Nola Pender developed the Health Promotion Model to focus on behaviors that enhance well-being and actualize health potential. The model has 3 areas of focus: individual characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes. It views health as a positive dynamic state rather than just the absence of disease. The model's major concepts include perceived benefits, barriers, and self-efficacy regarding health behaviors. Strengths include its applicability to community health, while weaknesses include lack of clarity on nursing metaparadigms.

1. Nola Pender: “Health Promotion Model”
Presenter:
Ms. Ritika

2. Outline
Biography
Theoretical basis of HPM
Introduction about HPM
Assumptions of HPM
Propositions of HPM
Major concepts
Sub concepts
Metaparadigms
Nursing process
Application in other areas
Strengths & weakness
Conceptual framework
Conclusion.

3. Biography
• Nola Pender was born on August 16, 1941, in
Lansing, Michigan.
• Her first encounter with the nursing
profession was when she was 7 years old and
witnessed the care given to her hospitalized
aunt by nurses.
• This situation led her to the desire to care for
other people and her goal was to help people
care for themselves.

4. Education
• Nola Pender entered the School of Nursing at West
Suburban Hospital in Oak Park, Illinois, and receive her
nursing diploma in 1962.
• In 1965, she received her master’s degree in human
growth and development from the same university.
• She moved to Northwestern University in Evanston, Illinois,
to obtain a Ph.D. in psychology and education in 1969.
• Pender’s dissertation research investigated developmental
changes in the encoding process of short-term memory in
children.
• Years later, she finished masters-level work in community
health nursing at Rush University.

5. Career and Appointments
• In 1962, Nola Pender began working on a
medical-surgical unit and subsequently in a
pediatric unit in a Michigan hospital.
• For 40 years at Michigan State University, she
trained students at undergraduate and
graduate levels and mentored many
postdoctoral candidates.

6. • Pender directed many studies of her Health
Promotion Model with adolescents and adults
which made her more active in nursing
research.
• Pender and her research unit developed the
program Girls on the Move, that studies and
measures the results of intervention by the use
the model to encourage young people to
perform active lifestyles.
• She was the president of the Midwest Nursing
Research Society from 1985 to 1987.

7. • Aside from being the president of the American
Academy of Nursing from 1991 to 1993, she was
also a member of Research America’s Board of
Directors from 1991 to 1993, and a member of
the U.S. Preventative Services Task Force from
1998 to 2002.
• In addition, Pender was an Associate Dean for
Research at the University of Michigan School of
Nursing from 1990 to 2001.
• And as a co-founder of the Midwest Nursing
Research Society, she has served as a trustee of
its foundation since 2009.

8. • Pender is presently a Professor Emeritus at
Michigan State University.
• Following her retirement as an active
professor, she devotes her time as an adviser
for health research both nationally and
internationally and shares her knowledge and
experiences to further improve the nursing
profession.
• She also serves as Distinguished Professor of
Nursing at Loyola University School of Nursing
in Chicago, Illinois.

9. Works
• As regards to health promotion, Nola Pender has written and
issued various articles on exercise, behavior change,
and relaxation training.
• She also has served on editorial boards and as an editor for
journals and books.
• Pender is also known as a scholar, presenter, and consultant in
health promotion.
• She has worked in collaboration with nurse scientists in Japan,
Korea, Mexico, Thailand, the Dominican Republic, Jamaica,
England, New Zealand, And Chile.

10. • By contributing leadership as a consultant to
research centers and giving scholar
consultations, Pender resumes influencing the
field of nursing.
• She also collaborates with the editor of the
American Journal of Health Promotion,
promoting legislation to support health
promotion research.

11. Selected Publications Related to Nola
Pender
• Health Promotion in Nursing Practice (6th Edition)
• Pender, Nola J. Study Guide for Health Promotion in
Nursing Practice
• Philosophies and Theories for Advanced Nursing
Practice
• Robbins, L.B., Gretebeck, K.A., Kazanis, A.S. and Pender,
Nola.J. Girls on the Move
• Program to Increase Physical Activity Participation,
Nursing Research, 2006
• Pender, Nola.J., Bar-Or, O., Wilk, B. and Mitchell, S.
Self-Efficacy and Perceived Exertion of Girls During
Exercise, Nursing Research, 2002

12. Awards and Honors of Nola Pender
Pender has been the recipient of numerous recognition and
awards that include:
• The 1972 Distinguished Alumni Award from Michigan State
University School of Nursing.
• In 1988, she received the Midwest Nursing Research
Society’s Distinguished Contributions to Research Award.
• In 1997, the American Psychological Association awarded
her the Distinguished Contributions to Nursing and
Psychology Award.
• Teacher of the Year Award from the University of Michigan
School of Nursing the following year.

13. • In 2005, she received the Lifetime
Achievement Award from the Midwest
Nursing Research Society.
• Pender was designated a Living Legend of the
American Academy of Nursing in 2012.
• The award has only been awarded to nurses
who have made outstanding contributions to
the profession.

14. Theoretical basis

15. Nola Pender’s Health Promotion
Model
• Nola Pender’s Health Promotion Model theory
was originally published in 1982 and later
improved in 1996 and 2002.
• The Health Promotion Model notes that each
person has unique personal characteristics and
experiences that affect subsequent actions.
• Health promoting behavior is the desired
behavioral outcome and is the endpoint in the
Health Promotion Model.

16. • The Health Promotion Model was designed to be a
“complementary counterpart to models of health
protection.”
• Its purpose is to assist nurses in knowing and
understanding the major determinants of health
behaviors as a foundation for behavioral counseling to
promote well-being and healthy lifestyles.
• Pender’s health promotion model defines health as “a
positive dynamic state not merely the absence of
disease.
• Health promotion is directed at increasing a client’s
level of well being.
• The health promotion model describes the multi
dimensional nature of persons as they interact within
their environment to pursue health.

