Testing the Integration of Habit Science and Learning Theory to Promote Behavior Change: A Habit-Based Sleep Health Intervention (HABITs) for Young Adults with an Evening Circadian Tendency

Objective To determine whether the Habit-based Sleep Health Intervention (HABITs) plus text messages promotes habit formation and improves outcomes for emerging adults. Method Young adults aged 18–30 with an evening chronotype and who were “at risk” in at least one of the following domains—emotional, cognitive, behavioral, social, or physical health—were randomized to: (a) HABITs alone (n = 72) or (b) HABITs+Texts (n = 89). HABITs involved three 50-minute sessions followed by six 30-minute sessions. Alongside the latter six sessions, HABITs+Texts concurrently received text messages. HABITs combined the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC) with principles from habit science. The text messages were informed by habit science, learning theory, and the Behavior Change Wheel. Assessments were conducted pre-treatment, post-treatment and at 6-months (6FU) and 12-months (12FU). Results Relative to HABITs, HABITs+Texts was not associated with greater change in primary and secondary outcomes. Collapsing across conditions, there were improvements from pre- to post-treatment as well as at 6FU and 12FU in engagement in sleep health behaviors ( p’s  < 0.001), formation of sleep health habits ( p’s  < 0.05), improvement in sleep and circadian functioning ( p’s  < 0.001), and reduction in health risk ( p’s  < 0.001). For ecological momentary assessment outcomes, there were improvements from pre- to post-treatment for the behavioral ( p  = 0.02), cognitive ( p  = 0.02), emotional ( p  = 0.02), and selected social domains ( p  = 0.01) but not the physical health domain. Conclusion Among at-risk young adults, text messaging does not appear to be beneficial. Within-group exploratory analyses supported the use of HABITs to promote the formation of sleep health habits and improve sleep and circadian functioning and health. Trial Registration: Clinicaltrials.gov identifier: NCT05167695. Registered on December 22, 2021. https://clinicaltrials.gov/study/NCT05167695