FUNDA ACT 1

Activity 1. Concept Map: Models of Health

Due Jan 29
Read on the Models of Health. Select at least 2 and make a concept map of your own. Do not copy
what is in the books oe ebooks. Create your own by giving an example or application in the
healthcare seetings.

Health promotion model

Scenario; A 35 year old man with no prior history of diseases starts to experience signs and
symptoms. Constantly fatigue, headache, being stiff due to sitting all day for work, changes in
weight and metabolism, cannot sleep, and other. He notice that and starts to prescribed himself
some medication without having the knowledge of what is wrong with him. In addition, he lacks
motivation to break his routine in which his routine is to work, sleep, eat, drink, and play games. Few
days later, his health becomes severe with having a fever like cold.

HEALTH BELIEF MODEL

The Health Belief Model (HBM) is a tool that scientists use to try to predict health behaviors. The
model is based on the theory that a person's willingness to change their health behaviors primarily
comes from their health perceptions.

According to this model, your individual beliefs about health and health conditions play a role in
determining your health-related behaviors. Key factors that affect your approach to health include:

Any barriers you think might be standing in your way

Exposure to information that prompts you to take action
How much of a benefit you think you'll get from engaging in healthy behaviors
How susceptible you think you are to illness
What you think the consequences will be of becoming sick
Your confidence in your ability to succeed

There are six main components of the Health Belief Model. Four of these constructs were main
tenets eeof the theory when it was first developed. Two were added in response to research on the
model related to addiction.

Perceived Severity
The probability that a person will change their health behaviors to avoid a consequence depends on
how serious they believe the consequences will be. For example:

If you are young and in love, you are unlikely to avoid kissing your sweetheart on the mouth just
because they have the sniffles and you might get their cold. On the other hand, you probably would
stop kissing if it might give you a more serious illness.
Similarly, people are less likely to consider condoms when they think STDs are a minor
inconvenience. That's why receptiveness to messages about safe sex increased during the AIDS
epidemic. The perceived severity increased enormously.
The severity of an illness can have a major impact on health outcomes. However, a number of
studies have shown that perceived risk of severity is actually the least powerful predictor of
whether or not people will engage in preventive health behaviors.2

Perceived Susceptibility
People will not change their health behaviors unless they believe that they are at risk. For example:

Individuals who do not think they will get the flu are less likely to get a yearly flu shot.
People who think they are unlikely to get skin cancer are less likely to wear sunscreen or limit sun
exposure.
Those who do not think that they are at risk of acquiring HIV from unprotected intercourse are less
likely to use a condom.
Young people who don't think they're at risk of lung cancer are less likely to stop smoking.
Research suggests that perceived susceptibility to illness is an important predictor of preventive
health behaviors.2

Perceived Benefits
It's difficult to convince people to change a behavior if there isn't something in it for them. People
don't want to give up something they enjoy if they don't also get something in return. For example:

A person probably won't stop smoking if they don't think that doing so will improve their life in some
way.
A couple might not choose to practice safe sex if they don't see how it could make their sex life
better.
People might not get vaccinated if they do not think there is an individual benefit for them.
These perceived benefits are often linked to other factors, including the perceived effectiveness of
a behavior. If you believe that getting regular exercise and eating a healthy diet can prevent heart
disease, that belief increases the perceived benefits of those behaviors.

Perceived Barriers
One of the major reasons people don't change their health behaviors is that they think doing so is
going to be hard. Changing health behaviors can require effort, money, and time. Commonly
perceived barriers include:

Amount of effort needed

Danger
Discomfort
Expense
Inconvenience
Social consequences
Sometimes it's not just a matter of physical difficulty, but social difficulty as well. For example, If
everyone from your office goes out drinking on Fridays, it may be very difficult to cut down on your
alcohol intake. If you think that condoms are a sign of distrust in a relationship, you may be hesitant
to bring them up.

Perceived barriers to healthy behaviors have been shown to be the single most powerful predictor
of whether people are willing to engage in healthy behaviors.2

When promoting health-related behaviors such as vaccinations or STD prevention, finding ways to
help people overcome perceived barriers is important. Disease prevention programs can often do
this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs.

