Using evolutionary theory to support lifestyle change and improve health in people at risk of developing chronic diseases

  • Elisabeth Grey

Student thesis: Doctoral ThesisPhD


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.
Date of Award22 Nov 2018
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorDylan Thompson (Supervisor) & Fiona Gillison (Supervisor)


  • Physical activity
  • Behaviour change
  • Healthy eating

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