21 minutes ago Tami Frazier  RE: Discussion - Week 3 COLLAPSE Top of Form NURS 6052 – Essentials of Evidence-Based Practice Week 3 Initial Discussion Post The Role of Theoretical Frameworks in Research Research is a process of evaluating a concept or theory concerning a specific subject. Analysis of a theory includes examining the behaviors and characteristics of people and how they interact with biological, interpersonal, and environmental factors (Polit & Beck, 2017).  Every theory attempts to explain phenomena and how they are related to a specific purpose.  Valid research uses a theory or model as the building blocks. Nursing theory relies on models to define what nursing is and the processes involved in providing care (Polit & Beck, 2017).  In this post, I will examine a research example that has adopted different theories and models to design, implement, and evaluate health promotion efforts (Joseph, Daniel, Thind, Benitez, & Pekmezi, 2016). Research Review Finding research related to nursing theories and models was an easy task.  Many fundamental nursing policies and procedures are founded on either a theory or a model.  For this paper review, I chose the transtheoretical model which states that “transition from one stage of change to the next are affected by processes of change” (Polit & Beck, 2017, p. 124).  The research paper was focused on reviewing numerous theories used to assess long-term maintenance of physical activity, weight loss, and smoking cessation (Joseph et al., 2016). Within this research, the authors referenced five prominent behavioral theories which are self-determination theory, the theory of planned behavior, social cognitive theory, transtheoretical model, and the social ecological model (Joseph et al., 2016).  The paper excluded studies that referenced cognitive behavioral therapy used for intervention.  PubMed and PsycINFO were used with relevant search terms and Boolean operators.  Each article was then reviewed by three different reviewers. Transtheoretical Model In this article, the transtheoretical model (TTM) was used to define and recognize behavioral change through natural processes.  The total number of participants was 20,645 with over 65% of participants being female with a mean age of 49.9 years (Joseph et al., 2016).  TTM is a combination of behavior change theories and psychotherapy (Joseph et al., 2016).  TTM presumes people move through the five stages of behavioral change which are precontemplation, contemplation, preparation, action, and maintenance in a cyclical manner instead of a linear route (Joseph et al., 2016).  Often participants in the study found themselves making progress with physical activity, weight loss, and smoking cessation only to regress creating a cycle of one step ahead and two steps back(Joseph et al., 2016).  Relapse is a common occurrence with TTM for new patients and long-term patients.  Maintaining the stage of change can be challenging due to intrinsic and extrinsic.

1. 21 minutes ago
Tami Frazier
RE: Discussion - Week 3
COLLAPSE
Top of Form
NURS 6052 – Essentials of Evidence-Based Practice
Week 3 Initial Discussion Post
The Role of Theoretical Frameworks in Research
Research is a process of evaluating a concept or theory
concerning a specific subject. Analysis of a theory includes
examining the behaviors and characteristics of people and how
they interact with biological, interpersonal, and environmental
factors (Polit & Beck, 2017). Every theory attempts to explain
phenomena and how they are related to a specific purpose.
Valid research uses a theory or model as the building blocks.
Nursing theory relies on models to define what nursing is and
the processes involved in providing care (Polit & Beck, 2017).
In this post, I will examine a research example that has adopted
different theories and models to design, implement, and
evaluate health promotion efforts (Joseph, Daniel, Thind,
Benitez, & Pekmezi, 2016).
Research Review
Finding research related to nursing theories and models was an
easy task. Many fundamental nursing policies and procedures
are founded on either a theory or a model. For this paper
review, I chose the transtheoretical model which states that
“transition from one stage of change to the next are affected by
processes of change” (Polit & Beck, 2017, p. 124). The
research paper was focused on reviewing numerous theories
used to assess long-term maintenance of physical activity,
weight loss, and smoking cessation (Joseph et al., 2016). Within
this research, the authors referenced five prominent behavioral

