Introduction: Why the Fogg Behavior Model in Public Health Matters
Behavior change remains a central challenge in promoting health and preventing illness. While many models guide intervention design, the Fogg Behavior Model (FBM) offers a simple, action-focused framework: behavior occurs when motivation, ability, and prompts align in the same moment. This scoping review synthesizes how FBM has been applied in health to promote healthier choices, with implications for practice and future research.
Scope and Methodology
Researchers conducted a comprehensive search across MEDLINE/PubMed, Cochrane, Epistemonikos, and PsycINFO, including grey literature, to identify health interventions that explicitly used the FBM. Following PRISMA-ScR and SAGER guidelines, the review mapped study characteristics, FBM components used (motivation, ability, prompts), delivery modes, outcomes, and contexts. The aim was to understand where FBM has worked, for whom, and under what design conditions.
What the Evidence Shows: Domains and Outcomes
Across six studies published between 2016 and 2024, FBM-based interventions touched on sexual and reproductive health, vaccination, chronic disease management, general wellness, and healthcare adherence. Studies largely involved adults and were conducted in clinical settings, though digital and hybrid delivery was common. Outcomes varied, but several patterns emerged:
- Motivation: Interventions leveraged anticipation, sensation, and social belonging to drive engagement. Messages framed benefits (e.g., better birth outcomes, cancer prevention) and linked behaviors to social norms and peer support.
- Ability: Programs reduced effort and barriers by fitting actions into daily routines, offering time flexibility, removing financial obstacles, simplifying information, and providing devices or platforms to ensure access.
- Prompts: Reminders, calls to action, and environmental cues activated behaviors at moments of receptivity. Timing and context were crucial to sustaining engagement.
Notable findings included increased intention to vaginally birth after cesarean, higher HPV vaccination intent with actual first-dose uptake within weeks, improved diabetes self-management metrics, and better parental engagement in child nutrition. Some studies achieved statistically significant improvements, though heterogeneity limited cross-study synthesis and causal claims.
Design Considerations and Practical Takeaways
FBM-based interventions tended to favor accessibility and ease of action. Key design elements included:
- Reducing cognitive load with user-friendly platforms and stepwise guidance.
- Improving practicality by aligning interventions with daily routines and offering flexible scheduling.
- Using timely prompts, including digital reminders and social cues, to trigger action when motivation aligns with ability.
Digital health technologies played a central role, with SMS, apps, and online platforms enabling scalable, low-burden delivery. However, digital equity emerged as a challenge: some participants needed devices or training to participate fully.
Limitations and Gaps
The review highlights several constraints: small sample sizes, reliance on self-reported data, and a lack of long-term follow-up to gauge durability of behavior change. A notable gap is the absence of sex- and gender-disaggregated analyses, limiting insight into how FBM-driven strategies perform across different populations. The predominance of U.S.-based studies also raises questions about generalizability to diverse cultural and resource settings.
Implications for Policy and Practice
FBM offers a pragmatic toolkit for public health programming: design interventions that clearly separate motivation, ability, and prompts; maximize ease of behavior execution; and deploy well-timed cues that activate action. Policymakers should consider integrating FBM principles into digital health initiatives and community-based programs to improve adherence and outcomes. Future research should compare FBM with other behavior change models, explore long-term adherence, and include sex- and gender-based analyses to enhance equity and effectiveness.
Conclusion: The FBM’s Potential in Public Health
In health interventions, the FBM’s trio—motivation, ability, and prompts—provides a concise, actionable backbone for behavior change. While current evidence is promising, broader application, rigorous methodology, and attention to equity are needed to unlock the full potential of the FBM in public health practice.
