Health behaviour is crucial for influencing health, making it a key component in health promotion. However, changing behaviours is complex, as many factors interact to determine health behaviours. Information, awareness, and knowledge are important but not enough. It is essential to move beyond focusing solely on individual psychological and cognitive factors to an understanding of the complex processes involved in health behaviour change. Social-ecological models account for these complex processes but risk being overly broad and all-encompassing.

This qualitative grounded theory study explores how individual, interpersonal, and environmental factors interplay to influence health behaviour, and examines how social-ecological models in health promotion can be tailored to address different ecological needs. Participants were recruited from a community-based cardiovascular disease-prevention program in Northern Sweden. Data was collected through in-depth interviews about health and health behaviours throughout the life course among middle-aged men and women.

The results illustrate how factors obstructing or enabling health behaviours vary in patterned ways for individuals with different health identities. Social-ecological interventions could be more effective if adapted to the specific needs of people with different health identities. In addition to screening for various risk factors, screening for health identities could be helpful in designing social-ecological health-promoting interventions.