Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors

Abstract

Health-compromising behaviors such as physical inactivity and poor dietary habits are difficult to change. Most social-cognitive theories assume that an individual's intention to change is the best direct predictor of actual change. But people often do not behave in accordance with their intentions. This discrepancy between intention and behavior is due to several reasons. For example, unforeseen barriers could emerge, or people might give in to temptations. Therefore, intention needs to be supplemented by other, more proximal factors that might compromise or facilitate the translation of intentions into action. Some of these postintentional factors have been identified, such as perceived self-efficacy and strategic planning. They help to bridge the intentionbehavior gap. The Health Action Process Approach (HAPA) suggests a distinction between (a) preintentional motivation processes that lead to a behavioral intention, and (b) postintentional volition processes that lead to the actual health behavior. In this article, seven studies are reported that examine the role of volitional mediators in the initiation and adherence to five health behaviors: physical exercise, breast self-examination, seat belt use, dietary behaviors, and dental flossing. The general aim is to examine the applicability of the HAPA and its universality by replicating it across different health behaviors, based on various measures, time spans, and samples from different countries.Les comportements nuisibles à la santé tels que le manque d'exercice physique et les mauvaises habitudes alimentaires sont difficiles à modifier. La plupart des théories socio-cognitives admettent que le meilleur prédicteur d'un réel changement est l'intention que la personne a de changer. Mais la conduite est souvent en contradiction avec les intentions. La divergence entre intention et comportement est due à plusieurs raisons. Par exemple, des obstacles imprévus

Predicting food hygiene. An investigation of social factors and past behaviour in an extended model of the Health Action Process Approach

“…This is consistent with previous research (Schwarzer, 2008). The results suggest that planning to prepare food hygienically (with respect to when, where, how etc.…”

Healthy eating for life: rationale and development of an English as a second language (ESL) curriculum for promoting healthy nutrition

“…HE4L also is the first nutrition curriculum for ESL students to integrate and apply the HAPA model of behavior change theory into the design of its curriculum materials. The HAPA model is unique in that it goes beyond knowledge acquisition in developing students' action and coping planning skills [29]. Teaching these skills and testing for their impact constitute a novel approach to behavior change theory.…”

“…We chose to use the theme-based approach given our primary focus on increasing fruit and vegetable consumption. The curriculum also is grounded in national and local adult English language learning (ELL) frameworks [28] and the health action process approach (HAPA) theory of behavior change [29]. Goals and objectives-Working with two experts in adult ESL, we developed an interactive, nutrition-focused curriculum for beginning-level students (i.e., students with very limited English language skills).…”

“…Guiding theory-The behavior change component of HE4L was based on the HAPA which has been used in various studies of dietary behaviors to demonstrate that certain social-cognitive constructs (e.g., intentions, self-efficacy, risk perceptions, outcome expectancies) and intermediary behaviors (e.g., action and coping planning) can influence diet behaviors [29][30][31][32][33][34]. The HAPA posits that action and coping planning are the proximal antecedents to behavior change and that these constructs bridge the gap between intentions and behavior [29].…”

“…The HAPA posits that action and coping planning are the proximal antecedents to behavior change and that these constructs bridge the gap between intentions and behavior [29]. Together with self-efficacy and intentions, these planning behaviors change or mediate the relationship between risk perception and outcome expectancies and selfreported nutrition behavior [30][31][32][33].…”