Table 3 Description of determinants of lifestyle behavior within the framework of the socio-ecological model
Level | Determinant | Examples |
|---|---|---|
Intrapersonal | Physical and mental wellbeing | Physical complaints interfere with the willingness for physical activity |
Psychological problems need to be solved first | ||
Knowledge | Having knowledge of a healthy lifestyle | |
Having knowledge of resources for guidance in lifestyle improvement | ||
Attitudes | By adopting a healthy nutrition pattern, it is hard to enjoy social activities such as a dinner | |
Unhealthy food and smoking are an addiction and are therefore difficult to change | ||
Do not like exercising or cooking | ||
Having anxiety for physical activity | ||
Motivation to change | A healthy lifestyle supports the improvement of wellbeing, physical fitness, health | |
A healthy lifestyle stimulates a positive body image | ||
Self-confidence | It is difficult to resist temptations regarding food | |
It is difficult to persevere lifestyle changes | ||
Interpersonal | Social environment | Receiving compliments about lifestyle changes stimulates to persevere |
Support from social environment in terms of changing lifestyle together and helping in making healthy choices stimulates to initiate and persevere lifestyle changes | ||
Institutional | Group sessions | Group sessions stimulates bonding with other women in the same situation |
Group sessions create social pressure for participating | ||
Provision of information | Contradictory provision of information creates confusion about what is healthy | |
Health care professional | Women prefer to have one contact person for each participant and relationship of trust | |
Monitoring and positive reinforcement stimulates to persevere lifestyle changes | ||
Content of intervention | Women prefer intervention content to be of multiple disciplines | |
Women prefer pragmatic and achievable advices, no extreme regimens | ||
Every woman feels unique and preferred to be treated accordingly | ||
Environment and society | Work/life balance | Irregular working hours are a barrier for having a balanced nutrition pattern and for routine physical activity |
Physically active work stimulates being physically active | ||
Neighborhood | Activities organized within lifestyle intervention in direct neighborhood stimulates participation, especially regarding weekly physical activities | |
Bike lanes, urban environment and pedestrian paths stimulate physical activity | ||
Public policy | Compensation by insurance company stimulates participation in lifestyle guidance | |
Discounts for healthy products such as healthy food or sport subscription stimulate buying these products and making healthy choices |