A mixed-methods approach to understanding barriers and facilitators to healthy eating and exercise from five European countries: Combining consumer science, behavioural economics, and psychology

Background: Healthy adults are consistently falling below national and international recommendations for physical activity and dietary intake across Europe. Interventions to address behaviour change in these fields typically target clinically at-risk individuals. To inform the development of interventions targeting healthy individuals, this study took a co-creative approach with samples of adults from five European countries to qualitatively and quantitively establish motivators, barriers and sustaining factors for positive physical activity and healthy eating behaviour change. Methods: Stage 1 involved a newly-designed online programme that was used to create an online community who identified challenges, motivators and solutions to sustaining positive health behaviours over two weeks. Stage 2 comprised an online survey, developed from the ideas produced in Stage 1, administered to a larger sample to quantify the relative importance of the motivators and barriers discussed. Results: Results from both stages indicated that enjoyment of health behaviours, positive emotions before and after activities, and installing rewards were key motivators for both behaviours across all five countries. Barriers included difficulties with habit-breaking, giving in to temptation and negative affective states. Participants reported that changes in physical activity and eating behaviour complemented one another. Those with a high BMI placed more importance on social motivators (e.g. social pressure) than those with healthy BMI. Participants’ reports of motivating factors and barriers often reflected relevant approaches from consumer science, behavioural economics, or psychology. Conclusions: Interventions to support adults who are not chronically ill but who would benefit from improved diet and/or increased physical activity should not focus exclusively on health as a motivating factor. Emphasis on enjoyable behaviours, social engagement and the role of reward will likely improve engagement and sustained behaviour change. Our data call for the integration of different fields in the behaviour change literature that would allow a stronger emphasis on motivational and emotional processes.