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2 results

  • 7 - Changing Behavior Using the Health Action Process Approach

  • from Part I - Theory and Behavior Change
  • Edited by Martin S. Hagger, Linda D. Cameron, Kyra Hamilton, Griffith University, Nelli Hankonen, University of Helsinki, Taru Lintunen, University of Jyväskylä
  • Book:
    The Handbook of Behavior Change
    Published online:
    04 July 2020
    Print publication:
    23 July 2020, pp 89-103

  • Summary

    This chapter outlines the utility of the health action process approach (HAPA), a hybrid social cognition model that aims to describe, explain, and modify health behaviors. The HAPA combines features of stage and continuum social cognition models. The model makes the distinction between motivational and volitional phases involved in the change process. In the motivational phase, outcome expectancies, action self-efficacy, and risk perceptions are constructs that make formation of intentions more likely. In the volitional phase, coping self-efficacy and action and coping planning are important determinants of behavior, with behavioral maintenance determined by recovery self-efficacy and action control. Behavioral intention bridges the motivational and volitional phases, while planning serves to link intentions with behavior. HAPA-based interventions target change in the appropriate components from each phase most likely to move the individual further toward goal attainment. For individuals who are not motivated to change, interventions targeting change in outcome expectancies, action self-efficacy, and, for some behaviors and in some contexts, risk perceptions promote intention formation. For individuals who already hold intentions to change, interventions focusing on changing coping self-efficacy, planning, and action control are most appropriate. Empirical evidence supports the usefulness of the phase-specific approach to changing behavior proposed in the HAPA.

  • Who benefits from a dietary online intervention? Evidence from Italy, Spain and Greece

  • Ralf Schwarzer, Lena Fleig, Lisa M Warner, Maryam Gholami, Lluis Serra-Majem, Joy Ngo, Blanca Roman-Viñas, Lourdes Ribas-Barba, Alessandro Distante, Evangelia Ntzani, George Giannakis, Maria L Brandi
  • Journal:
    Public Health Nutrition / Volume 20 / Issue 5 / April 2017
    Published online by Cambridge University Press:
    10 November 2016, pp. 938-947
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  • Objective

    The traditional Mediterranean diet includes high consumption of fruits, vegetables, olive oil, legumes, cereals and nuts, moderate to high intake of fish and dairy products, and low consumption of meat products. Intervention effects to improve adoption of this diet may vary in terms of individuals’ motivational or volitional prerequisites. In the context of a three-country research collaboration, intervention effects on these psychological constructs for increasing adoption of the Mediterranean diet were examined.

    Design

    An intervention was conducted to improve Mediterranean diet consumption with a two-month follow-up. Linear multiple-level models examined which psychological constructs (outcome expectancies, planning, action control and stage of change) were associated with changes in diet scores.

    Setting

    Web-based intervention in Italy, Spain and Greece.

    Subjects

    Adults (n 454; mean age 42·2 (sd 10·4) years, range 18–65 years; n 112 at follow-up).

    Results

    Analyses yielded an overall increase in the Mediterranean diet scores. Moreover, there were interactions between time and all four psychological constructs on these changes. Participants with lower levels of baseline outcome expectancies, planning, action control and stage of change were found to show steeper slopes, thus greater behavioural adoption, than those who started out with higher levels.

    Conclusions

    The intervention produced overall improvements in Mediterranean diet consumption, with outcome expectancies, planning, action control and stage of change operating as moderators, indicating that those with lower motivational or volitional prerequisites gained more from the online intervention. Individual differences in participants’ readiness for change need to be taken into account to gauge who would benefit most from the given treatment.