HEALTH EDUCATION Sub concepts of the Health Promotion

Model
Theories in Health Education
1. Personal Factors
Nola Pender’s Health Promotion Model
• Categorized as biological,
• Proposed by Nola J. Pender and was psychological and socio-cultural
designed to be a “complementary
• Predictive of a given behavior
counterpart to models of health
and shaped by the nature of the
protection.”
target behavior being
• It is directed at increasing a client’s level considered.
of wellbeing.
 Personal biological
• “Health promotion is the science and factors include
art of helping people change their variables such as age,
lifestyle to move toward a state of gender, body mass
optimal health”. index, pubertal status
strength, agility.

 Personal psychological
Focuses on the three areas: factors include
variables such as self-
1. Individual characteristics and
esteem, self-
experiences (prior related behavior and
motivation, personal
personal factors)
competence, perceived
2. Behaviour-specific cognitions and affect health status, and
(perceived benefit of action, perceived definition of health.
barrier to action, perceived self-efficacy,
 Personal socio-cultural
activity-related affect, interpersonal and
factors include
situational influences)
variables such as race,
3. Behavioural outcomes (commitment to ethnicity, acculturation,
plan of action, immediate competing education, and
demands, and preferences and health- socioeconomic status.
promoting behaviour.

2. Perceived Benefits of Action -

Anticipated positive outcomes that will
occur from health behavior.

3. Perceived Barriers to Action -

Anticipated, imagined or real blocks and
 personal costs of understanding a given
behavior.
4. 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.
5. Activity-Related Affect
1. Subjective positive or negative
feeling that occurs before,
during and following behavior
based on the stimulus
properties of the behavior
itself.
2. 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.
6. Interpersonal Influences
1. 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.
7. Situational Influences
1. 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.
8. Commitment to Plan of Action
• The concept of intention and
identification of a planned
strategy leads to the
implementation of health
behavior
9. 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

10. 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.
• 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 behaviors
should result in improved
health, enhanced functional
ability and better quality of life
at all stages of development.
Major 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 lifespan.
Bandura’s Self-Efficacy Theory
• Self-efficacy theory was originated from
Social Cognitive theory by Alberta
Bendura
• Self-efficacy is the belief that one has
the power to produce that effect by
completing a given task or activity
related to that competency
• Self-efficacy relates to a person’s
perception of their ability to reach a
goal
• It is the belief that one is capable of
performing in a certain manner to attain
certain goals.
• It is the expectation that one can
master a situation, and produce a
positive outcome.
• Self-efficacy is an important concept in
positive psychology.
• Bandura’s Social Cognitive Model says
that there are 3 factors that influence
self-efficacy:
 Behaviors
 Environment, and
 Personal/cognitive factors
• They all effect each other, but the
cognitive factors are important.
 • Self-efficacy and self-esteem are
different concepts, but related.
• Self-efficacy relates to a person’s
perception of their ability to reach a
goal, whereas self-esteem relates to a
person’s sense of self-worth.
• Self-efficacy is the most important
precondition for behaviour change.
• Self-efficacy plays a major role in how
goals, tasks, and challenges are
approached
People with a strong sense of self-eficicacy:
• Develop deeper interest in the
activities in which they
participate
• Form a stronger sense of
commitment to their interests
and activities
• Recover quickly from setbacks
and disappointments
• View challenging problems as
tasks to be mastered.
People with weak sense of self-efficacy:
• Avoid challenging tasks
• Believe that difficult tasks and situations
are beyond their capabilities
• Focus on personal failings and negative
outcomes
• Quickly lose confidence in personal
abilities.
Four Major Sources
1. Mastery Experiences 
• The most effective way of
developing a strong sense of
efficacy is through mastery
experiences
• Performing a task successfully
strengthens sense of self-
efficacy
• Failing to adequately deal with
a task or challenge can
undermine and weaken self-
efficacy
2. Social Modeling 
• Witnessing other people
successfully completing a task is
another important source of
self-efficacy
• Seeing people similar to oneself
succeed by sustained effort
raises observers' beliefs that
they too possess the
capabilities to master
comparable activities to
succeed
3. Social Persuasion 
• Bandura also asserted that
people could be persuaded to
believe that they have the skills
and capabilities to succeed.
 • Something positive and
encouraging can help achieve a
goal
• Getting verbal encouragement
from others helps people
overcome self-doubt and
instead focus on giving their
best effort to the task at hand
4. Psychological Responses 
• Our own responses and
emotional reactions to
situations also play an
important role in self-efficacy
• Moods, emotional states,
physical reactions, and stress
levels can all impact how a
person feels about their
personal abilities in a particular
situation
• For example a person who
becomes extremely nervous
before speaking in public may
develop a weak sense of self-
efficacy in these situations
Health Belief Model
• The Health Belief Model (HBM) is one of
the first theories of health behavior.
• HBM is a good model for addressing
problem behaviors that evoke health
concerns (e.g., high-risk sexual behavior
and the possibility of contracting HIV)
The health belief model proposes that a
person's health-related behavior depends on
the person's perception of four critical areas:
• the severity of a potential
illness,
• the person's susceptibility to
that illness,
• the benefits of taking a
preventive action, and
• the barriers to taking that
action.
• HBM is applied in nursing,
especially in issues focusing on
patient compliance and
preventive health care
practices.
• The model postulates that
health-seeking behaviour is
influenced by a person’s
perception of a threat posed by
a health problem and the value
associated with actions aimed
at reducing the threat.
• HBM addresses the relationship
between a person’s beliefs and
behaviors.
• It provides a way to
understanding and predicting
how clients will behave in
relation to their health and how
they will comply with health
care therapies.