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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

DOI 10.3389/fnbeh.2023.1151918PMC PMC10317209

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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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Authors: Michaelsen, M. M., & Esch, T.
Affiliations: Witten/Herdecke University (DE)
Corresponding author: Michaelsen, Maren M.
ORCID: Michaelsen, Maren M.
Esch, Tobias
Venue: Frontiers in Behavioral Neuroscience
Publisher: Frontiers Media SA
Published: 2023-06-19
Volume: 17
Pages: 1151918-1151918
ISSN: 1662-5153 (ISSN-L)
DOI: 10.3389/fnbeh.2023.1151918
PMC: PMC10317209
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: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
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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Understanding health behavior change by motivation and reward mechanisms: a review of the literature

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