1. Copyright © 2008 Delmar. All rights reserved. Chapter 13 Principles of Health Promotion

2. Copyright © 2008 Delmar. All rights reserved. 2 Healthy People 2010 Health of the total population and the consequences of the determinants of health: –Biology –Behavior –Social environment –Physical environment –Policies –Intervention

3. Copyright © 2008 Delmar. All rights reserved. 3 Healthy People 2010 Policies Intervention

4. Copyright © 2008 Delmar. All rights reserved. 4 Holistic Concept of Health Nursing and public health view of health as a holistic concept –Encompasses Physical Psychological Social Spiritual dimension

5. Copyright © 2008 Delmar. All rights reserved. 5 Smith Model of Health Four models: 1.Clinical health 2.Role performance health 3.Adaptive health 4.Eudaemonic health

6. Copyright © 2008 Delmar. All rights reserved. 6 Pender Actualization of inherent and acquired human potential through –Goal directed behavior –Competent self care –Satisfying relationships while maintaining structural integrity with environments

7. Copyright © 2008 Delmar. All rights reserved. 7 Health Promotion History WHO Ottawa Charter Multidisciplinary practice Florence Nightingale (1859) wellness- illness continuum –Promoted health through education –Nursing care included personal living and healthful environments

8. Copyright © 2008 Delmar. All rights reserved. 8 Health Promotion History Nursing’s meta-paradigm –Person Environment –Health Nursing

9. Copyright © 2008 Delmar. All rights reserved. 9 Health Promotion History 1973 –ANA Standards of Nursing Practice 1979 –Healthy People: Surgeon General’s Report on Health Promotion and Disease

10. Copyright © 2008 Delmar. All rights reserved. 10 Theoretical Foundations Behavioral Model –Behavior is a function of the rational decision making process –Lewin Positive valence Negative valence Value expectancy theory

11. Copyright © 2008 Delmar. All rights reserved. 11 Health Belief Model Based on value expectancy theory Rosenstock (1966) added variables to the model –Variables that explain or predict behavior: Susceptibility Severity Barriers Cues to action

12. Copyright © 2008 Delmar. All rights reserved. 12 Pender’s Health Promotion Model Pender modified the Health Belief Model Integrates concepts from HBM and social cognitive theory Revised in 2002

13. Copyright © 2008 Delmar. All rights reserved. 13 Pender’s Health Promotion Model Concepts grouped in three major categories: 1. Individual characteristics and experiences Prior-related behavior Personal factors

14. Copyright © 2008 Delmar. All rights reserved. 14 Pender’s Health Promotion Model Concepts grouped in three major categories 2. Behavior-specific cognitions and affect Perceived benefits Perceived barriers to the action

15. Copyright © 2008 Delmar. All rights reserved. 15 Pender’s Health Promotion Model Concepts grouped in three major categories 3. Perceived self-efficacy Activity related affect Interpersonal influences Situational influences –Behavioral outcome

16. Copyright © 2008 Delmar. All rights reserved. 16 Theory of Planned Behavior Extension of the theory of reasoned action Intention Attitude Subjective norm Perceived behavioral control Outcome expectancy

17. Copyright © 2008 Delmar. All rights reserved. 17 Transtheoretical Model of Behavioral Change Individuals progress through stages during behavioral change process –Precontemplation stage –Contemplation stage –Preparation stage –Action stage –Maintenance stage

18. Copyright © 2008 Delmar. All rights reserved. 18 Transtheoretical Model of Behavioral Change Three constructs that influence behavior change: 1.Process of change 2.Self-efficacy 3.Decisional change

19. Copyright © 2008 Delmar. All rights reserved. 19 Ecological Models Social Cognitive Theory –Triadic reciprocal determinism –Outcome expectancies

20. Copyright © 2008 Delmar. All rights reserved. 20 Ecological Models Bandura self-efficacy expectations –Developed from four sources of information: 1.Enactive attainment 2.Vicarious experiences 3.Verbal persuasion 4.Physiological or emotional arousal

21. Copyright © 2008 Delmar. All rights reserved. 21 Ecological Models Ecological model of health behavior –Five system levels 1.Intrapersonal 2.Interpersonal 3.Organizational 4.Community 5.Public policy

22. Copyright © 2008 Delmar. All rights reserved. 22 Other Ecological Frameworks Integrative Model for Community Health Promotion and the Structural Model of Health Behavior (SMHB) –Three foci of care: Illness/disease prevention Health promotion Illness care

23. Copyright © 2008 Delmar. All rights reserved. 23 Other Ecological Frameworks SMHB includes four factors that influence health at the population level –Availability/accessibility of consumer products –Physical structures –Social structures and policies –Media and cultural messages

24. Copyright © 2008 Delmar. All rights reserved. 24 Focus on Population Emphasis is on lowering the average risk of all individuals in the community Three approaches: 1.Framework for health communication programs 2.PRECEDE-PROCEED model 3.Social Marketing

25. Copyright © 2008 Delmar. All rights reserved. 25 Social Marketing Uses marketing strategies to create an advantage for changing behavior –Three concepts: Audience segmentation Marketing 4 Ps Marketing mix