The Health Promotion Model (HPM) is a framework designed to understand and predict why people engage in health-promoting behaviors throughout their lives. Developed by nursing theorist Nola Pender in 1982, the model provides a structure for examining the complex factors that influence an individual’s motivation to pursue better health. The HPM is widely used by healthcare professionals for research, education, and practice to help individuals make changes. This framework shifts the focus from avoiding illness to actively seeking a higher level of wellness.
Focusing on Wellness Rather Than Illness
The core philosophy of the Health Promotion Model departs from traditional approaches that focus on disease prevention or risk avoidance. Instead of viewing health as the absence of sickness, the HPM defines it as a positive, dynamic state. This perspective directs the model toward increasing a person’s level of well-being and helping them achieve their highest health potential.
Many other health models focus on identifying threats or perceived susceptibility to illness, often termed “health protection.” The HPM, in contrast, focuses on behaviors motivated by the desire to increase well-being. The goal is to generate positive health outcomes, enhanced functional ability, and a better quality of life.
Components of the Health Promotion Model
The structure of the HPM is organized into three broad categories of variables that work together to influence health behavior. These categories are individual characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes. Examining these components allows for a comprehensive understanding of the factors that shape an individual’s decision to pursue health.
Individual characteristics and experiences form the first category, acknowledging that each person has a unique history that affects subsequent actions. Prior related behavior, such as a history of successful exercise routines, can increase the likelihood of future health actions. Personal factors are also considered, which are categorized as biological, psychological, and sociocultural.
Biological factors include variables like age, gender, and body mass index. Psychological factors encompass self-esteem, self-motivation, and perceived health status. Sociocultural factors, such as race, ethnicity, education, and socioeconomic status, complete this initial set of influences.
The second, and most influential, category is behavior-specific cognitions and affect, which are considered the core mediating variables. Perceived benefits of action are the anticipation of positive outcomes from a health behavior, such as feeling more energetic after starting a routine. These benefits are weighed against perceived barriers, which are anticipated negative consequences or impediments, like the expense of a gym membership or time commitment.
Perceived self-efficacy is a person’s belief in their ability to successfully execute the specific health behavior. A high level of self-efficacy increases the likelihood of commitment and action, as people are more likely to try things they feel competent to perform.
Activity-related affect refers to the subjective feelings—positive or negative—experienced during or anticipated from a specific health behavior. If these feelings are positive, they increase the probability of commitment. Interpersonal influences involve the thoughts, beliefs, or behaviors of significant others, such as family and friends, who may model the behavior or provide support.
Situational influences relate to the physical and social environment, such as the availability of safe walking paths or access to healthy food options. These behavior-specific variables have significant motivational importance and can be modified through targeted interventions.
Predicting Health Behavior Outcomes
The Health Promotion Model outlines a dynamic process where the variables interact to predict the final health-promoting behavior. The individual’s characteristics and experiences influence their behavior-specific cognitions and affect, setting the stage for action. The stronger the perceived benefits and self-efficacy, and the fewer the perceived barriers, the greater the likelihood of a positive outcome.
This process results in a commitment to a plan of action, which is a conscious intention to carry out a specific health behavior. However, commitment is constantly moderated by immediate competing demands and preferences.
Competing demands are external factors, such as a sudden family emergency or an unexpected work deadline. Competing preferences are alternative behaviors that are more attractive or enjoyable than the intended health action, like choosing to watch a movie instead of going for a run.
For example, a commitment to exercise may be derailed by the competing demand of working late. This illustrates how the model accounts for the complexities of real life in predicting health behavior. The final behavioral outcome is the health-promoting behavior, which results in improved health and well-being.