2. theories which are self-determination theory, the theory of
planned behavior, social cognitive theory, transtheoretical
model, and the social ecological model (Joseph et al., 2016).
The paper excluded studies that referenced cognitive behavioral
therapy used for intervention. PubMed and PsycINFO were
used with relevant search terms and Boolean operators. Each
article was then reviewed by three different reviewers.
Transtheoretical Model
In this article, the transtheoretical model (TTM) was used to
define and recognize behavioral change through natural
processes. The total number of participants was 20,645 with
over 65% of participants being female with a mean age of 49.9
years (Joseph et al., 2016). TTM is a combination of behavior
change theories and psychotherapy (Joseph et al., 2016). TTM
presumes people move through the five stages of behavioral
change which are precontemplation, contemplation, preparation,
action, and maintenance in a cyclical manner instead of a linear
route (Joseph et al., 2016). Often participants in the study
found themselves making progress with physical activity,
weight loss, and smoking cessation only to regress creating a
cycle of one step ahead and two steps back(Joseph et al., 2016).
Relapse is a common occurrence with TTM for new patients
and long-term patients. Maintaining the stage of change can be
challenging due to intrinsic and extrinsic involvements.
Understanding and changing behavior are required to walk
through the process. Within the stages of change, the individual
weighs the pros and cons of surrendering certain behaviors in
relation to the outcome. “If the benefits of engaging in the new
behavior are perceived to progressively outweigh the cons of
the behavior true change can occur” (Joseph et al., 2016, p.
359). The TTM model was just one of the theories tested in
relation to weight loss, increased physical activity, and smoking
cessation.
Furthermore, nursing theory or models provide a framework for
research to formulate questions and proven hypothesis. Often
researchers use more than one theory to produce hypothesis to

3. study (Polit & Beck, 2017). It is essential to test the theory to
assess whether it fits the components of the intended study.
Through testing, the researcher can prove if the hypothesis is
obtainable with the information given. Significant value is
placed within the nursing community on the use of theory or
model-based research. With well-designed theory building
blocks, nurses can evaluate the research for its validity and
usefulness in everyday clinical practice.
References
Joseph, R., Daniel, C., Thind, H., Benitez, T., & Pekmezi, D.
(2016). Applying Psychological Theories to Promote Long-Term
Maintenance of Health Behaviors. American Journal of
Lifestyle Medicine, 10(6), 356-368.
http://dx.doi.org/10.1177/1559827614554594
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating
and assessing evidence for nursing practice (10th ed.).
Philadelphia, PA: Wolters Kluwer.
Bottom of Form
Communicating professionally and ethically is one of the
essential skill sets we can teach you at Strayer. The following
guidelines will ensure:
· Your writing is professional
· You avoid plagiarizing others, which is essential to writing
ethically
· You give credit to others in your work
Visit Strayer’s Academic Integrity Center for more information.
Winter 2019
https://pslogin.strayer.edu/?dest=academic-support/academic-

4. integrity-center
Strayer University Writing Standards 2
� Include page numbers.
� Use 1-inch margins.
� Use Arial, Courier, Times New Roman, or Calibri font style.
� Use 10-, 11-, or 12-point font size for the body of your text.
� Use numerals (1, 2, 3, and so on) or spell out numbers (one,
two, three, and so on).
Be consistent with your choice throughout the assignment.
� Use either single or double spacing, according to assignment
guidelines.
� If assignment requires a title page:
· Include the assignment title, your name, course title, your
professor’s name, and the
date of submission on a separate page.
� If assignment does not require a title page (stated in the
assignment details):
a. Include all required content in a header at the top of your
document.
or b. Include all required content where appropriate for
assignment format.
Examples of appropriate places per assignment: letterhead of a
business letter
assignment or a title slide for a PowerPoint presentation.

5. � Use appropriate language and be concise.
� Write in active voice when possible. Find tips here.
� Use the point of view (first, second, or third person) required
by the assignment
guidelines.
� Use spelling and grammar check and proofread to help
ensure your work is error free.
� Use credible sources to support your ideas/work. Find tips
here.
� Cite your sources throughout your work when you borrow
someone else’s words or ideas.
Give credit to the authors.
� Look for a permalink tool for a webpage when possible
(especially when an electronic
source requires logging in like the Strayer Library). Find tips
here.
� Add each cited source to the Source List at the end of your
assignment. (See the Giving
Credit to Authors and Sources section for more details.)
� Don’t forget to cite and add your textbook to the Source List
if you use it as a source.
� Include a Source List when the assignment requires research
or if you cite the textbook.
� Type “Sources” centered on the first line of the page.

