Health Action Process Approach (HAPA) as a Theoretical Framework to Understand Behavior Change

Abstract

Abstract.A theoretical framework to explain, predict, and modify health behaviors is presented which consists of various psychological constructs and a mediator mechanism. Risk perception, outcome expectancies, self-efficacy, intention, planning, and action control constitute the building blocks for a mediator model that is based on two processes: goal setting and goal pursuit. When it comes to the development of interventions to modify behaviors, one can target either the initial motivation phase or the subsequent volition phase. This is an open architecture framework allowing for various research designs and subsets of constructs. Hundreds of studies have been conducted based on this model. Three correlational and two intervention studies were chosen to illustrate the diversity of approaches targeting physical activity in Germany and Costa Rica, dental cleaning in India and Poland, and dust mask wearing in China. They differ in terms of the predictors that emerged as most relevant for behavior change. Keywords.Outcome expectancies, self-efficacy, planning, action control, self-monitoring.Resumen. Se presenta un marco de referencia para explicar, predecir, y modificar conductas de salud el cual consiste en varios constructos psicológicos y un mecanismo de mediación. La percepción de riesgo, las expectativas de resultado, la autoeficacia, la intención, y el control de acción constituyen los bloques de construcción para un modelo de mediación que está basado en dos procesos: el establecimiento de metas y la consecución de metas. Cuando se trata del desarrollo de intervenciones para modificar conductas, uno puede apuntar hacia la fase inicial de motivación, o bien, hacia la fase volitiva subsecuente. Este es un marco de referencia abierto, que permite varios diseños de investigación y un subconjunto de constructos. Se han realizado cientos de estudios basados en este modelo, de los cuales se escoge, como ilustración, tres estudios correlacionales y dos estudios de intervención, que abordan actividad física en Alemania y Costa Rica, higiene dental en India y Polonia, y uso de mascarillas contra el polvo en China. Estos difieren en términos de predictores que emergen como predictores más relevantes para el cambio de conductas.Palabras Clave. expectativas de resultado, autoeficacia, planeamiento, control de la acción, auto-monitoreo.

Reciprocal relationships between self‐efficacy, outcome satisfaction, and attendance at an exercise programme

“…The results of this study support a phase-specific approach to behaviour change (Schwarzer, 2008(Schwarzer, , 2016 and highlight the importance of sequentially targeting different beliefs and skills to facilitate successful initiation and maintenance of behaviour. At the beginning of the exercise programme, task self-efficacy was the strongest predictor of attendance, although by 12 months, the relationship was small and negative, suggesting that behaviour is no longer dependent on whether one feels capable of performing it.…”

“…While some reviews have concluded theory-based interventions are more effective than non-theory-based interventions (e.g., Taylor, Conner, & Lawton, 2012;Webb, Joseph, Yardley, & Michie, 2010), others have not (e.g., Prestwich et al, 2014;Roe, Hunt, Bradshaw, & Rayner, 1997). An emergent approach to understanding health behaviour change distinguishes between behavioural initiation and maintenance phases as well as the beliefs (e.g., self-efficacy, outcome satisfaction), skills, and strategies that support self-regulatory efforts during each phase (Rothman, 2000;Schwarzer, 2008Schwarzer, , 2016. An emergent approach to understanding health behaviour change distinguishes between behavioural initiation and maintenance phases as well as the beliefs (e.g., self-efficacy, outcome satisfaction), skills, and strategies that support self-regulatory efforts during each phase (Rothman, 2000;Schwarzer, 2008Schwarzer, , 2016.…”

“…The effectiveness of theory-based interventions is likely related to understanding and application of theoretical constructs and processes. An emergent approach to understanding health behaviour change distinguishes between behavioural initiation and maintenance phases as well as the beliefs (e.g., self-efficacy, outcome satisfaction), skills, and strategies that support self-regulatory efforts during each phase (Rothman, 2000;Schwarzer, 2008Schwarzer, , 2016. Behaviour initiation requires development of beliefs that support intention formation, whereas behaviour maintenance requires development of beliefs, skills, and strategies that support resilience to personal, situational, and environmental barriers (Schwarzer, 2008(Schwarzer, , 2016.…”

Diabetes Prevention in Australia: 10 Years Results and Experience

“…The psychological changes resulting from the HAPA approach predicted behaviour changes resulting in 12-month biophysical changes and support the theoretical basis of the intervention (Fig. 2) [1213141516]. …”

Interpersonal pursuit of intrapersonal health goals: Social cognitive–motivational mechanisms by which social support promotes self‐regulatory success

“…Last, social support can increase the likelihood of successful action control by promoting coping planning and recovery self-efficacy (Schwarzer, 2016). Coping plans address how to respond to unexpected obstacles, barriers, and risky situations that arise during continued goal pursuit and endanger both immediate and longer-term self-regulatory success (Sniehotta, Scholz, & Schwarzer, 2005).…”