Linking Patient Centred Communication to Health Behaviour in Social Cognitive Theory

Purpose: Patient-centred communication (PCC) is widely endorsed across international and regional health policy frameworks (Brody, 2017). However, its impact on everyday health behaviours remains inconclusive (Lewin et al., 2001), and the cognitive mechanisms through which PCC influences health outcomes remain insufficiently understood (Street et al., 2009). To address this gap, the primary purpose of this study, by integrating the notion of patient activation (Hibbard & Mahoney, 2010) with social cognitive theory (SCT; Bandura, 1997), is to examine the cognitive pathway through which PCC shapes both promotive (physical activity, fruit and vegetable intake) and preventive health behaviours (alcohol reduction).

Study Design: Data were drawn from the INSIGHTS-Hong Kong (International Studies to Investigate Global Health Information Trends) survey in 2021. 756 Hong Kong residents who had consulted a physician in the past 12 months were included in our analysis. Structural equation modelling was used to test the cognitive pathway through which PCC shapes promotive and preventive health behaviours.

Findings: Results indicate that more frequent PCC significantly enhances self-efficacy, which subsequently leads to stronger positive outcome expectations and goal formation, ultimately driving engagement in both promotive and preventive health behaviours. These results support a cognitive pathway in which PCC activates psychological resources that translate into lifestyle change.

Originality: Theoretically, this study integrates patient activation with SCT to articulate a cognitive pathway that explains how PCC drives both promotive and preventive health behaviours. Practically, it delivers actionable insights for health systems, highlighting the need to embed PCC into primary care infrastructure and provider training to ensure that PCC policy commitments yield improvements in population-level health behaviours.