6. � List the sources that you used in your assignment.
� Organize sources in a numbered list and in order of use
throughout the paper. Use the
original number when citing a source multiple times.
� For more information, see the Source List section.
General Standards
Use Appropriate
Formatting
Title Your Work
Write Clearly
Cite Credible
Sources
Build a
Source List
https://owl.english.purdue.edu/owl/resource/539/01/
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m/login.aspx?direct=true&db=ers&AN=98402046&site=eds-
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dynamic
Strayer University Writing Standards 3
Writing Assignments
Strayer University uses several different types of writing

7. assignments. The Strayer University
Student Writing Standards are designed to allow flexibility in
formatting your assignment and
giving credit to your sources. This section covers specific areas
to help you properly format
and develop your assignments. Note: The specific format
guidelines override guidelines in the
General Standards section.
Paper and Essay
Specific Format
Guidelines
PowerPoint or
Slideshow Specific
Format Guidelines
� Use double spacing throughout the body of your assignment.
� Use a consistent 12-point font throughout your assignment
submission. (For
acceptable fonts, see General Standards section.)
� Use the point of view (first or third person) required by the
assignment guidelines.
� Section headings can be used to divide different content
areas. Align section
headings (centered) on the page, be consistent, and include at
least two section
headings in the assignment.
� Follow all other General Standards section guidelines.
� Title slides should include the project name (title your work
to capture attention if

8. possible), a subtitle (if needed), the course title, and your name.
� Use spacing that improves professional style (mixing single
and double spacing as
needed).
� Use a background color or image on slides.
� Use Calibri, Lucida Console, Helvetica, Futura, Myriad Pro,
or Gill Sans font styles.
� Use 28-32 point font size for the body of your slides (based
on your chosen font
style). Avoid font sizes below 24-point.
� Use 36-44 point font size for the titles of your slides (based
on chosen font style).
� Limit content per slide (no more than 7 lines on any slide
and no more than 7
words per line).
� Include slide numbers when your slide show has 3+ slides.
You may place the
numbers wherever you like (but be consistent).
� Include appropriate images that connect directly to slide
content or presentation
content.
� Follow additional guidelines from the PowerPoint or
Slideshow Specific Format
Guidelines section and assignment guidelines.

9. Strayer University Writing Standards 4
Giving Credit to Authors and Sources
When quoting or paraphrasing another source, you need to give
credit by using an in-text
citation. An in-text citation includes the author’s last name and
the number of the source from
the Source List. A well-researched assignment has at least as
many sources as pages (see
Writing Assignments for the required number of sources). Find
tips here.
Option #1: Paraphrasing
Rewording Source Information in Your Own Words
· Rephrase the source information in your words.
Be sure not to repeat the same words of the author.
· Add a number to the end of your source (which will tie
to your Source List).
· Remember, you cannot just replace words of the
original sentence.
ORIGINAL SOURCE
“Writing at a college level requires informed
research.”
PARAPHRASING
As Harvey wrote, when writing a paper for
higher education, it is critical to research and
cite sources (1).

10. When writing a paper for higher education,
it is imperative to research and cite sources
(Harvey, 1).
Option #2: Quoting
Citing Another Person’s Work Word-For-Word
· Place quotation marks at the beginning and the end of
the quoted information.
· Add a number to the end of your source (which will tie
to your Source List).
· Do not quote more than one to two sentences
(approximately 25 words) at a time.
· Do not start a sentence with a quotation.
· Introduce and explain quotes within the context of
your paper.
ORIGINAL SOURCE
“Writing at a college level requires informed
research.”
QUOTING
Harvey wrote in his book, “Writing at a college
level requires informed research” (1).
Many authors agree, “Writing at a college
level requires informed research” (Harvey, 1).
http://libdatab.strayer.edu/login?url=http://search.ebscohost.co

