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Chapter 13

Chapter 13. Principles of Health Promotion. Healthy People 2010. Health of the total population and the consequences of the determinants of health: Biology Behavior Social environment Physical environment Policies Intervention. Healthy People 2010. Policies Intervention.

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Chapter 13

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  1. Chapter 13 Principles of Health Promotion

  2. Healthy People 2010 • Health of the total population and the consequences of the determinants of health: • Biology • Behavior • Social environment • Physical environment • Policies • Intervention

  3. Healthy People 2010 • Policies • Intervention

  4. Holistic Concept of Health • Nursing and public health view of health as a holistic concept • Encompasses • Physical • Psychological • Social • Spiritual dimension

  5. Smith Model of Health • Four models: • Clinical health • Role performance health • Adaptive health • Eudaemonic health

  6. Pender • Actualization of inherent and acquired human potential through • Goal directed behavior • Competent self care • Satisfying relationships while maintaining structural integrity with environments

  7. Health Promotion History • WHO Ottawa Charter • Multidisciplinary practice • Florence Nightingale (1859) wellness-illness continuum • Promoted health through education • Nursing care included personal living and healthful environments

  8. Health Promotion History • Nursing’s meta-paradigm • Person • Environment • Health • Nursing

  9. Health Promotion History • 1973 • ANA Standards of Nursing Practice • 1979 • Healthy People: Surgeon General’s Report on Health Promotion and Disease

  10. Theoretical Foundations • Behavioral Model • Behavior is a function of the rational decision making process • Lewin • Positive valence • Negative valence • Value expectancy theory

  11. Health Belief Model • Based on value expectancy theory • Rosenstock (1966) added variables to the model • Variables that explain or predict behavior: • Susceptibility • Severity • Barriers • Cues to action

  12. Pender’s Health Promotion Model • Pender modified the Health Belief Model • Integrates concepts from HBM and social cognitive theory • Revised in 2002

  13. Pender’s Health Promotion Model • Concepts grouped in three major categories: 1. Individual characteristics and experiences • Prior-related behavior • Personal factors

  14. Pender’s Health Promotion Model • Concepts grouped in three major categories 2. Behavior-specific cognitions and affect • Perceived benefits • Perceived barriers to the action

  15. Pender’s Health Promotion Model • Concepts grouped in three major categories 3. Perceived self-efficacy • Activity related affect • Interpersonal influences • Situational influences • Behavioral outcome

  16. Theory of Planned Behavior • Extension of the theory of reasoned action • Intention • Attitude • Subjective norm • Perceived behavioral control • Outcome expectancy

  17. Transtheoretical Model of Behavioral Change • Individuals progress through stages during behavioral change process • Precontemplation stage • Contemplation stage • Preparation stage • Action stage • Maintenance stage

  18. Transtheoretical Model of Behavioral Change • Three constructs that influence behavior change: • Process of change • Self-efficacy • Decisional change

  19. Ecological Models • Social Cognitive Theory • Triadic reciprocal determinism • Outcome expectancies

  20. Ecological Models • Bandura self-efficacy expectations • Developed from four sources of information: • Enactive attainment • Vicarious experiences • Verbal persuasion • Physiological or emotional arousal

  21. Ecological Models • Ecological model of health behavior • Five system levels • Intrapersonal • Interpersonal • Organizational • Community • Public policy

  22. Other Ecological Frameworks • Integrative Model for Community Health Promotion and the Structural Model of Health Behavior (SMHB) • Three foci of care: • Illness/disease prevention • Health promotion • Illness care

  23. Other Ecological Frameworks • SMHB includes four factors that influence health at the population level • Availability/accessibility of consumer products • Physical structures • Social structures and policies • Media and cultural messages

  24. Focus on Population • Emphasis is on lowering the average risk of all individuals in the community • Three approaches: • Framework for health communication programs • PRECEDE-PROCEED model • Social Marketing

  25. Social Marketing • Uses marketing strategies to create an advantage for changing behavior • Three concepts: • Audience segmentation • Marketing 4 Ps • Marketing mix

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