What is the Health Promotion Model?

Have you ever seen posters that advocate eating healthy or exercising daily? Have you seen announcements about screening blood pressure, cholesterol or stress in a pharmacy or hospital? These are examples of Health Promotion.

Proposed by Nola J. Pender, Health Promotion model describes the multidimensional nature of people as they interact within their environment to pursue health and wellbeing. It is directed at increasing an individual’s level of wellbeing. This model defines health as a positive dynamic state and not just the absence of disease. It is a process of empowering people to make healthy lifestyle choices.

The model focuses on 3 areas- 

1. Individual characteristics and experience – every individual has unique characteristics and experiences that affect subsequent actions.
2. Behaviour specific cognitions and affect – The set of variables for behaviour specific knowledge and effect have motivational significance. They can be modified through nursing actions.
3. Behavioural outcomes – the desired behavioural outcome is Health-promoting behaviour. Such behaviours should result in better quality life, improved health and better functional abilities.

Pender’s model includes a decision-making phase and an action phase.

• Decision-making phase includes individual perceptions and modifying factors.

Self-awareness, self-esteem, the significance of health to a person, an individual’s definition of health and perceived health status come under individual perceptions.

Demographic variables (age, gender, race) interpersonal variables (family patterns, interaction with health professionals and situational variables(prior experience with health promotion) come under modifying factors.

• The action plan includes perceived barriers to actions and the likelihood of taking health promotion actions.

Cost, unavailability and inconvenience are the perceived barriers

Why the Health Promotion Model model used?

This model is used in program planning, in order to understand and explain health behaviour and help in identification and implementation of interventions.

Theoretical propositions

1. Prior behaviour and personal factors influence beliefs and affect the enactment of health-promoting behaviour.
2. Individuals engage in behaviours from which they derive valued benefits.
3. Perceived barriers can restrict commitment to action and behaviour.
4. Self-competence to implement a behaviour increases the likelihood of commitment to action.
5. Higher perceived self-efficacy results in higher limited perceived barriers.
6. Significant others like family, friends and health care providers are sources of interpersonal influence that can increase or reduce the health-promoting behaviours.
7. Situational influences can increase or decrease health-promoting behaviours.

Strengths and weaknesses

Strengths – 

• The Health Promotion Model is complex in structure but easy to understand.
• The Health Promoting Lifestyle Profile scale was developed to measure health-promoting behaviours like health responsibility, exercise, nutrition, self-actualization and stress management.
• It is applicable in a community health setting.

Weaknesses – 

• It focuses only on disease centred, behavioural and lifestyle concepts of health education rather than broader concepts of health promotion.
• Very little attention was given to sociopolitical or economic context.

The Health Promotion Model focused on cognitive and perceptual factors as influencing health while environmental, situational and interpersonal factors were only important if they modified cognitive and perceptual factors.