11. m/login.aspx?direct=true&db=ers&AN=98402046&site=eds-
live&scope=site
Strayer University Writing Standards 5
Page Numbers
When referencing multiple pages in a text book or other
large book, consider adding page numbers to help the
reader understand where the information you referenced
can be found. You can do this in three ways:
a. In the body of your paper;
or b. In the citation;
or c. By listing page numbers in the order they were
used in your paper on the Source List.
Check with your instructor or the assignment guidelines to
see if there is a preference based on your course.
IN-TEXT CITATION
(Harvey, 1, p. 16)
In the example, the author is Harvey, the source list number
is 1, and the page number that this information can be
found on is page 16.
Multiple Sources (Synthesizing)
Synthesizing means using multiple sources in one sentence
or paragraph (typically paraphrased) to make a strong
point. This is normally done with more advanced writing,
but could happen in any writing where you use more than

12. one source.
The key here is clarity. If you paraphrase multiple sources
in the same sentence (of paragraph if the majority of the
information contained in the paragraph is paraphrased),
you should include each source in the citation. Separate
sources using semi-colons (;) and create the citation in
the normal style that you would for using only one source
(Name, Source Number).
SYNTHESIZED IN-TEXT CITATION
(Harvey, 1; Buchanan, 2)
In the example, the authors Harvey and Buchanan were
paraphrased to help the student make a strong point.
Harvey is the first source on the source list, and Buchanan is
the second source on the source list.
Traditional Sources
Strayer University Writing Standards 6
Discussion Posts
When quoting or paraphrasing a source for discussion
threads, include the source number in parenthesis after the
body text where you quote or paraphrase. At the end of
your post, type the word “Sources” and below that include
a list of any sources that you cited.
If you pulled information from more than one source,
continue to number the additional sources in the order that
they appear in your post.

13. For more information on building a Source List Entry, see
Source List section.
SAMPLE POST
The work is the important part of any writing
assignment. According to Smith, “writing
things down is the biggest challenge” (1).
This is significant because…
The other side of this is also important. It is
noted that “actually writing isn’t important as
much as putting ideas somewhere useful” (2).
SOURCES
1. William Smith. 2018. The Way Things Are.
http://www.samplesite.com/writing
2. Patricia Smith. 2018. The Way Things Really
Are. http://www.betterthansample.com/tiger
A web source is any source accessed through an internet
browser. Before using any source, first determine its credibility.
Then decide if the source is appropriate and relevant for your
project. Find tips here.
Home Pages
A home page is the main page that loads when you type
a standard web address. For instance, if you type Google.
com into the web browser, you will be taken to Google’s
home page.
If you do need to cite a home page, use the webpage’s

14. title from the browser. This found by moving your mouse
cursor over the webpage name at the top of the browser.
When citing a homepage, it is likely because there is a news
thread, image, or basic piece of information on a company
that you wish to include in your assignment.
Specific Web Pages
If you are using any web page other than the home page,
include the specific title of the page and the direct link (when
possible) for that specific page in your Source List Entry.
If your assignment used multiple pages from the same author/
source, create separate Source List Entries for each page
when possible (if the title and/or web address is different).
Web Sources
https://owl.purdue.edu/owl/research_and_citation/conducting_re
search/evaluating_sources_of_information/index.html
Strayer University Writing Standards 7
Effective Internet Links
When sharing a link to an article with your instructor and
classmates, start with a brief summary and why you chose
to share it.
Be sure to check the link you’re posting to be sure it will
work for your classmates. They should be able to just click
on the link and go directly to your shared site.
Share vs. URL Options
Cutting and pasting the URL (web address) from your browser
may not allow others to view your source. This makes it hard

15. for people to engage with the content you used.
To avoid this problem, look for a “share” option and choose
that when possible so your classmates and professor
get the full, direct link. Always test your link(s) before
submitting to make sure they work.
If you cannot properly share the link, include the article as an
attachment. Interested classmates and your professor can
reference the article shared as an attachment. Find tips here.
POOR EXAMPLE
Hey check out this article: http://www.
Jobs4You.FED/Jobs_u_can_get
BETTER EXAMPLE
After reading the textbook this week, I
researched job sites. I found an article on how
to find the best job site depending on the job
you’re looking for. The author shared some
interesting tools such as job sites that collect job
postings from other sites and ranks them from
newest to oldest, depending on category. Check
out the article at this link: http://www.Jobs4You.
FED/Jobs_u_can_get
Charts, images, and tables should be centered and followed by
an in-text citation. Design your page and place a citation
below the chart, image, or table. When referring to the chart,
image, or table in the body of the assignment, use the citation.
On your Source List, provide the following details of the visual:

