Mechanisms of Health Behavior Change in Persons With Chronic Illness or Disability: The Health Action Process Approach (HAPA)
Mechanisms of Health Behavior Change in Persons With Chronic Illness or Disability: The Health Action Process Approach (HAPA)
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DOI：
10.1037/a0024509
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发表时间：
2011-08-01
影响因子：
2.7
通讯作者：
Luszczynska, Aleksandra
中科院分区：
文献类型：
--
作者：
Schwarzer, Ralf;Lippke, Sonia;Luszczynska, Aleksandra
本文概述了健康行为改变的理论结构和机制，这些理论结构和机制被发现对慢性病和残疾人的研究很有用。自我调节框架（健康行动过程方法）作为背景，区分目标设定和目标追求。风险认知、结果预期和任务自我效能感被视为目标设定（动机）阶段的诱发因素，而计划、行动控制和维持/恢复自我效能感被视为在随后的目标追求（意志）阶段具有影响力。第一阶段导致形成意图，第二阶段导致实际行为改变。这样一个中介模型有助于解释健康行为改变中的社会认知过程。通过添加第二层，提供了一个主持人模型，其中区分了三个阶段，以细分受众，进行量身定制的干预。将人识别为伪装者、意图者或行为者提供了将基于理论的治疗与特定目标群体相匹配的机会。许多研究和评估的例子，特别是在身体活动领域，用来说明该模型的应用程序，以康复设置和健康促进慢性疾病或残疾的人。结论/影响：自我调节框架的理论发展和研究证据解释了康复环境中行为改变和坚持治疗的认知机制。
The present article presents an overview of theoretical constructs and mechanisms of health behavior change that have been found useful in research on people with chronic illness and disability. A self-regulation framework (Health Action Process Approach) serves as a backdrop, making a distinction between goal setting and goal pursuit. Risk perception, outcome expectancies, and task self-efficacy are seen as predisposing factors in the goal-setting (motivational) phase, whereas planning, action control, and maintenance/recovery self-efficacy are regarded as being influential in the subsequent goal-pursuit (volitional) phase. The first phase leads to forming an intention, and the second to actual behavior change. Such a mediator model serves to explain social cognitive processes in health behavior change. By adding a second layer, a moderator model is provided in which three stages are distinguished to segment the audience for tailored interventions. Identifying persons as preintenders, intenders, or actors offers an opportunity to match theory-based treatments to specific target groups. Numerous research and assessment examples, especially within the physical activity domain, serve to illustrate the application of the model to rehabilitation settings and health promotion for people with chronic illness or disability. Conclusions/Implications: The theoretical developments and research evidence for the self-regulation framework explain the cognitive mechanisms of behavior change and adherence to treatment in the rehabilitation setting.