Chun-Qing Zhang

The Health Action Process Approach (HAPA) is a prominent social-cognition model of health behaviour change, but its efficacy across diverse domains and populations requires systematic evaluation. This systematic review and meta-analysis evaluated the overall efficacy of HAPA-based interventions and examined potential moderators. Eligible studies were randomized controlled trials that explicitly nominated the HAPA as an intervention basis and assessed at least one health behavior outcome. Five electronic databases were searched from inception to February 2025, identifying 74 randomised controlled trials (197 effect sizes) comprising 9,115 intervention and 8,858 control participants. A random-effects multilevel meta-analysis revealed a significant overall post-intervention effect on health behaviours (d = 0.459). Significant effects emerged for physical activity (d = 0.504), fruit and vegetable consumption (d = 0.636), and other dietary behaviours (d = 0.776). Subgroup analyses identified several key moderators: interventions targeting approach behaviours yielded significant effects (d = 0.497), whereas those targeting avoidance behaviours were non-significant. Dual-phase interventions targeting both motivational and volitional constructs (d = 0.532) outperformed volitional-only (d = 0.350) or motivational-only (d = 0.289) designs. Furthermore, larger effect sizes were observed for interventions using inactive control groups (d = 0.543), delivered to clinical populations (d = 0.559), employing hybrid delivery modes (d = 0.672), and lasting 12-24 weeks (d = 0.619). These findings demonstrate that HAPA-based interventions are effective, particularly when utilising dual-phase, hybrid, and longer-term designs for clinical groups. Future research should focus on optimising intervention design and elucidating mechanisms underlying sustained behaviour change.

Background: Regular moderate-to-vigorous physical activity (MVPA) reduces the risk of noncommunicable diseases, yet one-third of adults globally fail to meet MVPA recommendations. Office employees, among the least active groups, face heightened risks due to prolonged sedentary behavior and barriers like lack of time, fatigue, and low motivation. Although scalable, web-based interventions frequently face challenges, such as low engagement, high attrition, and limited personalization. Blended interventions, combining digital tools with interactive components, show promise but lack robust evidence among office employees. Objective: This study aimed to evaluate the effectiveness of a theory- and evidence-based blended intervention in increasing MVPA among office employees. Methods: This 24-week, 3-arm randomized controlled trial included 141 office employees, randomized equally into blended (web-based+electronic workshops [e-workshops]), web-based only, and control groups. The intervention was developed using the intervention mapping framework, ensuring a systematic, evidence- and theory-based design tailored to the needs of the target population. All participants accessed a study website; the control group used the “Library” module with general MVPA information, while intervention groups also accessed a tailored, theory-driven “Intervention” module. The blended group additionally attended 3 live e-workshops (weeks 2, 4, and 8). MVPA was objectively measured using hip-worn accelerometers at baseline (T1), postintervention (12 wk, T2), and follow-up (24 wk, T3). Retention, engagement, and acceptability were assessed. Analyses followed the intention-to-treat principle, and generalized linear mixed models were used to evaluate between-group differences at T2 and T3, adjusted for baseline MVPA, sex, and ActiGraph LEAP (Ametris) wear time. Results: A total of 141 participants (mean age 32.1, SD 9.2 y; 75/141, 53.2% female) were randomized evenly across groups with comparable baseline characteristics, except for sex ( P=. 002). The blended group showed significantly greater MVPA increases than the control at T2 ( β coefficient=0.247, 95% CI 0.013‐0.480; P =.04) and T3 ( β coefficient=0.373, 95% CI 0.139‐0.607; P=. 002), and greater increases than the web-based at T2 ( β coefficient=0.287, 95% CI 0.062‐0.512; P=. 01) and T3 ( β coefficient=0.368, 95% CI 0.138‐0.597; P=. 002). Sensitivity analyses confirmed the robustness of these findings. Retention and engagement rates were 83% and 56%, respectively. Participants reported high acceptability across all domains. Conclusions: A blended intervention integrating tailored web content with interactive e-workshops significantly increased MVPA at T2 and T3 compared with both web-based and control groups. This success stems from the rigorous intervention mapping framework, which systematically identified effective behavior change and habit formation theories, while the blended approach addressed key limitations of traditional and web-based methods. These findings underscore the potential of evidence- and theory-based blended approaches to address common barriers to MVPA and promote sustainable MVPA in workplace settings, offering promising opportunities for broader scalability and personalization.

