Comprehending Health Behavior Change and Maintenance: A Systematic Review and Meta-Synthesis of Behavior Theories

Abstract

ABSTRACT Background Health behaviors exhibit diverse characteristics and types, leading to health behavior theories with varied focuses. However, an integrated framework elucidating the intrinsic mechanisms of different behavior types is notably absent. Purpose This study aimed to establish such a framework offering a comprehensive basis for explanations and behavior interventions. Methods A systematic review and meta-synthesis of qualitative research concerning health behavior change and maintenance were conducted. Results A total of 556 records were identified and screened, with 170 meeting the inclusion criteria. Thematic synthesis, a form of meta-synthesis, generated 23 themes, with the qualitative relationships between them presented in a conceptual model, forming an integrated framework. Discussion This framework provides a dynamic and hierarchical platform that enables the interpretation and analysis of various health behaviors within a unified structure. Furthermore, the recognition of the dynamicity of constructs and the multiplicity of behavior routes offers certain implications for intervention design, including behavior setting guidance, immediate benefits provision, and behavior interactions utilization. Translation to Health Education Practice The study provides an integrated framework for health educators/promoters. It offers a comprehensive view of health behavior change mechanisms from multiple perspectives and provides insights for the design, implementation and evaluation of behavior intervention practices.