Identity shifts as turning points in health behavior change

West J Nurs Res. 2003 Mar;25(2):134-52. doi: 10.1177/0193945902250032.


The authors used a grounded formal theory approach to synthesize the findings of 14 studies, with the goal of identifying common elements in qualitative studies of individuals' efforts to change a variety of unhealthy behaviors. The combined sample of 399 participants had experiences of weight loss, smoking cessation, and alcohol and drug-abuse recovery. Data were extracted from published reports and analyzed using grounded-theory techniques. In the provisional model, a value conflict in response to distressing accumulated evidence prompts a small step toward behavior change. If successful, an identity shift begins. Increased self-awareness and self-confidence fuel continued change. Numerous constraints to success are noted at each step. The links to previous conceptions of identity shift are discussed.

Publication types

  • Meta-Analysis

MeSH terms

  • Health Behavior*
  • Health Promotion
  • Humans
  • Nursing Methodology Research*
  • Qualitative Research
  • Self Concept*
  • Sick Role*