A systematic review of interventions using cue-automaticity to improve the uptake of preventive healthcare in adults: applications to dental visiting

Objective: Since behaviour is underpinned by both cognitive and automatic processes, psychological interventions aiming to instigate or modify habitual behaviour (cue-automaticity interventions) offer an alternative to the more commonly used (mainly educational) strategies to increase preventive healthcare use. Theory suggests that low socio-economic (SES) groups are especially likely to benefit. Cue-automaticity describes how repetition of behaviour, initiated by a particular 'cue', in a constant context, leads to the automatic instigation and/or execution of behaviour. Our primary objective was to assess the effectiveness of cue-automaticity interventions to improve the uptake of adult preventive healthcare, and to consider how this might be applied to the design of interventions to promote preventive dental visiting. Basic research design: An electronic search, with citation snowballing, of cue-automaticity interventions to influence adult preventive healthcare use was undertaken. Results: Searching identified 11,888 titles and abstracts. Paper screening left 26 papers, of which 6 RCTs met the inclusion criteria. All 6 incorporated an Implementation Intention (I-I) component. Four studies involved cancer screening and 2 involved vaccination programmes. Five studies showed a significantly positive increase in preventive healthcare use, while one did not. Conclusions: Whilst few studies using cue-automaticity to underpin the promotion of preventive care use have been undertaken, studies that do exist have promising results. As cue-automaticity interventions may be of particular benefit to low SES groups, research is needed to investigate whether cue-automaticity interventions can translate into reducing inequalities in attendance for dental check-ups.