Health Promotion Model

ABOUT THE THEORIST

Nola J. Pender, PhD,
RN, FAAN - former professor of
nursing at the University of Michigan
Visit her page at University of
Michigan
website: http://www.nursing.umich.edu/fa
culty-staff/nola-j-pender

The model focuses on following three areas:
o Individual characteristics and experiences
o Behavior-specific cognitions and affect
o Behavioral outcomes
The health promotion model notes that each person has
unique personal characteristics and experiences that
affect subsequent actions.
The set of variables for behavioral specific knowledge
and affect have important motivational significance.
These variables can be modified through nursing actions.
Health promoting behavior is the desired behavioral
outcome and is the end point in the HPM.
Health promoting behaviors should result in improved
health, enhanced functional ability and better quality of
life at all stages of development.
The final behavioral demand is also influenced by the
immediate competing demand and preferences, which
can derail an intended health promoting actions.

ASSUMPTIONS OF HEALTH PROMOTION MODEL
1. Individuals seek to actively regulate their own behavior.
2. Individuals in all their biopsychosocial complexity interact with
the environment, progressively transforming the environment
and being transformed over time.
3. Health professionals constitute a part of the interpersonal
environment, which exerts influence on persons throughout
their life span.
4. Self-initiated reconfiguration of person-environment interactive
patterns is essential to behavior change









T HE ORE T I C AL P ROP OS I T I ONS OF T HE
HP M
The HPM is based on the following theoretical propositions:
1. Prior behavior and inherited and acquired characteristics
influence beliefs, affect, and enactment of health-
promoting behavior.
2. Persons commit to engaging in behaviors from which
they anticipate deriving personally valued benefits.
3. Perceived barriers can constrain commitment to action, a
mediator of behavior as well as actual behavior.
4. Perceived competence or self-efficacy to execute a given
behavior increases the likelihood of commitment to action
and actual performance of the behavior.
5. Greater perceived self-efficacy results in fewer perceived
barriers to a specific health behavior.
6. Positive affect toward a behavior results in greater
perceived self-efficacy, which can in turn, result in
increased positive affect.
7. When positive emotions or affect are associated with a
behavior, the probability of commitment and action is
increased.
8. Persons are more likely to commit to and engage in
health-promoting behaviors when significant others
model the behavior, expect the behavior to occur, and
provide assistance and support to enable the behavior.
9. Families, peers, and health care providers are important
sources of interpersonal influence that can increase or
decrease commitment to and engagement in health-
promoting behavior.
10. Situational influences in the external environment can
increase or decrease commitment to or participation in
health-promoting behavior.
11. The greater the commitments to a specific plan of action,
the more likely health-promoting behaviors are to be
maintained over time.
12. Commitment to a plan of action is less likely to result in
the desired behavior when competing demands over
which persons have little control require immediate
attention.
13. Commitment to a plan of action is less likely to result in
the desired behavior when other actions are more
attractive and thus preferred over the target behavior.
14. Persons can modify cognitions, affect, and the
interpersonal and physical environment to create
incentives for health actions.










SIMPLICITY
The HPM simple to understand, the conceptual definitions
provide clarity and lead greater understanding of the complexity
of health behavior phenomena.
GENERALITY
The model is middle range in scope. It is highly generalizable
to adult population. The research use to derive the model was
based on male, female, young, old, well and ill samples. The
research agenda tested to applicability of the model to children,
aged 10 to 16 years ( Robbins, Grenebeck, Kazaris, & Pender
2006). Cultural and diversity considerations support model
testing in diverse population.
EMPIRICAL PRESCISION
The model has been supported through testing by Pender and
others as a framework for explaining health promotions. The
model continues to evolve through planned programs of research.
Continued empirical research, especially intervention studies, will
further refine the model. The Health Promotion Lifestyle Projects
emerged as an instrument used to assess health promoting
behaviors ( Pender et al, 2006
DERIVABLE CONSEQUENCES
Pender has identified health promotion as a goal for the twenty-
first century as disease prevention was a task of twentieth
century.
R E F E R E N C E S : Marriner TA, Raile AM. Nursing theorists and their work. 5th
ed. Sakraida T.Nola J. Pender. The Health Promotion Model. St Louis: Mosby; 2006

SIGNIFICANCE TO:
EDUCATION
The HPM is taught in community health or health promotion and
illness prevention courses at the undergraduate and graduate level
s in most nursing program.
PRACTICE
Health promotion counseling guidelines can be developed for an
entire institution and health promotion systems can be put into pl
ace that focus on HPM variables.
RESEARCH
Research in health promotion has been direction setting for nursin
g research. The HPM synthesizes research findings from nursing,
psychology, and public health into a model of health promoting
behavior that can be empirically tested.
OTHERS:
The HPM has been used and tested in many cultures worldwide.
Examples of countries in which the model has been used include:
Thailand, Japan, Taiwan, China, Mexico, Ecuador, Iran, and Bra
zil.


Prepared by: Michelle Andrea A. Demaguil, RN