Application of the Health Action Process Approach to Physical Activity: a Meta-Analysis

Abstract

Background: Social-cognitive determinants have been studied to explain and predict the adoption and maintenance of regular physical activity. This review aims to synthesize the outcomes of published studies that have investigated the 21 associations among such constructs and with physical activity on the basis of the Health Action Process Approach (HAPA). Method: A systematic literature search has been conducted for HAPA-based articles that report associations between social-cognitive constructs and physical activity including cross-sectional, longitudinal, and experimental research designs. Findings: Among the 32 studies initially identified, 11 were included in the meta-analyses with a total sample size of 2677 participants. Their age ranged from 12 to 93 years (mean 43.91 years). The majority (63%) were women, 36.75% were patients, and countries of origin were the U.S., South Korea, Germany, and France. The summary effect sizes for all model associations, except for paths involving risk perception, were positive and significant (all p<.001) but they remained heterogeneous. Moderator search yielded no evidence that moderators (i.e., country, age, gender, study design, and sample type) had systematic effects on the associations. Conclusions: Meta-analyses on the 21 paths in the HAPA resulted in high associations among social-cognitive constructs and with physical activity. To identify more homogeneous subsets of associations, another meta-analysis with a larger sample of studies is needed that allows to test a multitude of putative moderators.