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

Applied Psychology - Tập 57 Số 1 - Trang 1-29 - 2008
Ralf Schwarzer1
1Freie Universität, Berlin, Germany

Tóm tắt

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 intention–behavior 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 peuvent apparaître, ou encore les intéressés peuvent succomber à la tentation. L’intention doit donc être associée à d’autres facteurs plus immédiats susceptibles de compromettre ou de faciliter le passage de l’intention à l’action. Certains de ces facteurs ont été identifiés, à savoir la planification stratégique et la perception de l’efficacité personnelle. Ils aident à combler le fossé entre l’intention et le comportement. L’Approche des Processus d’Action en faveur de la Santé (HAPA) établit une distinction entre les processus motivationnels préalables à l’intention qui conduisent à une intention comportementale et les processus volontaires secondaires à l’intention qui débouchent sur un comportement effectivement favorable à la santé. On expose dans cet article sept recherches qui examinent le rôle médiateur de la volition dans l’adoption de et la persévérance dans cinq comportements utiles à la santé: l’exercice physique, l’inspection personnelle de ses seins, l’usage de la ceinture de sécurité, un bon régime alimentaire et l’utilisation du fil dentaire. Il s’agit de mettre à l’épreuve le caractère opérationnel de l’HAPA et son universalité en l’appliquant à différents comportements liés à la santéà partir de mesures et de périodes diversifiées sur des échantillons provenant de différents pays.

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