16. · Author’s name (if created by you, provide your name)
· Date (if created by you, provide the year)
· Type (Chart, Image, or Table)
· How to find it (link or other information – See Source List
section for additional details).
Charts, Images, and Tables
https://nyti.ms/24L5XkV
Strayer University Writing Standards 8
Source List
The Source List (which includes the sources that you used in
your assignment) is a new page
you add at the end of your paper. The list has two purposes: it
gives credit to the authors that
you use and gives your readers enough information to find the
source without your help. Build
your Source List as you write.
· Type “Sources” at the top of a new page.
· Include a numbered list of the sources you used in your paper
(the numbers
indicate the order in which you used them).
1. Use the number one (1) for the first source used in the paper,
the number
two (2) for the second source, and so on.
2. Use the same number for a source if you use it multiple
times.
· Ensure each source includes five parts: author or

17. organization, publication date,
title, page number (if needed), and how to find it. If you have
trouble finding
these details, then re-evaluate the credibility of your source.
· Use the browser link for a public webpage.
· Use a permalink for a webpage when possible. Find tips here.
· Instruct your readers how to find all sources that do not have
a browser link
or a permalink.
· Separate each Source List Element with a period on your
Source List.
AUTHOR PUBLICATION DATE TITLE PAGE NO. HOW TO
FIND
The person(s) who
published the source. This
can be a single person,
a group of people, or an
organization. If the source
has no author, use “No
author” where you would
list the author.
The date the source was
published. If the source
has no publication date,
use “No date” where you
would list the date.
The title of the
source. If the
source has no title,

18. use “No title”
where you would
list the title.
The page
number(s) used. If
the source has no
page numbers,
omit this section
from your Source
List Entry.
Instruct readers how to find
all sources. Keep explanations
simple and concise, but
provide enough information
so the source can be located.
Note: It is your responsibility
to make sure the source can
be found.
Michael Harvey
In the case of multiple
authors, only list the first.
2013
This is not the same as
copyright date, which is
denoted by ©
The Nuts &
Bolts of College

19. Writing
p. 1
Include p. and
the page(s) used.
http://libdatab.strayer.edu/
login?url=http://search.
ebscohost.com/login.aspx
Setting Up the
Source List Page
Creating a
Source List Entry
Source List Elements
Strayer University Writing Standards 9
1. Michael Harvey. 2013. The Nuts & Bolts of College Writing.
p. 1. http://libdatab.strayer.edu/
login?url=http://search.ebscohost.com/login.aspx
1. Michael Harvey, 2013, The Nuts & Bolts of College Writing,
http://libdatab.strayer.edu/login?url=http://search.
ebscohost.com/login.aspx
2. William R. Stanek. 2010. Storyboarding Techniques chapter

20. in Effective Writing for Business, College and Life. http://
libdatab.strayer.edu/login?url=http://search.ebscohost.com/login
.aspx?direct=true&db=nlebk&AN=359141&site=e
ds-live&scope=site&ebv=EB&ppid=pp_23
3. Zyad Hicham. 2017. Vocabulary Growth in College-Level
Students’ Narrative Writing. http://libdatab.strayer.edu/
login?url=http://search.ebscohost.com/login.aspx?direct=true&d
b=edsdoj&AN=edsdoj.9b7fad40e529462bafe3a936
aaf81420&site=eds-live&scope=site
4. Anya Kamenetz. July 10, 2015. The Writing Assignment That
Changes Lives. https://www.npr.org/sections/
ed/2015/07/10/419202925/the-writing-assignment-that-changes-
lives
5. Brad Thor. June 14, 2016. The Best Writing Advice I Ever
Got. http://time.com/4363050/brad-thor-best-writing-advice/
6. Karen Hertzberg. June 15, 2017. How to Improve Writing
Skills in 15 Easy Steps. https://www.grammarly.com/blog/
how-to-improve-writing-skills/
7. Roy Peter Clark. 2008. Writing Tools: 55 Essential Strategies
for Every Writer. p.55-67. Book on Amazon.com.
8. C.M. Gill. 2014. The Psychology of Grading and Scoring
chapter in Essential Writing Skills for College & Beyond.
Textbook.
9. ABC Company’s Policy & Procedures Committee. No Date.
Employee Dress and Attendance Policy. Policy in my office.
10. Henry M. Sayre. 2014. The Humanities: Culture, Continuity
and Change, Vol. 1. This is the HUM111 textbook.

