Strengths of the Health Action Process Approach: a Structured Review

Background Models of health behaviour change have historically focused on the proximal predictors of behaviour. However, people do not always act in accordance with their intentions and fail to take action under multiple and conflicting demands. The Health Action Process Approach (HAPA) is a model of health behaviour that attempts to provide a parsimonious explanation of health promoting behaviours that endeavours to bridge the intention-behaviour gap. Towards this end, the model distinguishes between motivational and volitional factors that contribute to behavioural engagement. Action self-efficacy, outcome expectancies and risk perception are motivational factors, whilst action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy are volitional factors. Aims/objectives Our objective was to complete a systematic literature review of the HAPA model, with was undertaken with a particular focus to synthesise and analyse the current empirical evidence attesting to the effectiveness of the planning and self-efficacy components within the model. Method Using the PRIMSA method for systematic literature review we searched over 12 academic databases and Google Scholar. This search resulted in a detailed review of 47 articles from 1999 to 2015 across eight different behavioural outcome groups with 17,350 participants. Conclusion Our results indicate that Intention remains a strong predictor of behaviour but strengthening intentions through action self-efficacy and implementing plans increases the likelihood that behaviour will occur. As a set, these variables were found to provide the most parsimonious and consistent model of health promoting behaviour across various outcomes in 47 samples of healthy adults.