Health Promotion Theory

1
Health Promotion Theory

• By Yi-Chen Chiu
• 2008

2
Definitions of health

• See handout
• Your definition of health

3
Definitions of health promotion

• See handout
• Your definition of health promotion

4
The challenges of health

• The average life expectancy has increased, the
  number of years of healthy living has declined.
• Considering quality of life
• How to implement health behavior change
  strategies, disease prevention, and health
  promotion interventions.

5
Nursing roles in health promotion

• Nurses as health care coordinators
• Nurse as public health educators
• Therefore, health promotion is defined as the
  combination of educational and ecological
  supports for actions and conditions of living
  conductive to health.

6
Health behavior change

• The process of health education directs people
  toward voluntary changes of their health
  behaviors.
• The social learning theory (SLT)

7
Definition of health behavior

• Health behavior are any activities that an
  individual undertakes to enhance health, prevent
  disease, and detect and control the symptomatic
  stage of a disease.

8
The social learning theory (1)

• The social learning theory is renamed as the
  social cognitive theory.
• Bandura (1997) emphasizes the influence of
  efficacy beliefs and outcome expectations on
  health behavior.

9
Self-efficacy

• Self-efficacy refer to an individuals perception
  of self-competence to perform the behavior
  required to influence outcomes it is a judgment
  of ones ability to carry out a particular course
  of action. it is a judgment of ones ability to
  carry out a particular course of action.
• Self-efficacy is different from outcome
  expectation

10
Outcome expectation

• Outcome expectation Outcome expectation is the
  assumed consequences of action taken. Outcome
  expectations refer to a persons estimate that a
  given behavior will lead to a particular outcome.
  

11
The relationship between self efficacy and
outcome expectation

• Diagram of self-efficacy concept

Person
Behavior
Outcomes
Efficacy belief Level, strength, generality
Outcome expectations Physical, social,
self-evaluation
12
The social learning theory (2)

• Behavior is regulated by its consequences
  (reinforcements)
• Considering the incentive
• Considering the environmental cue

13
Comments on the Social Learning Theory

• Positive and negative reinforcements vs.
  punishment
• Modeling

14
Comments on self-efficacy

• Self-efficacy is a focal determinant
• Self-efficacy shapes the outcomes people expect
  their efforts to produces.

15
Health promotion model (HPM) 1

• See handout for the old vs. revised models
• The HPM is a competence- or approach-oriented
  model.

16
The theoretical basis for the HPM 2

• Expectancy-value theory
• the outcome is of positive personal value
• based on available information, taking this
  course of action is likely to bring about the
  desired outcome.

17
The theoretical basis for the HPM 3

• Expectancy-value theory
• Subjective value of change
• Subjective expectancy of successfully
  obtaining the change or outcome

18
The theoretical basis for the HPM 4

• Social cognitive theory
• an inter-actional model of causation between
  environmental events, personal factors, and
  behavior
• self-observation self-reflection
  self-belief
• Self-belief influences individual behaviors

19
The theoretical basis for the HPM 5

• Self-belief includes self-attribution, self
  evaluation, and self-efficacy.
• Self-efficacy are particularly important.
• Perceived self-efficacy

20
The theoretical basis for the HPM 6

• Social cognitive theory believes that human
  processes the following basic capabilities
• Symbolization
• Forethought
• Vicarious learning

21
The theoretical basis for the HPM 7

• Self-regulation
• Self-reflection

22
Assumptions of the HPM 1

• Persons seek to create conditions of living
  through which they can express their unique human
  health potential.
• Persons have the capacity for reflective
  self-awareness, including assessment of their own
  competencies.
• Persons value growth in direction viewed as
  positive and attempt to achieve a personally
  acceptable balance between change and stability.
• Individuals seek to actively regulate their own
  behavior.

23
Assumptions of the HPM 2

• Individuals in all their biopsychological
  complexity interact with the environment,
  progressively transforming the environment and
  being transformed over time.
• Health professionals constitute a part of the
  interpersonal environment, which exerts influence
  on persons throughout their life span.
• Self-initiated reconfiguration of
  person-environment interactive patterns is
  essential to behavior change.

24
Studies using the HPM

• Health-promoting lifestyles of blue-collar
  workers a multicultural population of 179 cases
• Variables tested importance of health, perceived
  control of health, perceived self-efficacy and
  perceived health status

25
Limitations of HPM

• It is a complex model
• Has not been tested for the whole model (5 to 12
  variables have been studied)

26
Comments on HPM 1

• The behavior-specific variables of perceived
  self-efficacy, benefits and barriers were
  supported as predictors of health behaviors in
  the majority of studies.

27
Comments on HPM 2

• Clarity
• Simplicity
• Generality
• Empirical precision
• Derivable consequences

28
Why to use health-promotion theories?

• They are relatively easy to understand.
• They provide an explanation as to why
  interventions dont always work.
• They provide more readily achievable goals not
  just all or nothing.
• They are applicable to a wide range of behaviors.
• They locate a practitioners input into the
  context of the clients experience.

29
References

• Lucas, K. Lloyd, B. (2005). Health promotion
  evidence and experience. CA Thousand Oaks.