17. The model
focuses on
the
following
three areas:
1.Individual
characteristics and
experiences.
2.Behavior-specific
cognitions and affect
3.Behavioral
outcomes.

18. MAJOR ASSOMPTIONS

19. Major Assumptions in Health
Promotion Model
1. Individuals seek to actively regulate their own
behavior.
2. Individuals in all their biopsychosocial complexity
interact with the environment, progressively
transforming the environment and being transformed
over time.
3. Health professionals constitute a part of the
interpersonal environment, which exerts influence on
persons throughout their life span.
4. Self-initiated reconfiguration of person-environment
interactive patterns is essential to behavior change.

20. PROPOSITIONS

21. Propositions
• Prior behavior , inherited and acquired characteristics
influence beliefs, affect of health-promoting behavior.
• Persons should engage in behaviors from which they
anticipate personally valued benefits.
• Perceived barriers can constrain commitment to action, a
mediator of behavior as well as actual behavior.
• Perceived competence or self-efficacy to execute a given
behavior increases the likelihood of commitment to action
and actual performance of the behavior.

22. • Greater perceived self-efficacy results in fewer
perceived barriers to a specific health behavior.
• Positive affect toward a behavior results in
greater perceived self-efficacy, result in increased
positive affect.
• When positive emotions or affect are associated
with a behavior, the probability of commitment
and action is increased.
• Persons are more likely to commit and engage in
health-promoting behaviors.

23. • 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.
• Situational influences in the external environment can
increase or decrease commitment to or participation in
health-promoting behavior.
• The greater the commitments to a specific plan of action,
the more likely health-promoting behaviors are to be
maintained over time.
• 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.

24. • Commitment to a plan of action is less likely to
result in the desired behavior when other
actions are more attractive and thus preferred
over the target behavior.
• Persons can modify cognitions, affect, and the
interpersonal and physical environment to
create incentives for health actions.

25. Major Concepts of the Health
Promotion Model
• Health promotion is defined as behavior
motivated by the desire to increase well-being
and actualize human health potential. It is an
approach to wellness.
• Health protection or illness prevention is
described as behavior motivated desire to
actively avoid illness, detect it early, or maintain
functioning within the constraints of illness.

26. • Individual characteristics and experiences (prior
related behavior and personal factors).
• Behavior-specific
cognitions and affect (perceived benefits of
action, perceived barriers to action, perceived
self-efficacy, activity-related affect, interpersonal
influences, and situational influences).
• Behavioral outcomes (commitment to a plan of
action, immediate competing demands and
preferences, and health-promoting behavior).

27. Sub-concepts of the Health
Promotion Model
1. Personal Factors
Personal factors 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.
- Personal biological factors. Include variables such as age
gender body mass index pubertal status, aerobic capacity,
strength, agility, or balance.
- Personal psychological factors. Include variables such as
self-esteem, self-motivation, personal competence,
perceived health status, and definition of health.
- Personal socio-cultural factors. Include variables such as
race, ethnicity, acculturation, education, and
socioeconomic status.

28. 2. Perceived Benefits of Action
Anticipated positive outcomes that will occur from positive health
behavior.
3. Perceived Barriers to Action
Anticipated, imagined or real blocks and personal costs of
understanding a given behavior.
4. Perceived Self-Efficacy
Judgment of personal capability to organize and execute a health-
promoting behavior. Perceived self-efficacy influences perceived
barriers to action so higher efficacy results in lowered perceptions
of barriers to the performance of the behavior.
5. Activity-Related Affect
Subjective positive or negative feeling that occurs before, during
and following behavior.
Activity-related affect influences perceived self-efficacy, which
means the more positive the subjective feeling, the greater the
feeling of efficacy.
In turn, increased feelings of efficacy can generate a further
positive affect.

29. 5. Interpersonal Influences
Primary sources of interpersonal influences are
families, peers, and healthcare providers.
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).
6. Situational Influences
Personal perceptions and cognitions of any given
situation that can facilitate or impede behavior
Situational influences may have direct or indirect
influences on health behavior.

30. 7. Commitment to Plan of Action
The concept of intention and identification of a
planned strategy leads to the implementation of
health behavior
8. Immediate Competing Demands and
Preferences
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 behaviors
over which individuals exert relatively high
control, such as choice of ice cream or apple for a
snack

31. 9. Health-Promoting Behavior
A health-promoting behavior is an endpoint
or action outcome that is directed toward
attaining positive health outcomes such as
optimal wellbeing, personal fulfillment, and
productive living.

32. METAPARADIGMS

34. Pender’s health promotion model defines health as “a
positive dynamic state not merely the absence of disease.

36. NURSING PROCESS

40. Strengths and Weaknesses
Strengths:
• The Health Promotion Model is simple to
understand yet it is complex in structure.
• Nola Pender’s nursing theory gave much focus on
health promotion and disease prevention making
it stand out from other nursing theories.
• It is highly applicable in the community health
setting.
• It promotes the independent practice of the
nursing profession being the primary source of
health promoting interventions and education.

41. Weaknesses
• The Health Promotion Model of Pender was not
able to define the nursing metaparadigms or the
concepts that a nursing theory should have, man,
nursing, environment, and health.
• The conceptual framework contains multiple
concepts which may invite confusion to the
reader.
• Its applicability to an individual currently
experiencing a disease state was not given
emphasis.

43. Conclusion
• Due to its focus on health promotion and
disease prevention per se, its relevance to
nursing actions given to individuals who are ill
is obscure. But then again, this characteristic
of her model also gives the concepts its
uniqueness.