaningful rationale for behaviour change. Following further development, the second study tested whether the resources could improve people's understanding of the effects of physical activity and diet on health and bring about change in theory-based cognitive determinants of behaviour. This questionnaire-based study found the resources enhanced knowledge and effected positive changes in most of the targeted cognitions. The mismatch resources were then developed into an online intervention also incorporating evidence-based behaviour change techniques. The third study evaluated this intervention in a pilot randomised controlled trial. The intervention did not lead to significantly greater improvement in physical activity or diet than a minimal intervention comparison, however the behavioural and health changes achieved in the intervention group were of meaningful effect size. Process evaluation provided partial support for hypothesised mechanisms of behaviour change. The findings suggest the mismatch concept could be a useful frame to stimulate initial interest and motivation in health interventions; combined with additional behavioural techniques this can help promote healthy lifestyle change. Further work is needed to test the efficacy of a mismatch-framed intervention among populations of different ages, ethnicities and religious beliefs.

If current environmental problems are to be addressed and future environmental problems are to be prevented, significant changes are needed in the way people live. Environmental education has been identified as an important tool for encouraging people to make the changes needed for sustainability. However, environmental education has been largely ineffective in doing this. Education about the environment is being achieved, but education that creates the skills and motivation for action is not. The purpose of this research was to investigate the potential of goal setting to be used in environmental education programs to develop the skills and motivation required to change environmental behaviour and create positive environmental outcomes. Goal setting is one of the most replicable and reliable of psychology theories, with extensive evidence of its benefits for increasing performance and changing behaviour. The premise of this research was to take an already proven and well-established behaviour change theory and apply it within environmental education programs. The first step was to develop a framework, which enabled goal setting to be incorporated into a program. To do this the environmental behaviour change literature was reviewed and the components of successful environmental education were identified and incorporated into the framework. The goal setting literature was also reviewed to determine the characteristics of an effective goal and how goal setting could be facilitated to create greater goal achievement. As there has been little research on the community’s attitudes towards goal setting a questionnaire was developed to determine if the Perth community uses goals, the characteristics of those goals and how those goals may be linked to behaviour. The survey indicated that most people were already using goals in their daily lives and the majority of people would respond positively to the use of goal setting in an environmental education program. Thus, a new environmental education framework was developed which included providing action knowledge, teaching goal setting skills, setting goals and providing continued feedback and support. The proposed environmental education framework was then implemented and evaluated through two environmental education programs, Green Houses and Living Smart. The Green Houses program assessed the effectiveness of the framework for reducing household energy consumption and the effectiveness of different communication methods for delivering the framework. Personal communication through the workshop was the most effective method for changing behaviour, with workshop participants reducing their energy consumption by 17%. The website and booklet approach also had reductions in energy consumption (7% & 8%, respectively). The schools group was the only group not to achieve a reduction, suggesting that what the students learnt about energy saving was not being transferred to the home environment or impacting on their parent’s behaviour. The groups that set goals reduced their energy consumption by an additional 5% compared to the corresponding control groups and maintained those savings for a significantly longer period of time. The Living Smart program then assessed the effectiveness of the framework for creating behaviour change across a range of sustainability topics. As a result of the program, participants significantly increased both their environmental knowledge and sustainable behaviours. A control group that received the same environmental information as the Living Smart group, but no goal setting skills, only increased their environmental knowledge. This demonstrated that environmental information alone is not sufficient for changing behaviour. The qualitative evaluation identified that goal setting facilitated behaviour change in participants because it gave them direction and strategy and increased their motivation and commitment to changing their behaviour. Importantly, the goal setting process worked equally well across all the sustainability topics, suggesting that the tool works for a variety of behaviours, not just energy conservation. In conclusion, the goal setting process and framework created effective behaviour change that was maintained longer than when goal setting is not used. The goal setting process and framework can be delivered effectively through a range of communication strategies and can be applied effectively to a range of environmental behaviours. Therefore, goal setting is an effective and valuable behaviour change tool that has great potential across a range of environmental education programs to create positive environmental outcomes in, for and about the environment.