Testing two principles of the Health Action Process Approach in individuals with type 2 diabetes

Health Psychol. 2014 Jan;33(1):77-84. doi: 10.1037/a0030182. Epub 2012 Oct 22.


Objective: The Health Action Process Approach (HAPA) proposes principles that can be translated into testable hypotheses. This is one of the first studies to have explicitly tested HAPA's first 2 principles, which are (1) health behavior change process can be subdivided into motivation and volition, and (2) volition can be grouped into intentional and action stages. The 3 stage groups are labeled preintenders, intenders, and actors.

Method: The hypotheses of the HAPA model were investigated in a sample of 1,193 individuals with Type 2 diabetes. Study participants completed a questionnaire assessing the HAPA variables. The hypotheses were evaluated by examining mean differences of test variables and by the use of multigroup structural equation modeling (MSEM).

Results: Findings support the HAPA's 2 principles and 3 distinct stages. The 3 HAPA stages were significantly different in several stage-specific variables, and discontinuity patterns were found in terms of nonlinear trends across means. In terms of predicting goals, action planning, and behavior, differences transpired between the 2 motivational stages (preintenders and intenders), and between the 2 volitional stages (intenders and actors).

Conclusions: Results indicate implications for supporting behavior change processes, depending on in which stage a person is at: All individuals should be helped to increase self-efficacy. Preintenders and intenders require interventions targeting outcome expectancies. Actors benefit from an improvement in action planning to maintain and increase their previous behavior. Overall, the first 2 principles of the HAPA were supported and some evidence for the other principles was found. Future research should experimentally test these conclusions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Health Behavior*
  • Humans
  • Intention
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motivation
  • Self Efficacy
  • Surveys and Questionnaires
  • Volition
  • Young Adult