Adherence to a Heart-Healthy Lifestyle: Testing of the Information–Motivation–Behavioral Skills Model

Abstract

BACKGROUND: Adherence to a heart-healthy lifestyle is essential for the prevention of cardiovascular disease. Although recent preventive strategies have shifted from targeting individual behaviors to addressing multiple behaviors simultaneously, empirical evidence on the determinants of such adherence remains limited. OBJECTIVE: The aims of this study were to assess adherence to a heart-healthy lifestyle encompassing multiple behaviors and to identify its determinants through path analysis guided by the information-motivation-behavioral skills model. METHODS: A cross-sectional design was used with 500 community-dwelling adults in South Korea who had no history of cardiovascular disease. Data were collected through an online survey. Behavioral determinants derived from the information-motivation-behavioral skills model-specifically, heart-healthy information, motivation, and self-efficacy for diet and exercise-were operationalized and measured as key predictors of adherence. RESULTS: The mean adherence was 2.5 on a 1-to-4 scale. Heart-healthy information exhibited no significant total effect on adherence. Heart-healthy intrinsic motivation exerted a significant total effect on adherence (β = 0.593, P < .001), comprising both a significant direct effect and an indirect effect mediated by self-efficacy. Heart-healthy self-efficacy for both diet (β = 0.232, P = .001) and exercise (β = 0.304, P = .001) were found to have significant direct effects on adherence. The final path model demonstrated an excellent fit to the data, accounting for 50.0% of the variance in adherence. CONCLUSIONS: These findings underscore heart-healthy intrinsic motivation as an initial intervention target for enhancing adherence to a heart-healthy lifestyle in the context of cardiovascular disease prevention.

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