Pender’s Health Promotion Model


The health promotion model was developed in 1982 by Dr. Nola J. Pender. Pender believed that the goal of
nursing care was to help patients achieve optimal health and well-being. The model was created following
Pender’s work examining health promoting and preventative behaviours. The health promotion model claims
that each individual’s characteristics and life experiences have a direct impact on their actions and
decisions regarding their health. Health is not defined solely as the absence of disease but the state
of well-being. Pender’s health promotion model has been revised since its first creation and has had
significant influence on the work of other theorists.

What are the concepts of the health promotion model?

Pender’s health promotion model concentrates on three major categories: individual characteristics and
experiences, behaviour-specific cognitions and affect and lastly, the behavioural outcomes.

1. Individual Characteristics and Experiences

The first category explores the concept that each individual has his or her own set of characteristics
experiences, which in turn help shape their actions. Pender emphasised that one’s past actions have a
direct link to whether they would partake in future health-promoting behaviours. Personal attributes and
habits can also be a barrier to health-promoting behaviours.

2. Behaviour-specific Cognitions

The second category involves the behaviour-specific cognitions and affect which have a direct impact on
the individual’s motivation for change. Nursing interventions can be tailored to these variables to
assist in forming positive changes. Variables include; the observed benefits and barriers to the action,
self-worth, and the activity-related result.

3. Behavioural Outcomes

The third category is the behavioural outcome. The start of
the outcome begins with the person committing to taking the steps necessary to make a change. During
this phase the individual must be supported with barriers addressed in order to produce a positive
health-promoting behaviour. The goal of the health promotion model is to stimulate a behavioural change
that results in a positive health outcome.


Concepts in Pender’s Health Promotion Model

Major concepts in Pender’s health promotion model include; the person, their environment, health, and
nursing. The person is the central focus of the model. The person’s experiences and attributes have a
direct impact on future actions and decisions. One must assess the learned behaviours we gain from our
family and community environments. These learned behaviours influence the individual’s ability to
participate in health-promoting behaviours. The environment includes the person’s physical, social, and
economic conditions. A healthy environment is free of toxins, has economic stability, and allows access
to resources that promote healthy living. How one defines health has a direct impact on the promotion of
well-being and prevention of disease. Through motivation the individual is able to prevent illness and
promote healthy behaviours. In order to foster positive health-promoting behaviours the nurse must take
into account the individual’s self-worth, benefits for the change, environmental control, and any
potential barriers to change.

The Health Promotion Model makes four assumptions:

  1. Individuals seek to actively regulate their own behaviour.
  2. Individuals, in all their biopsychosocial complexity, interact with the environment,
    transforming the environment as well as being transformed over time.
  3. Health professionals, such as nurses, constitute a part of the interpersonal environment, which
    exerts influence on people through their life span.
  4. Self-initiated reconfiguration of the person-environment interactive patterns is essential to
    changing behaviour.

There are thirteen theoretical statements that come from the model. They provide a basis for
investigative work on health behaviours. The statements are:

  1. Prior behaviour and inherited and acquired characteristics influence beliefs, affect, and enactment of health-promoting behaviour.
  2. Persons commit to engaging in behaviours from which they anticipate deriving personally valued benefits.
  3. Perceived barriers can constrain commitment to action, a mediator of behaviour as well as actual
  4. Perceived competence or self-efficacy to execute a given behaviour increases the likelihood of
    commitment to action and actual performance of the behaviour.
  5. Greater perceived self-efficacy results in fewer perceived barriers to a specific health behaviour.
  6. Positive affect toward a behaviour results in greater perceived self-efficacy, which can in turn,
    in increased positive affect.
  7. When positive emotions or affect are associated with a behaviour, the probability of commitment and
    action is increased.
  8. Persons are more likely to commit to and engage in health-promoting behaviours when significant
    model the behaviour, expect the behaviour to occur, and provide assistance and support to enable the

  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 behaviour.
  10. Situational influences in the external environment can increase or decrease commitment to or
    participation in health-promoting behaviour.
  11. The greater the commitments to a specific plan of action, the more likely health-promoting
    are to be maintained over time.
  12. Commitment to a plan of action is less likely to result in the desired behaviour when competing
    over which persons have little control require immediate attention.
  13. Persons can modify cognitions, affect, and the interpersonal and physical environment to create
    incentives for health actions.


The simplicity of the health promotion model enables it to be easily adapted in the community health
setting. We have a chance to improve a patient’s well-being and prevent disease when health-promoting
behaviours are established in the community environment. Due to its ease of use, the health promotion
model is a valuable tool in the field of nursing research. The use of Pender’s Health Promotion Model
can positively affect and improve health behaviours. Pender’s health promotion model drives the nurse to
tailor their education to meet the individual and environmental needs of their patient in order to
initiate a health-promoting behavioural change.




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