21. 11. Savannah Student. 2018. Image. http://www.studentsite.com
12. Don Dollarsign. 2018. Chart.
http://www.allaboutthemoney.com
13. Company Newsletter Name. 2018. Table. Company
Newsletter Printed Copy (provided upon request).
C1: OffC2: OffC3: OffC6: OffC9: OffC13: OffC16: OffC4:
OffC7: OffC10: OffC14: OffC17: OffC18: OffC19: OffC20:
OffC21: OffC22: OffC5: OffC8: OffC11: OffC15: OffC12:
OffButton 1: Button 2: C23: OffC28: OffC25: OffC29: OffC24:
OffC30: OffC26: OffC31: OffC33: OffC27: OffC32: OffC35:
OffC36: OffC37: OffC34: Off
Running head: Liberty Challenged in Nineteenth Century
America 1
Liberty Challenged in Nineteenth Century America 3
Liberty Challenged in Nineteenth Century America
Institution:
Students name:
Date:
Thesis: The Civil war was majorly caused by Slavery and its
abolition which went around issues of anti-slavery and pro-
slavery.
I. The 3/5ths Compromise

22. a. The political status in the South was increased by increasing
slavery activities.
II. The Missouri Compromise of 1820
a. Missouri admitted as slave states and Maine as free
b. The Louisiana territory abolished slavery due to the house
vote (Savage, 2018).
III. The Compromise of 1850
a. California became the 16th free state.
b. The fugitive law required the northerners to take back their
run-away slaves to their owners.
IV. The Kansas-Nebraska Act
a. The Missouri Compromise of 1820 and 1850 was undermined.
b. The Republican party was created.
V. The Dred Scott Decision
a. Slaves were not considered as a person but as the property of
their owners. The constitution of the U.S indicated that the
Slaves could never become citizens (Gerstle, 2017).
b. Abolishment of the Missouri Compromise 1850.
VI. Reasons why slavery was and is incompatible with our
political and economic system
a. Human beings share the same rights to freedom and should
not subjected to forced labor.
b. Independence declaration indicated that each human being is
equal to the other and should pursue Liberty and happiness
(Catley, 2017).
c. Shortage of labor.
VII. The driving forces that led to the Civil War.
a. Social and economic differences.
b. The rights of the states vs federal rights.
c. Slavery
d. Expansion of the United States.
VIII. Conclusion/Summary
The civil war was majorly caused by slavery. Other factors that
led to the civil war include social and economic differences, the
expansion of the United States and States rights vs federal

23. rights. Slavery has proved to incompatible to our political and
economic system because it causes shortage of labor and due to
the Independence declaration that indicated all human beings
are equal to each other.
References
Catley, R. (2017). The American challenge: The world resists
US liberalism. Routledge.
Gerstle, G. (2017). Liberty and coercion: The paradox of
American government from the founding to the present.
Princeton University Press.
Savage, K. (2018). Standing soldiers, kneeling slaves: Race,
war, and monument in nineteenth-century America. Princeton
University Press.
5 hours ago
Jessica Dunne
RE: Discussion - Week 3
COLLAPSE
Top of Form
NURS 6052: Essentials of Evidence-Based Practice
INITIAL POST
Implementation of evidence-based practice (EBP) requires
proper scientific research. Research theories, models, and
frameworks exist to guide research and ensure outcomes are
determined through consistent, verifiable, methods. Poilt and
Beck (2017) assert that a reciprocal relationship exists between
research and theories. The value of basing research on
established theories, models, and frameworks is that replication
establishes evidence which can be appraised and utilized as
EBP. Once a theory has been established through research, that

