The Health Promotion Model

Health promotion is a prime objective when it comes to promoting health in the community. Health promotion focuses on health-promoting behaviors, disease prevention, rehabilitation and recovery. Health promotion in modern nursing aims to engage a diverse population to select healthy behaviors and make modifications that reduce the risk of developing illnesses and morbidities. Health promotion interventions can benefit people of all ages when it comes to self-care education. The Health Promotion Model (HPM) is proposed as a holistic predictive model of health-promoting behavior for use in research and practice (Aqtum and Darawwad, 2018). This paper will address the origin of the model, primary concepts and relationship statements, review of literature and model critique.

Major concepts of the Health Promotion Model are individual characteristics and experiences, behavior-specific cognitions and affect and behavior outcomes. The Health Promotion Model (HPM) has been used in modern nursing as a guide to explore the biopsychosocial process that motivates individuals to engage in behavior directed towards health enhancement (McEwen and Wills, 2014, p. 229).

Origin of the Model

The Health Promotion Model was designed by Nola J. Pender. Nola Pender began studying health-promoting behaviors in the mid-1970. The Health Promotion Model was first published in 1982 and revised in 1987. The model’s aim was to help nurses educate clients on behaviors such as smoking and drug abuse. The Health Promotion Model was constructed from Feather’s expectancy-value theory which focuses on how individuals engage in actions to achieve goals that are perceived as possible and that result in valued outcomes and Bandura’s social cognitive theory using a nursing perspective which focuses on thoughts, behavior, and environment interact. For people to alter how they behave, they must alter how they think (Pender, 2011). The Health Promotion Model lead to the development of other models such as the Health Promoting Self Care System Model by Susan Simmons and Self Nurturance model by Mary Ann Nemcek according to (Raingruber, 2017). The health promotion model was later modified in the late 1980s and 1996.

Primary Concepts and Relational Statement

Major concepts of the Health Promotion Model are 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), and behavior outcomes(commitment to a plan of action, immediate competing demands and preferences, and health-promoting behavior) (McEwen and Wills, 2014, p. 229). Pender’s model connects many relationships between concepts. Pender’s theory notes that individuals have personal characteristics and experiences that affect subsequent actions. The set of variables for behavior specific knowledge and affect have essential motivational significance. The variables can be modified via nursing actions. Health promoting behavior is the desired behavioral outcome, which makes the goal of the Health Promotion Model. A schematic model is structured with key concepts correlated with the three major concepts as presented below. Review of Literature Most research studies use Pender’s Health Promotion Model as a conceptual framework for studies, for example, Khodaveisi, Afsar, Shima, Soltanian (2017), used the health promotion model to study the effect of Pender’s Health Promotion Model in improving the nutritional behavior of overweight and obese women. The model was used to explain the relationship between several factors including nutritional behavior, personal factors, and behavioral influences on diet and physical activity. The effects confirmed that the Pender’s HPM-based teaching can positively affect and improve the women’s dietary behavior and that Pender’s health promotion theory helped transform the health of the individuals. A current study was done to test the HPM in explaining self-reported adherence and multiple sclerosis (MS) quality of lifestyles among 121 MS patients receiving care in health center. According to (Waines, Lewis, Valvano, Smith, Rahm and Stepleman, 2016), depression and stigma were some of the variables most strongly associated to each adherence and quality of life. Self-efficacy was not significantly related to adherence but was to quality of life. The study showed that HPM may assist to guide strategies used to enhance quality of life among men and women living with MS; however, the model may need similarly refinement to be used with adherence. According to (Aqtum and Darawwad, 2018), an integrative audit was utilized to find studies that were guided by the HPM. Seventeen studies were investigated and most of them were quantitative studies, these studies considered factors from the HPM. Most of the study variables were measured utilizing instruments derived from the HPM. The literature review conducted on various studies showed that Pender’s HPM can be used for conducting studies that predict high-quality benefits/barriers in health-promoting behaviors.

The Health Promotion Model can be very useful, mainly to observe the similarities and variations among groups, and health care providers can use these similarities and differences to assess, become aware of and use high-quality health-promotion programs, techniques, and interventions. Critique the Model According to (Raingruber, 2017), one of the strengths of the HPM is the development of the Health Promoting Lifestyle Profile that was developed to measure the dimensions of health-promoting behaviors. Using Fawcett’s framework for analysis and evaluation, the model was generated from another model and properly defines and explains major concepts that were easily understood. The schematic model was easy to follow, and the theory was testable. The model has been used in different studies, the literature was current and supported by evidence. The model was also used to educate individuals on health-promoting behaviors and the outcomes were measured. The HPM generated other models that have been used to guide nursing research. Pender’s theory has been criticized for focusing on cognitive and perceptual factors as influencing fitness while identifying environmental, situational and interpersonal elements as solely being necessary to the extent that they adjust cognitive and perceptual influences ((Raingruber, 2017). The model has also been criticized for focusing on preventative sickness, established behavioral and lifestyle-oriented concepts of health training paradigm as an alternative than addressing boarder ideas of health promotion paradigm. Using Fawcett’s framework for analysis and evaluation, the model does not define wellness and illness and is limited to health-promoting behaviors rather than disease prevention. The model also uses few concepts to address the health promotion behavior which is very complex, and the research used by Pender to derive the model was based only on the adult population.

Summary

In summary, the model has been revised and modified ever since it was created, due to the fact other researchers have tailored the model to their own study objects, proposing improvements, prompting the model to evolve. The HPM has helped nurses develop health-promoting interventions in order to improve the health of the population. The nurse’s role in health promotion is to assess health-promoting behaviors and educate individuals on strategies that help and improve their overall health. The model has positive outcomes, improved quality of life and patient’s knowledge of their illness and self-management.

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