Goal Commitment and Proactive Health Behavior in Chronic Disease Patients

Evolution and Driving Mechanism of Proactive Health Behavior in Chronic Disease Patients Based on Goal Commitment

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.

Study Overview

• Status: Recruiting
• Conditions: Hypertension; Diabetes Mellitus; Dyslipidemia
• Intervention / Treatment: Behavioral: Goal Commitment-Based Behavioral Intervention; Other: Usual Care

Detailed Description

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
• Enrollment (Estimated): 600
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Juyang Xiong, PhD; Phone Number: +86-13995629873; Email: xiongjuyang@hust.edu.cn

Study Locations

• China
  • Hubei
    • Wuhan, Hubei, China, 430030
      • Recruiting
      • School of Medicine and Health Management Tongji Medical College,Huazhong University of Science and Technology
      • Contact: Juyang Xiong, Ph.D.; Phone Number: +86-139 9562 9873; Email: xiongjuyang@hust.edu.cn

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Residents living in the study area for at least 1.5 years
• Diagnosed with at least one chronic disease, including hypertension, diabetes mellitus, or dyslipidemia
• Conscious and able to communicate effectively
• Educational level of primary school or above
• Able to use a smartphone and common mobile applications (e.g., WeChat)
• Willing to participate and provide written informed consent

Exclusion Criteria:

• Non-residents of the study area
• Unable to participate in group-based intervention activities
• Currently hospitalized
• Diagnosed with severe cognitive impairment, dementia, or psychiatric disorders
• Participants with severe comorbidities that may interfere with study participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Goal Commitment Intervention Group; Participants in this group will receive a goal commitment-based behavioral intervention designed to enhance proactive health behaviors. The intervention includes structured goal-setting, behavioral activation strategies, and continuous support to improve adherence to chronic disease management.	Behavioral: Goal Commitment-Based Behavioral Intervention; 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.
Active Comparator: Usual Care Control Group; Participants in this group will receive routine chronic disease management or standard health education without additional behavioral intervention.	Other: Usual Care; Participants in the control group will receive routine chronic disease management or standard health education without additional structured behavioral intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change 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.	Baseline to 6 months after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	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.	Baseline to 3 months after intervention
Change in Fasting Blood Glucose (FBG)	Changes in fasting blood glucose levels measured by blood tests.	Baseline, 3 months, and 6 months after intervention
Change in Triglycerides (TG)	Changes in triglyceride levels measured by blood tests.	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.	Baseline, 3 months after intervention, and 6 months after intervention
Change in Blood Pressure	Changes in systolic and diastolic blood pressure.	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.	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.	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.	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.	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.	Baseline to 3 months after intervention

Collaborators and Investigators

• Sponsor: Xiong Juyang

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2025
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): December 31, 2028

Study Registration Dates

• First Submitted: April 16, 2026
• First Submitted That Met QC Criteria: April 22, 2026
• First Posted (Actual): April 27, 2026

Study Record Updates

• Last Update Posted (Actual): May 6, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Behavioral Intervention; Chronic Disease Management; Patient Activation; Proactive Health Behavior; Goal Commitment; SOR Model
• Additional Relevant MeSH Terms: Endocrine System Diseases; Vascular Diseases; Cardiovascular Diseases; Metabolic Diseases; Glucose Metabolism Disorders; Lipid Metabolism Disorders; Behavior; Nutritional and Metabolic Diseases; Treatment Adherence and Compliance; Health Behavior; Patient Acceptance of Health Care; Hypertension; Diabetes Mellitus; Dyslipidemias; Patient Participation
• Other Study ID Numbers: SMHM-2026-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data (IPD) will be shared upon reasonable request. De-identified data supporting the findings of this study will be made available to qualified researchers after publication of the primary results. Data access will be subject to approval by the corresponding author and institutional review, in accordance with ethical and data protection regulations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No