NOLA PENDER’S HEALTH PROMOTION MODEL

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 endpoint in the Health
Promotion Model. 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 intended health-
promoting actions.

Propositions

 Prior behavior and inherited and acquired characteristics influence beliefs, affect, and enactment of
health-promoting behavior.
 Persons commit to engaging in behaviors from which they anticipate deriving personally valued
benefits.
 Perceived barriers can constrain commitment to action, a mediator of behavior as well as actual
behavior.
 Perceived competence or self-efficacy to execute a given behavior increases the likelihood of
commitment to action and actual performance of the behavior.
 Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior.
 Positive affect toward a behavior results in greater perceived self-efficacy, which can, in turn, result
in increased positive affect.
 When positive emotions or affect are associated with a behavior, the probability of commitment
and action is increased.
 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.
 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.
 Situational influences in the external environment can increase or decrease commitment to or
participation in health-promoting behavior.
 The greater the commitments to a specific plan of action, the more likely health-promoting
behaviors are to be maintained over time.
 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. 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.
 Persons can modify cognitions, affect, and the interpersonal and physical environment to create
incentives for health actions.

Major Assumptions in Health Promotion Model

 Individuals seek to actively regulate their own behavior.
 Individuals in all their biopsychosocial complexity interact with the environment, progressively
transforming the environment and being transformed over time.
 Health professionals constitute a part of the interpersonal environment, which exerts influence on
persons throughout their life span.
 Self-initiated reconfiguration of person-environment interactive patterns is essential to behavior
change.
Major Concepts of the Health Promotion Model

Health promotion is defined as behavior motivated by the desire to increase well-being and actualize
human health potential. It is an approach to wellness. On the other hand, health protection or illness
prevention is described as behavior motivated desire to actively avoid illness, detect it early, or
maintain functioning within the constraints of illness.

Individual characteristics and experiences (prior related behavior and personal factors).

Behavior-specific cognitions and affect (perceived benefits of action, perceived barriers to

action, perceived self-efficacy, activity-related affect, interpersonal influences, and situational
influences).

Behavioral outcomes (commitment to a plan of action, immediate competing demands and

preferences, and health-promoting behavior).

Subconcepts of the Health Promotion Model

Personal Factors
Personal factors categorized as biological, psychological and socio-cultural. These factors are predictive
of a given behavior and shaped by the nature of the target behavior being considered.

Personal biological factors. Include variables such as age gender body mass index pubertal
status, aerobic capacity, strength, agility, or balance.

Personal psychological factors. Include variables such as self-esteem, selfmotivation, personal

competence, perceived health status, and definition of health.

Personal socio-cultural factors. Include variables such as race, ethnicity, acculturation,

education, and socioeconomic status.

Perceived Benefits of Action

Anticipated positive outcomes that will occur from health behavior.

Perceived Barriers to Action

Anticipated, imagined or real blocks and personal costs of understanding a given behavior.

Perceived Self-Efficacy
Judgment of personal capability to organize and execute a health-promoting behavior. Perceived self-
efficacy influences perceived barriers to action so higher efficacy results in lowered perceptions of
barriers to the performance of the behavior.

Activity-Related Affect
Subjective positive or negative feeling that occurs before, during and following behavior based on the
stimulus properties of the behavior itself.

Activity-related affect influences perceived self-efficacy, which means the more positive the subjective
feeling, the greater the feeling of efficacy. In turn, increased feelings of efficacy can generate a further
positive affect.
Interpersonal Influences
Cognition concerning behaviors, beliefs, or attitudes of the others. Interpersonal influences include
norms (expectations of significant others), social support (instrumental and emotional encouragement)
and modeling (vicarious learning through observing others engaged in a particular behavior). Primary
sources of interpersonal influences are families, peers, and healthcare providers.

Situational Influences
Personal perceptions and cognitions of any given situation or context that can facilitate or impede
behavior. Include perceptions of options available, demand characteristics and aesthetic features of the
environment in which given health promoting is proposed to take place. Situational influences may
have direct or indirect influences on health behavior.

Commitment to Plan of Action

The concept of intention and identification of a planned strategy leads to the implementation of health
behavior

Immediate Competing Demands and Preferences

Competing demands are those alternative behaviors over which individuals have low control because
there are environmental contingencies such as work or family care responsibilities. Competing
preferences are alternative behaviors over which individuals exert relatively high control, such as
choice of ice cream or apple for a snack

Health-Promoting Behavior
A health-promoting behavior is an endpoint or action outcome that is directed toward attaining
positive health outcomes such as optimal wellbeing, personal fulfillment, and productive living.