Goal Commitment and Proactive Health Behavior in Chronic Disease Patients

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.