Cues to Action
One of the best things about the Health Belief Model is how realistically it frames people's
behaviors. It recognizes the fact that sometimes wanting to change a health behavior isn't enough
to actually make someone do it.

Because of this, it includes two more elements that are necessary to get an individual to make the
leap. These two elements are cues to action and self-efficacy.

Cues to action are external events that prompt a desire to make a health change. They can be
anything from a blood pressure van being present at a health fair, to seeing a condom poster on a
train, to having a relative die of cancer. A cue to action is something that helps move someone from
wanting to make a health change to actually making the change.

Self-Efficacy
Self-efficacy wasn't added to the model until 1988. Self-efficacy looks at a person's belief in their
ability to make a health-related change. It may seem trivial, but faith in your ability to do something
has an enormous impact on your actual ability to do it.

Finding ways to improve individual self-efficacy can have a positive impact on health-related
behaviors. For example, one study found that women who had a greater sense of self-efficacy
toward breastfeeding were more likely to nurse their infants longer. The researchers concluded that
teaching mothers to be more confident about breastfeeding would improve infant nutrition.3

Thinking that you will fail will almost make certain that you do. Self-efficacy has been found to be
one of the most important factors in an individual's ability to successfully negotiate condom use.4

Key elements of the Health Belief Model focus on individual beliefs about health conditions, which
predict individual health-related behaviors. The model defines the key factors that influence health
behaviors as an individual's perceived threat to sickness or disease (perceived susceptibility), belief
of consequence (perceived severity), potential positive benefits of action (perceived benefits),
perceived barriers to action, exposure to factors that prompt action (cues to action), and
confidence in ability to succeed (self-efficacy).

Health Belief Model Examples

The Michigan Model for Health™ is a curriculum designed for implementation in schools. It focuses
on social and emotional health challenges including nutrition, physical activity, alcohol and drug
use, safety, and personal health, among other topics. This model adapts components of the Health
Belief Model related to knowledge, skills, self-efficacy, and environmental support.

Considerations for Implementation

The Health Belief Model can be used to design short- and long-term interventions. The five key
action-related components that determine the ability of the Health Belief Model to identify key
decision-making points that influence health behaviors are:

Gathering information, by conducting a health needs assessment and other approaches, to

determine who is at risk and the population(s) of focus.
Conveying the consequences of risk behaviors clearly to understand perceived severity.
Communicating the steps involved in taking the recommended action and highlighting the benefits
to action.
Helping to identify and reduce barriers to action.
Demonstrating actions through skill development activities and providing support to enhance self-
efficacy and the likelihood of successful behavior changes.
These actions represent key elements of the Health Belief Model and can be used to design or
adapt health promotion or disease prevention programs. The Health Belief Model is appropriate to
be used alone or in combination with other theories or models. To ensure success with this model, it
is important to identify “cues to action” that are meaningful and appropriate for the intended
population.

https://www.ruralhealthinfo.org/toolkits/health-promotion/2/theories-and-models/health-belief
https://www.verywellmind.com/health-belief-model-3132721

The Health Belief Model is a theoretical model that can be used to guide health promotion and
disease prevention programs. It is used to explain and predict individual changes in health
behaviors. It is one of the most widely used models for understanding health behaviors.

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 effect 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 development stages. The final behavioral
demand is also influenced by the immediate competing demand and preferences, which can derail
intended health-promoting actions.

The Health Promotion Model was designed to be a “complementary counterpart to models of health
protection.” It develops to incorporate behaviors for improving health and applies across the life
span. Its purpose is to help nurses know and understand the major determinants of health behaviors
as a foundation for behavioral counseling to promote well-being and healthy lifestyles.

Pender’s health promotion model defines health as “a positive dynamic state not merely the
absence of disease.” Health promotion is directed at increasing a client’s level of well-being. It
describes the multi-dimensional nature of persons as they interact within the environment to pursue
health.

The model focuses on the following three areas: individual characteristics and experiences,
behavior-specific cognitions and affect, and behavioral outcomes.
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 illness constraints.

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 are categorized as biological, psychological, and socio-cultural. These factors are
predictive of a given behavior and shaped by the target behavior’s nature 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, self-motivation, 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
The 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 behavior’s performance.

Activity-Related Affect
Subjective positive or negative feeling 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 its efficacy. In turn, increased feelings of efficacy can generate a
further positive affect.

