Health Behaviours and Their Psychological Determinants: Concepts, Models and Implications for Health Promotion
Priya Magesh *
Department of Psychology, Faculty of Liberal Arts and Business Studies, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India.
*Author to whom correspondence should be addressed.
Abstract
Health-related actions depend not only on what people know or intend but also on their capabilities, learned routines, social relationships and opportunities to act. Explanatory models have proliferated, yet predictive success is often conflated with evidence that modifying a determinant will change behaviour. This critical narrative review evaluates the conceptual assumptions, evidential strengths and practical implications of prominent psychological and integrative frameworks for health promotion. Targeted scholarly retrieval and citation examination informed a thematic synthesis of foundational models, prospective studies, experimental evidence and contemporary systematic and umbrella reviews. The analysis compares health-belief and planned-behaviour approaches, social cognitive and self-determination theories, action-regulation and stage frameworks, and capability–opportunity–motivation accounts. Across domains, intentions and perceived efficacy are informative correlates of health action but are not reliable surrogates for enactment. Evidence concerning planning, monitoring and feedback supports carefully specified interventions, while habit and environmental opportunity help explain persistence, failure and the unequal distribution of benefits. Applications to physical activity, diet, tobacco and alcohol use, vaccination, screening and medication adherence illustrate why a successful mechanism cannot automatically be transferred between behavioural contexts. A theory label does not in itself establish greater effectiveness, and reported mechanisms are often confounded by bundled components, self-reported outcomes, selective follow-up and inadequate assessment of service access. Practical health promotion should begin with a precise behavioural target, distinguish subjective from material barriers and choose intervention functions whose causal predictions can be evaluated against actual behaviour and implementation outcomes. Future progress requires longitudinal mechanism tests, credible comparators, measures of maintenance and equitable reach, and more rigorous examination of context-dependent effects. Psychological insight is most useful when joined to the real conditions that make health-supporting action feasible.
Keywords: Behaviour change techniques, self-efficacy, intention–behaviour gap, habit formation, self-determination, behavioural intervention, health equity