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Health Promotion Model

Dr. Nola Pender's nursing theory, the Health Promotion Model, helps people reach optimal health by participating in their own health care and making choices that benefit their long-term well-being. Nurses play a crucial role in guiding individuals, families and communities toward the goals of improved health and the prevention of problems before they occur.

Key Concepts

  • People are shaped by their environments, but they also try to create situations in which they can fully express themselves. Life experiences and personal characteristics influence behaviors and relationships with the environment.
  • The environment is the sum of factors that influence life. It can be changed by people to help bring about positive health behaviors and create a beneficial context of triggers for action.
  • The nursing role is to coordinate individuals, families and communities for the purpose of bringing about the best conditions for creating optimal health.
  • Health is the process of actualizing the potential of people by positive behaviors, relationships with others and self-care while making necessary adjustments to the environment.
  • Illnesses and disease are life events that can either help or hinder patients' journeys toward health.


  • Personal characteristics and beliefs influence health-seeking behavior.
  • People will change behaviors if they expect a benefit that is valued by them.
  • There can be barriers to a change in actions.
  • The ability to perform a given action increases the probability that behavior will change.
  • Fewer barriers to health behaviors occur if people believe they are capable of changing.
  • A positive attitude toward a behavior results in a greater ability to change.
  • The likelihood of commitment to changing behavior is increased if positive emotions are linked to the behavior.
  • People are more inclined to change behaviors if others provide support and expect it to happen.
  • Health care providers, families and friends are important influences who can increase or decrease compliance with health changing behaviors.
  • Influences of the environment can increase or decrease compliance with health promoting behaviors.
  • If dedication to change is great, it is likely the health seeking behavior will be long term.
  • Dedication to change is less likely if people have conflicting demands over which they have little control.
  • If other behaviors are more attractive than health promoting behaviors, change is less likely to occur.
  • People can modify situations to produce incentives for behaving in a healthy manner.
Dr. Pender's model not only seeks to improve the overall health of the individual but also of the global population. It emphasizes positive motivation that influences behaviors and provides a framework for research that predicts a lifestyle that leads to optimal health. Behaviors that prevent success are addressed. The physical and social environment that influences human behavior also is considered in this research.

The three main areas that the model addresses are peoples' individual personalities and life experiences, behavior specific perceptions and emotions and the results of behaviors.
  • Individual personalities and experiences include previous behavior and personal biological, psychological, social and cultural influences.
  • Behavior specific perceptions and emotions include perceived benefits and possible deterrents to health-related actions. Interpersonal influences are addressed as well as other situational options and belief in one's capabilities.
  • Behavioral results are influenced by demands, preferences and commitment to actions and health promoting behaviors.
The following factors influence the model's success.
  • People try to create the most favorable living conditions as possible.
  • People are able to assess themselves and discover their strengths.
  • People strive for personal growth.
  • People try to find ways to control their behaviors.
  • People interact with and try to control their environments.
  • Nurses and other health professionals are a crucial part of communities.
  • People are able to change behaviors if needed.
These concepts build on each other and illustrate the fact that maternal health is influenced by many factors. The nature of the newborn affects the identity of motherhood. The psychosocial and emotional needs of newborn cannot be overlooked. The nurse is the primary caregiver and is in the position to provide integrated care and education, especially in the first 12 months of motherhood. The maternal role attainment in the first year of motherhood will have an impact on the entire life of the family.

Publications related to the Health Promotion Model

  • Health Promotion in Nursing Practice (6th Edition)
  • Nursing Theorists and Their Work, 8e
  • Shin, Y.H., Jang, H.J. and Pender, N.J. Psychometric Evaluation of the Exercise Self-Efficacy Scale among Korean Adults with Chronic Diseases, Research in Nursing and Health, 2001
  • Wu, T.Y. and Pender, Nola J. Determinants of Physical Activity among Taiwanese Adolescents: An Application of the Health Promotion Model, Research in Nursing and Health, 2001
  • Garcia, A.W., Pender, Nola .J., Antonakos, C.L. and Ronis, D.L. Changes in Physical Activity Beliefs and Behaviors of Boys and Girls across the Transition to Junior High School, Journal of Adolescent Health, 1998
  • Pender, Nola J. Motivation for Physical Activity among Children and Adolescents in J.Fitzpatrick and J. S. Stevenson, Eds. Annual Review of Nursing Research, 1998
  • Pender, Nola J., Sallis, J. and Long, B.J. Health Care Provider Counseling to Promote Physical Activity in R. K. Dishman, Ed. Advances in Exercise Adherence Champaign, Illinois: Human Kinetics, 1994
  • Pender, Nola J., Walker, S.N., Stromborg, M.F. and Sechrist, K.R. Predicting Health Promoting Lifestyles in the Workplace, Nursing Research, 1990
  • Whitlock, E.P., Orleans, C.T., Pender, Nola J. and Allan, J. Evaluating Primary Care Behavioral Counseling Interventions: An Evidence-Based Approach, American Journal of Preventive Medicine, 2002

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