NURS 2011 Health Promotion Model PDF

NURS 2011 Health Promotion Model Dr P Siewdass Review Three questions that can help persons and organizations assess the degree to which wellness is incorporated into a particular approach or program: Does this help people achieve their full potential? Does this recognize and address the whole perso...

NURS 2011 Health Promotion Model Dr P Siewdass Review Three questions that can help persons and organizations assess the degree to which wellness is incorporated into a particular approach or program: Does this help people achieve their full potential? Does this recognize and address the whole person (multidimensional approach)? Does this affirm and mobilize peoples' positive qualities and strengths? HPM Dr. Nola Pender developed the Health Promotion Model (HPM) that is used universally for research, education, and practice. Pender’s health promotion model (HPM) is one of the widely used models to plan for and change unhealthy behaviors and promote health The health promotion model focuses on helping people achieve higher levels of well-being. It encourages health professionals to provide positive resources to help patients achieve behavior specific changes. The goal of the HPM Is NOT just about helping patients prevent illness through their behavior, But to look at ways in which a person can pursue better health or ideal health. Four Assumptions of HPM Individuals seek to control their own behavior. Individuals work to improve themselves and their environment. Health professionals, such as nurses and doctors, comprise the interpersonal environment, which influences individual behaviors. Self-initiated change of individual and environmental characteristics is essential to changing behavior. Theory of Health Promotion A theory presents a systematic way of understanding events. It is a set of concepts, definitions, and propositions that explain such events by demonstrating the relationships between variables. The theory behind the HPM is that you have personal experiences that affect your actions. Theory of Health Promotion There are three main focuses of the HPM: - individual experiences, - behavior-specific knowledge and affect, - and behavioral outcomes. Theory of Health Promotion The factors that are associated with the HPM are mainly an :- individual's lifestyle, - outlook, - psychological health, - social and cultural traits, - biological factors. Health-promoting behavior is the ideal behavioral outcome, making it the end point in the HPM. 13 theoretical statements that come from the model. 1. Prior behavior and inherited and acquired characteristics influence beliefs, affect, and enactment of health-promoting behavior. 2. Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits. 3. Perceived barriers can constrain commitment to action, a mediator of behavior as well as actual behavior. 4. Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior 13 theoretical statements that come from the model 5. Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior. 6. Positive affect toward a behavior results in greater perceived selfefficacy, which can in turn, result in increased positive affect. 7. When positive emotions or affect are associated with a behavior, the probability of commitment and action is increased. 13 theoretical statements that come from the model 8.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. 9. 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. 10. Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior. 13 theoretical statements that come from the model 11. The greater the commitments to a specific plan of action, the more likely health-promoting behaviours are to be maintained over time. 12. 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. 13. Persons can modify cognitions, affect, the interpersonal and physical environment to create incentives for health actions. The major concepts of the HPM 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. HPM 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. HPM 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. HPM 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. HPM 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. HPM 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. HPM 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 HPM 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. Diffusion of Innovation The diffusion of innovations theory was developed by E.M. Rogers, a communication theorist at the University of New Mexico, in 1962. The theory explains the passage of a new idea through stages of adoption by different people who participate in or begin using the new idea. The diffusion of innovations theory Was developed in part by integrating previous sociological theories of behavioral change. Factors that affect the rate of innovation diffusion include: The mix of rural to urban within a society's population, The society's level of education, And the extent of industrialization and development. Different societies are likely to have different adoption rates The main people in the diffusion of innovations theory are: Innovators: Those who are open to risks and the first to try new ideas- Technology Enthusiasts Early adopters: People who are interested in trying new technologies and establishing their utility in society- Visionaries Early majority: Those who pave the way for the use of an innovation within mainstream society and are part of the general population - Pragmatist Late majority: People who follow the early majority into adopting the innovation as part of their daily life and are also part of the general population- Conservatives Laggards: People who lag the general population in adopting innovative products and new ideas- Skeptics Five Stage Adoption Process Knowledge or Awareness Stage- Individual is exposed to innovation but lacks complete information Persuasion or Interest Stage - Individual becomes interested in the new idea and seeks additional information Decision or Evaluation Stage- Individual mentally applies innovation to his present and anticipated future situation, and then decides whether to try it Implementation or Trial Stage- Individual makes full use of innovation Confirmation or Adoption Stage - Individual decides to continue the full use of innovation Innovation Characteristics Observability - The degree to which the results of an innovation are visible to potential adopters Trialability - The degree to which the innovation can be experienced on a limited basis Relative Advantage- The degree to which the innovation is perceived to be superior to current practice Compatibility - The degree to which the innovation is perceived to be consistent with socio-cultural values, previous ideas, and/or perceived needs Complexity - The degree to which an innovation is difficult to use or understand, its simplicity. Re-invention basically refers to the degree that an innovation is changed or modified as the adoption and implementation process is enacted Communication Channels Refers to the rate and degree that people talk about and spread the news about the innovations. 2 major communication channels were described by Rogers: 1. Mass Media Channels - These are effective in creating knowledge about the innovation E.g. System related videos or DVDs, or television commercials within the mainstream media 2. Interpersonal Channels-Person to person communication is very effective in changing people’s attitudes about the innovation which ultimately influences their decision to accept or reject the innovation. - Peer subjective evaluations of an innovation are very influential. Time is involved in three distinct dimensions of the innovation process 1. Innovation Adoption Process – including first knowledge of the innovation through to final acceptance or rejection of its utility and ultimate implementation, as discussed earlier. 2. Innovation Adopter Categories – time is also critical within the five adopter categories and how they influence one another to support full saturation of the innovation. 3. Rate of Adoption – time is also involved when looking at the ultimate rate of adoption within an organization, from start to finish, and how many people of the total population have adopted the innovation. - This rate of adoption is influenced by the innovation characteristics introduced above. Benefits The Diffusion of Innovation theory is a very important theory that can serve health care professionals and change agents well. The theory also benefits the targets of change, since respect and consideration for all involved stakeholders is intertwined with robust strategies for implementing innovative change.T Limitations of Diffusion of Innovation Theory It does not foster a participatory approach to adoption of a public health program. It works better with adoption of behaviors rather than cessation or prevention of behaviors. It doesn't consider an individual's resources or social support to adopt the new behavior (or innovation). References Diane Dormant, Joe Lee · (2011). The chocolate model of change. Al-Suqri, Mohammed Nasser · (2015). Information Seeking Behavior and Technology Adoption Kaminski, J. (Spring 2011).Diffusion of Innovation Theory Canadian Journal of Nursing Informatics, 6(2). Theory in Nursing Informatics Column. https://cjni.net/journal/?p=1444