Cited by 114Behavioral Health and InterventionsBehavioral and Psychological StudiesNeurotransmitter Receptor Influence on Behavior

Understanding health behavior change by motivation and reward mechanisms: a review of the literature

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Michaelsen, Maren M., Esch, Tobias·2023·Frontiers in Behavioral Neuroscience

Abstract

The global rise of lifestyle-related chronic diseases has engendered growing interest among various stakeholders including policymakers, scientists, healthcare professionals, and patients, regarding the effective management of health behavior change and the development of interventions that facilitate lifestyle modification. Consequently, a plethora of health behavior change theories has been developed with the intention of elucidating the mechanisms underlying health behavior change and identifying key domains that enhance the likelihood of successful outcomes. Until now, only few studies have taken into account neurobiological correlates underlying health behavior change processes. Recent progress in the neuroscience of motivation and reward systems has provided further insights into the relevance of such domains. The aim of this contribution is to review the latest explanations of health behavior change initiation and maintenance based on novel insights into motivation and reward mechanisms. Based on a systematic literature search in PubMed, PsycInfo, and Google Scholar, four articles were reviewed. As a result, a description of motivation and reward systems (approach/wanting = pleasure; aversion/avoiding = relief; assertion/non-wanting = quiescence) and their role in health behavior change processes is presented. Three central findings are discussed: (1) motivation and reward processes allow to distinguish between goal-oriented and stimulus-driven behavior, (2) approach motivation is the key driver of the individual process of behavior change until a new behavior is maintained and assertion motivation takes over, (3) behavior change techniques can be clustered based on motivation and reward processes according to their functional mechanisms into facilitating (= providing external resources), boosting (= strengthening internal reflective resources) and nudging (= activating internal affective resources). The strengths and limitations of these advances for intervention planning are highlighted and an agenda for testing the models as well as future research is proposed.

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  • Many adults experience optimal sleep at bedroom temperatures between 15-20 °C, a range that facilitates the body's natural cooling signals and promotes faster sleep onset.

    “Research suggests that many adults experience optimal sleep at bedroom temperatures between 15-20 °C, a range that facilitates the body's natural cooling signals and promotes faster sleep onset [62].”

    From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [62]

    The Introduction discusses lifestyle-related health behaviors, and §3.2 discusses physiological responses to stress, but neither addresses bedroom temperature or sleep onset. Searches for the 15–20 °C range, sleep, and cooling found no passage in our copy that supports the claim. (LLM, conf=0.75)

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1 of the 142 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Esch T. (2018). OpenNotes, patient narratives, and their transformative effects on patient-centered care. NEJM (Catalyst). Available online at: https://catalyst.nejm.org/doi/abs/10.1056/CAT.18.0078 (accessed January 25, 2023). · DOI
  2. Evans J. (2018). “ Dual process theory: Perspectives and problems,” in Dual process theory 2.0, ed. De Neys W. (Oxforshire: Routledge/Taylor & Francis Group), 137– 155.
  3. Nestler E. J. Malenka R. C. Hyman S. (2001). Molecular basis of neuropharmacology. New York, NY: McGraw-Hill Medical.

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Authors
Michaelsen, M. M., & Esch, T.
Affiliations
Witten/Herdecke University (DE)
Corresponding author
Michaelsen, Maren M.
Venue
Frontiers in Behavioral Neuroscience
Published
2023-06-19
Volume
17
Pages
1151918-1151918
ISSN
1662-5153 (ISSN-L)
OpenAlex
W4381166137
Cited by
114
References
142
Citations by year
2026: 49 · 2025: 41 · 2024: 20 · 2023: 4
FWCI
3.84
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Behavioral Neuroscience (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
health behavior change, motivation, reward systems, approach motivation, quiescence, behavior maintenance, behaviour change techniques, lifestyle modification, chronic disease prevention, nudging, intervention planning

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