Interpersonal Influences
Cognition concerning behaviors, beliefs, or attitudes of 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 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 of 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 directed toward attaining positive
health outcomes such as optimal wellbeing, personal fulfillment, and productive living.

Major Assumptions in Health Promotion Model

Individuals seek to regulate their own behavior actively.
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 influences persons
throughout their life span.
Self-initiated reconfiguration of person-environment interactive patterns is essential to behavior
change.

The Health Promotion Model was designed by Nola J. Pender to be a “complementary counterpart
to models of health protection.” It defines health as a positive dynamic state rather than simply the
absence of disease. Health promotion is directed at increasing a patient’s level of well-being. The
health promotion model describes the multidimensional nature of persons as they interact within
their environment to pursue health.

Pender’s model focuses on three areas: individual characteristics and experiences, behavior-
specific cognitions and affect, and behavioral outcomes. The theory notes that each person has
unique personal characteristics and experiences that affect subsequent actions. The set of
variables for behavior specific knowledge and affect have important motivational significance. The
variables can be modified through nursing actions. Health promoting behavior is the desired
behavioral outcome, which makes it the end point in the Health Promotion Model. These 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 actions for promoting health.

The Health Promotion Model makes four assumptions:

Individuals seek to actively regulate their own behavior.

Individuals, in all their biopsychosocial complexity, interact with the environment, progressively
transforming the environment as well as being transformed over time.
Health professionals, such as nurses, constitute a part of the interpersonal environment, which
exerts influence on people through their life span.
Self-initiated reconfiguration of the person-environment interactive patterns is essential to
changing behavior.

There are thirteen theoretical statements that come from the model. They provide a basis for
investigative work on health behaviors. The statements are:
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.
Persons can modify cognitions, affect, and the interpersonal and physical environment to create
incentives for health actions.

The major concepts of the Health Promotion Model are individual characteristics and experiences,
prior behavior, and the frequency of the similar behavior in the past. Direct and indirect effects on
the likelihood of engaging in health-promoting behaviors.

Personal factors are 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.
Biological personal factors include variables such as age gender body mass index pubertal status,
aerobic capacity, strength, agility, or balance. Psychological personal factors include variables such
as self esteem self motivation personal competence perceived health status and definition of
health. Socio-cultural personal factors include variables such as race ethnicity, accuculturation,
education and socioeconomic status.

Perceived benefits of action are the anticipated positive outcomes that will occur from health
behavior. Perceived barriers to action are anticipated, imagined, or real blocks and costs of
understanding a given behavior. Perceived self-efficacy is the judgment or personal capability to
organize and execute a health-promoting behavior. Perceived self efficacy influences perceived
barriers to action so higher efficacy result in lowered perceptions of barriers to the performance of
the behavior.

Activity-related affect is defined as the subjective positive or negative feeling that occurs based on
the stimulus properties of the behavior itself. They influence self-efficacy, which means the more
positive the subjective feeling, the greater the feeling of efficacy. In turn, increased feelings of
efficacy can generate further positive affect.

Interpersonal influences are 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 are personal perceptions and cognitions that can facilitate or impede
behavior. They include perceptions of options available, as well as 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.

Within the behavioral outcome, there is a commitment to a plan of action, which is the concept of
intention and identification of a planned strategy that leads to implementation of health behavior.
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 behavior over which individuals exert relatively high control.

Health-promoting behavior is the endpoint or action outcome directed toward attaining a positive
health outcome such as optimal well-being, personal fulfillment, and productive living.

https://nurseslabs.com/nola-pender-health-promotion-model/#h-what-is-health-promotion-model

https://www.ruralhealthinfo.org/toolkits/health-promotion/2/theories-and-models/health-belief
https://nursing-theory.org/theories-and-models/pender-health-promotion-model.php

https://digital.sandiego.edu/cgi/viewcontent.cgi?article=1223&context=dnp

https://www.coursesidekick.com/nursing/898778

https://www.coursesidekick.com/psychology/1843710

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/85350/
HEALTH_PROMOTION_MANUAL_Rev_5-2011.pdf

https://www.coursehero.com/file/201103326/THE-HEALTH-PROMOTION-MODELdocx/