The Influence of Partner’s Behavior on Health Behavior Change

IMPORTANCE: Couples are highly concordant for unhealthy behaviors, and a change in one partner's health behavior is often associated with a change in the other partner's behavior. However, no studies have explicitly compared the influence of having a partner who takes up healthy behavior (eg, quits smoking) with one whose behavior is consistently healthy (eg, never smokes). OBJECTIVE: To examine the influence of partner's behavior on making positive health behavior changes. DESIGN, SETTING, AND PARTICIPANTS: We used prospective data from married and cohabiting couples (n, 3722) participating in the English Longitudinal Study of Ageing, a large population-based cohort of older adults (≥50 years). Studying men and women who had unhealthy behaviors in 3 domains at baseline (ie, smoking, physically inactive, or overweight/obese), we used logistic regression analysis to examine the influence of the partner's behavior in the same domain on the odds of positive health behavior change over time. MAIN OUTCOMES AND MEASURES: Smoking cessation, increased physical activity, and 5% weight loss or greater. RESULTS: Across all domains, we found that when one partner changed to a healthier behavior (newly healthy), the other partner was more likely to make a positive health behavior change than if their partner remained unhealthy (smoking: men 48% vs 8%, adjusted odds ratio OR, 11.82 95% CI, 4.84-28.90; women 50% vs 8%, OR, 11.23 4.58-27.52) (physical activity: men 67% vs 26%, OR, 5.28 3.70-7.54; women 66% vs 24%, OR, 5.36 3.74-7.68) (weight loss: men 26% vs 10%, OR, 3.05 1.96-4.74; women 36% vs 15%, OR, 3.08 1.98-4.80). For smoking and physical activity, having a consistently healthy partner also predicted positive change, but for each domain, the odds were significantly higher in individuals with a newly healthy partner than those with a consistently healthy partner (smoking: men OR, 3.08 1.43-6.62; women OR, 5.45 2.44-12.16) (physical activity: men OR, 1.92 1.37-2.70; women OR, 1.84 1.33-2.53) (weight loss: men OR, 2.28 1.36-3.84; women OR, 2.86 1.55-5.26). CONCLUSIONS AND RELEVANCE: Men and women are more likely to make a positive health behavior change if their partner does too, and with a stronger effect than if the partner had been consistently healthy in that domain. Involving partners in behavior change interventions may therefore help improve outcomes.