Special section on self-regulation of eating behaviors among adolescents




The Health Technology Adoption & Maintenance (HTAM) model

Health Technology Adoption & Maintenance
Health Technology Adoption & Maintenance

The Health Technology Adoption & Maintenance (HTAM) model has been developed in the context of a medication adherence project that included digital devices. The model describes which psychological factors and processes are involved when people start using a digital device that is supposed to improve health behaviours or prevent illness. The model can provide a theoretical background for eHealth or mHealth applications. It is characterized by a set of interrelated factors that represent the process of adoption and maintenance of using technologies for behaviour enhancement.  Behavioural endpoints are preparation, initiating actual use (adoption), and maintenance (adherence).

Performing these behaviours requires a motivational and volitional process. First comes the motivation phase in which people develop intentions to use technologies. Afterwards, they enter the volition phase in which they plan, prepare and actually use the technologies for adherence. Moving from one phase to the other represents a switch of mindsets when people move from deliberation to action. Among other constructs, in particular perceived self-efficacy is required throughout the entire process. Social influence and facilitating external conditions are also important. The model captures the barriers of technology acceptance, allowing for intervention methods to overcome such barriers. This is expected to bridge the gap between the needs of the technologies and their adoption, enabling to deliver the technologies to the people who need them.

Measurement examples of the involved constructs include: Perceived usefulness (“How would the use of this [device] improve my life?”); Outcome expectancies (“If I use this [device], I gain control over my health and may prevent the onset of illness.”); Conditional risk perceptions (risk outcome expectancies) (“If I use this [device], then my risk of getting diseases becomes lower.”); Perceived ease of use (“It would be easy for me to become skillful at using this [device].”); Perceived action self-efficacy (“I am certain that I can use this [device] on a regular basis, even if it takes some time to learn its use.”); Action planning (“Have you planned when, where and how to do xxx (behaviour)?”);Coping planning (“While you are travelling and cannot adhere to your usual plans,…….”);Coping self-efficacy (“I am certain that I can use the [device] even when I am under time pressure or stress.”);Recovery self-efficacy (“I am certain that I can resume using the [device] even after I have not used it for a while.”);Subjective norm (social outcome expectancies) (“If I use this [device], I gain approval from others.”). Detailed measures need to be developed for each particular research context.

The model constitutes an extension of the popular Health Action Process Approach (HAPA), see



Just published: condom use, vegetable intake, dental flossing

Carvalho, T., Alvarez, M.J., Barz, M., & Schwarzer, R. (2015). Preparatory behavior for condom use among heterosexual young men: A longitudinal mediation model. Health Education and Behavior, 42(1) 92–99. DOI: 10.1177/1090198114537066

Gholami, M., Wiedemann, A., Knoll, N. & Schwarzer, R. (2015). Mothers Improve their Daughters’ Vegetable Intake: A Randomized Controlled Study. Psychology, Health, and Medicine, (20) 1, 1-7. DOI:10.1080/13548506.2014.902485

Schwarzer, R., Antoniuk, A., & Gholami, M. (2015). A brief intervention changing oral self-care, self-efficacy, and self-monitoring. British Journal of Health Psychology,. 20, 56–67. DOI: 10.1111/bjhp.12091

Brief HAPA Intervention Materials

There are a large number of small-scale intervention studies derived from HAPA. Such parsimonious “10-minute interventions” can be cost-effective and are easily implemented in school or work settings where groups of participants receive the task to fill out some leaflets after the baseline assessment. The content of the interventions reflect the HAPA constructs, in particular outcome expectancies, planning, self-efficacy, and action control (e.g., self-monitoring). We have produced the present intervention materials brochure (PDF) to respond to the many requests that we receive from all over the world for such brief intervention materials.

There is also an assessment tools brochure (PDF) that can be found here.

Health behavior models, scales, interventions