Health Action Process Approach

What is the Health Action Process Approach?

The Health Action Process Approach (HAPA), developed by Ralf Schwarzer, is a model of health behavior change that separates deciding to act from doing it. Wanting to exercise and arranging a workable exercise routine are different problems. HAPA tries to explain that gap.

The two phases of HAPA

Motivational phase

In the motivational phase, risk perception, expected outcomes, and self-efficacy contribute to forming an intention. Self-efficacy means confidence in your ability to perform the behavior.

Volitional phase

The volitional phase concerns planning, starting, and maintaining action. Action planning specifies when, where, and how to act. Coping planning considers what to do when obstacles arise. The model also distinguishes confidence in starting, maintaining a behavior, and returning to it after a setback. Schwarzer’s 2008 account explains these processes and applications across health behaviors.

How is HAPA used?

Researchers use the model to organize measures of beliefs, plans, and behavior. Practitioners can use it to ask where a proposed intervention should focus. Someone who already wants to walk each day may need a realistic time and route more than another message about the benefits of exercise.

That is a useful question, but the answer still has to fit the person's circumstances. A plan will not create a safe walking route or free time that someone does not have.

Evidence and limitations

A 2019 meta-analysis by Zhang and colleagues covered 95 studies and 108 independent samples. It supported several relationships in the model, with self-efficacy prominent in predicting behavior. The authors called for stronger experimental tests of individual constructs and longitudinal studies of change.

Predicting behavior does not establish how to change it. If people with greater self-efficacy are more active, it does not follow that increasing a questionnaire score will make them exercise. An intervention needs to show a change in the target behavior, including whether that change lasts.