24. theory serves to provide a foundation for new methods. They
also ensure that research can be replicated and subsequently
used to influence nursing practice (Polit and Beck, 2017). This
cycle of research based on theories and models expands and
elevates nursing practice. Nursing research directly influences
EBP and patient outcomes making it an invaluable tool.
Article Summary
I selected an article about weight loss maintenance, as
this issue affects nearly every single type of patient care. This
article was also interesting to me because it emphasized the
importance of psychological factors in maintaining weight loss,
and because psychiatric patients frequently struggle with their
weight. The model that I chose was Pender’s health promotional
model (HPM). Heydari and Khorashadizadeh (2014) contend
that Pender’s HPM can be used in research that aims to
determine effective factors or barriers in health promotion
behaviors and that this model can detect the impacts of
interventions on health management. Moreover, Pender’s HPM
can be used as a comparison with other models and to determine
the relationship or causality of variables associated with healthy
behaviors (Heydari & Khorashadizadeh 2014).
Valek, Greenwald, and Lewis (2015) maintain that Pender’s
HPM can guide clinical interventions to help clients maintain an
ideal weight. Obesity is a growing health problem in the United
States; by 2020 it is projected that 40% of the adult population
will be overweight or obese. Increased weight comes with
serious medical co-morbidities such as cardiovascular disease,
type two diabetes, sleep apnea, and cancer. Approximately 21%
of all healthcare dollars are spent on illness associated with
being overweight. Consequently, only 20 to 26% of people who
lose 10% or more of their body weight can maintain that loss
over two years (Valek, Greenwald, & Lewis, 2015).
Using Pender’s HPM, the author’s constructed clinical
interventions to help patients with weight loss maintenance
(WLM). The interventions were aimed at addressing
psychological factors including internal drive, ongoing self-

25. monitoring, long-term flexibility, positive mood and emotion,
appropriate goal setting, and managing external stimuli.
Pender’s HPM guided the authors to develop strategies that
would help improve self-esteem, foster commitment to a plan of
action, manage real and perceived barriers, recognize
interpersonal and situation influences, and effectively cope with
stress (Valek, Greenwald, & Lewis, 2015).
Practice recommendations for WLM regarding internal drive
include assessing motives for weight loss, discussing body
image, promoting positive self-talk, and providing a partnership
in decision making. Self-monitoring interventions include
providing patients with tools to monitor diet and exercise,
promoting ownership of a new lifestyle that promotes WLM,
and assisting clients in finding activities that they enjoy.
Providers can assess the status of weight habits and provide
feedback to enhance the long term flexibility of WLM.
Screening for depression and providing education on coping
with stress will help patients maintain positives moods and
manage their emotions. Providers should assist patients in
establishing appropriate weight loss goals. Finally, clinical
interventions that help patients manage external stimuli include
identification of a weight-loss mentor, and assessing how
patients compare their bodies to their peers (Valek, Greenwald,
& Lewis, 2015).
It should be recognized that this type of research could be used
to develop even more evidenced-based clinical interventions to
assist patients with WLM. It could also be used to help nurse
researchers design health promotion strategies that are relevant
to other clinical areas such as medication compliance,
preventative screenings, and smoking cessation. Pender’s HPM
is highly appealing because it empowers patients to take an
active role in their wellness or lack thereof. Models that focus
on health promotion guide holistic care, and foster the
development of preventative services rather than reactive care. I
believe that we are currently involved in a pivotal moment in
medicine, a paradigm shift; we are evolving our system from

26. reactive care to preventative care. More research is needed to
help facilitate such a meaningful and necessary shift, and the
nursing profession is positioned to help lead the way through
research and EBP.
References
Heydari, A., & Khorashadizadeh, F. (2014). Pender's health
promotion model in medical research. Journal of the Pakistan
Medical Association,64(9).
Polit, D. F., & Beck, C. T. (2017). Nursing research generating
and assessing evidence for nursing practice. Philadelphia:
Wolters Kluwer.
Valek, R. M., Greenwald, B. J., & Lewis, C. C. (2015).
Psychological factors associated with weight loss
maintenance. Nursing Science Quarterly,28(2), 129-135.
doi:10.1177/0894318415571598
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