Dorien Brouwer

other conditions, such as diabetes, coronary heart disease, and breast cancer. [13] Similar to other models this theory assumes that behavior change is a consequence of behavioral intention to change. An intention to change only develops when a threat is perceived and a coping response is available. We have added fear to this model, because fear is often present after TIA or ischemic stroke and may influence health-related behavior as well. [14, 15] Figure 1 . Potential determinants of health-related behavioral intention to change and actual change in patients with TIA or ischemic stroke based on the Protection Motivation Theory with fear added Besides the Protection Motivation Theory I used the Social-Cognitive Theory. This theory also describes how cognitive, behavioral, personal and environmental factors affect behavior and motivation. [16, 17] One of the factors that play a central role in this process is perceived self-efficacy, i.e. a person’s confidence to carry out behavior necessary to reach a desired goal. As self-efficacy is an important precondition for successful self-management to change health-related behavior, [18, 19] we used this model to study the role of self-efficacy in the behavior change process after TIA or ischemic stroke. When aiming to support patients after a TIA or ischemic stroke by means of an intervention these models for behavior change have to form the basis. [20-22]