Explaining health behaviour: a new model centred around health experience and its determinants

Damien Broekharst¹Sjaak Bloem^1*Edward Groenland¹Tessa Folkertsma²Jim Ingebretsen Carlson^3,4Frans Folvord^3,5Claire Everitt⁶Aad Liefveld⁷Francisco Lupiáñez-Villanueva^3,4

• ¹Nyenrode Business University, Breukelen, Netherlands
• ²Medical Center Leeuwarden, Leeuwarden, Netherlands
• ³PredictBy, Barcelona, Spain
• ⁴Universitat Oberta de Catalunya, Barcelona, Spain
• ⁵Tilburg University, Tilburg, Netherlands
• ⁶Pfizer, Kent, United Kingdom
• ⁷Link2trials, Hilversum, Netherlands

Introduction: Conventional health-related concepts used to predict health behaviour have limited predictive power as they are unable to accurately capture an individual's health experience, which correlates more closely with health behaviour. Therefore, certain authors set out to develop a predictive model centred around subjective health experience and its determinants. Although this model may be promising, it is still rudimentary. Hence, this study explores a new extended subjective health experience model and segments it along the lines of relevant demographic variables in order to further improve health behaviour predictions.Method: An online questionnaire was administered to a panel of 2550 Dutch citizens covering sample characteristics and instruments on health perceptions, acceptance, control, projected health, experienced health, adjustment and health behaviour. Data was analysed using descriptive, reliability, validity and model statistics.Result: Analysis revealed that nearly all assumed direct relationships within the overall and segmented models are statistically significant making them exceptionally robust. It also became clear that health perception indirectly relates to health behaviour through several pathways of which those involving sequential mediation by acceptance, experienced health and projected health with control possibly preceding or replacing acceptance seem to be strongest. The indirect pathways involving acceptance with either experienced or projected health with control potentially preceding or replacing acceptance seem to be moderate in strength. The weaker indirect pathways are those involving adjustment either combined with experienced and projected health or embedded within more extended sequences. It further became evident that the model explained between 39.2% and 50.9% of variance in health behaviour.Conclusion: Healthcare professionals and other stakeholders may benefit from using key concepts like acceptance, control, experienced health and projected health to guide the development and implementation of future behavioural interventions.