The 5A Model for Sustainable Well-Being: A Biopsychosocial Framework for Self-Regulation and Behavior Change

Health-related intentions do not necessarily produce sustainable action. The 5A model, developed within health coaching and elaborated in Il codice del benessere, organizes everyday well-being around five domains: self-directed care, allies and environment, nutrition and the relationship with food, physical activity and training, and mental attitude. This conceptual article specifies the model’s intended contribution without claiming a new causal theory or established effectiveness. A purposive, non-systematic examination of the source manuscript and selected primary, theoretical, and methodological publications distinguishes a domain map from behavioral determinants, candidate mechanisms, and outcomes. The proposed A-lever is operationalized as a documented decision process: identify a relevant constraint, compare feasible actions, select an acceptable initial action, state its anticipated enabling effect on a different target behavior, and define when the formulation should be revised. A comparative table locates this proposal alongside COM-B, the Health Action Process Approach, and self-determination theory. Earlier uncontrolled health-coaching reports are contextualized by recruitment, duration, analytic denominators, and limitations; participant overlap cannot be determined from the published reports. The earlier Wheel and the book’s educational version are not assumed to be psychometrically equivalent because item wording, response anchors, and scoring comparability remain incompletely documented. Four propositions and a staged evaluation plan specify practitioner agreement, feasibility, burden, adverse effects, independently measured behavior, and comparisons with credible personalized planning. Independent replication and transparent commercial-interest disclosure are priorities. The intended contribution is an auditable way to connect everyday domains with intervention sequencing, not evidence that the framework improves outcomes. Incremental effectiveness of the integrated 5A model and its A-lever heuristic has not been demonstrated; educational usability, decision reliability, and practical benefit require separate evaluation.

well-being; health coaching; self-regulation; behavior change; biopsychosocial framework

1. Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143–164. https://doi.org/10.1177/1090198104263660 [Google Scholar] [Crossref]

2. Breines, J. G., & Chen, S. (2012). Self-compassion increases self-improvement motivation. Personality and Social Psychology Bulletin, 38(9), 1133–1143. https://doi.org/10.1177/0146167212445599 [Google Scholar] [Crossref]

3. Buysse, D. J., Reynolds, C. F., III, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4 [Google Scholar] [Crossref]

4. Coan, J. A., Schaefer, H. S., & Davidson, R. J. (2006). Lending a hand: Social regulation of the neural response to threat. Psychological Science, 17(12), 1032–1039. https://doi.org/10.1111/j.1467-9280.2006.01832.x [Google Scholar] [Crossref]

5. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404 [Google Scholar] [Crossref]

6. Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., Kim, J. S., Heo, S., Alves, H., White, S. M., Wojcicki, T. R., Mailey, E., Vieira, V. J., Martin, S. A., Pence, B. D., Woods, J. A., McAuley, E., & Kramer, A. F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017–3022. https://doi.org/10.1073/pnas.1015950108 [Google Scholar] [Crossref]

7. Garfinkel, S. N., Seth, A. K., Barrett, A. B., Suzuki, K., & Critchley, H. D. (2015). Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104, 65–74. https://doi.org/10.1016/j.biopsycho.2014.11.004 [Google Scholar] [Crossref]

8. Gollwitzer, P. M., & Brandstätter, V. (1997). Implementation intentions and effective goal pursuit. Journal of Personality and Social Psychology, 73(1), 186–199. https://doi.org/10.1037/0022-3514.73.1.186 [Google Scholar] [Crossref]

9. Kleckner, I. R., Zhang, J., Touroutoglou, A., Chanes, L., Xia, C., Simmons, W. K., Quigley, K. S., Dickerson, B. C., & Barrett, L. F. (2017). Evidence for a large-scale brain system supporting allostasis and interoception in humans. Nature Human Behaviour, 1, 0069. https://doi.org/10.1038/s41562-017-0069 [Google Scholar] [Crossref]

10. Kottner, J., Audigé, L., Brorson, S., Donner, A., Gajewski, B. J., Hróbjartsson, A., Roberts, C., Shoukri, M., & Streiner, D. L. (2011). Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed. Journal of Clinical Epidemiology, 64(1), 96–106. https://doi.org/10.1016/j.jclinepi.2010.03.002 [Google Scholar] [Crossref]

11. Lally, P., van Jaarsveld, C. H. M., Potts, H. W. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology, 40(6), 998–1009. https://doi.org/10.1002/ejsp.674 [Google Scholar] [Crossref]

12. Mehling, W. E., Acree, M., Stewart, A., Silas, J., & Jones, A. (2018). The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLOS ONE, 13(12), e0208034. https://doi.org/10.1371/journal.pone.0208034 [Google Scholar] [Crossref]

13. Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6, 42. https://doi.org/10.1186/1748-5908-6-42 [Google Scholar] [Crossref]

14. Pipio, A., & Corbara, R. (2026). Il codice del benessere: Neuroscienze, corpo e libertà per costruire una vita che somiglia davvero a sé [Author manuscript, version supplied October 2026]. [Google Scholar] [Crossref]

15. Pipio, A., Romano, R., Sollami, A., La Rosa, G., Malagò, G., Cavallo, P., Laureti, A., Proietti, M., & Corbara, R. (2025). Health coaching: A model for enhancing quality of life. HSOA Journal of Psychiatry, Depression & Anxiety, 11, 056. https://doi.org/10.24966/PDA-0150/100056 [Google Scholar] [Crossref]

16. Pipio, A., Romano, R., Sollami, A., Marino, A., Malagò, G., Cavallo, P., Laureti, A., Proietti, M., & Corbara, R. (2026). Impact assessment of structured health coaching intervention on perceived stress and sleep quality. HSOA Journal of Psychiatry, Depression & Anxiety, 12, 065. https://doi.org/10.24966/PDA-0150/100065 [Google Scholar] [Crossref]

17. Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78. https://doi.org/10.1037/0003-066X.55.1.68 [Google Scholar] [Crossref]

18. Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology, 57(1), 1–29. https://doi.org/10.1111/j.1464-0597.2007.00325.x [Google Scholar] [Crossref]

19. Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ, 374, n2061. https://doi.org/10.1136/bmj.n2061 [Google Scholar] [Crossref]

20. Tasali, E., Wroblewski, K., Kahn, E., Kilkus, J., & Schoeller, D. A. (2022). Effect of sleep extension on objectively assessed energy intake among adults with overweight in real-life settings: A randomized clinical trial. JAMA Internal Medicine, 182(4), 365–374. https://doi.org/10.1001/jamainternmed.2021.8098 [Google Scholar] [Crossref]

21. Terwee, C. B., Prinsen, C. A. C., Chiarotto, A., Westerman, M. J., Patrick, D. L., Alonso, J., Bouter, L. M., de Vet, H. C. W., & Mokkink, L. B. (2018). COSMIN methodology for evaluating the content validity of patient-reported outcome measures: A Delphi study. Quality of Life Research, 27(5), 1159–1170. https://doi.org/10.1007/s11136-018-1829-0 [Google Scholar] [Crossref]

22. Weiner, B. J., Lewis, C. C., Stanick, C., Powell, B. J., Dorsey, C. N., Clary, A. S., Boynton, M. H., & Halko, H. (2017). Psychometric assessment of three newly developed implementation outcome measures. Implementation Science, 12, 108. https://doi.org/10.1186/s13012-017-0635-3 [Google Scholar] [Crossref]

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