Chronic diseases such as hypertension, diabetes, and dyslipidemia are major contributors to mortality and healthcare burden worldwide. Despite high awareness of health risks, many patients fail to adopt proactive health behaviors due to behavioral inertia and a gap between knowledge and action. This study aims to investigate the evolution and driving mechanisms of proactive health behavior in patients with chronic diseases based on goal commitment theory. By integrating prospect theory and evolutionary game theory, this study will explore how behavioral strategies evolve under different levels of goal commitment. In addition, a behavioral intervention based on the Stimulus-Organism-Response (SOR) model will be developed to enhance patient activation and promote adherence to proactive health behaviors. A parallel controlled intervention study will be conducted to evaluate the effectiveness of the goal commitment-based intervention. The findings of this study are expected to provide theoretical and practical evidence to improve chronic disease management and promote proactive health behaviors.
Chronic diseases, including hypertension, diabetes, and dyslipidemia, account for a substantial proportion of morbidity, mortality, and healthcare expenditure. Although a large proportion of patients are aware of their health risks, more than half fail to adopt proactive health behaviors. This gap between awareness and action is often attributed to behavioral inertia and insufficient motivation. This study aims to explore the evolution and driving mechanisms of proactive health behavior among patients with chronic diseases based on goal commitment theory. The theoretical framework integrates prospect theory and evolutionary game theory to model behavioral decision-making under uncertainty and dynamic interactions. First, a theoretical model will be constructed to simulate the evolution of proactive health behaviors under different levels of goal commitment, using evolutionary game analysis. Second, a conceptual framework based on the Stimulus-Organism-Response (SOR) model will be developed to examine how goal commitment influences patient activation and social norms, thereby affecting proactive health behavior. Empirical data will be collected through multi-site surveys among patients with chronic diseases. Subsequently, a parallel controlled intervention study will be conducted to evaluate the effectiveness of a goal commitment-based intervention in improving proactive health behaviors. Inclusion criteria include adult residents diagnosed with at least one chronic condition (hypertension, diabetes, or dyslipidemia), with adequate cognitive ability and willingness to participate. Exclusion criteria include inability to participate in group activities, current hospitalization, or severe psychiatric or cognitive disorders. The study is expected to provide insights into the mechanisms underlying proactive health behavior and offer evidence-based strategies for improving chronic disease management.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
600
This intervention is a structured behavioral program based on goal commitment theory, designed to promote proactive health behaviors in patients with chronic diseases. The intervention includes goal setting, personalized action planning, behavioral activation, and continuous follow-up support. Participants will receive guidance to enhance motivation, strengthen commitment to health goals, and improve adherence to chronic disease management through regular monitoring and feedback.
Participants in the control group will receive routine chronic disease management or standard health education without additional structured behavioral intervention.
School of Medicine and Health Management Tongji Medical College,Huazhong University of Science and Technology
Wuhan, Hubei, China
RECRUITINGChange in Proactive Health Behavior Score
The primary outcome is the difference in the mean change of proactive health behavior scores between the intervention group and the control group at 6 months after the intervention. Proactive health behaviors will be assessed using a validated Proactive Health Behavior Scale, including overall score and component scores.
Time frame: Baseline to 6 months after intervention
Change in Metabolic Syndrome (MetS) Score
The primary outcome includes the difference in the mean change of metabolic syndrome (MetS) scores between the intervention group and the control group at 6 months after the intervention.
Time frame: Baseline to 6 months after intervention
Change in Proactive Health Behavior Score at 3 Months
The difference in the mean change of proactive health behavior scores and its component domains between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
Change in Fasting Blood Glucose (FBG) at 3 Months
The difference in the mean change of fasting blood glucose levels between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
Change in Fasting Blood Glucose (FBG)
Changes in fasting blood glucose levels measured by blood tests.
Time frame: Baseline, 3 months, and 6 months after intervention
Change in Triglycerides (TG)
Changes in triglyceride levels measured by blood tests.
Time frame: Baseline, 3 months after intervention, and 6 months after intervention
Change in High-Density Lipoprotein Cholesterol (HDL-C)
Changes in HDL cholesterol levels measured by blood tests.
Time frame: Baseline, 3 months after intervention, and 6 months after intervention
Change in Blood Pressure
Changes in systolic and diastolic blood pressure.
Time frame: Baseline, 3 months after intervention, and 6 months after intervention
Change in Body Mass Index (BMI) at 3 Months
The difference in the mean change of body mass index between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
Change in Triglycerides (TG) at 3 Months
The difference in the mean change of triglyceride levels between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
Change in High-Density Lipoprotein Cholesterol (HDL-C) at 3 Months
The difference in the mean change of HDL cholesterol levels between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
Change in Systolic Blood Pressure (SBP) at 3 Months
The difference in the mean change of systolic blood pressure between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
Change in Diastolic Blood Pressure (DBP) at 3 Months
The difference in the mean change of diastolic blood pressure between the intervention group and the control group at 3 months after the intervention.
Time frame: Baseline to 3 months after intervention
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