Health behaviors are pivotal in determining overall health outcomes, making them a key focus for health promotion initiatives. However, fostering behavioral change is intricate due to the interplay of numerous factors influencing health-related actions. While information, awareness, and knowledge are essential, they are often insufficient on their own. Effective health promotion necessitates looking beyond individual psychological and cognitive factors to grasp the broader, multifaceted processes driving behavior change. Social-ecological models offer a framework to navigate these complexities, though they can sometimes lack specificity. This qualitative grounded theory study explores how individual, interpersonal, and environmental factors converge to shape health behaviors and examines how social-ecological models can be tailored to address diverse ecological needs. Participants were drawn from a community-based cardiovascular disease prevention program in Northern Sweden. Through in-depth interviews, the study investigated health behaviors across the life course among middle-aged men and women. Results reveal that barriers and facilitators to health behavior vary systematically based on individuals’ health identities. Customizing social-ecological interventions to reflect these identities could improve their impact. Beyond conventional risk-factor screening, evaluating health identities may guide the development of more precise, context-sensitive health promotion strategies.
