Understanding personal health thresholds: a conceptual framework for health education

Purpose This study introduces the personal health threshold model, a new conceptual framework that explains how individuals categorize health behaviors. The model aims to elucidate the psychological mechanisms underlying selective adherence to health behaviors and inform more effective health education approaches. Design/methodology/approach The model integrates insights from existing research streams, including compensatory health beliefs, licensing effects, risk perception, health lifestyle profiling, cognitive dissonance, self-exempting beliefs and health behavior clustering. By synthesizing these diverse perspectives, the model provides a comprehensive understanding of how various health behaviors are categorized, maintained and enacted in daily life. Findings The model consists of three core components: boundary establishment, boundary maintenance and dual decision-making. Boundary establishment refers to the cognitive categorization of health behaviors into non-negotiable and negotiable behaviors, influenced by various factors. Boundary maintenance elucidates the psychological mechanisms that preserve these boundaries, including compensatory justification, selective risk perception, identity reinforcement and dissonance management. Dual decision-making highlights the fundamentally different decision-making processes for behaviors on either side of personal thresholds. Originality/value The model is the first to conceptualize the psychological boundary mechanism that explains selective adherence to health behaviors. It uniquely integrates insights from seven distinct research areas, creating a new theoretical framework that challenges traditional health education approaches. The model offers new directions for developing more effective interventions that work with rather than against these established boundaries.