Because threatening health messages often trigger defensive responses rather than behavioral change, it is critical to identify effective approaches for reducing defensiveness toward health threats. Building on evidence of the efficacy of mindfulness, this study investigated whether brief mindfulness meditation can reduce individual defensiveness and promote health intentions and behaviors across two domains: sleep health and disease screening. Two online experiments (N₁ = 248; N₂ = 168) were conducted. Experiment 1 addressed sleep hygiene, while Experiment 2 utilized a fictional rare disease screening scenario. Fear, defensiveness, and intentions were measured in both experiments; Experiment 2 further assessed actual appointment-making behavior. Data were analyzed using ANOVA, ANCOVA, and mediation modeling via the PROCESS macro for SPSS. Brief mindfulness meditation consistently reduced defensiveness and indirectly increased intentions for sleep improvement and health screening in both experiments. In Experiment 2, a serial mediation effect was observed: mindfulness increased risk-feedback acceptance and reduced message defensiveness, which in turn bolstered screening intentions. However, the effect of mindfulness on actual screening appointment behavior was non-significant. Brief mindfulness meditation practice attenuates defensive responses to health threats and enhances behavioral intentions in both sleep and screening contexts. These findings suggest that brief mindfulness-based interventions can potentially amplify the impact of health communication by fostering a more receptive and less defensive processing of health-related information.

Purpose : The current study aimed to examine the associations among affective responses, intrinsic motivation, theory of planned behavior constructs, and moderate to vigorous physical activity (MVPA) in physical education lessons. Method : A total of 967 Chinese adolescents ( M _age = 15.8 years, SD = 1.48) participated in a 1-month prospective study and completed questionnaires assessing affective responses, intrinsic motivation, theory of planned behavior constructs, and MVPA in physical education lessons. Results : Full structural equation modeling indicated that affective appraisal during lessons showed the strongest prospective associations with intention and follow-up MVPA via intrinsic motivation and theory of planned behavior constructs, whereas affective feeling during lessons demonstrated smaller indirect effects. In contract, postlesson affective responses were generally weaker or nonsignificant. Conclusion : Positive affective appraisal during lessons appears to be particularly important for adolescents’ motivation and engagement in MVPA within physical education contexts. Future research employing experimental designs and in-the-moment affect assessments is needed to more robustly examine underlying causal mechanisms.

An expert meeting convened at the European Health Psychology Society conference in 2019 concluded that, to develop effective habit‐based interventions, more knowledge was needed regarding how habit manifests in health behaviour, how to make and break habits, and how to develop optimal interventions. The articles included in this Collection represent remarkable progress in providing this knowledge. In this editorial, we discuss the various advances that these studies offer in understanding how to personalise and contextualise habit‐based interventions, identifying which strategies appear effective for making and breaking habits, and highlighting constructs that may operate interdependently with habit to drive behaviour change maintenance. To maintain momentum in the development and application of habit theory for health, we encourage researchers to make greater use of artificial intelligence, both to learn more about habitual behaviour and to develop adaptive, user‐centred interventions.

BACKGROUND Physical inactivity is a critical risk factor for non-communicable diseases (NCDs), particularly among office employees with predominantly sedentary work environments. Addressing this issue is critical to improving public health and workplace productivity. OBJECTIVE This study aimed to evaluate the effectiveness of a blended intervention, combining web-based intervention and interactive e-workshops, in promoting moderate-to-vigorous physical activity (MVPA) among physically inactive office employees in Hong Kong. METHODS A 24-week randomized controlled trial (RCT) was conducted with 141 participants allocated equally to three groups: blended intervention, web-based intervention, and control. MVPA was objectively measured using accelerometers at baseline, postintervention (12 weeks), and follow-up (24 weeks). Retention, engagement rates, and intervention acceptability were also assessed. Statistical analyses included generalized linear mixed models and paired t-tests. RESULTS At postintervention, the blended group achieved significantly higher MVPA levels compared to the control group (β = 0.252, 95% CI [0.019, 0.485], p = 0.034) and the web-based group (β = 0.290, 95% CI [0.065, 0.515], p = 0.012). These improvements were sustained at follow-up, with the blended group outperforming both the control (β = 0.376, 95% CI [0.141, 0.610], p = 0.002) and web-based groups (β = 0.364, 95% CI [0.134, 0.594], p = 0.002). Retention rate was high across all groups (83% overall), highlighting its feasibility and acceptability. CONCLUSIONS The blended intervention effectively increased MVPA levels and demonstrated its potential to address physical inactivity among office employees. These findings highlight the value of integrating digital tools with interactive components for sustainable behavior change in workplace settings. CLINICALTRIAL The blended intervention effectively increased MVPA levels and demonstrated its potential to address physical inactivity among office employees. These findings highlight the value of integrating digital tools with interactive components for sustainable behavior change in workplace settings.