A Meta Analysis of the Health Action Process Approach

Abstract

Objective: The Health Action Process Approach (HAPA) is a social-cognitive model specifying motivational and volitional determinants of health behavior. A meta-analysis of studies applying the HAPA in health behavior contexts was conducted to estimate the size and variability of correlations among model constructs, test model predictions, and test effects of past behavior and moderators (behavior type, sample type, measurement lag, study quality) on model relations.Methods: A literature search identified 95 studies meeting inclusion criteria with 108 independent samples. Averaged corrected correlations among HAPA constructs and multivariate tests of model predictions were computed using conventional meta-analysis and meta-analytic structural equation modeling, with separate models estimated in each moderator group.Results: Action and maintenance self-efficacy and outcome expectancies had small-to-medium sized effects on health behavior, with effects of outcome expectancies and action self-efficacy mediated by intentions, and action and coping planning. Effects of risk perceptions and recovery self-efficacy were small by comparison. Past behavior attenuated the intention-behavior relationship. Few variations in model effects were observed across moderator groups. Effects of action self-efficacy on intentions and behavior were larger in studies on physical activity compared to studies on dietary behaviors, whereas effects of volitional self-efficacy on behavior were larger in studies on dietary behaviors.Conclusions: Findings highlight the importance of self-efficacy in predicting health behavior in motivational and volitional action phases. The analysis is expected to catalyze future research including experimental studies targeting change in individual HAPA constructs, and longitudinal research to examine change and reciprocal effects among constructs in the model.

Predicting Intention to Participate in Self-Management Behaviors in Patients with Familial Hypercholesterolemia: A Multi-National Study

“…A growing literature integrating these perspectives has corroborated this pattern of effects (French et al, 2013;Orbell et al, 2006), including our previous research in FH (Hagger et al, 2016b). Although the CSM and other social cognitive theories such as protection motivation theory (Rogers, 1975) and the health action process approach (Schwarzer, 2008) suggest that perceptions of threat and risk should motivate individuals to take action to respond to the threat, studies indicate that such beliefs make a relatively modest contribution to the prediction of health behaviors (Zhang et al, 2019). By comparison, the current research demonstrated that beliefs with respect to future participation in the management behaviors, particularly attitudes and subjective norms, were the most consistent predictors for all behaviors and across all samples (see Tables 2 and 3).…”

Social Psychological Predictors of Sleep Hygiene Behaviors in Australian and Hong Kong University Students

“…Turning first to the motivational effects in the proposed model, and consistent with the TPB [23] and meta-analytic studies in health behavior [24][25], attitude, subjective norms, and perceived behavioral control are proposed to predict intention; and intention and perceived behavioral control are proposed as predictors of behavior. Consistent with the HAPA [29] and meta-analytic research [37] which support a volitional process that operates in a post-decisional manner to facilitate the enactment of goal intentions, it is proposed that intention would predict action planning and action planning would predict behavior. Finally, model effects are expected to hold while adjusting for past behavior.…”

Participants’ enactment of behavior change techniques: a call for increased focus on what people do to manage their motivation and behavior

“…Several other studies have demonstrated that the use of selfregulation techniques plays a role in predicting intervention outcomes (e.g. planning in the HAPA model (17)). This growing evidence base shows the value of participant-level enactment.…”