BackgroundAccelerating advances in health behavior change requires releasing the brake, as well as applying the throttle. This paper discusses six challenges or “brakes” that have slowed progress.Purpose/Methods/ResultsWe engage with six issues that limit investigators’ ability to delineate and test the strategy–target and target–behavior relations that underlie effective interventions according to the experimental medicine approach. We discuss the need for guidance on how to identify the relevant mechanism of action (target) in an intervention and whether a periodic table of health behavior constructs might aid investigators. Experimental and correlational analyses (prospective surveys and behavior change techniques) have been used to test the validity of targets, and we present evidence that there is little agreement among the findings from different research designs. Whereas target engagement is typically analyzed in terms of increasing scores on constructs that impel behavior change, we discuss the role of impeding targets and the benefits of adopting a broader construal of potential targets and approaches to engagement. There is presently a paucity of competitive tests regarding which strategies best engage targets and we discuss empirical criteria and conceptual developments that could enhance the evidence base. Finally, we highlight the need to take “context” or conditional intervention effects more seriously by leveraging the interplay between questions about why interventions work and questions about when and for whom they work.ConclusionCandid appraisal of the challenges facing research on health behavior change can generate new opportunities for theoretical development and offer direction and cumulative impetus for empirical work.

中文翻译：

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是什么让我们慢下来？加速健康行为改变进步的六大挑战

背景加速健康行为改变的进步需要释放刹车，以及应用油门。本文讨论了六个减缓进展的挑战或“刹车”。目的/方法/结果我们参与了六个问题，这些问题限制了调查人员描绘和测试根据实验医学作为有效干预基础的战略-目标和目标-行为关系的能力方法。我们讨论了如何确定干预中的相关作用机制（目标）以及健康行为结构周期表是否可以帮助调查人员的指导需求。实验和相关分析（前瞻性调查和行为改变技术）已被用于测试目标的有效性，我们提供的证据表明，不同研究设计的结果之间几乎没有一致性。虽然目标参与通常是根据推动行为改变的结构得分增加来分析的，但我们讨论了阻碍目标的作用以及采用更广泛的潜在目标和参与方法的解释的好处。目前缺乏关于哪些策略最能吸引目标的竞争性测试，我们讨论了可以增强证据基础的经验标准和概念发展。最后，我们强调需要更认真地对待“背景”或有条件的干预效果，方法是利用干预措施为何起作用的问题与它们何时起作用以及为谁起作用的问题之间的相互作用。