Understanding the effects of counterfactual thinking with protective behavioral strategies on healthy eating using the COM-B framework

Healthy eating is often necessary to improve health outcomes, but many individuals don't consistently make healthy food choices. Previous intervention work has found that personally relevant interventions that identify actions to achieve goals are effective in changing behaviors. Counterfactual thinking (e.g. “if only … then …”) can be utilized to identify causal relationships and personally relevant behaviors to achieve health goals. Additionally, counterfactual thinking has been shown to increase goal-relevant domains such as motivation and intentions. The present study developed and evaluated an eating-based counterfactual reflection task that incorporated protective behavioral strategies (PBS) and measured capability, opportunity, and motivation to eat healthy. The results indicated that counterfactual thinking (vs. control) significantly increased self-efficacy and intentions to use specific PBS. Additionally, those in the counterfactual condition with less capability had a larger increase in their willingness to change their eating habits. Future research will refine the counterfactual task to be more relevant and effective for a wider range of individuals.